THE SITUATION FOR CHILDREN IN KENYA
In Kenya today, a staggering one in 12 children dies before their fifth birthday, and nearly a third of this number will die within their first month of life1. Most of these children die from preventable and treatable causes such as pneumonia, malaria and diarrhoea.
Fifty-two per cent of Kenyans live over five kilometers from the nearest health facility or trained health worker, and for those living in the country’s most remote districts, the distances are often far greater. Even when care is sought, facilities are often under equipped and poorly staffed. Across the country, there are just three doctors per 100,000 people, far few than the World Health Organization’s minimum standard of 230 doctors per 100,000 people. With the majority of mothers giving birth at home without professional care, having a baby in Kenya is dangerous for both mother and child – women face a one in 55 lifetime risk of dying during pregnancy or child birth.
SAVE THE CHILDREN’S HEALTH WORK IN KENYA
Save the Children is supporting the Kenyan government to achieve Millennium Development Goals 4 and 5 – to reduce the number of under-five deaths by two-thirds from 1990 to 2015, and to reduce maternal deaths by three-quarters in the same period. We are working with the Ministry of Health to develop strategies and resources that will increase children’s and mother’s chances of survival in some of the most under-resourced parts of the country. In 2012, we reached 584,480 people including 419,300 children under five with our health work. Working in Wajir, Mandera and Meru Counties:
We are training and equipping health workers to provide quality maternal, child and newborn healthcare
Save the Children knows that addressing Kenya’s acute shortage of professional health workers is critical to saving children’s lives. To do this, we’re working with the Ministry of Health to train health center staff on how to deliver neonatal care and how to provide basic emergency obstetric care for pregnant women with complications, a crucial intervention
which could save thousands of lives each year. At a community level, we are giving community health workers and the community health extension workers who support them the skills they need to identify common childhood illnesses, deliver direct treatment for diarrhoea, pneumonia and malaria, and to make referrals to local health facilities where necessary. Babies in Kenya are often delivered by traditional birth attendants (TBAs) who are generally untrained, leaving mothers at high risk of infection and complications. That is why we are also training TBAs to improve their skills and encourage them to refer women to local health facilities for antenatal care and to give birth.
In addition to delivering training, Save the Children also equips community health workers with kits containing essential items such as drugs, thermometers, oral rehydration salts and growth monitoring equipment to assess children for malnutrition. By doing this, we are providing the tools health workers need to provide life-saving interventions at a local level. Save the Children is also supporting outreach activities such as immunizations for young children, and supporting the vaccination cold chain to ensure that vaccines remain at the correct temperature when transported to health facilities.
We are increasing the uptake among communities for quality health services
In order to save as many children’s lives as possible, a fundamental pillar of Save the Children’s health work is to encourage families to seek medical care. We are working with local leaders and community health committees to address social, cultural and traditional barriers to health. We are highlighting health as a right, and helping to build community capacity to hold the government to account in developing village action plans to identify and act upon issues affecting the health of members of their communities.
Save the Children is also training community health workers to promote important health messages such as the importance of exclusive breastfeeding for babies under six months and of giving birth in a health facility. We provide community health workers with kits that include flipcharts and educational posters which are used during home visits and education sessions with the wider community. These materials are translated into local dialects and use pictures in order to effectively communicate simple, high impact health messages.
We are helping to reduce the impact of HIV and AIDS on children
An estimated 1.4 million adults are living with HIV and the epidemic affects more than 60% of orphaned children in Kenya. Women bear the brunt of HIV and AIDS, with 87,000 HIV-infected women giving birth each year. Save the Children is working with the government to improve communities’ access to quality HIV and AIDS healthcare and support, and to encourage the uptake of services which help to reduce the impact of HIV and AIDS on children and their families. We are helping 6,500 orphaned and vulnerable children, some of whom are affected by HIV, to get the support they need, whether it is medical or psychosocial care, or paying school fees to enable them to return to school. Older children
affected by HIV and AIDS who are without adequate care are provided with vocational training and support to develop a safe, sustainable livelihood so that they are able to provide for themselves in the long term.
Save the Children is also helping 1,500 adults living with HIV and AIDS through psychosocial support groups and livelihoods support. These adults then work with community health workers to raise awareness on the importance of getting tested for HIV, and the benefits that treatment can offer. By doing this, we are tackling the stigma surrounding HIV and AIDS while promoting key health education messages. In addition, community health workers deliver home-based care for children and adults living with HIV and AIDS, and carry out frequent check-ups to make sure that medicines are being taken.
We are supporting the wider health system
Save the Children takes a holistic, sustainable approach to improving the quality of healthcare provision in Kenya. We’re helping District Health Management Teams to improve the centralized health information system, to monitor the progress of community health services, and to provide ongoing support to community health workers. We are also training District Health Management Teams on governance and leadership, giving them the management skills they need to run the district health system effectively.
Save the Children also equips marginalized health facilities with essential equipment such as beds and supplementary stocks to improve the availability of essential medicines such as anti-malarials and antibiotics. By doing this, we are helping ensure that the communities served by health workers are able to access the medicines they need, when they need them. We are also strengthening links between health facilities, health workers and committees so that the most serious cases are referred on for appropriate care as quickly as possible.
We are advocating for long-lasting change for all children in Kenya
As well as delivering transformative change for Kenya’s children directly through our health work on the ground, Save the Children is advocating for long term changes in the health system which will benefit children for years to come. We launched our EVERYONE child survival campaign in 2009, under the Kenyan campaign title “5 and Alive”, to raise awareness of the shocking number of preventable child deaths occurring in Kenya and to mobilize the public to demand their health rights. We are using evidence from our health projects across the country to influence national and county policies, and promote good practices which have the potential to save thousands of lives each year. Specifically we are pushing for:
- An increase in the numbers of trained health workers, particularly midwives and community health workers, to provide children and women with quality healthcare
- Greater efforts to tackle the top causes of child deaths at a community level, including HIV and AIDS
- An increase in the budget allocation for healthcare to 15% of the national GDP
- The inclusion of the vaccine to protect children from rotavirus, a major cause of diarrhoea, as part of the national vaccination schedule
- Access for all children to clean water, adequate sanitation facilities and quality food.
In 2012, Save the Children made some important achievements for Kenya’s children through our EVERYONE/5 and Alive campaign. With our campaign partners, we successfully advocated for the development and implementation of a National Nutrition Action Plan which has the potential to prevent thousands of deaths each year. We helped to secure the roll out of a nationwide curriculum for community health workers and community health extension workers, ensuring these health workers have greater training and ongoing support from the government. We also recruited over 500,000 new supporters in Kenya for our campaign as a result of awareness raising activities across the country.