Kenya: Lwala Healthcare Project
Changing Lives Through Public Health and Education Programs: Q3 2016
October 28, 2016
Summary of Activities
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 30,000 to 40,000 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.
During this quarter, RMF funded maternal and child health costs including:
- Personnel costs for nurses Rose Gayo and Caren Siele
- 58% of medicine costs
Access to Quality Healthcare
- Lwala Community Hospital saw continued high patient numbers during this quarter, though they dropped slightly from the prior quarter (11,751 in the third quarter compared to 12,822 in the second quarter).
- Youth-friendly service outreaches conducted in primary schools across the catchment area provided health services to 422 students.
- There has been a gradual increase in the uptake of long-term family options during the course of 2016: from 319 in the first quarter to 354 in second quarter, to 390 in the third quarter.
Public Health Program
Positive Health-Related Behaviors
- Lwala has reached its target of fully immunizing 90% of under-5 children through an intensive immunization campaign and the increased diligence of Community Health Workers (CHWs).
- Community Health Workers have enrolled 1,119 individuals in the HIV-WASH community program so far this year and are providing home-based care and education services to these individuals on a monthly basis.
Improving Graduation Rates
- In-school mentoring sessions are bearing great results. Out of 393 girls enrolled in the in-school mentoring program, none have become pregnant during the year. The mentoring participants are often the most vulnerable girls in the school, so this success is particularly noteworthy.
- Another Better Breaks event was held in August. During this week-long camp, youth participated in leadership training, learned about sexual and reproductive health, and accessed health services. A total of 1,197 youth have already been reached by Better Breaks programming in 2016.
Economic Development Program
- The economic program has reached a cumulative total of 993 individuals through its farmer and community groups in 2016.
- The program will include a partnership with Village Enterprise, a nonprofit dedicated to ending extreme poverty in rural Africa through entrepreneurship and innovation. The economic program will continue to run the nutrition and farmer training program and make a financial investment in a successful community-staff cooperative group.
Monitoring and Evaluation
Data Collection and Management
- The M&E team has started developing technical requirements for an expanded electronic medical records system at the hospital. Doing so is the first step in building out the system, which is slated to take place in 2017.
- Data for the HIV-WASH community program has been uploaded into Lwala’s Salesforce database, which is a major step toward successfully tracking individual participants and project successes.
- Lwala Community Hospital was selected as one of only four organizations from Migori County to showcase KenyaEMR (Electronic Medical Records) and guide future developments. We were in the company of larger hospitals and organizations, as well as the MOH.
Operations and Finance
Managing Daily Functions
- A successful transition to outsource the kitchen and grounds-keeping functions (from having full-time staff dedicated to these functions) occurred during the quarter. We anticipate finding cost savings as a result of the outsourcing.
- The Finance team finalized an organization-wide Finance Policy and Procedures Manual during the quarter. Now, both policies and procedures in the US and Kenya are clearly laid out for staff and leadership.
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
During the reporting period, 11,751 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.
Young Mother Returns to School
At age 15, Lillian faced an unexpected pregnancy. Cultural pressures and expectations ultimately forced Lillian – an orphan – to marry a man twice her age, and she gave up on her dream of pursuing secondary school.
Lillian continued to search for opportunities to better provide for her two children. While in church, she met a Lwala Community Health Worker, who made an announcement about the out-of-school girls’ mentoring program. The out-of-school girls’ mentoring program provides a safe space for adolescent girls to learn about topics tied to their own well-being. Lillian joined the weekly sessions, learning about self-esteem, assertiveness, family planning, and communication skills in order to best relate with her husband.
Throughout the program, mentors encouraged girls to re-enroll in school. Lillian slowly started to realize that though she was a teen mother, she could still achieve her dreams. Lwala’s education team helped Lillian address her dream with her husband, who agreed to re-enroll her in school. Lillian credits her return to studying to the mentoring program, and she is currently in her second year of high school at Kuna Secondary School. Lillian states, “I can now pursue my dream of becoming a nurse. I like taking care of people.” Lillian continues to be an ambassador to other out-of-school girls participants, encouraging them to embrace schooling despite early pregnancies and marriages.
Elizabeth Achieng Omiti
Elizabeth Achieng Omiti is a widow caring for three of her grandchildren. She is known as Mama Kanisa, which translates to “Mother of the Church,” stemming from her leadership role at a local place of worship. Two years ago, Elizabeth tested HIV positive. She joined Lwala’s integrated HIV and WASH (HAWI) program to engage with community members and learn from Community Health Workers (CHWs) and hospital staff. Because of this support, she has been diligent about taking medications and attending regular appointments at the hospital. As an enrolled participant of the HAWI program, Elizabeth also sought opportunities to learn more about water access, sanitation, and hygiene to improve her health.
Though she had a latrine in her yard, it barely functioned and was falling apart. Prior to the training, Elizabeth thought that the unusable latrine showed neighbors that she kept a clean home. In reality, she discovered that a latrine alone did not keep her home clean; Elizabeth needed to fix and use her latrine.
After lacking help from family, Elizabeth turned to her fellow HAWI trainees for assistance. She led the team in organizing a series of “WASH Action Days,” where community members joined together to build latrines, providing loans, supplies, and labor. During this initiaive, Elizabeth’s family realized the latrine’s value and joined in on the construction at her home. Within a few days, and after hours of hard labor, Elizabeth had a new latrine. She felt confident, knowing that she now had a safe space for sanitation, and she encouraged neighbors and family to use the structure to promote healthy behaviors. Because of Elizabeth’s success in building a latrine and the camaraderie amongst HAWI members, one of her neighbors felt compelled to join the program. Elizabeth continues to advocate in the community, spreading the message of the HAWI program and the importance of building and using latrines.