The Birth of the AMPATH Maternal, Newborn and Child Health Program

It’s been a long gestation - overdue according to most. Several years ago, through an alignment of stars and the realization that AMPATH’s comprehensive HIV treatment program could provide a model for providing public health care, the Primary Health Care program at AMPATH was born. United by a commitment to improve the public systems of health and support the Kenyan government in delivering healthcare through innovative approaches, colleagues from across AMPATH started to meet once a month to shift from healthcare for the HIV-infected to healthcare for all.

Impossible deadlines arose for promises we hardly thought imaginable… and now, the Maternal, Newborn and Child Health team has focused much of its collective energy on reaching more women and children and improving the quality of health services for them. The team is focusing on strategies that increase a community’s involvement in caring for its children and mothers. Our group of obstetricians and pediatricians agreed that mothers cannot be separated from their infants, and therefore, their healthcare must be provided as one. We call this the Mother-Baby Health Network.

We intend to deliver on our goals to increase facility deliveries, home visits and infant immunizations. We believe that when providers, leaders and their community are accountable to women and children, and women themselves are accountable to one another, we will meet these goals. To test this out, the Maternal, Newborn and Child Health team is implementing three interventions that seek to promote peer support and accountability: community clubs for pregnant and breastfeeding women (chamas), integrated group care for pregnant women and infants (Afya Jamii), and smartphones for use by Community Health Volunteers. To give you a taste, here is a brief description of each intervention, which will hopefully be highlighted more in future issues of the Gazeti.

Chama cha MamaToto (chamas)

In October 2012, 16 community units invited pregnant and breastfeeding women to join together. These groups are meant to provide women with the information and peer support necessary to advocate for, and improve their access to, health services. To further empower women, AMPATH’s microfinance scheme called Group Integrated Savings for Empowerment (see more information on page 2) has been integrated and made optional to members.

Afya Jamii

In March 2013, we implemented facility based mother-infant group care in 5 facilities. Each pregnant woman attending her first appointment is registered into a group based on her estimated delivery date and the group meets monthly until the infant is 5 months old. To provide care jointly to groups of 15-20 women and their infants, providers are joined by local volunteers to ensure comprehensive antenatal, postnatal (including family planning), and well childcare during 2-hour appointments.

Smart Phones

In December 2012, we equipped 89 already-employed volunteers with tools to carry out home-based assessments using Android phones. We adapted national and international guidelines into care guidelines that cover the danger signs of pregnancy, infancy and the immediate postpartum.