At six months pregnant, Selah Achieng had made only one antenatal clinic visit. At eighteen years of age, she never knew the importance of frequent visits until a KIWASH trained Community Health Volunteer made a visit to her home. “Since the CHV visited me, I have visited the clinic three times. I now see the importance of attending clinic because I have learned a lot about staying healthy and protecting my baby from diseases spread by germs,” Selah said.
According to the Kenya Demographic Health Survey conducted in 2009, Kenya has a maternal mortality rate of 488 live births per 100,000 live deliveries. The government declared free maternity services in all public health facilities in 2013 as a way of reversing this trend and to achieve universal health coverage. However, the number of women giving birth in hospitals has not increased as anticipated. A recent survey of the status of integrated health and nutrition in Korogocho, one of Nairobi’s biggest slums, indicated a mortality rate of 706 deaths per 100,000 live births. The number of women attending at least four antenatal care visits – the recommended minimum number – was only 39 percent.
It is for this reason that USAID’s Kenya Integrated Water, Sanitation and Hygiene Program (KIWASH) selected Korogocho Health Centre to distribute hygiene kits as an incentive for early and frequent antenatal care and to sensitize the young mothers on critical health and hygiene practices.
The kits, which comprise a 20-liter water storage container, a 20-liter drinking water bucket, a bar of soap and a bottle of water disinfectant, are distributed to mothers after they have been given information on hygiene practices. These hygiene practices include the correct steps for hand washing with water and soap, the installation and use of tippy taps (simple handwashing stations) for hand washing after using the toilet and before preparing food, household treatment of water, and the safe disposal of fecal waste.
The kits have considerably increased the number of pregnant women attending antenatal care visits in Korogocho Health Centre. “We give a complete kit to mothers who deliver in the facility, and to mothers who attend their first ANC visit, so as to motivate other women to make four ANC visits which are critical to maternal health,” said Emily Wamba, the head nurse at Korogocho Health Centre. “Before the distribution of hygiene kits, I used to receive an average of five ANC clients per week. This number was very low. Now I am attending to 11 expectant mothers per week,” she adds.
During the ANC visits, community health volunteers trained by KIWASH also educate the mothers about the benefits of good nutrition, adequate rest, good hygiene, family planning, exclusive breastfeeding, and immunizations and other disease prevention measures.
USAID’s KIWASH program has trained over 300 health workers and community health volunteers to sensitize mothers on the correct steps for hand washing with water and soap, installing simple hand washing stations, treating drinking water and safely disposing of fecal waste. KIWASH has also distributed 1,331 hygiene kits to expectant and lactating mothers at health facilities across nine counties.
Selah likes her new hand washing station. “It makes it easier for all my family to wash hands and is a constant reminder to wash my hands and keep my family free of diseases.”