By Benson Maina Njoroge, Public Health Officer and Supervisor in Kibera, Nairobi
I have always believed that an open mind can add more meaning and can catch on details that may otherwise slip through our fingers. Since the introduction of the project, Amref Health Africa, the Ministry of Health through the Community Strategy and the Unit of Neonatal, Child and Adolescent Health, and the communities in Kibera and Makueni have enjoyed a good working relationship. This has created an enabling environment for the scale up of mCHW project in both sites.
The project whose primary focus is to enhance training and supervision of CHVs through a mobile platform supports assessment of developmental milestones for children under 5. These milestones include gross and fine motor skills, social skills, and language & speech skills. The mCHW mobile platform supports an informed referral decision making by the CHVs. In this regard, the project has identified and referred many children experiencing challenges in their development. The Kibera community, where I have served as a CHEW appreciates the project for the positive transformational changes they have experienced and continue to experience.
Developmental milestones monitoring at household level is a matter that until recently has not been taken seriously. I must confess that I was equally ignorant in that regard. However, with repeated training and interactions with the CHVs and households, I have been inspired to broaden my scope so as to provide better support as and when required in my capacity as a supervisor. Through the use of the application, I have come face to face with the heart-breaking challenges and accounts and success stories almost at the household level.
Interacting with a women’s group in Kibera, I have come to learn the following. Children with developmental challenges and disabilities:
- require 24 hour support while eating or to change diapers and even to turn in bed.
- require constant medical check-ups and some requiring physiotherapy twice a week
- have a problem of chewing and swallowing. This calls for special food, which is very expensive in most case.
- very few people if any are ready to help or to give a hand
Parents (mostly mothers) with children with developmental challenges are:
- entangled in the web of poverty; caring for the disabled child becomes almost a full time job; as a result, the mothers cannot get any time to engage in meaningful employment because caring for their disabled children take most of their time
- stigmatized by the community
- often disowned by their immediate families and shunned by their friends
- divorced by their husbands once they deliver a disabled child
- some are exploited by other people who make money out of their plight
The success story is that these women are now confident and not ashamed of themselves and their children. Even though the challenges appear many, together we can overcome them through partnerships and the use of technology to identify and refer cases for specialised treatment, and to support the mothers in providing care for their children.
With such an approach to improve the health of those in marginalised communitites and in remote areas of Kenya, the mCHW project has made a significant impact: It has bridged the gap between knowledge and practice, and it has empowered our communities’ first responders and frontline workers – our community health volunteers – with practice based skills and technology that fosters continuous learning.