We implemented a community co-managed primary healthcare delivery model to support better access to reproductive, maternal, child and newborn health services in

Chepsire sub-county, Nandi County. The project is an adaptation of the Ubuntu-Afya Kiosk model, designed and managed by Afya Research Africa (ARA), and being implemented in 25 other locations.

Background

The people of Chepsire receive primary healthcare services from Chepsire dispensary, initially housed in a 3-roomed structure with no electricity and water supply, and supported by a single nurse and a nurse aide. Chepsire is located in Tinderet sub-county, Nandi County. It hosts EPK Savani tea factory and tea farms which also processes tea leaves from local smallholder tea farmers.

Our plan

The project envisaged partnership with community self-help groups to provide managerial support and oversight; and incorporate supplementary enterprises to help cross-subsidize the cost of providing enhanced sustainable RMNCH services.

An initial engagement with the county government of Nandi, the Savani EPK tea factory team, and the Chepsire community culminated in the development of a working relationship defined through a memorandum of understanding (MOU) between ARA, SHOPS and the Nandi County Government Ministry of Health on one

hand, and a second MOU between ARA and the Buriet Chepkiwen community group on the other hand.

This relationship envisaged the refurbishment of Chepsire Dispensary into a larger premise, initially partly developed by an affiliate community-based organization, the Siret outgrowers empowerment program; and the incorporation of Buriet Chepkiwne women group, in the management of the facility.

Results

With ARA’s support, the Buriet Chepkiwen women group developed a savings and credit scheme linked up with Ubuntu SACCO, a savings and credit cooperative entity that connects the various self help groups in the Ubuntu-Afya model. The group committed to provide part of the interest earnings from the supplementary enterprise to cross-subsidize various components of the health service at Chepsire dispensary. Members of the community group were incorporated in the facility management team of Chepsire dispensary and worked in partnership with ARA, the sub-county health management team, and representatives from EPK-Savani.

The refurbishment resulted in an upgrade of the facility from a three room facility to an eight-room facility. The facility has a maternal and child health unit, a labor room, a delivery room, a postnatal room, a laboratory, a separate consultation room, a pharmacy and a reception area. After the refurbishment and equipping, the facility is now able to offer:

• Maternity and delivery services
• Immunization services
• Minor surgical procedures
• Laboratory diagnostic tests