Jerusha Manoah, 51, is living her dream of helping her neighbors live healthier lives by volunteering as a government community health worker (CHW) – a job that’s also enabling her to support women in her area to take charge of their reproductive health.
For over two years now, Jerusha has been offering family planning services to her clients in Kenya’s Kisii County, in addition to the routine duties of addressing her community’s most pressing health concerns, from diagnosing and treating young children with common illnesses like malaria and diarrhea, to promoting women’s health through pregnancy, delivery and motherhood.
“I always wanted to be a nurse, but I have found a renewed calling here because I’m bringing health to people’s doorsteps,” says a beaming Jerusha. “Working with pregnant women and moms with children under age five has made me realize the importance of access to effective and timely contraceptives. I’m happy I can be part of the solution in helping women plan and space their pregnancies and avoid unintended pregnancies.”
Equipped with training and a smartphone loaded with an mHealth app from Living Goods, Jerusha has been going door-to-door, usually on foot, providing basic health services to almost 100 families. During her visits she identifies and educates women of reproductive age on the different contraceptive options available for their needs and circumstances. She then registers interested clients, provides them with referrals to get family planning methods at health facilities, and follows up regularly to ensure they continue with preferred methods until or unless they decide they want to have more children. She also offers clients some family planning methods like pills and condoms when she has stock from government supply chains.
“Before I had my first child, Jerusha had already educated me on the importance of spacing children for my health and my baby’s, and so I knew that I wanted to wait at least two years before having another child,” shares Violet, a first-time mom of a six-month-old infant.
While visiting Violet, Jerusha first conducts the usual assessments and checks up on the health of both mother and newborn. She then settles in to discuss family planning and learns that Violet is already on a modern family planning method but would like to switch to another due to unpleasant side effects. With the help of visual aids, Jerusha takes Violet through the long and short-term family planning options available to a breastfeeding mother and at Violet’s request, refers her to a facility to get a three-month injectable contraceptive.
Next door, at Lydia’s house, Jerusha goes through the same process, which also ends up in a referral to a health facility where Lydia, a mother of two, will receive her preferred long-term family planning method for the first time.
“With Jerusha we get privacy and patience,” says Lydia. “Even though I don’t want more children right now, I was hesitant to take a family planning method because of some myths going around until Jerusha came to visit us and took her time to explain all the options and answer all our questions.”
With Kenya’s overall unmet need for family planning among women of reproductive age at 18%, Lydia and Violet are just a few of thousands of women whose access to family planning information and services could be vastly enhanced through support from upskilled CHWs like Jerusha. CHWs greatly facilitate access to an integrated continuum of care that caters to a range of women’s maternal, sexual and reproductive health needs, which ultimately contributes to healthier families and more gender equity.
So far, Living Goods has supported the training of almost 4,000 government CHWs across Kenya and Uganda in family planning and in 2020, these CHWs helped avert an estimated 28,000 unintended pregnancies while registering and providing care for more than 250,000 pregnant women. Over the next five years, Living Goods plans to work more concertedly with governments to scale family planning services via networks of digitally enabled, equipped, supervised and compensated CHWs to help avert 1 million unintended pregnancies across 5 countries.
“I love being a community health worker because I’m helping people and supporting women and their families to plan their futures,” says Jerusha.
*All photos for this story were taken pre-COVID