Transport voucher increases skilled deliveries in Angata Nanyukie, Samburu County

Three years ago, Najingu Lekupe was fighting for her life in Angata Nanyukie Dispensary in Samburu County, Kenya. She went into labour several hours before and called her Traditional Birth Attendant (TBA) to help her deliver at home. Eager to meet her newborn, Najingu did as she was instructed by the TBA. But the pain got worse and the baby did not come. “I was pushing but the baby did not come out and the pain became unbearable,” narrates Najingu. The TBA soon gave up and called other women to help take the young mother to the nearby dispensary.

Najingu suffered from cephalopelvic disproportion, a condition where the baby is too big to pass through the birth canal naturally. She had to undergo an episiotomy, a procedure where the doctor makes a small cut in the perineum to help with delivery.

Two years later, Najingu was pregnant with her second child. “I knew the importance of going to give birth at the facility, but did not attend my clinics until I met Amos, a Community Health Volunteer (CHV) who told me the benefits. I did not want a repeat of what had happened the first time so I decided to follow Amos’ advice,” she narrates.

The CHV further added Najingu into the Uzazi Salama transport voucher registry. The transport voucher, provided under Uzazi Salama, a partnership between Amref Health Africa and PharmAccess, through funding from the Mpesa Foundation, allows pregnant mothers in labour to access ambulance services to and from the nearest health facility, where they give birth. One of the major challenges that has led to the low skilled deliveries in Samburu County is lack of transport from homesteads to the health facilities. The transport voucher fills this gap, and has in turn, increased the number of skilled births in Angata Nanyukie Dispensary. Before the initiative, the dispensary recorded two births every month. Currently, it records at least 10 births on a monthly basis.

Through the partnership, each mother, who is enrolled for the service free of charge, gets Ksh3,000 for ambulance services. “The service is good. It helps those who come from far. Many women want to give birth in the facility after they have interacted with the CHV. However, transport to and from the hospital becomes a big challenge and they end up giving birth at home. I can honestly say that the transport voucher has helped women in my community have safe deliveries,” adds Najingu.

Najingu, just like many women in the area, does not own a phone. “I use my husband’s phone,” she asserts. Due to this, CHVs trained under Uzazi Salama have taken initiative to also sensitise husbands on the importance of attending Ante-natal clinics and skilled delivery. “We also make follow-ups to ensure the children get vaccinated,” explains Amos Lenarumoi, the area CHV.

Even though Najingu is grateful for the service, she worries for her friends who live in far off villages. “When I tell my friends about the ambulance services, they wonder why they cannot get the same in their villages. I know women in Susoni and Ngorika Villages who have delivered at home simply because they did not get the means to go to hospital. I, therefore, request that these services also be taken to other villages,” she concludes.

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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. .