About Uzazi Salama Project

Uzazi Salama is a Kiswahili word that means better and safe maternal and child health. The project aims at improving access to better maternal and child services in Samburu County, in Kenya. Through a very comprehensive model, Amref Health Africa through the Institute of Capacity Development, PharmAccess and the County Government of Samburu, through funding from MPESA Foundation, have used an innovative model to improve the MNCH indicators in the county. The project, which started as a pilot in 2015, caters for both the demand and supply needs using a four tier innovative model. The four tiers are community education, quality improvement, demand-side financing and health worker training. Samburu is one of the most marginalised counties in Kenya (second poorest in the country) with four out of five people living on less than US $1 per day. Most maternal and new-born health indicators in Samburu are lower than the national average, especially because of the low numbers of skilled deliveries. The M-PESA Foundation has committed funding support for a holistic programme aimed at improving health outcomes for mothers and neonates. The programme entails activities in four key areas: improving health service delivery infrastructure; capacity building of health workers; enhancing community based information and education; and health care financing. The use of technology in all of the four elements of the programme is a critical element for consideration for both online and off-line solutions. After a successful pilot conducted in 2 areas of Samburu Central sub-county (Suguta Mar Mar and Barsaloi) from June 2013 to September 2014, the M-PESA Foundation extended funding to roll-out these interventions to the rest of the County in the next 3 years. The main goal of the Phase II project is to significantly decrease maternal and newborn health morbidity and mortality rates in the whole of the Samburu County.


Project Roadmap

Samburu County counts 78 health facilities, out of which 59 are dispensaries and health centre. However, most facilities are hard to reach and are ill-equipped in terms of equipment and other medical supplies. In order to increase the use of quality MNH services in Samburu County.

Expected Outcomes
Outcome1 75% increase in utilization of maternity services (pregnant women using ANC services)
Outcome2 Increased numbers of skilled deliveries from 32% to 44%
Outcome3 40% reduction in maternal and neonatal mortality rates
Outcome4 Evidence-based best practices of community based health interventions documented to support government (county and national) planning and policy.
Major Intervention Areas
  1. Human Resources for Health (HRH)
  2. Community Systems Strengthening
  3. Continuous Quality Improvement
  4. M-innovations for Health Care Financing

Activities set to achieve Phase 2 outcomes

Community education using mLearning
Community education using mLearning

To encourage community members to use the health facilities it is proposed to set up community units to conduct community education.

Health financing with M- Tiba
Health financing with M- Tiba

It is proposed to deliver M-Tiba transport vouchers for pregnant mothers to access health facilities. The project will also investigate with the county the possibility of introducing M-tiba vouchers for maternity services at health facilities.

Training of health workers using e/mLearning
Training of health workers using e/mLearning

Samburu has a serious shortage of doctors and nurses. As a result, nurses and midwifes must often do more than they have been trained for. It is therefore proposed to continuously improve the skills of health workers in the whole county through eLearning and mLearning programs even for staff in remote areas.

Quality improvement
Quality improvement

It is proposed to develop and implement SafeCare quality improvement plans for all Samburu County health facilities. The sub-county key personnel and health workers will be trained as SafeCare facilitators and surveyors to run the SafeCare quality program at the sub-county level.

Provision of adequate transportation services
Provision of adequate transportation services

The program will strengthen the referral support system of the Samburu County by equipping the County health management team with an ambulance command center.

 
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Provide regulatory oversight on project implementation and Sustainability of project interventions

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Project donor
Enable mobile service reach in Samburu County.

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Programme & partnership management
Improve quality of health service in Samburu through implementation of safe care model
Health financing through Ambulance referral system.

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Learning design and implementation for health workers and community health workforce.
Improve data management for accountability. .