Kenya: Lwala Healthcare Project

Deborah Achieng

No pregnant mother wishes to pass HIV to her unborn child. Deborah Achieng, a farm worker and mother of four children who had little understanding of the virus, was no different. That is why, after a Community Health Worker (CHW) from LCA visited her at home and provided health education, Deborah visited a health clinic where she could be tested for HIV. As a result of this visit, Deborah learned that she was HIV positive.

Deborah had suspected that something was wrong with her health because she had been losing a significant amount of weight. Because she was also two months pregnant and had not started her antenatal care (ANC), the CHW kept visiting Deborah to encourage her to start antenatal care. After a one-month follow up, Deborah finally decided to visit the Lwala Community Hospital.

During her ANC visits, Deborah received counseling on infant feeding, safe sex practices, and family planning. She also joined a support group of HIV positive mothers at the health center.

When Deborah went into labor, she contacted the CHW who then called for an ambulance from LCA. Deborah was picked up and rushed to the facility where she immediately received the single-dose anti-retroviral prophylaxis. Four hours later, baby Shamimah was born, and she received a pediatric dose of nevirapine. Because of Deborah’s attention to ensuring her child received the necessary care and treatment, Deborah’s baby is now HIV free.

Deborah says she does not pay attention to any form of stigma. When she comes for her ARVs at the clinic, she does not mind the stares she gets from those around. She says all she knows is that she is there to take care of herself and her family. Accessing treatment is something that will make her life better. She looks forward to having one more child. But “not immediately,” she adds, with a smile.

Shamimah Adhiambo finally graduated from the Prevention of Mother to Child Transmission program at 18 months and has been confirmed as HIV free. Today, Deborah is a happy mother who hopes that one day Shamimah will be a nurse. The CHWs will monitor Shamimah until age 5 for childhood illnesses and will also offer advice to the mother.

Hospital Expansion Project Update

The Lwala Community Hospital construction project is complete! The project consisted of three major components: 1) construction of a new connecting wing to provide additional outpatient and staff office space at the Lwala Community Hospital, 2) expansion of the current hospital building to create additional inpatient ward space, and 3) development of new housing units so that clinical staff are located nearby the hospital for better round-the-clock staff coverage at the hospital and response to emergencies.

Despite some delay in the completion of the project, the project has been remarkably successful, the quality of the final work is high, and the new hospital space is already enhancing the quality of healthcare delivered to patients. The new connecting wing houses the child welfare clinic, maternal services, the pharmacy, the health records room, and an expanded laboratory. All of these spaces have been in service since August 2015.

These rooms provide sufficient space for their intended purpose; and because of the new layout of the rooms and increased waiting room space, the overall flow of patients has improved drastically. The renovation of the existing hospital now provides separate inpatient wards for males and females, a pediatric inpatient ward, delivery and postnatal rooms, an office for the Head Clinician, and a Nursing Station. The new staff housing units include two bedrooms, a spacious living area, a modern kitchen, a bathroom, and a small balcony. The staff housing portion of the project is nearly complete, with only the final touches remaining.

Prior to the project, all maternal and child health services (including well child visits) were provided from a single room located right next to the inpatient and sick patient areas of the hospital. With the new connecting wing, maternal and child health services are separated entirely from the inpatient and sick patient areas. Additionally, the adult inpatient wards have been expanded to accommodate more patients at any given time and to ensure that pediatric, neonatal, and adult patients are not mixed.

The expanded laboratory space ensures no contamination of specimens as well as enough room to house a large amount of new equipment to accurately diagnose malaria, TB, sickle cell anemia, and more. The centralized location of the new lab will improve patient flow and increase nurse/clinician consultation with lab technicians in diagnosing patients.

Five new service provision rooms have been added to the hospital to greatly assist with the increase in patient numbers that the hospital has seen in the last few years. Additionally, the layout of the entire hospital has shifted to ease patient flow. For example, the laboratory and pharmacy have been moved closer to the outpatient rooms to make it easier for patients to navigate the various services they may receive at the facility.

With the completion of the construction project, LCA will focus on improving the quality of health service provision within the new space. Focus areas such as staff training, development and retention, and development of electronic data systems will receive even greater attention.

The LCA operations team will be responsible for maintenance of the new construction and renovation and of all equipment and furniture. With these new objectives, LCA aims for community members to more frequently and consistently seek preventative care. In the future, there may be opportunities to build additional staff housing in accordance with the latest design, though we believe that the new staff housing is sufficient at present.

LCA is able to better serve the community as a result of the expanded space. With a better equipped and resourced hospital in place to provide high quality, comprehensive healthcare and community-based programs that encourage positive health-seeking behavior, we anticipate that the health and well-being of the people of North Kamagambo will improve significantly over time.