Effectiveness of Ng’adakarin Bamocha model in improving access to ante-natal and delivery services among nomadic pastoralist communities of Turkana West and Turkana North Sub-Counties of Kenya

Abstract

IntroductionAccess to maternal and child health care services among the nomadic pastoralists community in Kenya and African continent in general is unacceptably low. In Turkana, only 18.1% of the women had seen a nurse or a midwife for antenatal care during pregnancy while only 1.3% of pregnant women reported delivery at health facilities in 2005. Ng'adakarin BAMOCHA model, based on migratory routes of the Turkana pastoralists and container clinics was adopted in 2007 to improve access to maternal and child health services by the nomads.MethodsA cross-sectional study design was used to establish the effectiveness of Ng'adakarin BAMOCHA model on accessibility and uptake of ante-natal care and delivery services. A total of 360 households and 400 households were interviewed for pre-intervention and post-intervention respectively. The study compared the pre-intervention and post-intervention findings. Structured questionnaires and focus group discussion were used for data collection.ResultsThere was no improvement in the fourth ante-natal care visits between pre-intervention and post-intervention groups at 119(51.5%) and 111(41.9%) respectively (p < 0.05). Knowledge of the community on the importance of ANC visits improved from 60%-72% with significance level of p < 0.05. There was a significant increase 6%-17% of deliveries under a skilled health worker (p < 0.05). TBA assisted deliveries increased from 7.5%- 20.2% with a p < 0.05. There was significant reduction in home deliveries from 89.5%-79.5% with a p < 0.05.ConclusionThe Ng'adakarin Bamocha model had a positive effect on the improving maternal health care among the nomadic pastoralist community in Turkana.

Antenatal care and skilled delivery service utilisation in Somali pastoral communities of Eastern Ethiopia

“…A similar finding is reported in linking antenatal care use with the socio-economic of the women in different parts of low-income countries [37]. A recent study from Kenya shows that as the educational level of a couple increases, so does the use of antenatal care [24].…”

Traversing the margins: Access to healthcare by Bakarwals in remote and conflict-prone Himalayan regions of Jammu and Kashmir

“…This is supported by readiness assessment scores at the district hospital which are lowest for human resources and consumables. These findings resonate with a case study in Kenya (Jillo et al 2015) where health facilities are often located in urban centres with almost no mobile health facilities to cater for transhumant pastoralists and communities in far-flung regions in the north and semi-arid areas where infrastructure is non-existent. The cost of accessing medical and health facilities in Kenya is also costly and often beyond the reach of many indigenous communities, who may not have the means to travel long distances to purchase certain prescribed drugs that are unavailable in public health facilities.…”

“…Interventions emulating the Ng'adakarin Bamocha model in Kenya which is based on migratory routes of Turkana pastoralists to improve access to maternal and child health services should be promoted as the effectiveness of the model has been established (Jillo et al 2015). The intervention consisted of strategically locating 20-ft-long freight container clinics along the migratory routes which are operated by a trained community nurse and community health workers providing curative services, immunization referral to level 2 health facilities and community education.…”

Health interventions among mobile pastoralists: a systematic review to guide health service design

“…Among reports included in this review, interventions that deliberately incorporated a pastoralist‐specific delivery strategy reported higher levels of success in reaching pastoralist communities. Methods ranged from strategically located services (‘temporary fixed’) to fully mobile services [17,38,67–70]. Additional strategies included maternal waiting homes, mobile TB ‘manyatta’ camps and One Health design [15,27,28,54,67,70,71].…”

“…Methods ranged from strategically located services (‘temporary fixed’) to fully mobile services [17,38,67–70]. Additional strategies included maternal waiting homes, mobile TB ‘manyatta’ camps and One Health design [15,27,28,54,67,70,71]. While mobile campaigns described success in reaching the target population, only five presented data on cost and resource utilisation.…”