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MAISHA
Maternal Health Community Stakeholder Forum At the end of February 2016, MAISHA hosted three facility-‐based meetings between community stakeholders working to improve maternal health outcomes. The community forums were held at Nyamaraga, Ogwedhi, and God Kwer health facilities and included all ten CHV groups MAISHA partners with in Migori. Shaded from the hot equatorial sun, Traditional Birth Attendants (TBAs), Community Health Volunteers (CHVs), the Community Health Extension Worker (CHEW), facility staff and Migori’s Ministry of Health (MOH) focal persons gathered at rural health facilities to share their experiences and challenges. Such a meeting among these groups was the first of its kind for the majority who participated. The main objective, to harmonize the roles and expectations of all partners, was widely reached through public dialogue and discussion.
country coordinator, Winnie Koima. Following these formalities, MOH trainer, Charles Ochieng, facilitated the group activities. As always, Ochieng – who has worked with both CHVs and TBAs before – was able to ease tensions and encourage discussion between everyone. First CHVs and TBAs were asked to find a partner who they were u nfamiliar with, and after a brief chat the pairs introduced one another to the group. This activity was particularly endearing since TBAs’ actions (e.g. providing at home delivery services) and CHVs’ mandate have at times challenged one another. Creating a common ground between the CHVs and TBAs led to insightful conversations on both their shared experiences bringing mothers to facilities for maternal health treatment and the newly defined symbiotic nature of their roles.
The TBAs and CHVs agree that by working together they can have a more profound impact on the communities they serve. Both groups are willing and enabled to accompany mothers to health facilities for The forums were opened with welcoming remarks prenatal care (PNC), delivery, and antenatal care (ANC). from facility managers, county MOH staff and MAISHA in-‐ Moreover the TBAs who have received MAISHA’s
What does a badge have to do with it? TBA badges are integral tools for the inclusion of TBAs in facility-‐based maternal care. The badges not only identify which TBAs have received sensitization training but also declare a TBAs commitment to skilled-‐birth attendants for delivery (the latter is written in the local language of Luo on the bottom of each badge). TBAs with badges will be welcomed at all facilities including facilities outside their community. The badges are an important indicator to facilities that sensitized TBAs are partners in maternal health care.
Dispatch 11 – March 2016
“We were able to discuss and clarify issues so we can now harmonize with the facility.” Rose Odhiambo, Migori Sub-‐county East Reproductive Health Coordinator sensitization training understand the importance of facility-‐based care, and no longer undermine the work of CHVs by performing at home maternal healthcare. Likewise, TBAs and CHVs are able to correspond and share information about the mothers they are in contact with to ensure timely follow-‐ups.
MOH Sub-‐county Reproductive Health Coordinator, Rose Odhiambo, pointed out the importance of this information, especially since it can be difficult to obtain clear understandings of what occurs at the facility level. The MOH staff in attendance, health facility workers and MAISHA coordinator agreed to follow-‐up on these issues to ensure that TBAs and CHVs are not discouraged from One of the most exciting developments since the bringing mothers to the facility. TBA sensitization training in November 2015 is the number of mothers that TBAs have referred. For instance, Providing a platform for discussion and TBAs attached to Ogwedhi health facility have referred partnership between the various community partners is over 40 mothers since the beginning of 2016! This is not incredibly valuable. If strong communication channels are only a testament to the effectiveness of the training but lacking between TBAs, CHVs, health workers, and the also an ode of confidence for both CHVs and health MOH than miscommunication and mistrust can workers who may h ave been skeptical of TBAs inclusion in undermine the work of MAISHA and the health system at MAISHA’s maternal health programming. The TBAs have large. In order for maternal health outcomes to improve demonstrated an impressive level of commitment to sustainably all the partners and access points must improving maternal health in their communities. correspond and cooperate mutually. The MAISHA team believes these community stakeholder forums are a big However, while improvements h ave been made a step forward to ensuring everyone is empowered to work number of obstacles remain. The second key outcome together and provide exceptional maternal health care for from the stakeholder forum was identifying the mothers in rural Kenya! challenges faced by both the TBAs and CHVs. Both groups shared experiences where they were unwelcomed by In sum, the stakeholder forum was an excellent certain facility staff or provided poor assistance upon tool for TBAs, CHVs, and health facilities to become arrival at a facility with a mother. The main issues include: acquainted with one another and harmonize their roles slow service, lack of acknowledgement upon arrival, lack and expectations. MAISHA and the MOH were able to of medicine or b eds, and incorrect diagnosis, which led to gather useful information concerning the challenges that mothers returning home to delivery their babies. remain, but also the opportunity to celebrate the success and contributions of all our p artners!
YEAR 5 AT A GLANCE APRIL 2016 o Community Action Days in Nyeri and Migori MAY 2016 o IMCI Training for health workers in Nyeri and Migori AUGUST 2016 o Nutrition module training for CHVs in Nyeri and Migori o COTR Nursing students educational visit o MAISHA Seminar at DeKUT OCTOBER 2016 o FEMOC training for health workers in Migori and Nyeri NOVEMBER 2016 o Family planning module training for CHVs in Nyeri and Migori