Background:

For nomadic communities, such as the Maasai, access to health care is a great challenge. The integrated Entasopia Health Programme is located in Kajiado district. It is a community-based health care programme aimed at improving the health status of the people of Magadi and parts of Ngong division.

Objective:

The programme is undertaken at the Entasopia health centre, which acts as a referral centre for six collaborating government health dispensaries. The centre also acts as a field research station for malaria. Additionally, a community-based control of trachoma and other eye diseases have been carried out over 16 years. This is being utilised as an entry point for dialogue on other diseases such as malaria and diarrhoea.

Donor(s):

Sight Savers International, Shompole Trachoma Control Project/ Pfizer Inc, Dulverton Trust Foundation, Magadi School Health Programme, AMREF UK / AMREF Kenya / AMREF Netherlands/ AMREF USA

Project Activities:

• Training of Community Health Workers (CHWs) and Traditional Birth Attendants (TBAs) on control of diseases like diarrhoea, malaria, trachoma together with safe motherhood.
• Provision of curative and preventative services (including maternal child health and family planning) at the Entasopia health centre.
• Strengthening immunisation services in conjunction with the Ministry of Health and Magadi Soda Company.
• Child and adolescent health activities for school-going and non school-going children in Entasopia and Olkiramatian.
• Running of a scaled-down mobile outreach clinic in areas still inaccessible to the static health facilities.
• Trachoma prevention and control.
• Organisational development of local NGOs, ECDP.

1. The health centre is the referral and coordinating point for all the project activities in Magadi division.
2. The health centre offers primary health care services including curative, preventative, promotive health services to the local community.
3. A new block at the health centre and staff houses constructed.
4. Project staff have been trained in line with their technical profession.
5. A new committee responsible for the administration has been formed.
6. The Trachoma project implemented WHO recommended “SAFE” strategy (S-Trichiasis surgery, A – Antibiotic administration, F for Face washing, and E for Environmental improvement) in Olkiramatian and Oldonyo-nyokie locations of Magadi division in which 90 volunteer CHM's were trained. 65 trichiasis surgery cases were performed while 12,000 bottles of tetracycline eye ointments were distributed by the volunteer CHM's (figures of Shompole location included). Through the support from Sight Savers International, the AMREF project accomplished its long vision of integrating cataract surgery into the trachoma project. So far 50 cases have been operated on:
   • AMREF Kenya participates actively with the National Prevention of Blindness and facilitates the involvement of the International Trachoma Initiative (ITI),
   • Child and adolescent health activities are ongoing in the 8 primary schools, one secondary school in the division and also with the non school-going youth.
   • A study on vision acuity is ongoing at Trachoma Control Project whereby all the patients are assessed before and after trichiasis surgery. The research aims at establishing the effects and advantages of trichiasis surgery.
   • The long awaited Volunteer Counselling and Testing (VCT) and Prevention of Mother to Child Transmission (PMTC) have started in Entasopia health centre. So far, since August 2004 when the services started, 79 clients know their HIV status improving their ability to make informed decisions.
   • Increased capacity of the the Trachoma Control Project Officer to provide quality surgical services.
   • The project vision of integrating cataract surgery into the existing Community Based Trachoma was eventually realized in May and October 2004 whereby 55 blind or semi blind patients have benefited. The outcome and impact of this intervention are immediate as it instantly re-stores lost vision or sight of the beneficiaries.
   • There is a working referral systems and support for each health facility aimed at improving the provision of quality healthcare offered to the target population.
   • Health management systems have been established in most health facilities through creation of health facility management committees.
   • CBHC has provided effective and quality interventions through 500 trained CORPS as volunteer CHW. This enhances community participation and ownership leading to long-term sustainability.
   • Established strong, visionary and unique partnerships approach and joint interventions through divisional quarterly stakeholders review meetings.