Miriam Mbithe is a woman on a mission. Every day, the 50-year-old single mother of five braves the rugged terrain of her neighborhood in Isiolo, Kenya and treks for kilometers on end shuffling between her work as a community health worker, a matron at a girls’ secondary school, a women’s groups coordinator and an entrepreneur. These roles, she says, bring together the causes she is most passionate about – the health, education and economic empowerment of girls and women.
It all started when Miriam was first recruited to serve as a government CHW more than 10 years ago in her hometown, a semi-arid and pastoralist region with high maternal and child mortality rates and high teenage pregnancy rates. She received initial training to assess and refer young children for basic health issues like pneumonia and malnutrition while providing pre and postnatal support for pregnant moms. This work allowed her to provide much needed health services to over 70 mothers and their children but also exposed her to the broader socio-economic challenges women around her faced.
“When I started volunteering as a community health worker, I saw that women – including teens and underage girls – needed better support to reverse the high maternal and child death rates and to escape generational cycles of dependency and poverty,” says Miriam. “It struck me how enhancing women’s access to information, healthcare, education and capacity to meaningfully participate in economic activities not only changed their lives but transformed their entire families as well. When women succeed, the whole community thrives,” she muses.
Two years ago, Miriam and all the nearly 700 CHWs in Isiolo started receiving more comprehensive support through a co-funded partnership between Isiolo County government and Living Goods. Apart from receiving regular in-service training and enhanced supervision, Miriam is now also equipped with medicines and a mobile phone loaded with the Smart Health app. This allows her to treat young children for ailments like fever and diarrhea after conducting a guided assessment on the app that directs her on diagnosis, dosage and aftercare. She’s also able to report all data collected in real time making vital community health data accessible on government channels for decision making on targeted health interventions and programs.
While her job as a health care provider allows her to go door-to-door and interact with women in the comfort of their homes, her job as a school matron and community organizer has made her a trustworthy mentor for young women like Susan* (not her real name).
The last time 19-year-old Susan sat in a classroom was four years ago. Her education was cut short due to financial difficulties, and when her family sent her to work in a city 500 kilometers away from home, she was sexually molested and impregnated. What was intended as a temporary stint turned into a living nightmare. The teen feels lucky to have Miriam as her go-to healthcare provider and ally and has received health education, personalized care, and emotional support – as well as encouragement to resume her studies and pursue her dream of becoming a teacher.
“Miriam has been my rock” shares Susan. “I was sad and confused at first, but she has taught me how to care for myself during pregnancy, she made sure I attended all my antenatal clinics, she helped me create a birth plan, and was right outside my door when I delivered my baby boy. She also helped me to join a mothers’ group where we are supporting each other to do economic activities to provide for our children while also helping me pursue legal action for the injustice I endured,” she adds.
Like Susan, 18-year-old Frieda also credits Miriam for providing her with support which allowed her speedy return to school three months after delivering her son, John.
Miriam has been supporting almost a dozen girls like Susan and Freida to have healthy pregnancies and find placement in local schools to finish their education after delivery – including rescuing some from early marriages or undergoing female genital mutilation. With her entrepreneurial activities as a farmer, Miriam knows just how important is for women to have a steady source of income and always mentors and encourages women of all ages to join economic support groups in their area, forums which also provide opportunities for joint health and financial education and learning.
“Aside from my mom, Miriam has been a constant pillar of support since I learned that I was pregnant. She has taught me a lot about being a mom like the importance of breastfeeding, good nutrition and immunization, but most importantly, she’s helped steer me towards both my formal and financial education,” Susan adds.
Miriam smiles when she hears this. The pride in her eyes is evident. But she must rush. She has to tend to her livestock and farm before hurrying to school in time to supervise evening prep and bedtime for ‘her girls’ as she fondly calls them. She pauses to reflect on her contributions and those of her fellow CHWs, most of whom are women, in improving the health outcomes in her community. She beams when she narrates how almost all women in her neighborhood are now attached to an economic support group near them where they save and borrow money to invest in income generating projects. Pregnant women now deliver at facilities and take their children for all required immunizations.
“I am so happy about the changes I see, which means we are no longer losing as many women and children due to preventable causes. There’s also increased uptake of family planning services which allows proper spacing of children for optimal maternal health,” she reports. “Men are also increasingly joining the bandwagon in supporting women to have better health, plan their families, and attain better economic standing. Now, that’s a win!”