How mom groups in Kenya save lives

AbbVie Foundation partner AMPATH is empowering expectant mothers in Africa to take control of their family’s health and finances.

Published October 3, 2019 / All Stories

Prioritizing prenatal health

For an expectant mother, pregnancy is often a joyous but busy time as she prepares for the baby’s arrival.

In many parts of the world, she would seek prenatal care from her doctor, make plans to deliver in a health care facility and consider breastfeeding as a form of good nutrition for her child.

The soon-to-be mom would gain support and guidance from other women in her life, from her own mother to her friends and coworkers, covering topics like parenting techniques and how to ensure her family is financially stable.

But this scenario is not a reality in many countries around the globe, including Kenya where access to health care is limited, giving birth at home is commonplace and earning an income as a mother is challenging.

Members of a chamas group in Kenya gather for a guided discussion. The discussions center on health and finance topics.

A pilot program with a purpose

Enter the Chama cha Mamatoto (mother-child) groups, started in 2012 as a pilot program by AMPATH, a partnership between Moi University School of Medicine, Moi Teaching and Referral Hospital (both in western Kenya), and a consortium of North American academic health centers led by Indiana University.

On-the-ground leaders at AMPATH, which stands for Academic Model Providing Access to Healthcare, saw an opportunity to launch the “chamas for change” groups to give women access to prenatal education and also empower them economically.

Ongoing support from longtime partner AbbVie Foundation has fueled the growth of the chamas program, which continues to expand in communities across Kenya and results in health improvements for mothers and their babies. Today, 84 percent of chamas participants deliver their baby in a health facility, compared to 50 percent in a control group, according to an AMPATH study.

Bringing pregnancy questions to light

As a co-founder of the chamas program, Laura Ruhl, MD, MPH, helped bring to life community group-based care with a primary goal of increasing the number of women who deliver at a health facility and providing ongoing health education for pregnant women. They started with 18 groups across western Kenya, with community health workers facilitating discussions around health and social topics that sometimes included domestic violence and sex during pregnancy.

“Women in Kenya don’t really talk about pregnancy or motherhood much,” said Ruhl, who serves as field director for population health with the AMPATH Consortium in Kenya. “Everything is driven through the mother-in-law, and who wants to go to their mother-in-law for questions like this?”

Oftentimes, members of a chamas group will stay together for 3-4 years, with conversation topics evolving as their children grow and develop.

A history of support through chamas groups

Chamas groups have a longstanding presence in east Africa, often as a way for people to pool their resources and funds during emergencies like famine, floods or funerals. The AMPATH chamas model brings together women during their pregnancies through biweekly meetings. Besides health conversations, the women also gain financial skills and access to group savings and loans.

More than 3,000 women have participated in chamas groups to date, with many groups staying together for up to 3-4 years, building lasting friendships and continuing the programs on their own. The longevity of the groups has exceeded AMPATH’S expectations, Ruhl says.

The chamas founders envisioned the program as short-term, to see a woman through pregnancy, childbirth and the first year of her infant’s life.

“But then the women asked for more and more,” Ruhl says.

Microfinance is an important element of the chamas program, with women pooling their money to invest in each other, sometimes opening small businesses together.

Seeing the impact firsthand

Today’s chamas groups have evolved to fit the needs of the women during different stages of their lives, with some inviting spouses to join and discuss topics like how to decrease stress within the home and improve their child’s development over time. As the project manager of the chamas groups since 2012, Justus E. Ikemeri has seen firsthand the impact on individual mothers and their families. He recalls one chamas group focused on microfinance, in which the members pooled their money together and worked together to eventually increase the funds fivefold. Several chamas groups have opened small businesses together, offering an opportunity for both women and their spouses to earn income.

“In the microfinance program, everybody shares – you invest in each other,” Ikemeri said. “My vision is to take the program country-wide and then international.”

Women in Kenya gain critical skills in microfinance programs.

The strength of community-based health care

A community-driven model has proven successful in other AMPATH programs, including a previous initiative also supported by the AbbVie Foundation to address Kenya’s HIV/AIDS crisis. The initiative involved AMPATH sending out teams to provide in-home testing and care in local communities.

“Our partners at AMPATH know that it takes engaging local health workers to create real change in west Kenyan communities,” says Melissa Walsh, vice president, corporate responsibility & global philanthropy, AbbVie. “Whether the focus is HIV, universal health coverage or working with expectant mothers, the AMPATH model continues to have significant impacts on people and their families – in very sustainable and long-lasting ways.”

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