The aim of the regional workshops is to reach out to grassroots by organising awareness training on health promotion. It originated from a brainstorming session in 2011 with AEMRN (Afro-European Medical and Research Network) a former Board member of the Alliance. AEMRN had been holding rural mobile clinics in several African countries. Kitale, a rural town in Western Kenya was selected as the location for our first Regional Workshop which followed a week long mobile clinic service. Over 100 participants representing a wide diversity of sectors including community leaders, health professionals, patients, teachers, local NGOs and government among other stakeholders. They identified the most urgent health-related issues of the community.
Regional Health Promotion workshop 2017
Kitale, Kenya, 7 July 2017
Kitale district hospital World Bank Laboratory
The meeting was opened by a word of prayer from Kennedy Makokha.
Mr. Eliud Wamalwa, Chairman, Health Promotion Alliance of Kenya (HPAK) introduced the board members of the Alliance. He informed the participants that HPAK is officially registered by the NGO Board. Eliud Wamalwa introduced Mr. Bernard Kadasia, the President of the Geneva-based Alliance for Health Promotion. Bernard Kadasia led the participants in introducing themselves.
Mr. Kadasia read a message of greetings and encouragement from the newly-elected Director General of the World Health Organization (WHO), Dr. Tedros Adhanom Ghebreyesus. The workshop participants were delighted to receive the message and asked that Mr. Kadasia should convey greetings and thanks to Dr. Ghebreyesus.
Dr. Maurice Wakwabubi, Trans-Nzoia County Chief of Health officially opened the workshop. Dr. Geoffrey Kasembeli, Consultant, Afro-European Medical and Research Network (AEMRN) gave an overview of AEMRN history and activities in Kenya and Uganda. He pointed out that the Annual Kitale Health Promotion Workshop was first organized by the Alliance for Health Promotion and AEMRN in 2012 to add value to the annual mobile medical clinics that AEMRN was already running in Africa.
Mr. Kadasia spoke on general global health and health promotion. He pointed out that the main current reference frameworks for global Health Promotion are: the Sustainable Development Goals (SDG) , the Shanghai Declaration on promoting health in the 2030 Agenda for Sustainable Development and the Prince Edward Island Declaration and Call to Action on Health Promotion for Sustainable Development. He highlighted the key themes as being Governance for Health; Health in All Policies/Whole Society Approach/Multi-sector Approach to Health promotion; Health Literacy and Social Mobilization; Health as a Political Choice; Key Role of Civil Society; and Healthy Environment (Cities and Communities).
Mr. Kadasia went on to give the objectives of the workshop as follows:
- Go beyond the medical. Combine treatment with Health Promotion awareness training
- Take global declarations to grass-roots and take local voice to global level – WHO and Global Health Promotion Forum
- Empower and build capacity of individuals, communities, governments, civil society
- Harness and share local knowledge
- Strengthen partnerships among the relevant sectors and stakeholders
- Agree on strategies and actions to improve the health and well-being of individuals and communities in the region
Mrs. Leah Okumu, County Health Promotion Officer, talked on the topic of Health Literacy and Social Mobilization. She pointed out that under the devolved Government system, a good number of structures had been put up that could be used to support Health Literacy and Social Mobilization. These include the formulation of national and county policies and strategies, and starting of Health Promotion Units at various levels. she talked on churches on how we can promote health. She noted that despite all these, not much has been done in terms of actual programmes and activities on the ground.
She added that some areas of health like HIV had received a lot of attention. Even then the important role that mothers can play and the potential for them to change the health status and well-being of families and communities had not been fully recognized and utilized. Mothers come late for Ante-Natal Clinics and for services to Prevent Mother to Child Transmission of HIV. As a result we have children being born HIV-positive. The practice of giving birth at home also leads to numerous cases of children getting infected and raises the risk of death of the mother and baby. Moreover, mothers have developed unhelpful attitudes because of not getting the right information. At the same time, there exist many misconceptions about Reproductive and Sexual Health. Harmful traditional beliefs and practices contribute to poor health and ill-being. Thus, she insisted that women should be made one of the major targets of health literacy and social mobilization because they play a pivotal role in the health and well-being of the family. Efforts must address traditional beliefs including those that shape attitudes of women towards going to the health centres to seek treatment and care.
The County health promotion team has started to carry out health literacy programmes through local radio stations like Imani Radio.
Mrs. Okumu summarized the challenges in health promotion as, little funding, an inadequate work force, individual and societal attitudes to health and well-being including to uptake of health services and low health literacy levels especially among the women.
The workshop discussed some of the strategies for health promotion going forward. Participants agreed that there was need to initiate and strengthen new partnerships. Some of the programmes and stakeholders that should be brought closer include the County Government, Population Service Kenya, Kitale AIDS Programmes, Sex Abuse, Malaria and TB Control. Partnerships are important at local level and should be extended to national and international levels including with the WHO and the Alliance for Health Promotion. It was pointed out that for Health Promotion among the communities to be effective, collaboration must be forged with community “Gate-Keepers” and like chiefs, village elders, church elders, and other opinion leaders.
During a question and Answer Session, it emerged that the attitude of nurses and other staff in healthcare settings was often a barrier to people seeking services. Mothers were said to be uncomfortable with the way they were handled. It also emerged that the Community Healthcare Volunteers, on whom most of the responsibility for health literacy and social mobilization falls, are demoralized. They are not paid and are not recognized enough. Open defaecation was identified as a significant health risk factor. Using latrines could substantially reduce the incidence communicable diseases.
The County Chief of Health, Dr. Wakwabubi highlighted the progress in health programming and infrastructure in the county over the last 5 years. The budget for Health Promotion had gone up especially to educate mothers on the importance of delivering at facilities with skilled attendants. The number of new healthcare facilities had increased and old ones had been substantially refurbished or expanded. Delivery beds had been increased. Capacity for complex modern diagnostics had been installed at Kitale District Hospital and six new ambulances had been bought. Medicines were available at all times in the county hospitals and having a Kenya Medical Training College campus had been opened at Kitale. Enough doctors and nurses had been hired. The County Referral Hospital is now nearly completed. It will have 6 operation rooms and 15 Intensive Care Unit (ICU) beds.
Mr. Ronald Simiyu, speaking on behalf of the Boda Boda riders, informed the workshop that the rate of accidents had reduced. He attributed this to the riders having formed groups which regulate the behaviour of their members. The Groups also ensure that the riders have valid driving licences. Training of riders has been formalized and riders are helped to attend regular road safety promotions.
The Boda Boda sector still faces challenges. These include; lack of protective clothing and gear, poor hygiene, sexual harassment of passengers, indiscipline, rowdiness and incidents of alcohol and drug abuse.
The workshop agreed that the training of riders must be stepped up and maintained. The sector should be further organized until it has fully running and strong groups, effective governance and clear operating systems.
Participants were divided into three working groups with each group addressing one category determinants of health in the county. Each group was also asked to discuss how health literacy could be done to address the factors identified. The categories were:
- Economic factors
- Social and cultural factors
- Environmental and occupational factors
Group 1Economic Factors
- Low income
- Poor market
Educating the people on
- Formation of subsistence groups
- Formation Self-help groups
- Access microfinance organizations
- Establishment of income
- Promote health in the community
2.Social and Cultural Factors
- Women inheritance
- Home delivery (maternal)
- Religion beliefs
- Female genital Mutilation
Education to people
- Calling groups together
- One on one
- Poor drainage system
- Over population
- Social disposal
- Lack of latrines leading to open deafecation
- Climate change
Educational to people
- Community dialogue day organized by community health workers
- Chief barasas (village council) which involves village elders with other stake holders
- Church leaders and members
- Information Education and Communications materials
AGENDA GOING FORWARD
The workshop agreed on the following broad Agenda going forward
- The Health Promotion Alliance of Kenya will work closely with the Trans-Nzoia County Health Promotion Department to produce detailed work plans and budgets for grassroots Health Literacy and Social Mobilization
- Advocacy for Health Promotion to be allocated a separate substantial budget and increased staff in the Trans-Nzoia County Budget starting in 2017-2018
- Non-Governmental Organizations and Community Based Organizations as well as other Civil Society Organizations to be approached and encouraged to join the Health promotion Alliance of Kenya to make it an inclusive and strong organization
The meeting ended up with a word of prayer from Pastor Kennedy Makokha.
4th Regional Health Promotion workshop 2015
Kitale, Kenya, 30 October 2015
preceded by AEMRN Mobile Clinics
28-29 October 2015
3rd Regional Health Promotion workshop 2014
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Kitale, Kenya, 22 August 2014