A SELF-SUSTAINABLE MATERNAL AND CHILD HEALTH FINANCING PROJECT IN WESTERN KENYA
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Go to Changeshop: A SELF-SUSTAINABLE MATERNAL AND CHILD HEALTH FINANCING PROJECT IN WESTERN KENYA.
Madaktari Mobile Initiative is a Kenyan NGO that seeks to promote maternal and child health in Kenya through addressing access to and cost of healthcare.
About Your Organization
Madaktari Mobile Initiative
Country where this project is creating social impact
Is your organization a
Non‐profit/NGO/citizen sector organization
How long has your organization been operating?
Less than a year
Has the organization received awards or honors? Please tell us about them
References - Please provide two references with a two-sentence biography, email address, and phone number for each
Dr. Judy White (email@example.com +44 1138124479) - Senior lecturer in public health and health promotion at Leeds Metropolitan University, UK.
Dorothy Mibei (firstname.lastname@example.org +254 723990827) - Public Health Specialist and head of the TB and lung diseases program in Embakasi district of Nairobi, Ministry of Medical Services, Kenya.
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Select the stage that best applies to your solution
Idea (you're poised to launch)
How long have you been in operation?
Still in idea phase, but looking to launch soon
Which of the following best describes the barrier(s) your innovation addresses? Choose up to two
The Need: What problem are you trying to solve?
The project aims to solve the high maternal and Child mortality among poor rural communities. According to the 2009 Kenya Demographic and Health Survey, 7,000 women die each year in Kenya as a result of child-birth related causes, while 90,000 children die each year after birth. Of these deaths, 30% occur in Kakamega County, the location of this proposed project. The maternal deaths are majorly caused by excessive bleeding at child birth, and obstructed labour. The leading cause of child deaths is breathing problems soon after birth. These deaths can be avoided if deliveries were to be conducted in hospitals under the supervision of a skilled health worker. However, the high delivery costs in hospitals and lack of access to these facilities acts as the main barriers to hospital delivery.
The Solution: What is your solution? Be specific!
The solution is to develop a sustainable financing scheme, through economic empowerment of poor rural women, that enables them pay for delivery costs at hospitals and also caters for transport costs to these health facilities. The project seeks to rely on developing the personal skills of the women and using locally available materials to generate revenue for meeting delivery costs. So, when a woman becomes pregnant and comes for her first antenatal care visit, she is offered to join the project. Once she accepts, she is given raw materials to make such small items like traditional baskets, table mats, neck laces etc. throughout her pregnancy. The project will team up with leading supermarkets which will stock and sell the items. 30% of generated revenue will go directly to the woman for her daily upkeep and also as motivation to produce more items, 50% will be put in her project account for tranport and delivery costs, while 20% will be used for the project's operational costs.
The Model: Walk us through a specific example of how your solution makes a difference; include your primary activities
Scenario 1: Mary is 18 years old and expectant with her first child. She is in labour. She has been attempting a home delivery but it looks like there is a complication. She is bleeding profusely. She urgently requires a caesarean section to save her and the baby. This means that she has to go to the Kakamega provincial hospital which is 15kms away. Being from a poor family, she has no money to hire a private vehicle to the provincial hospital or even to pay for the caesarean delivery. The relatives are making frantic efforts to raise money from well wishers. However, in half an hour, Mary and her unborn child lie dead in the grass thatched mud hut that is her house- yet another mortality statistic from Africa.
scenario 2: When Mary became expectant, she joined the Financing project where she she was provided with raw materials and started making baskets. The baskets were collected every week from her house and delivered to Nakumatt supermarket, the leading store chain in East Africa. She received part of the cash from the sale to cater for herself and her family while the rest was put in her project account. When she went into labour, she was transported to the provincial hospital 15kms away for delivery. The cost of transporting her to the hospital and the delivery was met from her financing project account. Mary is now back home with a bouncing baby girl. She has opted to continue being a member of the project in order to raise money to look after her child. She is even thinking of pooling her savings with those of her other friends in the project to start a dairy farm
The Marketplace: Who are your peers and competitors? Identify others also working to address the needs you are and what differentiates you from them. What challenges could these players pose to your success or growth?
I regard other organizations working to improve maternal and child health in Kakamega county as more of collaborators and peers rather than competitors. These include the government through the ministry of health, USAID, PATH and WORLD VISION. Although these organizations and institutions have sought to improve maternal and child health in the country, they are donor dependent, and they have failed to address access to and delivery in hospitals by poor rural mothers. This project is different in that it will entail the women themselves financing their transport and delivery costs. The only donor funds that will be required will be for start-up, after which the project will be self-sustaining. Unlike the other organizations, this project will empower the women both socially and economically
This Entry is about (Issues)
Founding Story: We want to hear about your "Aha!" moment. Share the story of where and when the founder(s) saw this solution's potential to change the world.
I have worked as a medical doctor in the field of maternal and child health over the past three years in some of the remotest and rural areas of Kenya, both from a clinical and a public health perspective. I have therefore seen first hand the struggles that poor rural women go through accessing health facilities for delivery. A case in point is when I was the Health Programme Coordinator at an NGO in a remote district in Kenya. The area was served by only one rudimentary dispensary with no delivery facilities. The nearest referral facility for delivery was 70km away via an earth road. Women in the village had no choice but deliver at home, often with fatal outcomes for both mother and child. Even for those I was able to transport in the NGO's landrover, none had the capacity to pay for delivery at the hospital. Yet these women were highly skilled in the making of jewellery, and I thought - wait a minute, can't we make use of their skills to finance their transport and delivery costs?
Please describe the goal of your initiative; outline what you are trying to achieve
The goal of the project is simple - promotion of maternal and child health by ensuring that no mother dies at child birth and that the babies born live to celebrate their first birthdays. Delivery should be a time of celebration but in most rural communities in Kenya, it is a time of pain and anguish as families lose their beloved sisters, mothers, wives and aunties. While it is known that 63% of these deaths occur due to lack of delivery in a hospital as a result of these facilities being too far away and costly for the women, little has been done to change the status quo. This initiative therefore aims at ensuring that access to hospitals and cost of delivery are no longer a barrier to poor rural women benefiting from skilled deliveries.
What has been the impact of your solution to date?
The solution is still an idea and is yet to be rolled out
What is your projected impact over the next five years?
In five years, we project that the initiative will have helped save 63% of mothers who would otherwise have died due to home delivery. This is estimated from the fact that 63% is the number of deaths that arise due to deliveries conducted outside of hospital settings in kenya. Taking an average rural village in Kenya with a population of 30,000 women and with Kenya's fertility rate of 4%, you would expect 1,200 deliveries in this village per year. This means that with this project, you will be saving 756 women who would otherwise have died at child birth. This translates to 3,780 saved lives in 5 years. Besides, in five years, the initiative will have empowered the women economically through the sale of the items to the extent that no external funding will be required to run the project
What barriers might hinder the success of your project? How do you plan to overcome them?
One of the barriers might be lack of community acceptance and ownership of the project. This might result from lack of understanding of the project by the community, especially the men (husbands) who might feel left out and not benefiting. However, the initiative will dedicate three months to community education and mobilization aimed at gaining support for the project. In addition, most of the operations of the project will be run by community members selected by the community itself.
The second barrier could be that the items the women produce might not sell due to poor market acceptance. In this regard, the project intends to team up with the leading supermarket chain in East Africa to stock the products at its outlets countrywide. Still, constant market evaluation will be done
Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact
Start of production of small items for sale - baskets, table mats, floor mats etc.
Identify three major tasks you will have to complete to reach your six-month milestone
Community Education, sensitization and mobilization
Recruitment of expectant mothers into the project during their first antenatal visit at the health centre
Provision of raw materials to the recruited women depending on their skills and area of expertise
Now think bigger! Identify your 12-month impact milestone
Sale of produced items to the market
Identify three major tasks you will have to complete to reach your 12-month milestone
Regular support to the women as they produce the small items
Setting up a collection system for produced items from the women
Setting up transport system of collected items from the rural village to the supermarket
Tell us about your partnerships
Madaktari Mobile Initiative currently partners with Rotary International through Rotary Club Kakamega, USAID through the Aphia Plus project, and the Ministry of Health through the Kakamega district Medical Officer of Health and Bushili Health centre in Kakamega. We partner with these organizations/institutions to offer our maternal and child health mobile services. USAID provides travel and food allowances to our health workers, Rotary club provides financial assistance towards media and poster advertising while the Ministry of Helath donates drugs and some health workers.
Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?
The innovation is set to be piloted in Kakamega town in Western Kenya, after which the organization seeks to expand to other rural areas of Western Kenya subject to the outcome of the pilot. The target population will remain poor rural women and children. As the project takes root and expands, the innovation will seek to partner with international supermarkets like Morrisons in the UK for the sale of the produced items. We are already in talks with Leeds Metropolitan University, UK, through their centre for health promotion research to take part in the project
What type of operating environment and internal organizational factors make your innovation successful?
The project is a bottoms-up approach meaning that it will be run largely by the community. This means that community acceptance is bound to be high. With support from a technical team in the form of an advisory board, decisions concerning the project will be made by the community. There is goodwill from the government through the Kakamega district medical officer of health which has the potential of convincing the government to take up similar projects throughout the country in rural areas.
Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list
The greatest need of the project is technical expertise in business administration, health economics and community development. This is especially so considering the multi-sectoral nature of this project and the need to harmonise both medical and social models of health.