“We knew what to do to bring back clients to care,” James says. “For example, we integrated COVID-19 into our health education sessions on maternal and child health to bust myths and address fears—call it killing two birds with one stone.’’

The facility is in a community with many adolescents and young mothers, who are often at greater risk of losing access to care. To reach them, facility teams collaborated with outreach teams to expand their community education, including how to safely access services during COVID-19.

“Our clients are highly mobile and affected by serious barriers such as stigma and discrimination—and now COVID-19,” James says. “So focal persons tag along during the field and home visits to offer counseling.”

By January 2021, outpatient attendance had increased to 1,048 and the facility registered over 80 deliveries, an increase from below 50 deliveries between October and December 2020.

The facility hit its maternal and child health target, bringing clients back to the health facility.

“We had to collaborate with the community leaders to move the needle, so they are part of the whole facility and community approach to scale up service uptake,” James says. “The facility hit its maternal and child health target, bringing clients back to the health facility and surpassing their indicators.”

Other factors that have contributed to the facility’s success are the strong team of focal persons who work to improve the day-to-day operations of the facility. They are friendly and professional when dealing with clients. Each of the focal persons heads a sub-unit and they work together to ensure all the different care points are functional.

“The health worker in charge at Magoro HC III has demonstrated servant leadership,” says Dr. Rogers Masaba, RHITES-E malaria advisor, of James. “He is a team-builder and -player and his team observes and usually emulates him.”  

A work plan was developed for health staff to follow and the health worker in charge rotates staff and developed an “employee of the quarter list” to keep them motivated.

Following RHITES-E’s support, the facility conducts timely logistics planning and as a result, the facility experiences no stock outs, which has kept clients flowing in for refills and services. The facility has also managed to integrate COVID-19 prevention messaging in its maternal and child health, family planning outreach, and antenatal care (ANC) screening activities. For example, laboratory officers have been trained to counsel clients who come in for early ANC screenings to also test them for first trimester ANC.

“This has increased the number of new mothers and improved ANC enrollment and retention,” says Stella, a registered midwife at Magoro Health Center III. “The volunteer health trainers and mentor mothers have tremendously supported clients to access and complete the various services being offered at the facility. They increase awareness, acceptability, and uptake of these services. This has improved service provision.”

RHITES-E is funded by the US Agency for International Development. It aims to reduce maternal, newborn, and child mortality and morbidity by focusing primarily on increasing clients’ use of critical services, with a focus on antenatal care (ANC), postnatal care (PNC), health facility deliveries, essential newborn care, integrated management of childhood illnesses (IMCI), and effective referral services.