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Jamii Yangu, Jukumu Langu. (My community is my responsibility)

To create awareness on immunization and eradicate cases of immunization default through a network of Community Health Volunteers.

Photo of sylvanus  okumu

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Describe what you intend to do and how you'll do it in one sentence (required 250 Characters)

We shall use CHVs to sensitize caregivers on the importance of immunization for their children. The overall goal is to reduce cases of immunization default through educating caregivers and immunization follow-ups by CHVs in their community units.

Explain the idea (less than 2,000 characters)

Full immunization coverage in Kenya declined from 67% in 2016 to 63% in 2017, which is the lowest ever recorded in previous 5 years based on the survey done by Kenya National Bureau of Statistics (KNBS). In Tharaka Nithi County, the immunization coverage is 51% which is very low. The low immunization coverage can be attributed in part to frequent nurses strikes, ignorance among caregivers on the importance of immunization, and limited/inaccessible/unreliable health facilities more so in rural areas like Muthambi in Mwimbi Sub County. Most teenage parents leave their babies in the villages and seek jobs in urban areas like Nairobi in order to provide for their babies. The majority of children who default immunization are under the care of grandparents who do not know the relevance of immunizations. In March 2018, HopeCore trained 48 CHVs; the trained CHVs are health ambassadors in their respective villages/community unit. This was a pilot program and in 9 months, the CHVs managed to conduct 6,167 door-to-door health education visits and follow-ups. We registered a significant reduction in diarrheal related cases, few immunization default cases, and minimum cases of malnourished children in the villages that had CHVs. Through this project, we shall recruit and train an additional 200 CHVs who shall cover over 126 villages with an aim of empowering 60,000 caregivers on the importance of immunization and other health topics. Each CHV shall track and make follow-ups to ensure that all children under 5 years in his/her village receive an immunization from the nearest health facility. We shall also have community outreach events in the most remote areas where we shall offer immunization services. Through this project, the number of children under 5 years who receive full immunization shall increase, children who receive proper immunization really develop childhood diseases, this shall enable the caregiver to reduce the amount of money they spend on medical bills

Which part(s) of the world does this idea target?

  • Eastern Africa

Geographic Focus (less than 250 Characters)

This project shall be implemented in two sub-counties, Mwimbi and Muthambi, in Tharaka Nithi County, Eastern Kenya. The approach can be replicated in any rural set up in Africa that has low immunization awareness and high immunization defaults.

Who are your end users and how well do you know them? (750 characters)

Our end users are women and their families. At the root of all of our programs, we aim to empower and provide caregivers with the information and services they require in order to properly care for their families. HopeCore has been implementing Public Health programs in these two sub-counties for the past 8 years through community outreach events, maternal and child health and school-based mobile clinics where we educate over 6,000 caregivers. We have tracked numerous children from prior to their entry into school and through their primary education. Additionally, a key aspect of every intervention HopeCore engages in is a robust feedback loop. This feedback loop allows HopeCore to fully understand the needs and desires of our end users

How is the idea unique? (750 Characters)

We believe this ideal shall be successful because we have already prototyped and it has proven to work. CHVs have a full understanding of the needs of their communities and therefore making them the most reliable contact persons for community sensitization. This approach shall be effective and most economical because we already have active CHV network and all we need is to expand the team and have an additional capacity building on immunization. Each CHV is equipped with an android phone that has a data collection app and educative videos in the local language. The M&E team use this data in monitoring the project. The CHV educate caregivers who later become health champions in their villages.

Idea Proposal Stage (Select 1)

  • Pilot: We have started to implement the idea as a whole with a first set of real users. The feasibility of an innovation is tested in a small-scale and real world application (i.e. 3-15% of the target population)

How many months are required for the project idea? (140 characters)

24 months: Phase one will ensure 80% of children under 5 years in Mwimbi and Muthambi Sub County get full immunization.

Organization Name (less than 140 characters)

Village HopeCore International

Type of Submitter

  • We are a registered NGO or Non-Profit Organization

Organizational Characteristics

  • Women’s health/rights focused
  • Indigenous-led organization
  • Youth-led organization
  • Locally/community-led organization

Organization Location (less than 140 Characters)

Village HopeCore operates in Mwimbi and Muthambi Sub Counties in Tharaka Nithi County, Eastern Kenya.

What is the current scale of your organization’s work?

  • Regional (reach within 1 geographic region)

Website URL

https://www.villagehopecore.org/

Tell us more about your organization/company (1-2 sentences)

We offer an integrated, comprehensive, and community-based poverty eradication program that utilizes both microenterprise and public health programming. Our health programming is also accessible and offers free clinical services through schools, community-based maternal and child health clinics, market outreach events, and our office-based clinics to the vulnerable individual who cannot access quality and affordable medical services and information with much focus on children.

Who will work alongside your organization in the project idea? (750 characters)

For several years, we have had a formidable partnership with the County and Sub County AIDS Control Council, public health offices to implementing our health programs. We submit all clinic reports to Magutuni Sub County Referral Hospital in partnership with the Ministry of Health. We also share MOH 515 data with the ministry of health, this includes immunization surveys &default cases. Our collaboration extends to Chogoria Mission Hospital who have been supporting us by providing nutritional supplements and immunization services. Similarly, we receive in-kind donations of multivitamins for women, Vitamin A, and deworming medications for children under 5 from Vitamin Angels, an organization based in the United States.

How many people are on your team?

4

Tell us more about you and your team

Our team is local! All levels of our staff and management are Kenyans. 1) Naomi Nyamchama, the Director of Operations, her role is to ensure the vision of our Board is translated to our program staff, funds are available to facilitate the running of programs, and policies and procedures are followed to ensure efficient use of funds and resources. 2) Irene Mokua, Clinical Services Coordinator, ensures the ongoing training of our staff, including CHVs, and that clients receive quality, well-informed services 3) Erick Bosire, Public Health Program Manager, and 4) Mugambi Faith, Community Health Program Coordinator, ensures that the organization attains its role of providing comprehensive community-based health services, she coordinates 8 full-time Community Health Workers and the 48 Community Health Volunteers. We have supporting staff including : 4 Health Educators- they focus on ensuring quality learning resources are available. 8 Community Health Workers

Overview of How Your Concept Has Evolved (5-6 sentences):

As a result of participating in the user experience map activity, we realized that we can eventually recruit additional CHVs from the beneficiary pool & we also developed the immunization calendar as a reminder too for the caregiver. As demonstrated in our map, the mother passes this information to other women. Through this cycle, more and more mothers will become community health advocates. During our business model canvas activity, we came to realize that our existing resources make our project more viable than we had imagined. Additionally, we were able to articulate more clearly how we have integrated significant feedback loops into our program to ensure that we are responding to community needs.

Viability (3-4 sentences and activity upload):

https://canvanizer.com/slideshow/wNOXBfmwJuV5L

Feasibility (3-4 sentences):

Since the refinement phase started, we were able to reach out to 101 mothers to gain a better understanding of their current immunization knowledge and behaviours related to their children’s health and immunizations: 77 of the 101 mothers reported having attended a school-based maternal and child health clinic offered by HopeCore – thus representing the coverage we currently have in offering health education in our area. Over 70% could not remember the recent immunization that their children need,78 of the mothers prefer to be reminded by CHVs to attend the clinics.

Desirability (3-4 sentences and activity upload):

Our user experience map is people-centred where the CHV identifies a home that has a children under 5 years during door to door education, she empowers the mother about immunization, she agrees to take her children to the clinic. The CHV also gives the mother an immunization calendar for reference in future. The mother consults her husband who agrees to accompany her to the clinic. Men involved in the health of the family is very vital as this has been a major challenge everywhere in the world. Through CHV's involvement, we are able to have health champion mothers and fathers in the community, this strengthens health-seeking behaviour hence developing a healthier society. Additionally, we have male CHVs as a way of empowering men

Community Focus (2-3 sentences):

Immunization and nutrition play a key role in the growth and development of a child. Full immunization coverage in our target community is below 50% which is worrying, therefore, a comprehensive action has to be taken to address immunization defaults. This project engages the community by utilize the local personnel(CHVs) in addressing the problems of their community units, the outcome of community engagement is ultimately social capital and stronger relational networks that result to successful project implementation.

Community Impact (2-3 sentences):

Our idea will not operate in a silo, this approach to immunization default reduction is integrated within our larger health program, thus making it sustainable beyond the support from Gates Foundation. The mothers in our community will learn from the CHVs and pass these messages to other women and their children. The entire community will be healthier and more educated by the next generation. We will see immediate results within one year as it relates to the number of children who are not up-to-date on immunizations, and the number of mothers regularly attending ANC visits.

21 comments

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Spam
Photo of Shahed Alam
Team

Hi sylvanus okumu nice idea, I like the detailed user experience map. Is it possible for new mothers or their family members to inform community health volunteers(CHV) about the birth of baby, so CHV can prioritize her visit in order to pass crucial information like early initiation of breastfeeding, umbilical cord care, importance of immunization to the family members, etc.

Spam
Photo of sylvanus  okumu
Team

Thanks, Shahed Alam for the feedback.
We are pioneering an Antenatal Care(ANC) program where each CHV keeps track of all the expectant mothers and new mothers within their Community Unit (CU). The essence of this program is to ensure every expectant mother attends at least 4 ANC clinics, the expectant mother takes prenatal vitamins and to ensure that they deliver at a health facility, at the same time the CHV educates the mother on breastfeeding, immunization and general care for infants.

Spam
Photo of Shahed Alam
Team

Thanks, for your reply. Do these volunteers get any incentive or appreciation?

Spam
Photo of sylvanus  okumu
Team

Thank you,
We only give them a monthly stipend of 30 dollars as this is the much our budget can support. The CHVs dedicated around 2-3hours per day in supporting their community units through health education, they spend the rest of the day doing their routine economic activities. We believe that no amount of money can be worthy of the work done by CHV/volunteers, as said:
”Volunteers don’t get paid, not because they’re worthless, but because they’re priceless.” – Sherry Anderson

Spam
Photo of Anne Riitho
Team

Building on what sylvanus okumu said, we also hope to include a follow up portion to our ANC clinic whereby we would have CHVs visit the home on designated days following a birth. For example, day 2, 5, 7, then continuing once per week, and finally once per month after the first 3 months. This follow up schedule provides support for the new mother as well as another touch point to encourage immunizations!

Spam
Photo of Shahed Alam
Team

Sounds good, Good luck!

Spam
Photo of Naomi Nyanchama
Team

Hi Okumu,
Community Health Volunteers are respected members in their community and have been elected by community members to serve. They reside within the community and therefore know the challenges that face each of the families. With a specific number of households to manage they can easily visit the households one by one to give health information as well as monitor the use of this information. This therefore, means that they can highlight the challenges that mothers/caregivers are facing, that causes them to default in immunization for their children. This information being relayed to Village HopeCore in a timely manner ensures that Village HopeCore provides timely interventions to ensure the children have received the immunizations. Some of these interventions include taking the Maternal and Child Health Clinic services into the community where the need is great i.e. where the caregivers have to travel long distances to access health facilities.

Spam
Photo of Anne Riitho
Team

Thanks for your support, Naomi!

Spam
Photo of Isaac Jumba
Team

Hi sylvanus okumu and team, great to see the updates in your idea.

Remember to start updating your submission with the additional information and seek feedback as we go along before the deadline. It will be great to share with us your thinking about your business model and an idea on how many people will be impacted in your solution and how you will be measuring this.

Spam
Photo of Anne Riitho
Team

Thanks, Isaac! We are really excited to share the findings from our user feedback. We have started collecting it and will share before the deadline. Do you have any specific ideas on questions to include as we continue seeking the feedback? We'd love to incorporate them.

The business model will be posted this week, keep an eye out.

Spam
Photo of Shreya Durbha
Team

This is a great initiative - I appreciate that you're using CHVs to both educate and provide care. As Brian Ouma mentioned below, people are the best solution. I also like that your CHVs are technologically equipped with an Android that enables them to collect data. This is especially important in ensuring that the project is as efficient as can be made possible. I wanted to know more about your partnerships with schools - have you thought of sending the CHVs to schools alongside door-to-door outreach as a way to save time and reach a more late-stage audience? I know your focus is on kids 5 and under but maybe that could be a way to reach the kids who are a bit older but still haven't gotten vaccinated? Otherwise, great work. I am very excited to see where this goes and support it!

Spam
Photo of Anne Riitho
Team

Hi! Building on what Okumu has already shared, we also have a very interesting approach to working with teachers. We recognized that educating the children and their parents wasn't enough if the health messages are not reiterated and reinforced at the school level. We, therefore, launched our Teacher Health Champion program. We train one teacher in each one of the 200 partner schools we work in to be a community health worker in the school. This health champion also leads the health clubs in the schools. We follow up with that teacher to ensure the school is drinking clean water and using soap for handwashing. Additionally, the Health Champion is in direct contact with a designated community health volunteer and/or HopeCore health educator so that in case of any illness outbreak in their school, we can respond quickly! We encourage everyone to adopt the teacher health champion model as we have seen great results so far!

Spam
Photo of Brian Ouma
Team

Good initiative Okumu. People are the best solution to people problems. Your CHV's will actually benefit a lot from our portable coolers, not sure how they go around the problem now but you can always guide us i refining our concept.

Spam
Photo of Anne Riitho
Team

Hi Brian, That is great feedback! We are looking into various options for immunization supply chain options. We will happily share our learnings with you as we move forward.

Spam
Photo of Faith Kainyu
Team

Hi Sylvanus Okumu,
This is a great idea! Use of CHVs to reach to the interior rural area has proven to work so well. They understand their community better. Also, they are the best to sensitize their community on most of the health issues.

Spam
Photo of Anne Riitho
Team

Thanks for the feedback, Faith! If you have experience we would love to learn more from you. Keep sharing your ideas with us.

Spam
Photo of MELAVIN KING
Team

Most immunization default cases are because the guardian of the child does not take the child to an immunization clinic. It is usually difficult to access the guardian because they don't attend church, chiefs meeting or any social gathering. Visiting their homes is then left as a viable option of getting into contact with them. The CHVs, I believe, can bridge this gap in health service delivery. They have to be equipped with the right skills so as not to lash out at immunization defaulters but to provide them with solutions and support on how their children can be vaccinated. The CHVs, therefore, need to have good interpersonal skills so guardians talk to them about any issues they have had when trying to vaccinate their children. The CHVs also need to have a good working relationship with the link facility so they can easily refer and follow up on the clients. I love the idea.

Spam
Photo of Temba Vicent
Team

Hello sylvanus okumu,

Thank for sharing your idea.Is it possible to sharing the criteria and qualifications of community health volunteers ?

Spam
Photo of Anne-Laure Fayard
Team

Hi sylvanus okumu I really like your idea and its community-centeredness. Great presentation and love the introduction video to the team. Like Temba Vicent I was wondering who were the community health volunteers and how they were selected. I also wonder how you were training them. You might check Temba's idea https://challenges.openideo.com/challenge/briefsgates-vaccine-innovation/ideas/mama-chanjo-key-immunization-mothers-strengthen-healthcare-system-and-vaccination-service-to-new-and-expectant-mothers-with-their-babies as well as Ochola Amosiah https://challenges.openideo.com/challenge/briefsgates-vaccine-innovation/ideas/promoting-community-capacity-in-immunization-governance
I also thought of this idea posted by students in my class; https://challenges.openideo.com/challenge/briefsgates-vaccine-innovation/ideas/women-ambassadors-for-vaccine-education-wave Heather Riess 

Really looking forward to seeing this idea evolve.

Spam
Photo of Heather Riess
Team

Hi Dr. Fayard, thank you for looping us in. Hi sylvanus okumu I would also like to know more about your training program as well as what method you use to track people's immunizations. I would love to hear if you have any recommendations for our idea which is quite similar!

Spam
Photo of Anne Riitho
Team

Great description, Okumu! I can't wait to see the conversation this generates.