Barriers and successes in using village volunteers to improve intake of prenatal micronutrients to improve maternal neonatal health in rural Kenya

Abstract

Background: In Kenya, there are huge health care access inequalities. Core groups can bridge these inequities through sustainable community initiatives. Multiple studies indicate the effectiveness of micronutrient supplementations in promoting maternal and infant health. Few studies have evaluated use of core groups to promote community health uptake of prenatal micronutrient supplementation. This paper describes use of core groups to improve utilization of prenatal micronutrients among the pregnant and nursing mothers. Objective: To describe the perceived barriers and successes realized in accessing the pregnant and nursing women with multiple micronutrients. Methodology: The study took place in 231 villages in 8 locations in Western Kenya. Eight focus group discussions were conducted by the primary author in the native language, Kiswahili. The researcher used a structured interview guide and the sessions were tape recorded. In addition, three note takers attended each session to record the discussions in the event of technology failures. The tape recordings were subsequently transcribed into English for content analysis of major themes reflecting barriers and successes of micronutrient distribution. Results: A total of 131 core group members participated in the eight focus groups. Each focus group constituted 15 to 17 participants, ranging from 24 to 65 years, 47.3% men and 52.3 % women. Main barriers were related to limited access to health services, micronutrients and knowledge on their value. Main successes identified were community buy-in and acceptance of micronutrients from people they trusted. Conclusion: The study shows that, use of community based systems in promoting access to micronutrients vitamins is feasible and can be effective if further tested quantitatively. Findings can be used to guide future community-based initiatives in rural Kenya. Specific recommendations for enhancing success include use of existing community health systems unique to each community for easy sustainable buy-in