Kenya: Lwala Healthcare Project
Creating Partnerships to Change Education: Q1 2016
April 29, 2016
Summary of Activities
Lwala Community Alliance (LCA) is a community-led, nonprofit health and development agency working in Migori County in rural western Kenya. Through the Lwala Community Hospital, the organization provides 30,000 patient visits each year. The LCA’s mission is to meet the health needs and build the capacity of all people living in North Kamagambo, including the poorest residents. The Lwala Community Hospital is part of a larger effort to achieve holistic development in Lwala and the surrounding community, including educational and economic development.
RMF funded maternal and child health costs including:
- Personnel costs for nurses Rose Gayo and Vincent Onsongo
- 58% of medicine costs
Medical Services Provided
Basic Primary Care Services
Treatment of TB
Maternal and Child Health Services
- Antenatal and Postnatal Care
- Growth Monitoring
- PMTCT of HIV
- Family Planning
Comprehensive care for HIV
- Preventative Services (including PMTCT and male circumcision)
- Counseling and Testing (voluntary, diagnostic, and provider-initiated)
- Care and Treatment (for people living with HIV, including ARVs and nutritional support)
- Implementation of HAWI (HIV & WASH Integrated project) continued during this quarter. 739 HIV-affected individuals were enrolled throughout the catchment area, and CHWs (Community Health Workers) were trained on provision of care at the household level and how to refer and link patients to the hospital.
- “Thrive thru 5” continues to make impressive gains, with over 3,500 households and 3,900 children in North Kamagambo registered in the program cumulatively.
- Cholera preparedness exercises were carried out in the community to ensure safe drinking water and hygienic conditions in households, through both distribution of treatment packs and community education activities.
Monitoring and Evaluation
- A baseline assessment on literacy levels was carried out with all participants in the eReader program, along with students from three control schools. This will allow LCA to compare the baseline results and endline results from both the treatment and control schools to measure any significant differences.
- A culture of data usage is continuing to take root in program decisions through the introduction of an ongoing Data Dive initiative across different teams.
- Two new Princeton in Africa Fellows were selected from a very competitive candidate pool and will begin working on the M&E team in Lwala during July and August.
- The in-school and out-of-school girls’ mentoring program was launched for another year, now implemented in 13 primary schools and reaching nearly 480 young women. New mentors were recruited and trained at the beginning of the year to successfully support the program’s growth.
- Nearly all (8 of 9) sponsored students received scores on their high school exams that will allow them to attend a high-ranking university in Kenya.
- Ten new scholarship beneficiaries were added in early 2016: 1 supported by Equity Bank-Mastercard Foundation, 2 by Education for all Children (EFAC), and 7 by Kenya Education Fund (KEF).
Comprehensive Health Care
- The hospital renovation was fully completed and occupied during the quarter, including use of a new pediatric and women’s inpatient ward in addition to the new laboratory, pharmacy, and maternal and child health service rooms.
- Virtually all patients who came into Lwala Community Hospital were tested for HIV, both inpatients and outpatients. This 100% linkage is critical to reducing new infections and providing better health outcomes for the infected.
- There was increased participation in HIV support groups associated with the roll out of HAWI (HIV & WASH Integrated project).
- Lwala Community Alliance (LCA) carried out a competition at the Sankalp Forum in Nairobi, called the Economic Design Challenge. Over 10 submissions were received, and a team of judges selected an innovative idea from Village Enterprise, which LCA began working with soon after.
- A second Economic Design Challenge was carried out among the Lwala Kenya staff, and a winner was selected. The winning team’s idea will be piloted during Q3 and Q4 in the Lwala community.
Operations and Finance
Caring for Staff
- The staff housing project was completed, and occupants moved into the new spaces during this quarter. The new staff housing is fully equipped with water, electricity, and other amenities.
- The audit process in Kenya was successfully completed, and a definitive opinion was given.
- The new chart of accounts system was fully underway during the quarter, allowing executive leadership and program managers to more accurately track and forecast their spending and fundraising requirements.
Lwala is a village of approximately 1,500 people near Lake Victoria in western Kenya. Within an hour’s walk, approximately 3,000 additional people live in nearby villages accessible by dirt roads. Poor physical infrastructure, including impassable roads during the rainy season, lack of electricity and lack of reliable drinking water, have helped to create a critical healthcare challenge in Lwala. The mission of the Lwala Community Hospital is to meet the holistic health needs of all members of the Lwala community.
- Improve patient care and clinical operations
- Improve access and facility infrastructure
- Expand and improve quality of education programs
- Professionalize the organization through better policies and practices
- Properly procure and account for physical, financial, and human resources
- Increase impact of health outreach programs
- Build capacity of community members in income generating activities
- Improve programs through better communication and monitoring and evaluation
Click to enlarge
During the reporting period, 10,140 patients were served at Lwala Community Hospital.
Approximately 30,000. The total population of North Kamagambo is 16,500, and programs are a magnet to people beyond North Kamagambo.
Lwala Launches New eReader Program at Primary Schools
Change the Face of Learning
In early February, more than 400 pupils and community members of rural North Kamagambo, Kenya, gathered at Kadianga Primary School for the launch of Lwala Community Alliance’s eReader pilot project. Among them was Fred Ochieng Ouko, a 12-year-old boy in class 6 at Kadianga Primary School.
Fred is the sixth-born in a family of nine children: three boys and six girls. Three of Fred’s sisters are married, and none of his siblings have attended high school. Fred’s parents cannot afford to buy him his own textbooks, so he shared books with two other students in his class. The three classmates would rotate who would take the course books home after school, requiring the other two to copy down questions in order to complete their homework. Kadianga Primary School did not have storybooks for the pupils to read at school. In fact, besides their course books, the only other books in the classroom were four Bibles, which students would share during pastoral lessons.
Fred’s circumstances are representative of those of many children his age living in Lwala Community Alliance’s rural catchment area. According to a survey conducted among class 6 students in January 2016, 61% of pupils report having access to only 5-10 books at school, and 82% of pupils report having access to 10 or fewer books at home. Yet despite the minimal availability of books, the surveyed pupils express strong interest in reading, with 93% reporting they would like to have more books to read at school and/or at home.
Given this background, Lwala Community Alliance has partnered with Worldreader to launch an eReader pilot project. 150 eReaders — each with 200 books — are being used in this pilot program to change the face of learning in the community.
Prior to the launch of the eReader pilot, Lwala Community Alliance’s education initiatives were exclusively extracurricular, functioning to supplement regular school instruction. This pilot marks the first time Lwala Community Alliance is working with teachers to enhance learning in the classroom. Run by members of Lwala Community Alliance’s education team, the eReader pilot project leverages an existing relationship with class 6 teachers and pupils from the in-school mentoring program. Education team member Alfred Odhiambo, himself a former teacher at Lwala Primary School, is the lead implementer of the pilot. After joining Lwala Community Alliance staff in October, Alfred quickly began working with schools to prepare for the new project. With the support of a Worldreader staff member, he trained teachers on how to use the eReaders and incorporate the devices into their classroom lessons.
Designed as a small-scale comparative study, the eReader pilot is also breaking new ground for Lwala Community Alliance’s monitoring and evaluation (M&E) team. Based on the strength of a written proposal, Lwala Community Alliance selected 6 among the 13 area primary schools to participate in the pilot. These six schools were then paired according to achievement (low, middle, and high), and one school from each pair was randomly assigned to either the treatment or control group. The three schools in the treatment group prepared to receive eReaders, while the 3 control schools prepared for lessons as usual.
At the start of the 2016 school year in January, the education team delivered a baseline evaluation to class 6 pupils in all 6 treatment and control schools. The baseline evaluation was designed to assess pupils’ reading literacy based on 3 measures: reading individual words without context, reading a short passage, and answering comprehension questions. Each measure was tested in both Kiswahili and English. The evaluation also collected pupils’ demographic information, reading behaviors, attitudes towards reading, and access to educational resources. The evaluation will be conducted again at the end of the school year to assess the effect of the pilot, using a difference-in-differences methodology, changes in literacy levels among pupils in the control and treatment schools, and any changes in pupils’ reading behaviors and attitudes.
Fred now has his own eReader with 200 books to use both at school and at home. Fred can carry the eReader home with him in the evening, which makes completing his homework a much easier task and allows him to share the device with his siblings so they too can develop a love for reading. Lwala Community Alliance believes the new eReader project can help pupils like Fred not only become better readers, but also improve overall school performance and foster a culture of reading and learning in North Kamagambo.
Rehema Atieno Adenyo
Community Role Model
Before joining LCA’s girls’ mentoring program, Rehema had problems with her husband and mother-in-law that resulted from a lack of money, food, and her respect in the family. She argued with her husband and mother-in-law quite frequently, which caused Rehema a lot of frustration and unhappiness. At times, she even moved back to her parents’ home to avoid this difficult situation. She then joined the Minyenya mentoring group and became a star participant. She was asked to join an “advocate” training because of her strong participation in the mentoring program. After completing mentoring sessions, she went on to join the DIG (Development in Gardening) apprenticeship program, where she learned how to farm for income and nutrition. Throughout the mentoring sessions and DIG trainings, Rehema put a lot of effort into learning and growing through the programs.
A few months after Rehema graduated from the mentoring program, LCA’s education team asked her if she would be willing to be a mentor herself. The team recognized her ability in working with other young women and her knowledge in areas of sexual and reproductive health, family communication, and making positive life decisions. Rehema agreed to serve as a mentor, as she really had changed positively because of the program. She was already giving good advice to newly married women in the community, maintaining a clean and hygienic household, and working a fruitful kitchen garden. Furthermore, she had strengthened her relationship with her husband and mother-in-law. Now as a mentor, and with the positive changes in her life, Rehema has become a role model in the community, and other young women admire her and want to follow in her footsteps. Rehema says that her husband is proud of her and always encourages her to work hard. She is currently training to work in a hair salon and hopes to start her own salon one day. She thanks LCA for changing her life and is glad to play a role in creating positive impact in the community at large.