Kenya: Lodwar Clinic and Turkana Drought Relief and Mobile Medical Outreach Project
Integrated Outreaches Support 12 Sites: Turkana Central, February 2017
March 18, 2017
Dr. Dominic Ongaki and Emma Kiriungi
Summary of Activities
Turkana Central sub-county has the highest burden of HIV, with a prevalence of about 6.7%. The most affected areas are around the lake region, Lodwar town, and settlements along the highway. Malnutrition cases are also on the rise, with a recent survey showing that slightly more than 30% of the children are malnourished.
Turkana Central sub-county has 43 functional health facilities, with a distance of about 25–30 km between them, making accessibility for essential services a nightmare for the majority of our residents. To reach all the population, integrated outreaches play a key role in improving in our performance indicators as a sub-county.
As a sub-county, Turkana Central appreciates RMF for coming on board and upscaling outreach activities to 12 sites, which are undertaken monthly through the sub-county MOH office. These outreaches will improve the performance of MNH indicators, nutrition, HIV services, and general public health through health education and talks.
Role of the Sub-County MOH Office in Outreaches:
- Designed a daily activity hot reporting tool for uniformity
- Carried out supervision and offered technical support whenever needed
- Provided medications and other non-pharmaceuticals through the support of the Ministry of Health
Activities Performed during Outreaches:
- Health Education
- Nutrition Screening
- Vitamin A Supplementation
- Antenatal Care Services
- General Treatment for Children and Adults
Improved Health Seeking Behavior
Health education is key to improving health seeking behavior and the general wellbeing of the community.
- General hygiene and sanitation were covered at some sites.
- Importance of immunization, ANC attendance, and family planning were also covered at other sites.
Nutrition Screening and Management
The aim of nutrition screening is to support growth and development milestones for children and also support pregnant women to prevent pregnancy-related complications.
- Most malnutrition cases were in Ngimuriae and Nangolpus (areas in Kerio Division, where the nutrition survey report also singled out the most cases).
- Cases screened were managed and scheduled for monthly reviews to monitor their progress.
Immunization and Treatment
Immunization is key to preventing communicable conditions among children during the growth period. As a sub-county, we have a monthly target of about 450 fully immunized children. During this outreach period:
- 138 children were fully immunized, accounting for 30.7% of our monthly target.
- 44 children received OPV 3 antigen.
- 42 and 48 received PENTA 1 and 3 respectively.
- A total of 549 adults and children received general treatment. Referrals for conditions that could not be managed in the field were issued and followed up by the community health volunteers.
Vitamin A Supplementation and Deworming
Vitamin A supplementation in children is essential in supporting rapid growth, maintaining healthy vision, and helping to combat infections. During this outreach period:
- A total of 289 children received Vitamin A supplementation.
- 94 lactating mothers received supplementation.
Deworming is a major gap in our sub-county. The outreaches will highly boost the indicator, even as we try to reach as many children as possible. It’s one of the indicators in which we performed dismally at the just concluded annual county review meeting.
A majority of pregnant women come to only one ANC appointment late in their pregnancy. As a sub-county, 4th ANC coverage for 2016 was 45%. To improve 4th ANC coverage, outreaches will play a key role in reaching as many mothers as possible. This can be achieved by line listing all the mothers who came for ANC at the facility and then follow up with them during outreaches. The outreaches will target all the mothers who usually do not access services.
As a result of the just concluded outreaches:
- 45 pregnant women received tetanus toxoid vaccination.
- 29 were new ANC patients.
- 5 completed a 4th ANC visit.
- A total of 201 pregnant women received iron and folate supplementation (IFAS).
After responding to a September 7th, 2009 NY Times article by Jeffrey Gettleman, which highlighted the life threatening impact of the drought in Northern Kenya, Real Medicine Foundation coordinated a supply chain for water and food aid, and medical support to the region. We were able to provide a 4-week supply of food and water to 4,500 persons in severely drought affected regions of Turkana, Kenya where it had not rained in 4 years.
- Provide Medicines and Medical supplies to meet the needs of the targeted population
- Increase Mobile/Outreach Clinics in the remote villages
- Provide Medical Services at the Health Facility in Lodwar Town:
- Supporting the physical/medical needs of the targeted population
- Home visiting
- Referrals of patients needing advanced care to tertiary care hospital, and HIV and TB government clinics
- Teaching about and providing nutritious food