Management Sciences for Health, Inc.

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Portfolio Title: Lea Mimba

Grant Type: Innovation

Counties: Kakamega

Timeline: August 2017 - April 2019

Funding Round: 3

The Problem

In Kakamega County, only 45% of pregnant women receive the recommended four antenatal care (ANC) visits during pregnancy, significantly less than the national average. Women in Kakamega face many barriers to accessing ANC, such as poor attitude of clinical staff, long wait times, and cost. The traditional one-on-one ANC model often does not meet women’s needs for information, support, and high-quality clinical care, and does not recognize that healthcare is the result of interactions between women and providers, shaped by the knowledge and beliefs that each bring from their respective backgrounds.

Lea Mimba: A Group Antenatal Care Model

MSH is partnership with Kenya Progressive Nurses Association and Kakamega County Government is testing an innovative group ANC model that seeks to address the challenges with conventional mode of ANC. The learning from this initiative will build on lessons from similar pilots including in Uganda by MSH and in Kenya by Jhpiego and Jacaranda Health.  

The project named Lea Mimba, a Swahili phrase meaning ‘take care of your pregnancy’, is testing and evaluating the group ANC model in six health facilities in Kakamega. It incorporates elements of human-centred design, multi-stakeholder dialogue and self-determination, whilst directly engaging stakeholders in co-design and co-creation, to ensure that the model responds to women’s and health providers’ needs and expectations. Lea Mimba creates cohorts of women at their first ANC visit, grouping women by gestational age. At group sessions, a nurse-facilitator provides quality ANC and education around pregnancy, self-care, the importance of ANC visits and skilled birth attendance, and encourages group discussions. Women also get to share personal experiences and develop a sense of community. The cohorts provide women with psychosocial support, increase their confidence in health systems and empower them to demand quality care.

Expected Results

The client-centred group ANC model is expected to improve quality of care and women’s knowledge and experience of care, leading to increased ANC uptake and retention. Ultimately, this will contribute to reduction in maternal and newborn morbidity and mortality in the intervention areas.

Progress as of August 2018

  • Baseline formative assessment conducted and results used to refine the project design.
  • Co-design and co-creation sessions accomplished and results used to model a client-centred model of ANC
  • Group ANC facilitation tools and Information Education Communication materials developed through participatory process, field-tested and refined.
  • Group ANC training manuals, job aids, standard operating procedures for use by health workers developed and adopted for use.

For more information about this project, contact:

Melissa Wanda Kirowo                                                   

Management Sciences for Health

Kimani Karuga

Options Consultancy Services Ltd.