Kenya: Lwala Healthcare Project
Lwala Community Hospital Aids North Kamagambo: Q1 2018
August 12, 2018
Summary of Activities
RMF-supported Lwala Community Alliance (LCA) is a community-led, nonprofit health and development innovator working in Migori County in rural western Kenya. Through Lwala Community Hospital, the organization provides approximately 50,000 patient visits each year. The mission of the organization is to build the capacity of the people of North Kamagambo, including its neediest residents, to advance their own comprehensive well-being. The hospital is part of a larger effort to achieve holistic development in Lwala and the surrounding community, including educational and economic development.
This quarter, RMF-supported LCA:
- Provided 2,246 couple years of protection (CYP). CYP is a measure that weighs the value of a contraceptive method by the number of years it provides protection from pregnancy.
- Trained clinicians from Lwala and nearby partner facilities on the non-pneumatic anti-shock garment (a tool used to prevent women from experiencing post-partum hemorrhage).
- Enrolled 298 in-school girls and 62 out-of-school girls in January, 2018 in our mentoring groups to learn self-confidence and risk avoidance behaviors.
- Prepared to implement the Young Love curriculum in order to prevent risky relationships that often leads to HIV transmission and teen pregnancy.
- Supported children, women, HIV-infected persons, and the elderly.
- Provided immediate access to primary health care or HIV/AIDS testing and care in the area.
- Focused on primary care for children, access to medicine, HIV testing and care, public health outreach, and safe maternity.
Quality Health Care
Reducing Morbidity and Mortality
There was a sustained reduction of morbidity and mortality through access to quality health care for the people of North Kamagambo. There were 15,630 total patient visits between December 2017 and February 2018 across all three facilities that we support: Lwala Community Hospital and two government health centers/dispensaries, Minyenya and Ndege Oriedo. Lwala registered a 96% skilled delivery rate for all mothers in the catchment area. In 2017, we achieved 98% prevention of mother-to-child transmission of HIV. So far in 2018, there are 70 babies in our eMTCT program.
Maternal and Child Health Program
Improved Health-Seeking Behavior
By the end of February 2018, Lwala enrolled 6,331 children in the maternal and child health community program. We continue to provide education to community members on the consequences of poor sanitation and benefits of latrine construction through an intensive community-led total sanitation (CLTS) initiative. Lwala has continued to exceed its target of fully immunizing 90% of children under 5.
Educating School Children
Improving Literacy and Graduation Rates
Improved graduation rates, educational results, and health outcomes for school-aged girls and boys of North Kamagambo has been the outcome of the Education Program. The one-to-one model of the e-reader program showed a 19% improvement in literacy in program participants. We are anticipating a multiplied impact during the second and third years of the program.
Economic Development Program
Providing Skills Training and Grants
In order to provide financial access to even the most impoverished community members, Lwala continues to partner with the organization Village Enterprise. Village Enterprise provides training and microgrants to community members so that they can start their own small businesses. In February 2018, Lwala provided poultry vaccines to all of the groups starting agriculture enterprises and offered business skills training to 87 small business owners.
Understanding Health Stigmas
Kamagambo Community Survey
Preparation is underway for a follow-up to the mobile-based, community-wide household survey that was completed in early 2017. This survey will be conducted in our current catchment area, North Kamagambo, and our expansion area, East Kamagambo. This survey will allow us to understand population-based information, such as health-seeking behavior and HIV stigma. We expect the survey to begin in late April 2018.
Annual Staff Retreat
Team Building and Vision
In February, Community Programs Director Winnie Oyugi traveled to Seattle to participate in the iLeap International Fellowship Program. In December, Lwala held our annual staff retreat in the nearby city of Kisii. Our Executive Director and Impact Director traveled to Lwala to attend, and staff participated in team building activities and vision sessions.
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
Sarah and Her Family
Nutrition and Healing
Sarah is a young mother living in Nyagweta, a village in Kadianga Area about 30 minutes from Lwala Community Hospital. Her husband works in their village, doing odd jobs and handiwork for their neighbors and friends. Neither Sarah nor her husband attended formal schooling, and they have often struggled to maintain a steady income. With four children under eight years old, finding sufficient funds to provide food and clothing for the entire family was a challenge for many years.
Lwala Community Alliance first learned of Sarah’s family two years ago through the community health nurse, Mr. Obel. He found them living in a mud hut with a leaking roof and barely enough room to sleep. Sarah had just given birth to twins, a boy and a girl, who were always unclothed and extremely small for their age. Their mid-upper arm circumference (MUAC), a standard measure of malnutrition, put them in the category of severe acute malnutrition (SAM). Mr. Obel learned that Sarah and her husband had previously resisted receiving services from Lwala, as they preferred working with traditional healers and religious leaders in the community. However, Mr. Obel educated Sarah’s family on the severity of their children’s condition and the various services available to them through Lwala Community Alliance.
Following the consultation with Mr. Obel, they eagerly agreed to enroll their older daughter, Hillary, and the twins, Samuel and Alice, in Lwala’s nutrition program. As a part of the nutrition program, the children receive food supplements every other week and are evaluated by Lwala’s nutritionist every month. In addition, Sarah attends nutrition training with Lwala’s field-based nutrition team. In this training, Sarah has learned agricultural practices to maximize the amount of food she can grow on her family’s land, and she has received seed input support to jumpstart her own kitchen garden.
It has been two years since Sarah and her children were first identified by Mr. Obel, and their family has continued to grow. The youngest child, Maria, was born at Lwala Community Hospital nine months ago. Sarah attended all four recommended antenatal care visits before delivering, and Maria is on schedule to receive all of her vaccinations. Hillary and the twins have recovered from their bouts of malnutrition and are developing on schedule. They continue to receive nutrition supplements every other week to ensure that they remain healthy.
Sarah’s oldest daughter, Hillary, poses with the bag of nutrition supplements that her family received from Lwala’s nutritionist. Sarah has benefitted greatly from the nutrition training at Lwala. Her kitchen garden is flourishing, growing vegetables such as spinach and maize that provide her children with essential nutrients. Not only is she proud of her children’s growth over the past two years, she is also proud of her own growth as a mother, being able to provide her children with the food that they need from her own garden. Sarah is grateful to the Lwala staff for empowering her to promote healthy behaviors in her family and provide her children with the resources they need to grow and remain healthy.