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GD attending to the patient in the community under home based care service.

German Doctors

The project focuses on Universal Health Coverage  in Kilifi County – Kenya, and aspiring to be a significant player in the sphere of community health.

Project focus areas

The project area potentially includes the whole of Kilifi-South. Specifically, in the first half of the project phase, the focus continues to be on Bomani-Malde dispensary with rolling clinics (clinical and nursing, social and child protection services as well as ultrasound services amongst others) are rolled out to Junju dispensary, Mtepeni dispensary and Barani dispensary. All the three dispensaries are community owned, government supported facilities run by not more than two nurses each.

 

Outcome areas

  • The target population make use of primary healthcare services and increase their health seeking-behaviour
  • The healthcare staff / students have competence to facilitate achievement of UHC in the target area

Outputs/key result areas

  • Improved quality of healthcare services and strengthened referral mechanisms at the targeted dispensaries
  • Increased access of appropriate and quality-assured healthcare services to the target location
  • Knowledge of healthcare staff and students is increased through the regular CPDs and CMEs

 

our main goals

To improve the health status of the community in the project target area, with special attention to vulnerable and minority groups through enhancing and improving the quality of health services at dispensary and the community levels

Key interventions of the project

During the project cycle, German Doctors  and CHPF organized and supports the healthcare services at various level two dispensaries in Kilifi-South as follows:

  • Continued local work force support to Bomani-Malde dispensary for clinical services, maternity, family planning services, laboratory services, support to the pharmacy, child protection services, social services, TB/VCT and HIV-related services, and physiotherapy.
  • Continued international work force support to Bomani-Malde dispensary, Junju Dispensary, Mtepeni dispensary, Barani dispensary and any other facility, which might be added throughout the three years in Kilifi South, for clinical services through the presence of two short-term doctors at any point in time, who generally stays for a period of 6 weeks and rotate in between the dispensaries.
  • Integrated outreach support from the Bomani-Malde dispensary to the target locations(HIPs)
  • Support for equipment and incidental minor construction works to support clinical services. In cases where there are no service delivery rooms, with approval from the MOH the project will add additional rooms for clinical works.
  • Special clinics services. These are for hypertensive, diabetes mellitus and mental clinic clients who visit the dispensary on appointment basis for their regular check-ups and refilling of medication.
  • Screening of all the clients visiting the dispensary for identification of the chronic conditions (HTN, DM, Mental cases).
  • Provision of essential obstetric care and basic emergency obstetric care (maternal services). Bomani dispensary through Rotary club Mtwapa revamped the maternity wing. Delivery and post-delivery services are offered 24hours by the staff of GD project.
  • General outpatient services/consultations. Client diagnostic and treatment of common illnesses and management.
  • Physiotherapy services are also offered to the needy and identified clients
  • Development of standard operating procedures (SOPs) for all the departments in collaboration with the Kenyan health guidelines.
  • In collaboration with NCMTC, the short-term doctors impart knowledge to the students of NCMTC through skills labs and CPDs
  • Referrals to other higher-level hospitals like Mtwapa health Centre, Vipingo, Oasis hospitals etc.

Milestones

  1. Recruited adequate and qualified staff to meet the increasing number of patients seeking services at the dispensary. The project is paying their remuneration
  2. Accessibility of essential obstetric care and basic emergency obstetric care for women during and in the first 24 hours after delivery with more than 30 women reached monthly.
  3. Adequate supply of drugs through supplementing the essential drugs in the dispensary
  4. Improved diagnostic services (laboratory and ultrasound services) offered in all the four supported, (Bomani, Barani, Junju and Mtepeni) dispensaries.
  5. Additional service delivery rooms (container at Bomani dispensary and provision of a tent Junju dispensary)
  6. Renovated the existing buildings for use (additional service rooms)
  7. Installation of Health Management Information system (Sanitas)
  8. Installation of solar panel (power back-up)
  9. Expanded the clinical services available at the dispensary with Physiotherapy, child protection and social services which were not there before; and introduced special clinics and provision of individual medical services for patients with chronic conditions e.g Diabetics and hypertensive clients providing them with consultation, investigations, medical and supportive care.
  10. Implementing a program to provide supportive, palliative and rehabilitative care for the elderly and for people with chronic conditions through home-based care services
  11. Improved referral and follow up of patients up (medical specialist care), down (home-based care) and sideways (rehabilitation, educational, social work)

Targeted group

1. Pregnant women

2.Families with young children and single mothers

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3.Adolescents and youth

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4.People living with chronic conditions

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5.Elderly

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the pupils under the German Drs program during the celebration of an African Child.

This day seeks to honor the memory of the children who participated in the Soweto Uprising of 1976 and raises awareness about the continuing need for improvement in the education provided to African children. The theme for this year's DAC is “Education for all Children in Africa: The Time is Now”

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A dental doctor checking on the patient. exercise that took place during the special clinic at BOMANI DISPENSARY.

German Doctors Delivers

In a move to address the issue of Universal Health Coverage (UHC), multi-sectorial approach has to be adopted. In that regard the German Doctors through Community Health Promotion Fund (CHPF) has come out collaboratively to address the (UHC) agenda. This is through: promotive, palliative and preventing measures via the setting up of Health Information Points (HIPs) at community level and Curative approach at the BOMANI dispensary. The aim of the project is to ensure access to better and quality healthcare for all.

GD DR handing over the tent at JUNJU Dipensary in September 2024 for additional srevice rooms in the facicility
GD Dr (physician) attending to the patient. With blue shirt is North Coast Medical Training College Student on clinical rotation. Their involvement ensures that they acquire knowledge and come out productive with required skills to address health challenges.

SCHOOL HEALTH PROGRAME

Fungal diseases is one of the cases that affects young children more so those in primary school. for this reason, the GERMAN DOCTORS group gave a solution through the school health program. Pupils  were enlightened on the cause and the prevention mechanisms. At the end they were issued with the clotrimazole which is a medicated antifungal skin cream, lotion, ointment or solution.

Figure1: the pupils being taught on the causes ad prevention measures for fungal infections
school health education on prevention and promotive measures
Figure 2: Issuance of the Clotrimazole which is a medicated antifungal skin cream, lotion, ointment or solution.

Patient Monthly Support Group Meeting

Patient monthly support group meeting
CHPFUND- Health Information Point (HIP) program
The meeting seeks to address the perennial challenges affecting elderly and patients on daily basis. we do make follow ups on the elderly and other patients suffering from hypertension and diabetes. In the course they are taught on the importance of strict adherence to prescriptions and management skills. Need for health nutrition is another key area of concern where they are encouraged to adhere to. The program is in line with the national goal and vision 2030 0f Universal Health Coverage (UHC). We ensure that all people are reached out to in the remote areas. At this level we do promotive, palliative and preventive in the community. In case of serious cases we do refer to the dispensaries and any other level for curative purposes. 
 
Figure 1. Capturing patient deatails
Figure 2. Programme advocate enlightening the elderly and patients on important health issues.
Figure 3. Meeting for an interactive session to capture basic details and feedbacks from the patients.
Figure 4. Mr Joseph Chome with black shirt an advocate having an interactive session on maters elders and the critical issues affecting them

Home Based Care Case Study

“You have power over your health”.

The project is to improving maternal and community health through enhanced universal health coverage” is a three-year initiative that is funded by German Doctors and implemented by Community Health Promotion Fund (CHPF), in collaboration with North Coast Medical Training College, and Bomani-Malde Dispensary (a government facility) in Kilifi County Bomani Junju Mto/Mkuu sub-location. The project’s interventions aim to assist Kilifi County Health Department in improving access to universal health coverage services by assisting the implementation of existing Ministry of Health policies and guidelines. It aims at improving the maternal and community health of Bomani/Junju/Mto-Mkuu sub-location, Kilifi South with special attention to vulnerable and minority groups in addressing the existing needs of the rural population through different interventions being implemented.

The German Doctors are advocates for a life in dignity and provide healthcare services and training for disadvantaged people. German Doctors also strive to improve health in the long run through prevention programs, accompanying nutrition programs, and training in hygiene. Through the project, German Doctors wants to bring in human and other resources and use its experience, through collaboration with partners, to empower the local community, to improve provision of quality healthcare, and to support and improve existing systems to achieve UHC in the project area.

Home-based care program was introduced in the year 2022 to support patients who are in critical condition, patients who are not able to come to the dispensary. The program is being done by the doctors, clinical officers, social worker, physiotherapy, community health promoters and students from NMCT. The students mainly are coming in for learning and exposed to the community health dynamics.

We have 200 patients on hypertension and diabetes, in records and …… are stable client whom are attending their clinic and adherence to drugs. As a project we give them health talks at the clinic’s day, HIPs and during outreaches; So, Irene Mkare is among the 12 patients whom were under the home-based care program.

Irene Mkarie takes a deep breath as she narrates her story, “am a mother of ……. Children and am a widow, am 62 years old, live in Chidongo village in Junju mto mkuu-ward in Kilifi sub- county. I never went to school, during our time our parents did not value education more so on a girl child. I come from a family of ………., of children and l was among of the girls who was not taken to school.

It has not been easy for me and my family when l was bed ridden with stroke, but I thank the German doctors’ services they offered for a period of ……. months, there is this lady German doctor l have forgotten her name, who also did a major work to take care of me on therapy sessions. I used to be visited like twice in a week for physiotherapy treatment and the other doctor used to give drugs and measure my pressure. He used to give me words of encouragement and always assures me that l will walk again and l will speak I will just be back to my normal situation. Which today my family is very happy especially my caretaker who is my daughter law she always gives out the testimony of me on the before and after the treatment. Am also grateful to her because she was working very closely with the doctors and she was trained on how to take care of me. Until today she smiles, I call my daughter in-law my qualified home nurse, I can now speak which l couldn’t at all I was like a baby, I could not walk neither make any kind of movement l was a big burden to my caretake. But now I can walk off course not long distance, l can turn myself on the bed, l can eat on my own, which is a big relief to my family.

 Bomani dispensary gives the best services, and the doctors have good heart of supporting people and they will always give you hope of life. I never thought l will be back to normal, and today here I am very live l can chat with the doctors, friends and neighbors who thought l will die. What l will say is that the German project is that; they have really saved the lives of people in this ward. I can tell you people are spending a lot of money for transport to get the kind of services that l received, and the people living in poverty and exclusion just die. She is sad, I was in a lot of pain, I felt lonely, tears rolling over my face, I never though l will be back to my feet the only thing l could think was just death, l was just seeing a grave Infront of my bed. Am so grateful to the community health promoters who reported my condition to the officers on the ground, if it were not to them, believe me l would have been dead.

May you continue saving lives of   people living in poverty and exclusion everywhere you go and God will reward you abundantly; she smiles”.

the picture above shows tghe nurse taking history of a patient identified from the community in Chidongo, suffering from benign prostate hyperplasia (BPH) who is on follow up.
Community Health Promotion Fund community nurse administering Home Based Care by issuing walking clutches to the res to ease the movement.
in the picture above, NCMTC student is done with dressing and she is preparing the patient to take random blood sugars during HBC visit in the area of junju.

As an organization we are happy with the progress of Irene Makire, no matter how devastated she was at the begging, because she lost hope and the family never thought she will recover. But with the closely monitoring by the doctors, it is amazing. Today Irene speak, laughs and walk, a bit independent, you would think that Irene suffered from severe stroke. Kudos to the team of doctors-Dr. Rutger & Bea !!!!!!!