Mastercard Foundation and CMMB Partnering on COVID-19 Emergency Response Equipping community health workers and health facilities to respond to the COVID-19 pandemic in Kitui County, Kenya
Mastercard Foundation and CMMB - Partnering on COVID-19 Emergency Response
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Introduction
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he COVID-19 pandemic has caused devastating impacts across the world with adverse effects on vulnerable communities As COVID-19 threatened health worldwide, CMMB mounted an urgent response to protect the vulnerable populations it serves, such as those in Kitui South.
The pandemic was yet another pressure on a population that is desperately poor, lack basic amenities and every day is a struggle to maintain basic health, sanitation and hygiene. The urgency of our COVID-19 response was driven by our commitment to provide quality healthcare in a world in which every human life is valued.
Our COVID-19 response in Kitui South through support from the Mastercard Foundation was focused on three main areas: Community prevention, safe water, and equipping health facilities.
In Numbers: CMMB’s Covid-19 Response 16,578 Kanziko ward
5000 handmade re-usable masks distributed to 1,200 expectant women
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residents benefit from water collected from the subsurface sand dam
Soap to 41 villages in Kitui South
113,077
PPE for
344
CHVs and 27 CMMB staff
350 CHVs trained in COVID-19 community prevention
Mastercard Foundation and CMMB - Partnering on COVID-19 Emergency Response
people reached through COVID-19 messaging
Community Prevention
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t the onset of the pandemic in Kenya, there was uncertainty and fear by both community members and healthcare workers. For healthcare workers, their fear was twofold: they did not have much information about a virus that was causing havoc across the world and they did not have PPE’s to protect themselves. For community members, lack of information marred with myths and misconception of the viral infections had a direct impact on people’s health-seeking behaviours and infection control.
distancing. CHVs were a critical resource in the prevention and management of COVID-19 because they provide critical front-line care to the remote communities we serve. CMMB also provided Information Education and Communication (IEC) materials as well as using audio-visual content and radio on the disease to use in community sensitization, raise awareness, and build resilience. The CHVs were also involved in contact tracing, home-based care for COVID-19 patients and distribution of soap and other sanitation materials.
CMMB Kenya’s COVID-19 response involved the training of the Rapid Response Team and Health Care Workers (HCWs) on COVID-19 management. CMMB with additional support from donors provided personal protective equipment (PPE) to HCWs and Community Health Volunteers (CHVs) in the sub-county. The support provided confidence to CHVs ensuring that essential routine activities including household visits particularly to children under 5 years, newborns and pregnant mothers were uninterrupted. This in turn ensured that service delivery for essential maternal and newborn services was not interrupted.
Following community sensitization by CHV, households installed handwashing stations with soap and water at their entrances. In some homes, families used innovative means of building handwashing facilities, such as tippy taps and leaky tins.
CMMB supported the training of CHVs to understand COVID-19 signs and symptoms as well as best practices and protocols for prevention, control, and mitigation, including effective behaviour change communication on handwashing and social
In efforts to ensure pregnant women could access health facilities for deliveries, CMMB worked with the security council in Kitui
Life Ensured pregnant women could access health facilities for deliveries
“I take pride in what I am doing for and in my community. Every community member and they know me. If they have any health concerns, I am their first point of contact before I refer them to the hospital. I am glad I can serve my community this way,”
Ms Elizabeth Kamene, CHV Mutumo in Kitui County
South to develop a curfew pass for use by boda boda riders ferrying pregnant women to and from health facilities past the dusk to dawn curfew deadline. Further, CMMB continued to support immunization services by procuring gas to use in running immunization refrigerators in the health facilities. This ensured a steady supply of viable vaccines that provided uninterrupted immunization services to the communities.
Impact: The support from MasterCard Foundation supported: CMMB Kenya to procure PPEs for 344 Community health Volunteers (CHVs) whose key tasks included community education on COVID prevention and contact tracing. CMMB Kenya to develop and distribute COVID 19 educational material to communities through CHVs and health facilities. About 376 boxes of soap were distributed for use by communities.
Mastercard Foundation and CMMB - Partnering on COVID-19 Emergency Response
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Safe Water
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and-washing, proper hygiene and sanitation are essential in preventing the spread of COVID-19 viral infection. However, availability of water is an uphill task in Kitui South, a waterstressed region and home to the poorest and vulnerable people. Communities in the region travel for as long as 11 kilometres, one way, in search of water, especially at the peak of the drought. CMMB Kenya’s COVID-19 response involved the drilling and installing of a sub-surface sand dam. The dam collects subsurface/ underground water then is purified and stored in an underground tank. A solarpowered water pump sends the collected water through pipes into Kanziko Health Center and neighbouring households. Over 16, 000 residents stand to benefit from the water from the dam. Kanziko health center is a high-volume facility among the 43 primary health facilities in Kitui South Subcounty. The facility serves over 100 pregnant mothers for antenatal care and 25 deliveries every month. Another funder Proctor & Gamble (P&G) supported CMMB to increase awareness on 4
Water Provide access to safe drinking water for communities through the use of CHVs
water purification and provide access to safe drinking water for communities through the use of CHVs. Community awareness on hygiene and sanitation was also integrated in PUR sachet distribution events. In addition, through the generous support of the Celentano family; CMMB installed rainwater harvesting systems in eight (8) schools in Kitui South. Four hundred and twenty (420) adolescent girls from the eight schools were also provided with six months’ supply of dignity kits.
“A sand dam is a simple, low cost, low maintenance technology that retains rainwater. These types of dams work best in dryland environments like Mutomo,”
Jesse Kihuha, Project lead for CMMB’s programs in South Eastern Kenya.
Impact: The support from MasterCard Foundation supported:
The construction of the sub-surface sand dam which provided clean and piped water in the government health facility in the entire sub-county to have reliable running water throughout the year. The dam will provide access to water to more than 16,578 residents across the 5 villages. Handwashing sinks were installed in five different points of the health facility including the maternity ward.
Mastercard Foundation and CMMB - Partnering on COVID-19 Emergency Response
Equip Health Facilities to Treat and Manage Covid-19
Health Training of health workers
Impact: The support from MasterCard Foundation supported: 190 health care workers from 43 health facilities in Kitui South were supported with sets of PPEs. That is 33,621 face masks, hand sanitizers and disposable gloves.
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MMB conducted a needs assessment survey, at the onset of the COVID-19 pandemic, targeting 43 health facilities in Kitui South sub-county. The assessment flagged deficiencies of PPEs, COVID-19 information educational material, low uptake of safety measures by health care providers, and lack of essential equipment for critical patient care. These insights were crucial in informing CMMB’s strategic support to the health system on the preparedness, immediate response and areas of support by the project. CMMB Kenya’s COVID-19 response involved the purchase and distribution of PPEs including alcohol-based sanitisers, disinfectants, disposable gloves and surgical face masks. Other equipment included digital thermometers and oxygen concentrators for facilities. Health facility clinical staff were also trained, in person and virtually, on infection control, providing treatment for COVID-19, as well as training on the key equipment crucial in COVID-19 management. The PPE support ensured sustained access to essential maternal child health services including; ANC, Immunization and skilled birth deliveries despite the pandemic. CMMB donated PPEs, information materials, and a sanitation booth to Kauwi
Four (4) sub-county hospitals were provided with 4 oxygen concentrators. Sub County Hospital, Kitui County’s main isolation center for COVID-19 patients. To continue community engagement and counter disinformation on COVID-19, Kitui County (health promotion department) with support from CMMB, produced a series of radio messages that were broadcast in three (3) local vernacular radio stations.
“The infrastructure support by CMMB was timely. We are also grateful for the PPEs and for stocking our drug store with medical commodities that helped us to prepare, prevent and protect our community from COVID-19,”
Dr Evans Adino, doctorin-charge at the Kitui Sub-County Hospital.
Provided gas to facilities to ensure that vaccine fridges ran optimally
The support ensured no health facility was closed due to lack of PPE, thereby continuing the provision of essential health services in Kitui South.
Remote training and cascading of information ensuring that all CHVs have been sensitized on COVID-19 disease. Key technical project staff have continued to mentor CHVs and their supervisors on key components of COVID 19 communitybased response such as messaging and community education, community-based surveillance with a focus on infection prevention and control.
Mastercard Foundation and CMMB - Partnering on COVID-19 Emergency Response
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Lessons in Providing Local Solutions for Local Problems
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Curfew pass for use by boda boda riders ferrying pregnant women to and from health facilities past the dusk to dawn curfew deadline.
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CMMB provided re-usable masks to identified 1, 200 pregnant women in the community. CMMB also provided these masks to the CHVs to ensure they followed up these women.
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CMMB provided home-based schooling items for children to use for learning at home during the COVID-19 lockdown such as revision materials and solar-power lights
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Integration of COVID-19 messaging into routine CHV health promotion messages to support COVID-19 resilience and response.
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Dignity kits for students from vulnerable backgrounds has the
potential to improve the learning experience of young girls in addition to retaining these girls in schools. 6.
Involvement of CHVs in immunization defaulters, mobilizing pregnant women and teenagers to attend ANC visits led to increased immunization, ANC attendance and skilled birth deliveries.
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Improving WASH in health facilities improves the delivery of maternal and child health services by enhancing patient’s access to safe fresh and potable water and reducing nosocomial infections.
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In anticipation for PPE stockouts, CMMB’s country office staff procured supplies early and procured locally whenever possible. CMMB’s Medical Donations Program shipped supplies
Mastercard Foundation and CMMB - Partnering on COVID-19 Emergency Response
from our US-based warehouse. This rapid response helped our teams refine internal communication to best meet the needs of the health facilities we serve. These learnings have benefited our programs in improving our supply chain system in the long-term. 9.
Given that gatherings such as group training sessions were prohibited, CMMB developed remote training tools for CHVs and healthcare workers. SMS packages helped in sustaining the rigor of continuously keeping the CHVs with updated information while out in the communities. Remote training and communication strategies will continue to benefit our capacity building efforts beyond COVID-19.
Acknowledgment CMMB Kenya would like to thank the Mastercard Foundation for the $250,000 towards CMMB COVID-19 efforts. The contribution supported CMMB's COVID-19 emergency relief efforts in low-resource countries to help fight the spread of COVID-19 by strengthening the capacity of health facilities in Kenya, Zambia, and South Sudan.
Jumuia Place, Lenana P.O.Box 13811-00100 Nairobi, Kenya Office Line: (+254) 710 607 154
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Mastercard Foundation and CMMB - Partnering on COVID-19 Emergency Response
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