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Safe Motherhood Project

Your donations funded the purchase of an emergency ambulance to support the 12,000 inhabitants of Mageta Island, but we now need to buy a second ambulance for the island
Healthcare for pregnant women on Mageta Island was basic and struggled to cope with emergency complications. The result of this was an unnecessary loss of life to both newborn babies and mothers.

For pregnant women on Mageta, healthcare was very difficult to access, as there are no hard roads or cars on the island, and the health centre is away from where most people live.

We appealed to our supporters for help to purchase a Tuk-Tuk ambulance to provide emergency obstetric and maternity support to for the Island.

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Before the arrival of the emergency ambulance:

  • There is evidence that for every kilometre further away that the health centre is from a person’s home, there is a 7% decrease in the likelihood of her using that facility.

  • The difficult terrain of Mageta Island meant that two-thirds of HIV-positive women on the island were unlikely to access vital pre-and postnatal care.

  • Pregnant women had to walk for several miles to the island’s health facility because there is little access to motorised transportation and the only emergency vehicle was a motorbike, which could not meet the need effectively or safely.

Satellite view of Mageta Island, courtesy of Apple Maps

The project has provided:

  • The modified Tuk-Tuk ambulance, which has enabled vulnerable pregnant woman to deliver their babies at Mageta‘s community health facility. The ambulance can navigate the difficult terrain of the Island safely and is also  equipped to deal with on-the-road emergencies

  • Vital postnatal care, including testing for HIV

  • Training for 30 community health volunteers (CHV) in emergency obstetric care. (Each CHV can reache around 100 households.

  • Increased skilled/facility deliveries with about 234 deliveries within a span about 24 months through the use tuk tuk ambulence.

  • Increased access to Antinatal and Post natal care services (ANC/PNC).

  • Increased access to general health care services through outreaches

  • Improved referrals through tuk-tuk ambulence

  • Education for households on the importance of dedicated maternity services.

Mildmay Kenya, in partnership with the Siaya County Health Management Team adopted an integrated, community-focused intervention to increase access to and utilisation of maternal and child health-related services. This partnership was anchored on the Community Health Strategy with Community Health Volunteers as the primary and frontline health care providers.This approach has contributed immensely to reduction in morbidity and mortality among women of child bearing age and children in the Island.

 

Testing for HIV is an important component of antenatal care. Women are tested when they go into labour as a further precaution. If a woman tests positive for HIV, intervention at this stage can prevent her from passing HIV to her unborn baby.

Education is also an important part of this project as there are cultural beliefs that health professional involvement is not necessary.

Men in particular needed to understand that the life and wellbeing of both the woman and child can can be at risk.

Impact

  • More than 6,000 women are reached annually through this programme.

  • Reduction of maternal deaths in childbirth and  transmission of HIV from mothers to babies, impacting on the health and lives of the 12,000 people living on Mageta Island.

  • Trained community health volunteers providing maternity and emergency obstetric care, applying their skills sharing their knowledge, benefitting  the community as a whole.

  • The emergency vehicle is community property and the community is supported to run it sustainably as a vital resource for the Island.

Outcomes

  • A more robust healthcare system for pregnant women on Mageta Island that can cope with emergency complications and can expect to give birth successfully the  majority of the time.

  • Pregnant mothers supported throughout pregnancy and during childbirth.

  • Improved health among the general population, but in particular, high-risk groups.

  • Improved education regarding personal health among the general population, but particularly, high-risk groups.

  • People in the community living healthier, longer lives.

Snapshot of ongoing activities that support the Safe Motherhood Project:

It is common practice in the Island that women come to seek health services for themselves and their children only after they have secured their catch for the day. This had resulted into many children missing their welfare clinics, coming to thje clinic only when they are ill. 

 

The Tuk-tuk ambulance has halted this practice as every month an outreach is conducted on four beaches; Kabraua, Sika, Kuoyo and Mahanga, where the women can gather near their work. In every visit we prioritise the pregnant women, lactating women and children under the age of five years. This is a great achievement on Mageta Island, given that the population has poor health-seeking behaviour that runs from one generation to the next.

In 2019 the Ministry of health rolled out the HPV vaccine among 10 year old girls in Kenya as a way of preventing cervical cancer. Our strategy was to reach the children in schools rather than waiting for them to present themselves at the clinic, which would have resulted in many no-shows. In this way, the clinic was able to meet its target of vaccinations. If it were not for the Tuk-tuk ambulance, many of the young girls would have gone unvaccinated since the facility would have relied on the motorbikes to ferry the vaccines across the Island.

When you walk around the Island, many of the inhabitants say “who knew that this Tuk-tuk  ambulance would be so successful on an island with no roads?" But thanks to the Tuk-tuk ambulance, the area political representative has recognised its immense value to the community and ensured that better roads are constructed for ease of movement from the villages to the health centre.

 

Before the delivery of the Tuk-tuk, when there was no other transport on the island, women in labour would be taken to the health centrer on the back of a motor bike, or they would give birth at home. Now, they can call the ambulance driver on his direct line and he will arrive in good time to transport them to the health centre, and this has reduced the number of mothers giving birth at home and putting themselves at risk.

The Tuk-tuk ambulance has also ensured that women who develop complications and need to be treated on the mainland are brought to the facility in time to be evacuated.

 

The Tuk-tuk is currently instrumental in delivering long-lasting, treated mosquito nets to families on the Island following a national campaign on malaria prevention and control.

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When the Tuk-Tuk ambulance is not being used for emergencies and obstetric interventions, community health workers use it as a mobile consulting room to travel around the island, bringing healthcare to the inhabitants in their villages.

For example, the photograph below is of a cervical cancer screening and vaccination outreach where we gave out Information, Education and Communication materials about HIV and other healthcare issues to schoolgirls.

Please help us to purchase a much-needed second ambulance for the people of Mageta Island

New Tuk Tuk visualisation

There is urgent need to purchase a second ambulance for the island's residents because we have realised that one ambulance for 12,000 people is simply not enough.

 

Having seen the number of lives potentially saved by more efficient access to medical care, a second vehicle would greatly increase the reach and impact of the services the health centre could be providing.

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KENYA Fund

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