John Kutna, Amref Health Africa in Kenya
For over 15 years now, I have been privileged to work with various agencies in the provision of technical and leadership support for humanitarian programs in Kenya. I am currently working for Amref Health Africa in Kenya directly supporting reproductive, maternal, newborn, child and adolescent health (RMNCAH) and nutrition projects, including the Canada-Africa Initiative to Address Maternal, Newborn and Child Health (CAIA-MNCM) project funded by the Government of Canada through Global Affairs Canada.
Kenya hosted the second Annual Reproductive, Maternal, Newborn, Child Health and Nutrition (RMNCHN) conference in Nairobi in February to share lessons learned from projects supported by the Government of Canada under the Partnership for Strengthening Maternal, Newborn and Child Health (PS-MNCH). Over this period, we have all experienced challenges and successes, co-created social and technological innovations and knowledge products geared towards contributing to the knowledge pool on RMNCHN locally, nationally and internationally. The conference was therefore an ideal opportunity to share evidence-based approaches amongst partners and disseminate to wider audiences who can adapt and improve upon these approaches and escalate the push for universal health coverage, sexual and reproductive health and rights and positive nutrition outcomes, including food and nutrition security, across the country.
In this journey, the Amref Health Africa CAIA-MNCM project witnessed positive outcomes in maternal and child health and nutrition in Siaya County, most notably:
- Improved uptake of services at health facilities;
- Improved quality of health services offered;
- Strengthened county health systems and leadership; and,
- Remuneration of community health volunteers (CHVs) who are the key drivers to the promotion of preventive and curative health care at the community level.
The Reproductive, Maternal, Newborn, Child Health and Nutrition conference provided for active engagement with government officials and other stakeholders who provided key learnings and insights into the path strode so far in improving health and nutrition outcomes for women and children in Kenya and the massive opportunities and challenges that remain. For instance, despite the work done by our network of partners and others across the country, maternal mortality remains at 362/100,000 live births nationally with some counties recording alarmingly higher numbers. We also noted that nutrition outcomes in the marginalized communities dwelling in the northern arid lands and amongst pastoralist communities in Kenya remain sub-optimal as food security and food diversification remain a challenge in those areas. It is my view that achieving responsive policies, equitable distribution of financial and human resources and adequate resource mobilization for provision of quality health and nutrition services will contribute to reducing ongoing gaps.
As we near the close of the project, it is my observation that the key to achieving sustained program support is to promote linkages and coordination between stakeholders including fostering multi-sectoral relationships to address RMNCHN challenges holistically and leveraging each other’s strengths and competencies to achieve positive results. Further, these relationships and interventions need to be anchored in unity of purpose and sound policy at the county and national levels aligning them with government strategy and agenda with a greater outlook towards long-term sustainability.
Networks such as PS-MNCHN therefore have a role to play by influencing policy development and direction through evidence-based advocacy work which should be rooted in programmatic practice. I also hold the belief that addressing underperforming outcomes for sexual and reproductive health and rights amongst adolescents and young people is also essential in a largely youthful population as is the case in Kenya. This requires working to overcome traditional barriers, both policy and socio-cultural, that limit access to quality information and services essential to promoting sexual and reproductive health and rights outcomes in communities. Widespread sharing and learning initiatives beyond the PS-MNCHN network should also be embraced to both contribute towards and benefit from the body of knowledge in this sector thereby refining programmatic work to become more context-specific and responsive to various community needs and realities.
To this end, commitments made by multiple stakeholders present at the RMNCHN conference bode well for future success in the fight to eliminate preventable deaths and morbidities for women, newborns, children and adolescents in our beloved country. Of special note to me were:
- Commitments to advocate for increased investments for the training, deployment, management, leadership, and governance of community health volunteers, including proper remuneration;
- Commitment to scaling-up investments in high impact interventions, such as immunization, skilled attendance during pregnancy, birth and quality care for mothers and newborns and access to proper nutrition;
- Commitment to call upon the government and all development partners to comply with their commitments and in a coordinated manner aggressively align respective policies to the commitments including universal health coverage (UHC) and ICPD25 Nairobi Summit; and,
- Work in coordination with nutrition-sensitive interventions to ensure complementarity and call for investments in MNCHN sensitive sectors.
I believe that the fulfilment of these key commitments will set us squarely on a clear and cohesive path to success in improving nutrition and health outcomes for women and children in Kenya and beyond.
The Canada-Africa Initiative to Address Maternal, Newborn and Child Mortality is a partnership among four Canadian organizations – Amref Health Africa, Children Believe (formerly Christian Children’s Fund of Canada), Centre for Global Child Health at The Hospital for Sick Children (SickKids) and WaterAid Canada. With support of $24.9 million from the Government of Canada (85% of the total project budget), this four-year project (2016 to 2020) aims to directly reach 1.7 million women, children and men across 20 districts in Ethiopia, Kenya, Malawi and Tanzania.