PERI-URBAN INFORMAL SETTLEMENTS IN EMBAKASI AND KAMUKUNJI SUB-COUNTIES, NAIROBI COUNTY

 

In many African countries, including Kenya, rapid urbanization, driven by high levels of rural-to-urban migration, has led to the growth of urban informal settlements which are mainly characterised by the poor housing, lack of basic amenities and low availability and utilization of formal health services including maternity care. [1, 2, 3]. In the informal settlements of Nairobi, accessing health care is challenging for the people who need it most especially with the for-profit sector playing a unique and dominating role in health service delivery as 50% of the county’s health facilities are registered as private4.This challenge facilitates the delay to access affordable and quality healthcare leading to poor maternal and new born healthcare outcomes. It is no wonder then that the city is ranked the eighth highest county in Kenya in terms of number of maternal deaths 5.

Centre for Maternal and Newborn Health-Liverpool School of Tropical Medicine (CMNH-LSTM) partnered with the Kenyan Ministry of Health, DFID and UNICEF to increase the availability and improve the quality of Skilled Birth Attendance and Emergency Obstetric and Newborn Care (EmONC). LSTM does this through competency based EMONC training for maternity care and training of maternity care providers on quality improvement and strengthening MNH data gathering.

Under the DFID-MNH program, UNICEF worked in Nairobi’s two sub counties Embakasi and Kamukunji with an aim of:

  • Decongesting MNH CEmONC Centres of Excellence through the provision of Mama pack as an incentive to women delivering at identified BEmONC Centres to decongest the CEmONC Centres;
  • Supporting BEmONC centres by activities such as improving skills of health workers through trainings, procurement of equipment and drugs, Supported the County to establish a Human Resources for Health Management Plan.
  •  Improve quality and throughput of service delivery in BEmONC and CEmONC Centres by:
    • Enhancing the profile of the health facilities through maternity tours for antenatal mothers
    • Promoting skilled delivery through health promotion by community units
    • Supporting community – health facility communication through community dialogue days
    • Establishing and training community units attached to Centres of Excellence in community, maternal, newborn and child health (cMNCH) and community integrated management of childhood illness (cIMCI).

 

1 Chi-Chi Undie, John-Langba Johannes, Kimani E: "The place of cool waters": Women and water in the slums of Nairobi, Kenya. Wagadu: A Journal of Transnational Women's and Gender Studies. 2006, 3:

2 United Nations Human Settlements Programme: The challenge of slums: Global Report on Human Settlement 2003. UN-HABITAT. 2003

3 Ziraba, Abdhalah Kasiira, et al. "Maternal mortality in the informal settlements of Nairobi city: what do we know?" Reproductive health 6.1 (2009): 6.

4 Kenya Master Facility Listing

5 http://kenya.unfpa.org/news/counties-highest-burden-maternal-mortality UNFPA 2014. Counties with the Highest Burden of Maternal Mortality

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M-Afya

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Despite the investments made to date and current MNH activities, there are opportunities for improving MNH outcomes related to the following priority gaps: 

Nairobi
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