Community-based OVC project in Nairobi slum: Survey results

With commitment to the MDG of improving the well-being of 100 million African slum dwellers, UN Habitat asked our team to help develop health care and social support systems for OVC in African urban slums. We agreed and focused our work on Mlolongo, a slum community of Nairobi, where HIV/AIDS rate is 15%, one of Kenya's highest. The central task was to help the community improve health and well-being of children under 5. Working with the African Population and Health Research Center (APHRC), a household-based survey reaching all children under 5 was carried out with strong support from three communities, population 10,000. The survey collected information concerning: health of the child; recent illnesses and care sought; household conditions; family use of bed nets; hand washing habits; health status of child relating to age, weight, nutrition and immunization status, parents' place of residence, and caregiver's rating of the child's mood, behavior and development. 1730 children under 5 were included in the survey. The most common illnesses during previous 2 weeks were: cold (296); malaria (273); cough (206); diarrhea (101); stomach pain (41), fever/chills (31). Although 1206 households used bed nets, and 1063 households practiced hand washing, malaria and diarrhea were among the most common illnesses. Health Cards are given at birth for recording immunizations, weight and age. Only 51% of households could locate the Card. Of those, 66% were complete, but much information was outdated. Related to food security, many children lacked enough to eat several times a week. In contrast, 643 always had enough to eat. Just 18.25% of children under 2 years were breast fed only, because many mothers were working. A comprehensive follow-up by CHWs of children with specific health needs, including incomplete immunization records, and nutritional deficiencies, has resulted in: the distribution of 400 LLIT bed nets; weekly food supplements to children under weight for age; substantial increase in completed immunizations; and education and promotion of handwashing including distribution of soap to reduce diarrhea. Findings and recommendations are shared with Government Health Department to enable continued collaboration. Here is a community-based approach to primary health care that is evidence-based and affordable in the African slum setting