Introduction

Mwanzo Mwema, which means “healthy /good start and beginning” in Kiswahili, is a Muskoka Initiative Canadian International Development Agency (CIDA) funded project. It is currently being implemented in Taita Taveta County, in the coastal region of Kenya, by the University of Manitoba (U of M), Canadian Foodgrains Bank (CFGB) , World Renew (WR) and the Anglican Development Services Pwani (ADS Pwani).

The overall purpose of the project is to contribute to a reduction in maternal, newborn and child morbidity and mortality by developing, implementing, evaluating and translating an integrated community based program model that simultaneously addresses the health, nutrition and food security needs of vulnerable populations in Taita Taveta County, Kenya.

Objectives

  • Identify and specify a critical package of  maternal newborn and child health (MNCH) care interventions from conception through the first 2 years of life
  • Assess the accessibility, quality and utilization of the critical services
  • Partner with the local health system and community members to improve the accessibility, quality and utilization of the services
  • Identify and specify a critical nutrition package for women of reproductive age, pregnant and lactating mothers and infants
  • Develop sustainable means for supplying and distributing critical nutritional components
  • Build the capacity of local partners in assessing and responding to health care and nutritional needs
  • Translate knowledge gained in the project to influence program policies and design in African countries

Project setting and beneficiaries

The project will be implemented in 14 sub-locations of each of the 4 districts in Taita-Taveta County. These sub-locations have been selected based on need (equity) and geographic clustering. At the community level the project will specifically target 22,000 women of reproductive age, 2,500 pregnant and postpartum women and their families and 11,400 children under five with a focus on those under 2 years of age as direct beneficiaries (2,500 (1,250 male and 1,250 female) under the first year of life, 8,900 above 12 months of age and under 5 years, split equally into male and female).Additionally, 60 health care workers (in the form of community health/link workers) will also be direct beneficiaries of the project.

Project implementation

Implementation of MNCH and nutrition project activities will be done through the strengthening and establishment (where needed) of an MNCH community health and nutrition “link worker” program. This link worker model is in keeping with the current Government of Kenya’s Community Health Strategy that focuses on the development and implementation of Community Health Units and Community Health Workers (CHWs) within its current health system framework.   These link workers/CHWs will deliver MNCH and nutrition program activities at the community level, with a focus on both individual and group approaches, and when necessary will link beneficiaries to existing available MNCH and nutrition services.

A link worker approach will also be used to deliver food security activities, linking beneficiariesto group agricultural activities at already existing Farmer Field Schools in the area. These food security activities represent the nutrition sensitive aspect of our interventions.

At the health facility level, Government of Kenya consultants and project technical experts will provide health care providers with training and refresher courses on select MNCH and nutrition interventions.  These activities will consist of both group (training) and individual (mentoring and supportive supervision) approaches. 

Identification of key beneficiaries and access to MNCH and nutrition services will be the main focus during the first 6-8 months of project implementation while improving/strengthening the quality of care at the facility level will be phased in after the first 6-8 months. Linkages to Farmer Field Schools and agricultural and food security activities will  be a focus throughout the duration of the project.