Today we got up bright and early to visit three clinics. We were joined by the sickle cell team and maternal mortality documentary team. They wanted to come with us to observe how we conduct interviews as well as see what the clinics in Makeni are like.

Yesterday we found out that World Hope is no longer funding Community Health Workers (CHWs) stipends. After hearing this news, we decided that we needed to visit a few clinics to see how the program is functioning despite no stipends being paid to the health workers. We also wanted to see how much of an understanding nurses and Community Health Officers (CHOs) had of preeclampsia.

 

The first clinic we went to was called Kageaneh. We spoke to the female CHO about the CHW program and about the number of cases of preeclampsia she sees. She currently has 11 CHWs working at her clinic and all of them are being paid a stipend for their work. She believes that they are being paid by the government. We asked her about supplies and she told us that they have not received a shipment of supplies since February, which is one of their biggest challenges for providing quality care. When we informed her our strips now screen for preeclampsia, she seemed excited about it but she said that she has not had any cases of preeclampsia at her clinic. She was extremely familiar with the condition and knew the difference between eclampsia and preeclampsia. She also had a blood pressure cuff to test for hypertension.

The second clinic we went to was Kamabai. We met with a male CHO who didn’t seem to be as informed about his clinic as the Kageaneh clinic CHO. He wasn’t sure if his CHWs were being paid a stipend and he wasn’t sure who was paying their stipends if they were receiving one. I was surprised at his lack of information because the Kamabai clinic is one of the newest, biggest and nicest clinics in Makeni. He later told us that he hasn’t had any cases of preeclampsia. He said if a woman has preeclampsia they are immediately referred to a district hospital and so most cases of the condition are dealt with at the hospital.

Kamabai Clinic

This is a catchment map of the communities and villages that the Kamabai clinic serves.

 

The third clinic we visited was in Binkolo. The CHO we met said that he currently manages the care of 15 surrounding communities. He told us that the CHWs he manages are receiving a stipend that the government pays for. He informed us that they currently screening pregnant women for preeclampsia with a protein assay, blood pressure cuff and physical examination. When we informed him that our strip can screen for both UTIs and preeclampsia he was happy and said that combined screening tests are efficient and would help his work.

Some of the Ukweli, Sickle Cell and Documentary team members.

 

Later in the day we met with our translator, Hasson, to talk about an employee contract with Ukweli. We wanted to make sure he understands that his contract focuses on the milestones and accomplishes he makes during the months we employ him. It was interesting to watch how Khanjan negotiates and comes to an understanding with Hassan about his job duties and making money to keep the venture self-sustaining.

Overall, we had a really good accomplished day!