Evelyn Makena @evemake_g
After locking the door of a tiny warmly decorated consultation room, Judith Aluoch finds herself alone with a patient. Listening to the patient—a young mother cuddling an infant—Judith quickly scribbles on an open hardcover notebook.
The mother is seeking treatment for her one-month old baby who has come down with a fever, was not breastfeeding properly and had breathing difficulties.
Referring the mother to a well-stocked pharmacy next door, for the recommended medication, Judith walks out of the room to a waiting area where several other patients are waiting to be served on a Thursday morning.
It has been two years since Judith, a nurse, started working at Rakwaro Community Dispensary, set along the shores of Lake Victoria in Homa Bay county. Within the two years, the number of patients she serves in a day has significantly grown.
“When I started, there were days I served no patient, but now I attend to close to 20 patients in a day,” she says.
The transformation has taken place since the clinic that was set up in 1997, started operating under Ubuntu- Afya medical centres; an ingenious model that puts community involvement at the core of health services delivery. The clinic is one of 16 similar clinics set up, managed and co-owned by communities and Afya Research Africa, a healthcare social enterprise.
Under the Ubuntu model, Afya Research Africa (ARA) provides initial investment and infrastructure support to set up medical centres in rural and hard-to-reach areas.
The organisation works with organised groups such as self-help groups who make a contribution in form of land, labour and building materials. The contribution made by ARA and the groups secures partnership and co-ownership of the clinics.
“The aim of the model was to make basic healthcare services accessible to communities even in remote areas,” says Samson Gwer, Executive Director and co-founder, Afya Research Africa. Samson, a paediatrician along with Moses Nderitu a clinician and epidemiologist established ARA in 2009 to provide healthcare technology solutions.
Along the way, the two identified a need to bring health services closer to rural communities where public health facilities were not easily accessible through Ubuntu model in 2016. County Innovation Challenge Fund under the UK government provides funding to ARA. So far, there are 27 Ubuntu-Afya clinics in Western, Coastal and Central Kenya.
The focus of the clinics in Homa Bay county, which has the highest number of clinics, has been improving maternal and neonatal health and treatment of non-communicable diseases. “Generally, mothers and children in most populations are worst affected by the burden of disease.
Mothers are at a high risk of poor health during pregnancy and delivery while children under five face constant threats to their health,” says Samson. With maternal mortality rates of 550 deaths per every 100,000 live births, Homa Bay ranks as one of the top 10 counties in Kenya with the highest maternal deaths.
Through the clinics more mothers and children have access to quality healthcare at an affordable cost. ARA supports the bodaboda riders and chamas with seed capital .
“The co-ownership arrangement has increased acceptance of the clinics by the community. Involvement of the community ensures that the solutions offered are tailor-made to our unique needs. As a community we have embraced the clinics as our own,” says Tom Gunda, Chairperson Rakwaro Beach Management Unit BMU, the group that initially set up Rakwaro Clinic and now co-owns it with ARA.
To further bolster the effectiveness of the clinics, Ubuntu Afya Clinics also collaborate with the county government. The county government of Homa Bay supports the clinics by deploying staff and supplementing medical supplies.
“For patients at the clinics who require treatment at a higher level, we support the referrals by availing ambulances to them,” says Professor Richard Muga, County Executive Committee member, Health Services, Homa Bay county.