Across Kenya, remote communities experience a myriad of challenges when accessing healthcare. In particular, unreliable access to maternal care drives high levels of maternal mortality among women. This is exacerbated by a system of social, cultural, economic and logistical barriers. Orus, a community situated in East Pokot, experiences significant maternal and child health challenges, facing long journeys to clinics compounded by poor infrastructure and terrains. As a result, women in Orus mostly rely on informal systems of healthcare to give birth, aided by traditional birth attendants.
Stema fostered a multi-disciplinary partnership with MAMA Kenya and the Orus community. The aim was to improve maternal health in East Pokot, while simultaneously recognising that improving maternal health must impact the collective health and wellbeing of Orus. Employing a community-led and systems design-thinking approach to action, Stema focused on uncovering the broader social, economic, cultural and political systems that surround and interact with the Orus community.
Led by the community, Stema conducted a series of asset mapping and systems thinking activities to think through the problem. In addition, STEMA led in-depth conversations with key stakeholders such as the local village chief, community health volunteers and the sub county health board to gather recognition and support for the Orus community and its needs. As an outcome, the Orus community identified the need for a physical space for health and wellbeing, but also a space that considers the broader causes and concerns of health. Mapping and identifying local resources allowed stakeholders to find a suitable piece of land for construction of a community health centre, while respecting local superstitions.
Following the relationships built with key stakeholders, MAMA Kenya was able to secure funding to build a community health centre, create local employment and ensure the centre was well resourced by a follow up grant. In addition, the strong network of women exchanging knowledge and support, particularly traditional birth attendants, was a vital resource to be mobilised.
Stema was able to support the delivery of training materials for traditional birth attendants and aid MAMA Kenya to develop systems of micro enterprises for women to bring in income and economic empowerment. Overall, the project demonstrates the value of placing those at the heart of the problem into the heart of the response. This can mobilise appropriate and local resources so a physical structure has the capacity to address multiple broader components of the health ecosystem. By considering a system of small, gradual interventions that come together to improve maternal health, build trust and foster community resourcefulness we can begin to address the complexity of health burdens.