Stephen Kamau | October 2015
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Presentation at the Global Maternal Newborn Health Conference, October 20, 2015

Background: The maternal mortality rate in Kenya is estimated at 460 maternal deaths per 100,000 live births. The Linda Afya ya Mama na Mtoto project, aims to improve maternal-infant health in Kakamega County, Kenya, using community mobilization and PRONTO EmONC simulation and team training. To combat severe commodities shortages, PRONTO was adapted to include a small incentive scheme attached to strategic goals.

Methods: PRONTO trainings include facility-specific strategic planning sessions.  Participants from 26 intervention facilities self-selected goals, including additional training and the purchase of key commodities, to improve the capacity to deliver effective and appropriate EmONC. Each facility received 24,000 KShs (~$260 USD) to achieve their goals, which were developed during PRONTO’s simulation training. PRONTO conducted site visits at all intervention facilities at least three months after the trainings to ascertain the rate of goal accomplishment.

Results: Each of the 26 facilities set at least five goals.  Most facilities selected to purchase non-consumable supplies such as ambu bags, suction bulbs, towels, sphygmomanometers, portable lights, and delivery kits. Provider teams achieved 99.4% of the set goals.

Conclusion: Many clinics in Western Kenya lack regular supply of EmONC commodities. Most of the goals set during training were related to obtaining basic commodities, elucidating some of the most urgent resource needs perceived by providers. Encouraging healthcare teams to identify gaps in essential commodities, and then providing financial resources to mitigate such gaps, was a highly effective strategy to obtain critical EmONC supplies. Without these commodities, healthcare providers are unable to implement skills learned in EmONC courses, such as PRONTO. Combining EmONC simulation training with commodities procurement is an innovative and integrated approach to mitigating supply gaps to assure appropriate EmONC.