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Receiving long term contraception

Back pack mobile clinics

 

CHAT is reaching increasing numbers of people living urban slums through the innovative back pack strategy for health care delivery.

CHAT’s Delivery Strategies

 

There are three principal ways whereby CHAT reaches the people it services.

 

1. Motor mobile clinics. Specially outfitted Land Rovers travel to rural communities on a regular basis. These bright yellow vehicles are recognized and welcomed throughout the areas CHAT services. 

2. Camel mobile clinics. In more remote, northern areas where roads are non-existent or very poor and the people semi-nomadic, CHAT’s clinic travels from community to community for a month at a time utilizing a specially outfitted camel caravan. Read more about camel clinics here.

3. Back pack mobile clinics. As Kenya’s urban population grows, in part due to rural to urban migration, there is an increasing need to provide services to those living in slum areas of small towns and cities.

Back pack mobile clinics were devised to address the needs of those people living in the slum areas, people who because of poverty, a lack of government facilities, or social stigma or beliefs do not have access to affordable and holistic family planning services. The communities can range from small villages to larger towns. 

CHAT motor mobile vehicle
CHAT camel clinic
CHAT community based health worker

Back pack mobile clinics work like this

 

Motivated people, often women but not exclusively, from the communities are identified and trained to go door-to-door with their back pack of supplies to discuss health concerns with residents and where appropriate to provide a range of health care services. Because these people are working in their own community, they easily earn the trust of the residents and generally enjoy high rates of success at the provision of the various services.

 

Initially these individuals, called “community own resource persons” or CORPs, work closely with CHAT’s staff, especially its medical team, to ensure they are providing high quality and appropriate service. They identify individuals and families in their community that need intervention. When CHAT’s team visits the community, the CORP ensures that the residents are seen by the clinical staff. And when CHAT’s clinic is not in the community, the CORP provides continual support.

 

CORPs are approved by and trained, in part, by the Kenyan Ministry of Health. Their agreement with CHAT stipulates that they must meet a certain standard of quality and service delivery before they are compensated for their work. This is called a “motivation allowance”.

The range of services a CORP provides includes:

  • monitoring the health of pregnant women;

  • monitoring the health of newborns;

  • providing immunizations;

  • testing people for diseases such as TB, malaria, and HIV/AIDS;

  • providing basic curative care (for example, treatment for respiratory infections or minor wounds)

  • providing counseling and guidance for those with chronic diseases;

  • facilitating access to existing government services;

  • providing family planning information and contraception

 

Contraception includes condoms, the “pill”, three to five month injections (for example, Depo-Provera), and three to five year implants. Note that while the primary goal is to afford women the ability to control their own reproductive health, the other interventions help to build trust and lead to a more inclusive health care.

Long term contraception injection

A woman receives a three month contraceptive injection. Longer term (3-5 year) implants are also available.

Childhood immunizations

Children are monitored for growth and to ensure they receive childhood immunizations.

HIV/AIDS testing in Kenya

Virtually all clients are tested for HIV, TB and malaria. Results are reported to the Ministry of Health.

Sustainability

 

CHAT’s long term intention with the back pack strategy is to develop enough resilience, skill, and capacity with the CORPs that they become independent and sustainable and no longer reliant on CHAT for either guidance or funding. CORPs are tasked with creating what are called Village Development Committees (VDC) in places that have no “voice’ or structure to improve the community. In short, they help the residents learn to advocate for themselves and to access resources within their own community, including the creation of income generating activities.  

 

In short, a successful back pack program ultimately becomes an “exit” strategy for CHAT when the community develops the capacity to be self-reliant and self-sustainable.

CHAT_good (62).jpg
Health care in Kenyan slums

The Cost

 

The cost to identify, train, outfit a new CORP for one year is approximately $10,000. This includes:

  • extensive training (some of it mandated by the Ministry of Health);

  • all medical equipment and supplies (including contraception);

  • transportation and accommodation as needed;

  • communication (mobile phone air time and data costs);

  • a laptop

  • sundry office supplies;

  • uniforms;

  • record keeping and compiling reports (including financial accounting);

  • wages of CHAT support and supervisory persons on a cost shared basis;

  • part of the wages for an existing CORP who will help train the new individual

  • the CORP’s wages

If you know of an individual, family, or organization interested in creating long term sustainable health care in Kenya, please email us at thesmallproject@gmail.com

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