56,313 Healthier Kids: Big Results! (Part 1)

I am happy to report exciting news. Since 2008, Kilifi Kids and its partners, notably the Rotary Club of Kilifi and Kilifi District Hospital, have planned, raised funds, and deployed medication to a target population of 30,000 school-age students per year in the Kilifi District to fight the deadly parasitic diseases of helminthes and schistosomiasis. Throughout our trials, we knew we were helping the community but it wasn’t until we received the results of a recent in-depth study that we could fully appreciate the impact of our work on the community.

Drumroll please. After four years of work, we learned that more than 50,000 children were de-wormed. Subsequently, we dropped parasitic infections from 32% (last measured in 2003) to nearly nothing today. Wow!

Below, I have included excerpts from that report that give the details:

The burden of disease caused by soil transmitted helminthes (STH) and schistosome infections are enormous. More than 200 million people are affected world wide, of whom more than 300 million suffer from associated severe morbidity; 155,000 deaths reported annually (WHO-2001). These infections account for more than 40% of the global burden of all tropical diseases excluding malaria. Schistosomiasis and STH infections are diseases of poverty.

Vitengeni and Ganze divisions are the poorest divisions in Kilifi District according to an official Government reports. In 1998 to 2003, a survey conducted by African Medical Research Foundation (AMREF) in Kilifi District showed that schistosomiasis and helminthes account for more the 40% of infection among school going children…Mass drug administration (MDA) of praziquantel and albendazole were administered [to the Vitengeni and Ganze] as follows: paraziquantel once yearly and albendazole twice yearly. This exercise was conducted by the personnel from the Ministry of Public Health and Sanitation with the help from the trained teachers and personnel from the health facilities in the Division. MDA was started in May 2008 and continued up to 2010 at the time we conducted this evaluation. A total of 56,313 pupils were dewormed reached during the 3–year program.

In September/October 2010, we carried out an evaluation of the project by conducting questionnaires to school headteachers and pupils and examined stool and urine from 250 children from 10 schools who had participated in the deworming programme. The study’s main objective was to assess the impact of deworming among school-going children, establish the prevalence of worms after a 3-year Mass Drug Administration, and assess knowledge, attitude, and perception of school-going children on the worms.

250 specimens of both stool and urine were taken from the 10 sampled schools making a total of 500 specimens per school. Only 3.6% of the stool samples were positive for Entamoeba Coli while 0.8 % of the children had Entamoeba histolytica. However, Trichuris trichiura was observed in 0.4% of the pupils stool. All the positives were referred and treated in health facilities No infections with Schistosoma mansoni and S. haematobium were observed except that 1.6% of the urines had yeast cells. This was attributed to the mass drug administration of praziquantel and albendanzole that has been on-going for the last 3 years.

Thank you to all involved parties to make these accomplishments a reality. It is incredible to see the progress that has been made in Kilifi in the past five years and our team is eager to expand our work to help even more in need both in Kilifi and throughout Kenya.

Understanding the Impact of Mobile Health Care

In July 2010, I had the honor of traveling to Kenya to meet with the Kilifi Kids team there and work on developing our mobile health care – or mHealth – pilot project. During our stay in Kilifi, we spent many days meeting in the town, where I met the amazing volunteer team from the Kilifi Rotary Club as well as the staff at the District Hospital that will be so central to the pilot project.

This set the stage for an even more impactful moment – traveling to the countryside to visit local dispensaries, meet with Community Health Extension Workers (CHEWs) and attend Community Health Worker (CHW) meetings.

There it became clear how mobile health technology could improve service quality and timeliness across the homesteads comprising the many rural villages outside the town of Kilifi. Infrastructure challenges, namely transportation, sanitation, communication, and roads collectively limit CHW’s ability to reach families and gather the information. The current paper based data collection and reporting system then adds an additional challenge to creating proactive and responsive health services in the community.

In my work at Capture Your Flag, I have been able to spend time with volunteers working with Community Health Workers. These interviews have been educational and wonderful complements to what I learn from our inspiring team on the ground in Kilifi.

This interview, with Lauren Serota from frog design, discusses the importance of first understanding culture through the eyes of a community. Only here can we truly understand the problems from a local perspective and develop solutions tailored to address them.


Capture Your Flag: How UNICEF mHealth Project Uses Design Thinking to Innovate

In another interview, I spoke with Kilifi Kids teammate Clara Williams while we were in Kilifi. Here, Clara connects puts the local, cultural context of what Lauren discusses into an information and data driven project framework.


Capture Your Flag: How Health Economist Helps Kenya mHealth Project Empower Locals

The combination of our inspired on-the-ground Kilifi Kids team with our continued priority to develop localized solutions attuned to culture using decision-making tools and information frameworks continues to be refined and take shape. This preparation is critical, as a key challenge for our team is to harness the complexity across these areas to effectively translate them into the mobile health technology applications and associated. We will cover this more in future posts, so stay tuned!