By Caroline SANG
Mandera County of North Eastern province is one of the counties in Kenya experiencing shortage of qualified health care workers (Nurses, RCOs, and Nutritionists) with some of the health facilities remaining closed/non-operational. On the other hand, Health Centers are either manned by one nurse or a registered clinical officer meaning that they are left non-operational when that particular worker is on leave or away on official duty out of her/his station. This situation as compared to other parts of the country needs urgent intervention.
Above all these challenges, there is one cadre of community health workers that has played an integral role and has ensured that health and nutrition services are provided to the community without any interruptions. These are the Community Health Workers who have bridged the existing human resource gap. With funding from DFID and ECHO, Islamic Relief has hired a total of 80 Community Health Workers in Mandera north and east.
Hassan Maalim Mohamed is a dedicated Community Health Worker attached to Hareri Health Centre and also works in the hard-to-reach areas which have no health facility. He is indebted to Islamic Relief for the several trainings he has undergone which have made him be what he is today and as he puts it:
“……when I was recruited 3 years ago, I dint know what IMAM is until I was invited by IRK to attend an IMAM training. I have so far attended 2 IMAM trainings”.
Hassan also stated that he has not only attended IMAM trainings but has also attended others such as BCC, MIYCN, DHIS and HiNi trainings among others. Just like many of his colleagues, Hassan has gained a lot of experience, knowledge and skills in relation to nutrition services and this has enabled them to discharge their duties effectively. Hassan is quick to mention that he plays an integral role in OTP/SFP/HiNi services and maintains records and participates in active case finding and defaulter tracing.
When we arrived for the interview, Hassan was attending to a pregnant woman who had come for her third antenatal clinic and SFP visit. When we asked what services she got from Hassan, the mother states that she received “madawa ya kuongeza damu” (Ferrous Sulphate Tablets).It is worth mentioning that the Community Health Workers in Mandera County play a major role in discharging nutrition services and it is distinctively clear that without them the gap would be bigger than it is now. This sentiment is attested by one Fatuma Ibrahim; a lactating mother in the SFP program who stated that:
“…Hassan is a blessing to us more so to those of us who are in the “Uji” Program (SFP Program) as I believe that due to his interventions I have regained my health and my child is able to get adequate breast milk…”
On a weekly basis, Hassan visits the outreach sites to offer nutrition and immunization services. This has been made possible with logistical support from Islamic Relief through the DFID and ECHO funded nutrition program. This he states has enabled children under 5, pregnant and lactating women to access nutrition services including deworming and vitamin A supplementation.
When asked how Islamic Relief has facilitated his work, Hassan states that he receives a monthly stipend and the health facility gets logistical support for the same. One of the aspects as pointed out by Hassan that has really helped him and his colleagues is the provision of Community Health Worker Kits through the DFID program and as he states:
“…the provision of the Community Health Worker kits was timely and has really improved our service delivery to the community, coupled with the sensitization of the contents of the kit, our skills and knowledge was greatly improved ….what I can assure IRK and its donors is that we will continue to offer quality nutrition services always”
Hassan is always available to attend to the mothers who stream to the health facility at any time of day. Ms. Shaiya Adan, a 21 year old mother who brought her child to the health facility where Hassan works reported that Hassan is always available to assist them.
The Community Health Workers play an important role in the community and their continuity is entirely dependent on the support that they receive from Islamic Relief and her donors. To crown it all, Hassan is optimistic that with the improving nutrition status of his community members, the shift will be towards addressing food security matters, improving coping mechanisms and adoption of alternative livelihood options.