With additional 26 new CHWs to the current 88 old CHWs, WADADIA began the new quarter with a plan to conduct 2,295 home visits for 2,295 PLHIVs. This was an expected additional target of 520 clients to the previous target of 1,775 beneficiaries receiving services from the organisation’s CHWs. The new 26 CHWs were also targeted for the Phase II HCBC training in the month of April 2014.
Under SDA 2.1 for PMTCT, WADADIA had 2 outreach activities planned targeting 38 pregnant women as well as one for Male involvement in PMTCT targeting 15men. Besides the outreach events, the organisation through CHWs had a target of tracking pregnant women and achieving
87 skilled deliveries during the month of April 2014.
Under leadership and governance, the organisation had a plan to conduct one monitoring visit for each of the three sub counties of program implementation, making a total of 3 monitoring visits for the month of April 2014. Three monthly progress review meetings for CHWs in all the three Sub counties were also planned for this reporting period. The organisation also aimed at compiling and submitting the April monthly report to the PR, through the North Rift regional office of the Kenya Red Cross Society.
HCBC Phase II training
On implementing the planned activities, all the 26 new CHWs were able to complete their Phase II HCBC training that was held at MUMCOP hall in Mumias town. The training was conducted with the aim of completing the 10 days HCBC curriculum as required by NASCOP. The trainees who had benefited from the first phase of training with one month field practice were evaluated and taken through this second phase training held at MUMCOP hall in Mumias town. The first day was for introduction overview, and review of HCBC field activities. The second and third day of the training was for Review of HCBC principles and components, Integration of HCBC in level one services, PWP concept and pillars as well as PWP messages. The third day also involved field visit preparations that were to be conducted on day 4 of the training. Day four was set aside for the field visit and day five saw participants present their field visit reports. Work plans, way forward and closure were done on day five which was the last day of the training.
CHWs continued with home visits to their client with the aim providing HCBC services. The visits had several objectives among them was to assess the progress made since previous visits. They also aimed at updating care givers and their clients on nursing care skills. Besides that, CHWs addressed nutritional issues, adherence, safe water, prevention treatment and management of OIs as well as personal hygiene. Through the 2,056 home visits, CHWs reported to have reached 2,019 beneficiaries where 1,519 were females and 500 males. 85 clients did not receive the services in April 2014. CHWs reported 1,964 clients to be on ARVs. The reports indicate more women to have been enrolled and received services on HCBC compared to the male clients. This is attributed to the fact that women in these communities are the most infected and even affected by the burden HIV. Besides that, men in these communities take long to cope with effects of HIV thus leading to delay in uptake of health care services both at community and facility level. Most men being bread winners in most families stay away at work which makes it difficult to be reached with services during home visits.
PLHIV Outreach Events
All the 3 planned outreach training events were held for 90 PLHIVs and care givers. In total theses were 22male and 68 females. The content disseminated was developed as provided in the minimum package manual for outreaches which included: Basic facts about HIV, a topic that involved definitions of HIV and AIDS, PWP and PMTCT and HTC. Other topics covered were STIs which included types of common STIs and how to prevent the infections, condom use positive living, stigma reduction, opportunistic infections and how to prevent them was also covered, community and health facility linkages. To ensure the sessions were lively, participatory and interactive, the facilitators used various techniques of facilitation among them, mini lectures, questioning, role plays, skills demonstrations, group work and plenary discussions, brainstorming and energizers were also instrumental in delivery of the content to the 90 beneficiaries.
ANC/ PMTCT Initiatives
Tracking of pregnant women
Both old and new CHWs continued with enrolment and tracking of pregnant mothers for the purposes of supporting the mothers in accessing ANC services as well as PMTCT services for the HIV positive ones. Tracking of pregnant women also aimed at supporting and ensuring that all the pregnant mothers are equipped with information for healthy living of both the mothers and their unborn babies during the course of pregnancy. CHWs were also required to ensure that the mothers accessed health facilities for delivery by skilled health care providers. During this reporting period, tracking was done for 766 pregnant women with 131 deliveries being reported. 102 of these deliveries were facility deliveries while 29 were home deliveries. The home deliveries were attributed to cultural values, beliefs and practices. It was also noted that due to literacy levels and lack of support by their spouses due to cultural values and distance to facilities were causes to the reported home deliveries. 26 pregnant women among those being tracked were PLHIVs all on HCBC and PMTCT interventions. 5 of the 26 PMTCT mothers delivered in April 2014. One the five mothers delivered at home but the responsible CHW assisted her in accessing post natal care at a health facility within 72 hours. 24 teenagers of ages 16 to 19years were also reported to have delivered with 3 of them delivering at home. None of the teenage mothers were HIV positive by the time of delivery.
Stephen Ombikhwa, a CHEW with pregnant women in an outreach training event in Matungu Sub county
Through the PMTCT outreaches, 45 pregnant women and 16 men were reached with information on HIV ANC and PMTCT. These were two events for pregnant women and one other event organised for men involvement in PMTCT. Through these events, participants were issued with IEC materials on the importance of ANC clinics and family planning.
Under SDA 3.1 for Leadership and Governance, the organisation was able to conduct the 3 planned monitoring visits in the three Sub counties of program implementation. 18 PLHIVs and 9 ANC/MCH clients with 5 of them on PMTCT were reached through the visits. Under this same SDA, the organisation participated in the PR’s CSOs quarterly coordination progress review meeting held in Eldoret town at Boma Inn hotel for the entire north rift SRs. WADADIA was represented by the Program Assistant, the Accounts officer and one Field officer. The Community Health Workers’ monthly progress review meetings were conducted as planned. Except for Mumias with two meetings held, one meeting was held in each district making it a total of four meetings held as planned for the month.
Quality Improvement Training
The WADADIA program staff were privileged to participate in the Continuous Quality Improvement training held at the Boma Inn of Eldoret town. The training organized and supported by the KRCS’ Global fund management unit was conducted by IDEAL Public Health and Development Consultancy – (IPHDC) targeting the North rift SRs program staff. This was a three day training attended by the Program Assistant and the two field officers.
The training with the aim of equipping trainees with knowledge, skills and practices on Continuous Quality Improvement in HIV programming was successful as all participants were issued with certificates of participation. Action plan as well as action points were developed as way forward for the training for all the organisations. Following this, the staff were tasked with developing organisational action plan for implementation of the QI process.