Kenya has long been a venue for many of AMURT’s service projects over the years, but new challenges continue to affect millions of residents. Education, healthcare, HIV/AIDS prevention and treatment, job creation, and care for orphans and vulnerable children have all been areas of emphasis and continue to be a large part of AMURT’s presence in Kenya.
JAMII BORA: leading by example
Iddi Leatiya and his wife, Damaison, received us graciously at their home five kilometres from Wamba town. They were eager to discuss the impact of AMURT’s Jamii Bora program on their family.
Emmanuel, their first son, was born at home as was the tradition amongst the Samburu people. However, there were some complications with that birth, which caused Iddi and his wife a lot of stress. They were therefore receptive to the message of the AMURT-trained community health workers (CHWs): delivery at the health facility is the safest way to bring a new child into the world.
Hence, when she was pregnant with Isaac, her second son, Damaison went to the Wamba health facility for four ante-natal clinics, and was accompanied by her husband to the maternity wing for Isaac’s birth.
According to Christine Orre, one of the nurses at the Wamba health facility, the story of Iddi and Damaison is not an isolated one. Other men are beginning to encourage their wives to use the health facility for both antenatal clinics and delivery. The table below, drawing data from Wamba health facility records, shows a 32% increase in antenatal visits from 2013 to 2014. And by mid-2015 there was a 20% increase in antenatal visits compared to the same period in 2014.
Nurse Orre credits this improvement, as well as the increase in health facility births (from 1 to between 4 and 10 a month), to both the continuous sensitization of the community by the CHWs and the modernizing of the maternity department by AMURT. Word has gone around the Samburu community that the government-run Wamba health facility (which is free) has better equipment than the Catholic Mission (which is expensive).
The CHWs are the extension of the health facility into the community. They visit women of childbearing age in their homes; participate in Community Dialogue Days, held quarterly; educate fathers during their support group meetings; and monitor the government WASH program. Now that AMURT has built their capacity, the CHWs are sustainable resources for the community.
Damaison smiled when we asked her how she was treated at the health facility. “They received me well,” she said, “And they used the new equipment. I told other women that delivery at the facility is risk-free, compared to a home delivery.”
Iddi also smiled. He is the chairman of the village and has been encouraging the other men to advise their wives to deliver at the health facility. He gives them the phone number of AMURT’s project coordinator who then calls the ambulance.
Ballast makers: one thing leads to another
NOPE, one of AMURT’s partners, trained three women as peer educators as part of its sexual and reproductive health program in Maralal town. The women were active in bringing new and useful knowledge to their peers, but they were yearning for more. Hence, they took the initiative to form two women’s support groups, Nashame and Maram, to provide 30 women with more opportunities for development.
First they started a merry-go-round, a form of table banking, in which each member by rotation receives the pooled monthly contributions of all the other members (around $60 per member per month). As one woman said, “Before we could only purchase one cup of flour, but now with the merry-go-round we can purchase 6 cups at a time. As a group we are stronger.”
But the women wanted to generate more money to support their families and pooled resources to start a rock crushing business. Every day they gather at a quarry to manually break rocks into pieces suitable for the construction industry. It is laborious work, but they are happy to be generating money on their own terms. As one member said, “We don’t like begging from relatives, so we started something on our own.”
With income generated from quarrying, the women, with guidance and training from NOPE, created a SILC (Savings and Internal Lending Community), a more sophisticated savings and loan structure that enables members to generate interest on savings and take out loans at any time, usually in excess of their savings. Each member invests a minimum of Ksh 1000 ($10) each month in the SILC. Through the SILC’s social fund the women helped 16 pregnant members give birth at the government health facility.
The trained peer educators are still guiding their fellow women, sharing new knowledge during monthly support group meetings and even work breaks. Isabella, one of the members, was very enthusiastic when asked to explain what she had learned. “We learned about contraception so we can space our babies to give us more time for work. We learned about exclusive breast feeding for 6 months, and how to best attach the baby to the breast. And we learned how to extract our breast milk to feed the baby while we are at work. This, and guidance on personal and household hygiene, have made us healthier.”
According to the women, their husbands are also responding well to the new knowledge. Now the men see the benefit of giving birth at the health facility, and even accompany their wives sometimes. When the women are attending antenatal clinics, getting their babies immunized, or giving birth the men take their places at the quarry.
The stone crushing business provides the women with a strong incentive to maintain their solidarity as their lives can best advance with increased revenue. And by regularly meeting together they can support each other in applying healthy behaviours for improved maternal and child health. Hence, in these women’s groups various aspect of development converge, making the program rich and sustainable.
Changed attitudes, healthier people
One of the objectives of the Jamii Bora project is to change the attitudes of men, encouraging them to support their wives in safe pregnancy and safe delivery.
To ascertain whether men are actually changing, we met with Rokini Lenadosi, the Eze or traditional leader of Ledero community, and founding member of the Nomadic Community Support Program, a community-based organization (CBO) created in February 2014 with support from AMURT’s partner, the Matibabu Foundation. Our conversation was encouraging.
The Eze said: “Before we were in darkness. Now we have a clearer sense of focus and direction. The lives of mothers and babies have been saved. Even if the project ends, the knowledge will stay with us forever.”
What has changed?
The men now accept that they should reduce the heavy workload of their wives in the third trimester of pregnancy. As a result, husbands share domestic chores, even fetching water and wood. This is a major shift from the traditional gender roles that kept men with the animals and women caring for the home and making charcoal.
“We have changed the old culture,” said the Eze. “We had a lot of deaths of pregnant women in the past and did not know the cause. And many died in childbirth because they were sick and tired. Now the women do not become so weak later in pregnancy.”
The women share with the husbands what they learned from the maternal and child health training given to the CBO members. The learned about child spacing, safe motherhood and exclusive breast feeding. They learned about the benefits of giving birth in the government health facility. And they learned about financial planning.
Now the men don’t sell a goat at the last minute at throwaway prices to support a new baby, but sell when the price is high and save the money. If they don’t have the discipline to save money themselves, they give a goat or cash to the CBO as a type of savings scheme for a new birth.
The twenty CBO members (fifteen women and five men) were selected by local leaders to represent different villages. The CBO is tasked with community education for behaviour change, savings and loan schemes, and charitable support for the poor. Its loan fund has doubled from the initial capital of Ksh 6000 (provided by AMURT), and is used to transport pregnant women to the health facility, or to support their stay there after birth. According to the Eze, they have already assisted fifty mothers with loans and gifts.
One beneficiary was Maria Letikir who had an infection in the uterus and umbilical cord after giving birth. She had no personal savings, so the CBO paid for her to stay three days in the government health facility. Now she is back to full health.
Many of the CBO members have started their own merry-go-round groups in their own villages to pool resources on a monthly basis, thereby strengthening the communal spirit.
The Eze said that before women were treated like the wooden part of a spear: when it breaks it can be replaced. But now the women are treated like the metal blade: highly valued and worthy of being kept in prime condition.
In 2010, fifteen enterprising women joined together to form the Naretoi Women’s Group in Marelal. They started a merry-go-round, with members contributing a fixed amount on a monthly basis to benefit one of the women. Their success attracted the attention of other women, so by 2014 they had a membership of 65.
The county government took note that 65 women could meet regularly to further their future, and donated a milling machine to the group in 2014 as an incentive. The women started a posho mill which becomes active after the maize harvests.
GRACE Africa, one of AMURT’s partners in the Jamii Bora Project, identified the potential of the group and trained them in the more efficient saving and lending schemes of a Savings and Internal Lending Community (SILC). SILC is a much more elaborate savings mechanism that enables members to take out loans at any time, eliminating the sometimes lengthy waiting period of a merry-go-round, and includes a social fund.
The SILC social fund is built with a percentage of the interest revenue and with money accrued from fines of late payments and absenteeism. It can be used to get children to school, sick people to the hospital, dead people buried, and expectant mothers fed.
In the two years they have participated in Jamii Bora the women have increased their SILC capital from Kshs. 175,000 to 250,000. They have used loans to expand their group wholesale butcher business (they sell animal parts purchased from the slaughterhouse), and invest in their individual shops and kiosks. Hence, they have contributed to the project objective of increasing household income for 5000 households.
The woman say that another outcome is more male involvement in domestic life and pregnancy. Their husbands support the women’s group, because it makes money, so they willingly fetch wood and water in wheelbarrows when the women are busy. In addition, the men are more likely to accompany their wives to the first ANC visit to know their HIV status, and even to take women to the health facility for delivery.