Makueni is one of most remote counties in Kenya, with 67% of the population living below the poverty line. With the support of Comic Relief, Amref has been working in Makueni since 2012 to improve access to quality maternal health services, increase demand for services and help prevent childhood disease and malnutrition.
A key part of the project is to train Community Health Volunteers (CHVs) to help educate the community on skilled delivery, ante-natal care, childhood disease and nutrition and other key factors in maternal, new-born and child health. Since 2012, the project has trained a group of 50 CHVs in Kasikeu who have remained engaged and supported the community. The CHVs have also received training on mobile applications to collect basic health information of community members, identify danger signs and make timely referrals. The project has developed an m-health application - ‘MJALI’ (Mobile Jamii Afya Link) which enables CHVs to quickly and easily collect data on household visits. CHVs have also been supported to initiate Income Generating Activities at the centre, including a small local shop, rearing and selling goats and ‘table banking’ a form of cooperative lending.
Munini Joseph Mutisya is a Community Health Volunteer in Kasikeu, Makueni.
"I’ve been a CHV since before 2009, which was when I was first trained by the government of Kenya and retrained again by Amref in 2012.
"I learned many things, about health, how to help my community, to prevent many diseases. We have been trained how to educate a mother to attend antinaetal classes and to get the required immunisations to prevent mother to child transmission of HIV. As a CHV, we are trained to encourage mothers to deliver at the health facility. A long time ago, they delivered at home and the death rate was high. Since our training we are seeing a lot of positive repercussions and maternal mortality has drastically reduced.
"The biggest challenge in the community here in Kasikeu is transport. Houses are scattered. To reach some places you have to climb huge hills - it can be dangerous. Our work is important, because we go and educate in schools, parents meetings, markets and educate about health.
"It is hard work being a CHV, but I enjoy my job and I am used to it. I wake up early at 5am. We eat breakfast, go and feed the cattle, cook for lunch and then in the afternoon you go for household visits. In the afternoon you can see 2-3 households. Sometimes we are called at night to a pregnant mother who needs to deliver and we communicate with the health facility, who bring an ambulance.
"Now that the Mobile Community Health Worker app has been introduced, my work is easier. We can look up conditions and how to spot symptoms. A huge problem round here is malnourishment. In the community sometimes you find very poor families which cannot afford a balanced diet. Many of the children have delayed development because they don’t have access to the right food. Often, we have to use our resources to help them. You cannot see somebody suffering and you leave them suffering."