January 2010
By Caitlin Reiner and James Nardella, Michael Lear and Dr. Martina Fuchs
The mission of the Ochieng’ Memorial Lwala Community Health Center is to meet the holistic health needs of all members of the Lwala community, including its poorest. Whenever possible it addresses health problems at their roots through community health interventions. It aims to provide excellent community-based health care, not to become a tertiary care facility. The health center is part of a larger effort to achieve holistic health and development in Lwala, including educational and economic development. The primary beneficiaries are children, pregnant women, HIV infected persons and the elderly. Prior to the establishment of the clinic, there was no immediate access to primary health care or HIV/AIDS testing and care. For this reason, the Lwala health intervention has focused on primary care for children, access to medicines (particularly vaccines and antimalarials), HIV testing and care, public health outreach and safe maternity. The impact has been substantial since opening.
Lwala Village is part of the North Kamagambo Location in Rongo District, Nyanza Province, Kenya. North Kamagambo counts approximately 30,000 people.
In addition to basic primary care services, the Lwala facility provides maternal and child health services such as antenatal and postnatal care, vaccinations, growth monitoring and family planning; treatment of tuberculosis; comprehensive care for HIV, preventative services including PMTCT and male circumcision, counseling and testing as well as ARVs and nutritional support for persons living with HIV.
From August through October 2009, primary care was provided to 3,141 patients; more than 45 children were fully immunized; 198 women received antenatal care visits; 5 HIV positive mothers were delivered and received PMTCT care. A new HIV testing algorithm was implemented in accordance with MoH guidelines. Two Umama Salama workshops were held during which 17 women and 6 men were trained in Safe Motherhood lessons. A Rapid Core Assessment Tool for Child Health (CATCH) survey was conducted. Menstrual hygiene intervention was implemented in a local primary school. A successful measles vaccination campaign was conducted in conjunction with the Ministry of Health in response to a measles outbreak in the country. In addition, in conjunction with FACES, active recruiting for mothers to bring their male babies for infant male circumcision was done. Access to condoms was improved by the placement of condom dispensers in the latrines. Two Children’s Club sessions for HIV positive children were held. Also, a proposal requesting a kit of essential drugs from the Ministry of Health was submitted. Approval was obtained to receive both a monthly dispensary and a monthly health center kit which includes essential drugs such as antimalarials and antibiotics.
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Providing care and treatment to HIV infected children is a priority for the Lwala Community Health Center and FACES, our partner in providing comprehensive HIV services to the community. HIV positive children often go undetected because parents are reluctant to bring their children in for testing. Using a family centered approach, Lwala’s staff has worked with FACES to counsel, test, and enroll children into care.
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When Gracia Atieno’s mother came to the Lwala Community Health Center in April of 2009, she was very sick. Clinic staff counseled and tested her for HIV. After confirming a positive diagnosis, the staff tested Gracia. Sadly, the 8-month-old little girl was positive.
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