Breaking Barriers, Saving Lives: A Glimpse into the Maternal and Child Health Struggles of Homa Bay County

In the heart of Kenya lies Homa Bay County, a region grappling with some of the most challenging maternal and child health issues in the country. At the recent Homa Bay International Investment Conference (HOBIIC) 2024, a power panel led by Dr. Susan Ontiri, Country Director of ICRH Kenya, unveiled the stark realities faced by mothers and children in this region, shedding light on the urgent need for action and change.

Imagine a young mother, Mary (not her real name), in her early twenties, living in a rural village in Homa Bay. Mary has just given birth to her first child, a beautiful baby girl. However, Mary’s joy is overshadowed by the harsh reality of her surroundings. Homa Bay County has the highest rates of new HIV infections in Kenya, and Mary fears for her daughter’s future in a county where access to quality healthcare is a luxury.

Mary’s story is not unique. In Homa Bay County, gender-based violence (GBV) is on the rise, with many young girls like Mary experiencing abuse and exploitation. The county also faces a staggering 23% teenage pregnancy rate, leading to increased risks for both mothers and babies.

The statistics are alarming – maternal mortality in Homa Bay County is at 516 per 100,000 live births, and under-5 mortality stands at 92.2 per 1000 live births. These numbers paint a grim picture of the challenges faced by mothers and children in this region.

The power panel at HOBIIC 2024 brought together experts and stakeholders to discuss solutions to these pressing issues. One key focus was the need for a multisectoral response – collaboration across sectors such as health, education, and social services to address the complex challenges faced by the county.

Another crucial aspect discussed was the importance of policy support. By crafting and redefining policies, the county can drive impactful change in maternal and child healthcare, ensuring that mothers like Mary have access to the care and support they need.

Healthcare innovations were also highlighted, with panelists exploring groundbreaking approaches and technologies to improve maternal and child health outcomes. From innovative prenatal care to telemedicine solutions, the panelists emphasized the need for creative solutions to address the unique challenges faced by Homa Bay County.

Community engagement was identified as a key driver of change. By involving communities in healthcare decision-making and promoting health-seeking behaviors, the county can empower individuals like Mary to take charge of their health and the health of their families.

The power panel at HOBIIC 2024 ignited sparks of change and emphasized the urgency of addressing these issues to secure a healthier future for Homa Bay County. Through continued collaboration, innovative solutions, and community involvement, we can break barriers and save lives in Homa Bay County and beyond.

The stories of mothers like Mary remind us of the human cost of these statistics. Behind every number is a life, a family, and a community in need of support and care. By working together, we can make a difference and ensure that every mother and child in Homa Bay County has the opportunity to thrive.

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Breaking the Silence: Addressing Sexual and Gender-Based Violence in Kenya

In Kenya, the stark reality is that up to 30% of girls and 18% of boys experience sexual violence by the age of 18 years. These harrowing statistics reveal a deep-seated issue that requires  urgent attention and action. Sexual violence not only inflicts physical harm but also leaves lasting scars on mental health, often leading to increased mental health problems and substance abuse disorders.

At the International Centre for Reproductive Health-Kenya (ICRHK), our commitment to addressing Sexual and Gender-Based Violence (SGBV) is unwavering. Our research and interventions aim to uncover the underlying factors associated with SGBV and provide evidence to scale up quality prevention and response interventions. By understanding the links between individual and community factors, we can better tailor our interventions to meet the needs of survivors and prevent future occurrences.

One of our key initiatives is the Sexual and Gender-Based Violence Center at Coast General Teaching and Referral Hospital. This center provides comprehensive SGBV services and includes a newly launched child therapy room, ensuring that survivors of all ages receive the care and support they need to heal and rebuild their lives.

In addition to our clinical services, ICRHK is also actively involved in promoting school-based interventions. These interventions aim to build knowledge and empower young boys and girls about their rights to be protected from sexual violence. By educating and empowering the youth, we are laying the foundation for a future where SGBV is not tolerated, and survivors are supported.

The road ahead is challenging, but with each step forward, we are breaking the silence around SGBV and creating a safer, more inclusive society for all. Together, we can make a difference. Join us in our mission to end SGBV and ensure that every individual has the right to live free from violence and fear.

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Breaking the Cycle of Exploitation: The Story of Linda Mtoto

In the bustling streets of Mombasa, Kenya, lies a hidden reality that often goes unnoticed – the commercial sexual exploitation of children (CSEC). This global concern has deeply impacted the lives of many, including young girls and boys who have fallen victim to this form of sexual violence.

According to the Violence against Children study (VAC Survey, 2019), alarming statistics reveal that nearly half of females and over half of males aged 18 to 24 have experienced sexual violence during childhood. Among these, CSEC stands out as a prevalent issue, particularly along the Coast, where poverty, neglect, and cultural norms have created fertile ground for exploitation.

Amidst these challenges, a beacon of hope shines through the Linda Mtoto project, a collaborative effort between the International Centre for Reproductive Health-Kenya (ICRH-K), Kindernothilfe (KNH), and the County Government of Mombasa. This initiative aims to combat CSE among children aged 10-17 in Mombasa County by identifying victims, creating strong community structures, and providing essential support.

One of the key strategies of the project is a community-based approach, leveraging the efforts of Community Health Volunteers and Child Protection Volunteers. Through their dedication and commitment, these volunteers work tirelessly to raise awareness, identify at-risk children, and provide support to survivors.

Additionally, the project takes a holistic approach by integrating life skills programs into schools, empowering children with the knowledge and tools to protect themselves. Institutional linkages ensure that children and caregivers receive the necessary support and services to heal and thrive.

The Linda Mtoto project also focuses on capacity building and community sensitization, ensuring that stakeholders are engaged and advocating for the protection of children. Education and vocational support are provided to child beneficiaries, offering them a path towards a brighter future.

As the project continues to make strides in combating CSE, it serves as a reminder that with unity and determination, we can break the cycle of exploitation and create a safer world for our children. The story of Linda Mtoto is not just one of intervention but of transformation, showing that through collective efforts, we can protect the innocence and dignity of our most vulnerable.

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Transforming Lives: ICRHK's Impact in Reproductive Health, Maternal Health, and Family Planning

In the heart of Kenya, the International Centre for Reproductive Health-Kenya (ICRHK) is not just an organization; it’s a beacon of hope for women and families. We understand that reproductive health services are not just about health; they’re about empowerment, dignity, and the future.

At ICRHK, we’re dedicated to ensuring that every woman has access to quality family planning and maternal, newborn, and child health (MNCH) services. We believe that these services are not just essential for individual well-being, but for achieving broader development goals related to health, poverty reduction, gender equality, and environmental sustainability.

Our work goes beyond research and documentation; it’s about transforming lives. Through initiatives like the Performance Monitoring for Action (PMA) surveys and the Exemplars in Family Planning (FP) project, we’re not just collecting data; we’re shaping policies, improving services, and changing lives.

Our commitment to family planning is evident in our implementation of FP supply chain management activities. By rolling out an integrated logistics management information system, we ensure that FP commodities are available up to the last mile. This means that women in even the most remote areas have access to the contraceptives they need to plan their families and take control of their futures.

Our work doesn’t stop there. We’re also fighting against cervical cancer, one of the leading causes of cancer-related deaths among women in Kenya. Through early diagnosis, treatment of precancerous lesions, and access to advanced treatment, we’re working to reduce the burden of this disease and save lives.

In maternal health, our research on Birth Companion, Network of Care, and group Antenatal Care is not just about improving health outcomes; it’s about ensuring that every pregnant woman receives the care and support she deserves. By focusing on these areas, we’re not just improving health outcomes; we’re empowering women and communities.

At ICRHK, we’re not just a research institute; we’re a community of change-makers. We’re committed to continuing our work in reproductive health, maternal health, and family planning because we know that by investing in women’s health, we’re investing in a brighter future for all.

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Nancy’s Resilience: A Tale of a Child-Headed Family in Jomvu Sub-County, Mombasa

When Nancy (not her real name) heard from the Community Health Volunteers that the Linda Mtoto project team would visit her in their home, she was so excited and eager to share her personal experience in the Commercial Sexual Exploitation of Children.

Nancy’s case was identified by one of the CHVs engaged in Linda Mtoto’s project in Jomvu Sub-County. Upon case assessment and verification, it was discovered that Nancy was not only a victim of CSE under survival sex but had also been neglected by her parents. Nancy is a child aged 17 and lives with her siblings in Narcol, an informal settlement in Jomvu Sub-county. She is the firstborn in a family of four: two girls and two boys. Unfortunately, she is a victim of family disintegration after her parents separated in 2013. The children were left behind with their father. Their mother’s whereabouts remain unknown to date. Nancy and her siblings live in a rental house where they pay a monthly rent of KSH1000. The house is connected to electricity but has no access to water. They are therefore forced to fetch water for domestic use from outside at a cost.

Nancy’s father does not have any reliable source of income and is an absentee parent. Sometimes the children do not know where their father spends the night, which causes anxiety among the children. Nancy also admits that the family relatives are present but are neither concerned about their welfare nor provisions.

Nancy, overwhelmed by family responsibilities, started engaging in in order to fend for her siblings. Life got tough. “Why do I have to go through all this?” Nancy asks, while nodding her head.

Nancy narrates the ordeal of being the sole breadwinner in the family as a child. She says that she really hates selling her body but blames the circumstances forcing the family separation. She sometimes fails to raise the rental fee of 1000/=.  She is always pleading with the landlord, who is constantly threatening them with eviction. Nancy stated that she normally gets KSH150, which is too little to take care of their basic needs such as food, education, and clothing. Sometimes her clients force her to have sex without payment.

Nancy also recalls the numerous times that distant relatives (from her father’s side) would ask her for sex in exchange for a packet of maize flour.

Psychological support: 

The Linda Mtoto Project offers structured psychosocial support to all enrolled children in the program. Counselors meet with children for 6 sessions over a period of 6 weeks. Topics discussed during the sessions include awareness of the emerging trends, e.g., online CSEC, child protection, self-awareness, self-esteem, effects of CSEC; effective communication, positive parenting, sex and sexuality, psycho-education and visioning.

Nancy was linked to counselors and received individual therapy for 7 weeks. ‘I learned the effects of engaging in CSEC and anger management,” says Nancy.

Current situation: 

Nancy presently engages in casual work, offering laundry services to individuals for a fee, and selling groundnuts to school-going children as a means to support her siblings. She has affirmed that she no longer engages in CSEC activities after completing counseling. Furthermore, during Nancy’s formative years, her aspiration was to become a teacher. However, following visioning therapy sessions with her counselor, she discovered her true passion for beauty and hairdressing. Thanks to the support of the Linda Mtoto project, Nancy has been enrolled as a part-time student at the Mikindani Vocational Training Center. She is currently pursuing a course in beauty therapy and eagerly anticipates completing her training. Her goal is to utilize these newfound skills to enhance her family’s economic prospects.

A child’s wish: 

Nancy really longs to see her family reconciled. She also longs to see her parents taking up their responsibilities, which include offering parental love to their children. This case was also reported to the children’s department and presented as neglect by the parents who are both alive.

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Khadija's Journey: A Promise to Make Her Parents Proud Again

The jovial and ever-smiling 15-year-old “Khadija,” not her real name, ushered us into their homestead. She was standing alone as her siblings were playing with their friends behind their mud-thatched house. Neighbors kept on peeping from every corner perhaps eager to discover what was happening.

“Don’t mind them let’s proceed,” she said with a gentle voice. Khadija was brought up in Bombo, Kisauni Sub-County. Her father worked as a casual worker, and her mother was a vegetable hawker in the nearby estates. However, their stability took a hit when her father lost his job, the primary breadwinner for the family. This setback triggered an unfortunate cycle of domestic violence and the relentless intrusion of poverty.

“I scored highly in my Kenya Certificate of Primary Education (KCPE) and I was among the top students in my school,” said Khadija. Which year? “In 2020.” She proudly responded.

Life became more manageable, a far cry from the struggles they had faced before “My dad had become a better person, and we loved him. My mother was at peace too,” said Khadija. The children found solace and love from their parents again.

Khadija had been accepted into a provincial school in Makueni County. However, her parents struggled to gather the necessary tuition fees. Khadija’s father made a courageous decision to secure a loan from a local financier, ultimately securing Ksh100, 000. The jovial Khadija joined Ngumo Girls High School in 2021.

Peer pressure:

Khadija reflected, her voice gentle as she spoke, “All my friends had expensive shoes and plenty of shopping. I used to envy them. On visiting days, their parents would bring them delicious roasted chicken, pilau, and more shopping. My own parents couldn’t afford such luxuries. To add to it, some of my friends constantly bragged about having boyfriends waiting for them at home.”

Under the pressure of her peers’ expectations, Khadija felt compelled to find herself a boyfriend during the holiday season. Unfortunately, it didn’t take long before she found herself pregnant, forcing her to discontinue her education. Her father was furious, especially since he had taken out a loan to pay for her tuition. He made the tough decision never to send her back to school again.

Psychological support:

The Linda Mtoto Project delivers a structured program of psychosocial support to all the children enrolled in the project. Each child participating in the project undergoes a 6-week period of 2-hour group sessions. These sessions cover a range of important topics, including awareness of emerging trends like online CSEC (Child Sexual Exploitation and Abuse), child protection, self-awareness, self-esteem, the consequences of CSEC, effective communication, positive parenting, sex and sexuality education, and psycho-education to equip children with better-coping mechanisms for various life situations.

Khadija was identified by trained community health volunteers associated with the Linda Mtoto project in April 2021. After thorough verification, she was connected with counselors who provided her with six counseling sessions.

Reflecting on her experience, Khadija shared, “Following the counseling sessions, I took the initiative to seek forgiveness from my parents, although my dad initially resisted. I also made the tough decision to end my relationship with my boyfriend. During the counseling sessions, I gained insights into the consequences of CSEC, dealing with peer pressure, and I felt empowered about my rights.

Family-centered therapy intervention

In June 2021, Khadija’s dad was linked to the Linda Mtoto counselors for psychosocial support. The family-centered therapy intervention focuses on improving family communication, raising awareness about child protection, and emphasizing individual psychological assistance for adults who are distressed in adversity-stricken communities.

‘By the time I was participating in this intervention, I was completely crushed by my daughter’s behavior. I had thought of chasing and disowning her. She had really embarrassed my family in the whole community. I thought my problems were the most complicated on earth. However, during the therapy sessions, I met other caregivers/parents who shared their experiences, and I realized that I wasn’t the only one with such problems. Some of their challenges were more complicated than mine, “says Khadija’s father.

Khadija’s father was engaged in different therapeutic problem-management sessions to reduce his anxiety disorders. Weekly phone calls and supervision were also conducted to provide him with the necessary support.

“When I started listening to other people’s experiences, I started consoling myself. The Linda Mtoto project staff gave me all the necessary support for my healing journey. I decided to give my daughter a second chance. I took her back to school and we decided to take care of the child. The man who was responsible for her pregnancy took off immediately when he heard Khadija was expectant. I embraced her despite what had happened. I built trust and now she is always open with me. I felt empowered and I started to detach myself from my worries. I apologized to my Khadija and we are a happy family again,” he says.

Education support:

 The Linda Mtoto project provides tailored educational and vocational assistance to children based on their individual needs. This assistance is extended following a comprehensive assessment of each child, conducted by both project staff and community health volunteers. Khadija was one of the children who received educational support amounting to 20,900 Kenyan Shillings.

Expressing her gratitude, Khadija declared, “I am deeply grateful for this support, and I am committed to making my parents proud.”

Khadija remained true to her promise, emerging as one of the top students in her class with an impressive B grade. Her father was overjoyed with pride. Presently, Khadija serves as a role model within the Majaoni children’s support groups.

Entrepreneurship (management of finances, savings, and increasing household income) Intervention:

 In August 2021, the Linda Mtoto project organized and provided assistance for an entrepreneurship and financial literacy training program. Khadija’s father was among the beneficiaries. The two-day was conducted by experts from the Women’s Enterprise Fund and representatives from the Ministry of Agriculture. The curriculum covered various topics, including group formation, value addition, agribusiness, soft skills, bookkeeping, savings, and connections to government funding sources.

 “We learned how to generate capital, how to start small businesses as well as keeping sale records. A week after the training, I expanded my charcoal business. We also formed a group with other participants and registered it through the Ministry of Social Services. Currently, we are in the process of applying for a government loan worth Kenya Shillings 100000,” says Khadija’s father.

Khadija concludes our interview by affirming “I’m content knowing my child is being well cared for by their parents, and I’m also performing well in school.”

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Faida's Journey: From Survival to Leadership: The Inspiring Case Story of Kenya Children Assembly's National Deputy Speaker

In the heart of Majoni, Kisauni Sub County, a story unfolds that exemplifies the power of determination and resilience. It’s the story of a young girl, whom we will refer to as ‘Faida,’ whose journey from a life of uncertainty to becoming the National Deputy Speaker of the Kenya Children Assembly (KCA) is nothing short of inspiring.

The principles of the Convention on the Rights of the Child (CRC), the new Children Acts of 2022, and the Kenyan Constitution all share a common vision: to ensure children’s voices are heard, their rights are upheld, and their participation in decision-making processes is valued. In 2010, the Kenyan Constitution laid the foundation for the creation of Children’s Assemblies, and one such assembly, the Kenya Children Assembly (KCA), was established in 2011. The primary objective of KCA was to amplify the voices of children, providing them with a platform to express their views and concerns. To achieve this, operational guidelines were formulated by the Directorate of Children Services, with the ultimate aim of reaching marginalized children, and ensuring their participation in shaping their own futures.

Faida, a 16-year-old girl from Majoni, was one such child who found herself at a crossroads. A community health volunteer identified her as a young girl engaged in survival sex, and it was evident that she carried the weight of uncertainty about her future. Faida was subsequently connected with a counselor for psychosocial sessions, where she completed six counseling sessions. These sessions ignited a transformation within her, and she made a resolute decision to turn her life around.

Her parents who were peasant farmers, had faced their fair share of challenges. Prolonged droughts had forced them to scale down their farming activities after their wells dried up. Despite these hardships at home, Faida was unwavering in her determination to create a better future for herself. Her dream was to become an officer in the Kenya Defense Force, and she actively participated in children’s support groups, often taking on leadership roles and engaging enthusiastically in group activities.

On April 11, 2022, children from Kisauni Sub County came together to elect their representatives who would champion child protection policies within the Kenyan Children Assembly. The KCA allows children aged 7 to 17 to exercise their civic duties by electing their peers to represent them at the national level. Those elected serve for a term of two years, with the possibility of re-election for a second term. The children’s assembly empowers children to participate in decision-making, policy formulation, planning, and implementation of activities affecting them.

Faida’s boldness shone through, and she was elected as the Speaker of Kisauni Sub County. Her words reflected her sense of honor, “I felt honored to be called an Honourable member. This challenged me that if I work hard in school, one day I can make it to parliament.”  Following this, the elected children leaders embarked on a national election in Nairobi in December 2022. This national election was highly competitive, but Faida’s determination and commitment to leadership saw her elected as the Kenya Children Assembly National Deputy Speaker. She shared her excitement, “I’m honored and am looking forward to participating in decision-making, policy formulation, planning, and implementation of child-affected activities and issues affecting them.”

Faida’s journey from a life of uncertainty to becoming the National Deputy Speaker of the Kenya Children’s Assembly exemplifies the transformative power of providing children with opportunities to participate in decision-making processes. It empowers them to make informed choices, express their views, and claim their rights, including the right to be protected from harm. Faida’s story is a testament to the importance of enabling children to be active participants in shaping their futures, ensuring that no child’s voice goes unheard.

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