Meet Chris. Chris has been a nurse since 2010 and currently works at a health facility in Archer’s Post Kenya. The facility is modest in size but serves the people of Archer’s Post as well as nomadic pastoralists who walk long distances from their remote villages to the health facility. In total, there are ten nurses, nine support staff, one lab technician, one nutritionist, one counselor, one health record officer and one ambulance driver. “Unfortunately, at this facility we do not have a doctor. We only have nurses and support staff, but we are really doing great,” Chris says.
He continues, “Our most common cases are bites from animals like snakes, trauma cases, upper respiratory infections, coughs and malaria. Malaria is very common because we have the river right on the other side over there. So, you find up to 5 or 6 cases of malaria in a week. “
Through the USAID-funded Afya Timiza Project, Amref Health Africa has supported the health facility to improve their wound and infections care, and their family planning, maternal and child health, and immunization services since 2017. Chris smiles as he tells us, “We can talk until tomorrow about all the great things Amref has provided for us.”
Amref Health Africa has provided the health facility with computers for e-Learning. E-Learning refers to educational courses that are delivered entirely online, outside of a traditional classroom setting. E-Learning allows health workers like Chris to improve their skills and continue their education without taking them away from their families and patients.
“When we are free, the computers have been installed with a lot of continuing education programs. We use them when we are providing Continuous Medical Education sessions for other health workers every Friday. The e-Learning has allowed us to refresh our skills and to give knowledge to those who have not been trained.”
Everyone at Chris’s health facility received training through the e-Learning and it has made a noticeable difference in the care they provide for the community: “There was a great improvement. We used to have a lot of neonatal deaths. We did not have good mechanisms for identifying the causes of these deaths and preventing these same causes from happening.
But after we all took an e-Learning course on Neonatal and Maternal Surveillance and Response, we are now able to identify complications very early on, take action, and prevent neonatal and maternal deaths from happening. If you see our performance data, you’ll see that we have not had a lot of deaths from the time we began using E-Learning until now.
We’ve also learned a lot about hand-washing, caring for and preventing infectious…A lot has really improved.”
The Afya Timiza (Swahili for “Achieving Health”) project has also established Community Health Units, or Community Units – small teams of health workers that serve as outposts for the larger health facility that serve people living in more remote villages.
Chris says, “We came to realize that before we had Community Units – currently we have two Community Units – it was very hard for us to deliver specific knowledge to the mothers in the villages.
But now we have Community Units, and Community Health Workers trained on basic medical skills and practices and they can refer pregnant women early enough for antenatal care and immunization services for babies. They can also recognize early signs of communicable diseases. It’s really doing good for us. You see, we are very few, we cannot reach everybody. But if there is something that we want all the communities to know, we just go through the Community Units and the knowledge reaches them very fast.”
Chris and his colleagues say that more and more pregnant women come to the health facility for antenatal care visits and to deliver their babies safely with trained health workers.
Still, many women in these remote villages continue to deliver their babies with Traditional Birth Attendants (TBA) which can put both mother and baby at risk to complications. Chris recalls, “We had a recent case where a mother was in labor but the child was in the shoulder-presenting position. The TBA was trying to pull out the baby that way. She was unable to do it. They called us but it was too late and the baby was lost. This happens sporadically but some TBAs have now been trained by Amref through Afya Timiza to refer mothers to health facilities during child birth.
In the areas where there is an Amref-trained TBA, we have not had many issues because they are acting as health workers. They are referring the mothers and being part of the team, which is good.”
Amref Health Africa