INTRODUCTION

In January 2016, the project officially commenced with the intervention program at Obekai dispensary whereby we have designed and are implementing Enhanced Health Care (EHC) package using the (Find Link Treat Retain)FLTR to improve access and quality of care of maternal and child health at tier 1 and 2 in Kaliwa Location.

Project Community Meeting at Obekai Dispensary

ELEMENTS OF (ENHANCED HEALTH CARE DELIVERY EHC) AT OBEKAI DISPENSARY

• Identification and surveillance of the pregnant woman and newborn babies.

• Recognition and management of pregnancy-related complications, particularly pre-eclampsia, haemorrhage, premature rupture of membranes and infection.

• Recognition and treatment of underlying or concurrent illness in pregnancy – malaria, anaemia, infection among others.

• Screening for conditions and diseases such as STIs (particularly syphilis), HIV infection and hepatitis B

• Preventive measures, including tetanus toxoid, immunisation, de-worming, iron and folic acid, intermittent preventive treatment of malaria in pregnancy (IPT), prenatal vitamins provision, use of Long Lasting Insecticides Treated Nets (LLITNs).

• Immunization of all young infants and under-five children born during the study period including Vitamin A administration at 6 months of age and yearly

• Obtain weights for all newborns, infants, under five children and pregnant mothers in the community and health facilities by providing weighing scales (infant, adult).

• Malaria diagnosis using the Partec Cyscope in the community and health facilities

• Haemoglobin estimation using Haemocue in the community and at the facilities

OBEKAI DISPENSARY - BUSIA COUNTY

 

Obekai Dispensary is in Kenya in the larger Busia county in Teso South sub county in Kaliwa Location approximately five Kilometers from Tangakona Center on the Busia- Mumias Road

 

Obekai Dispensary

Contributing to improvement of maternal and child health in Kenya.

INTERVENTION IMPLEMENTATION PROCESS

• Identification of women early in pregnancy and newborns at the community level.

• Encourage antenatal clinic/MCH attendance

• Assure actual facility delivery of ANC/MCH EHC interventions through follow up at community and facility levels by CHWs and SHWs respectively.

• Provide safe and quality, feasible, affordable and accessible healthcare.

• Procurement of Medical products, vaccines and Technologies in Obekai facility.

• HMIS • An ICT system has been set up to enhance record keeping and tracking of data through Community surveillance, medical records systems through use of Mobile phone technology in order to obtain disease surveillance, demographic and statistical data for planning and follow up.

• We are utilizing existing facilities at Obekai but support the operations of CHEWs/SHWS. We shall work with Public, Private Partnerships for Health (PPPH) like Save The Children who have seen the need and have setup motorcycle ambulance services to ferry women to the facility during delivery.

Below are several images captured during an NHIF sensitization and recruitment drive organized by the Project in collaboration with Busia NHIF office


NHIF Officials giving a talk

Enrolled women, their spouses and community leaders

People listening to the speaker

A participant receiving guidelines from NHIF Official

NHIF Official Registering members of the community

Registration Process

Project women and babies at the event

 

FLTR IMPLEMENTATION

FIND – We are using CHWs from within Kaliwa villages and skilled health workers (SHWs) to find the pregnant women in the homesteads as early as possible in their pregnancy, enroll and follow them up during the pregnancy period

LINK - CHWs encourage prompt ANC/MCH clinic attendance and schedule ANC/MCH clinic appointments by mobile phone device at the time of initial CHW visit (Link). The aspects to monitor include bio-data and key pregnancy, newborn and under-five surveillance. This has created a link between level 1 and level 2 of the health system.

TREAT - The ANC/MCH clinics in the facilities provides the EHC package to each subject and mainly addressess the quality of service delivery, technologies and commodities component. These include haemoglobin testing using the haemocue machine and malaria test using the Partec Cyscope machine. Any ailments is treated at Obekai facility and where referral is needed they are referred to higher level facilities (Either Alupe Sub-district Hospital or Busia County Referral Hospital). Newborns are given the routine vaccinations, weights taken and vitamin A provided including all the relevant services as outlined in the EHC package.

RETAIN - Subjects are tracked and if one defaults the CHW is dispatched to the subject’s home to counsel the woman/family and accompany the woman to the health facility for the ANC/MCH visit. This component of the intervention links to building efficient and effective health information system that allows for efficiency in monitoring/tracking of subjects at antenatal, delivery and postnatal care, ranging from 6 months to 5 years depending on the month and year of birth over the 5 year study period

Below are some of the images of Operations at Obekai Facility


Operations at Obekai

Operations at Obekai

Operations at Obekai

Operations at Obekai

Operations at Obekai

Operations at Obekai

Operations at Obekai

Operations at Obekai

Operations at Obekai

Operations at Obekai

Operations at Obekai

Operations at Obekai



PRELIMINARY FINDINGS

Since the inception of the intervention at Obekai, we have seen improvement in:

• coverage of pregnant mothers and children under five at tier 1,

• Improvement in access to health care.

• provision of improved health care and safety of clients