WITH CARE IN KENYA HARTMANN Healthcare Project Kisumu/Kenya
Overview 1. About CARE 2. Background Kenya 3. Project information 2
ABOUT CARE
CARE International Founded 1945 in the USA: more than 100 million CARE Packages helped relieve hunger and need in post-war Europe Today: one of the biggest and leading humanitarian organizations worldwide: 14 member organisations Work in 95 countries 890 projects 65 Mio. people supported 10.000 employees worldwide (95% local staff) CARE is politically independent, ethnically and religiously neutral CARE has consulting status at the United Nations 4
The World of CARE CARE International Members Countries with CARE programming 5
KENYA
Kenya Generell Information Population 46,050,000 (2015) Languages English (official), Kiswahili (official), numerous indigenous languages Religions Christian 83% (Protestant 47.7%, Catholic 23.4%, other 11.9%), Muslim 11.2%, Traditionalists 1.7%, other 1.6%, none 2.4%, unspecified 0.2% Population below poverty line* 43.4% Numbers and facts from: https://www.cia.gov/library/publications/resources/the-world-factbook/geos/ke.html *National estimates of the percentage of the population falling below the poverty line are based on surveys of sub-groups, with the results weighted by the number of people in each group. Definitions of poverty vary considerably among nations. For example, rich nations generally employ more generous standards of poverty than poor nations. 7
Kenya Health Statistics Birth rate 26.4 births/1,000 population country comparison to the world: 46* Life expectancy total population: 63.77 years male: 62.3 years female: 65.26 years country comparison to the world: 185* Infant mortality rate total: 39.38 deaths/1,000 live births male: 43.92 deaths/1,000 live births female: 34.75 deaths/1,000 live births country comparison to the world: 51* Children under the age of 5 years underweight 11% (2014) country comparison to the world: 42* Maternal mortality rate 510 deaths/100,000 live births country comparison to the world: 30* *number stands for the place in the world ranking list 8
Kenya Health Systems Kenya s new constitution has brought changes to the country s governance structure, strengthening devolved counties and having an effect on delivery of health services. The new structure gives greater health responsibilities to the counties which are expected to identify their particular health priorities and plan. Despite considerable progress, Kenya still lags in attaining MDG* 4 and 5: Between 2003 and 2012, Kenya s infant mortality rate reduced from 77/1000 live births to 52/1000 live births, still far from the MDG target of 26/1000 live births. The under 5 mortality rates improved slightly from 115/1000 live births in 2003 to 74/1000 in 2012 (MDG target 33/1000 live births), whilst the Maternal Mortality Ratio (MMR) reduced from 414/100,000 live births in 2003 to 400/100,000 in 2012 (MDG target 147/100,000) by 2015. Progress is continually hindered by various factors including poor policy implementation, weak health systems which do not engage with or respond to community needs and result in poor access to and utilization of preventive and curative health services as well as retrogressive socioeconomic and cultural barriers. *MDG: Millenium Development Goal; MDG 4: Reduce Child Mortality; MDG 5: Improve Maternal Health; MDGs were changed in SDGs (Sustainable Development Goals) in 2015 9
CARE Kenya Background CARE started operating in Kenya in 1968 Focusing on long term development, capacity building resilience building and humanitarian assistance to alleviate poverty and its underlying causes, while building capacity for self-help through various interconnected but distinct projects implemented in various regions in the country. CARE has built synergies with local communities and institutions in Kenya through various initiatives. CARE values the participation and input of the beneficiary communities in the planning and implementation of programs. This human-centred design has ensured that CARE remains strong and legitimate where it works. In Kenya, CARE s mission is to reduce poverty at the household level and to provide emergency relief. It does this by addressing the underlying causes of poverty, building capacity for selfreliance, working in partnership with all stakeholders at community and national levels, programming based on sound analysis, innovation, research and learning and by addressing all forms of injustice at all levels. 10
HARTMANN Project
Project Region Kisumu County, Nyanza Region Kisumu County has a total population of 968,909 with an annual population growth rate of 2.1%, projected to rise to 1,145,747 by 2017. Kisumu is especially struggling to reduce high maternal and child mortality rates (10% of newborns die each year; 15% of all children do not reach their fifth birthday; only 15% of pregnant women get health checks) and faces profound health challenges, including lack of qualified health workers and a decrepit health infrastructure. Key reproductive health issues affecting women are: poor access to reproductive health services, poor quality of services and a high number of unskilled birth deliveries. Moreover, Kisumu experiences one of the most severe food poverty in Kenya, and child mortality tends to be highest among poor families. There are only a few health centers in Kisumu and they are badly equipped. Qualified health workers are also in short supply. The region needs investment in the health infrastructure to improve basic health services and training. Training applies not only to healthcare professionals, but also to families living in the area. They very often lack information about how to influence their health when it comes to family planning, hygiene or birth preparation. 12
Project Region Kisumu County, Nyanza Region Lack of access to basic healthcare and reproductive health for women and children, together with poverty and malnutrition create a strong need for maternal, new-born and inclusive reproductive, nutrition and family planning care. According to the health service analysis the key issues in the district are low health facility delivery rate and ANC* attendance, low uptake of FP* services and consistently high malnutrition rates; largely attributed to negative cultural practices, ignorance and long distances to health facilities. Kisumu is in a Malaria endemic zone, with Malaria largely contributing to negative outcomes of pregnant mothers and children under five. There are a number of negative retrogressive behaviors that compromise safe motherhood and child survival. The diseases that carry the biggest burden are malaria, HIV, diarrhea and respiratory infections. This, coupled with the high malnutrition rates, contributes to the high child mortality rates, yet these deaths could mostly be prevented with simple preventive community interventions. *ANC: Antenatal Care *FP: Family Planning 13
HARTMANN Project Objectives & Beneficiaries Improving maternal and child health Newborns, infants and mothers face increased health risks when basic healthcare services are not available. As a result, the project focuses on the health of mothers and children to improve the general living conditions in Kisumu county. In total the project supports around 13.000 people living in the project area close to the health centers in Gita and Nyalunya, Eastern Kisumu. During the first project phase, the competencies of local health centers and health institutions will be improved with regard to the health of mothers and children as well as family planning. Together with local health authorities and peers, CARE will evaluate the existing health programs and services in discussion forums and develop concepts for improvement. The project will also support local health workers by offering trainings in birth assistance, caesarean section and care for newborns. For quality control, a supervision system will be implemented. Apart from that the project will finance repairs and equipment of the Gita and Nyalunya health center. 14
Project Objectives & Beneficiaries Spreading information To ensure that the improved services are really used by the residents in the area, HARTMANN and CARE will invest in information and education of men and women. Families should be aware of the available services in their region, which family planning options they have and when they should visit a health center in case of difficulties during pregnancy. These information and training sessions will take place in schools, via professional health workers in the communities, in workshops in health centers and via a mobile phone platform where people can register to gain health information. 15
Health Centre in Gita
Charter for patient services
Documentation of patients
In the Healthcenter
In the Healthcenter
In the Healthcenter
In the Healthcenter
CARE is part of integrated family health networks in Kisumu
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