Kenya: Innovative community organizations improve the survival of rural children

BACKGROUND. In rural areas of Kenya, high childhood mortality due to malaria, diarrhea and pneumonia is still commonplace. THE PROJECT. Since 2004 and for 5 years, Plan International, a child-centered humanitarian organization,has implemented a USAID-funded Child Survival project in the Kilifi district (tot pop 260,000) of the Coast Region. This project, a partnership with the Ministry of Health and non-governmental organizations (NGOs), aimed to sustainably reduce the morbidity and mortality of under-five children. One major project strategy was to link community caretakers with the formal health system (either government or NGO) through the Care Group which brings together 10-15 volunteer health contacts, each representing a homestead. Health contacts select one among themselves who meets agreed criteria as community health worker (CHW). The CHW is trained on community Integrated Management of Childhood Illnesses. The role of a Care Group is to share and discuss health information with their households as well as to mobilize their household for health action including utilization of health services. RESULTS. The project helped organize 1400 care groups which have achieved: immunization coverage has risen by 15% (62%-77%); skilled birth delivery by 23% (13%-35%); bednet use rose from 21% to 77% and the proportion of underweight children has fallen from 27% to 14%. The number of Lives Saved using the USAID Child Survival calculator is estimated to be at least 780. CONCLUSIONS. Based on this project, the Ministry of Health has adopted a variant of the Care Group in its Essential Package for Health Services.