Effectiveness of Ng’adakarin Bamocha model in improving access to ante-natal and delivery services among nomadic pastoralist communities of Turkana West and Turkana North Sub-Counties of Kenya

Introduction: Access to maternal and child health care services among the nomadic pastoralists community in Kenya and African continent in general is unacceptably low. In Turkana, only 18.1% of the women had seen a nurse or a midwife for antenatal care during pregnancy while only 1.3% of pregnant women reported delivery at health facilities in 2005. Ng’adakarin BAMOCHA model, based on migratory routes of the Turkana pastoralists and container clinics was adopted in 2007 to improve access to maternal and child health services by the nomads. Methods: A cross-sectional study design was used to establish the effectiveness of Ng’adakarin BAMOCHA model on accessibility and uptake of ante-natal care and delivery services. A total of 360 households and 400 households were interviewed for pre-intervention and post-intervention respectively. The study compared the pre-intervention and post-intervention findings. Structured questionnaires and focus group discussion were used for data collection. Results: There was no improvement in the fourth ante-natal care visits between pre-intervention and post-intervention groups at 119(51.5%) and 111(41.9%) respectively (p<0.05). Knowledge of the community on the importance of ANC visits improved from 60%-72% with significance level of p<0.05. There was a significant increase 6%-17% of deliveries under a skilled health worker (p<0.05). TBA assisted deliveries increased from 7.5%- 20.2% with a p<0.05.There was significant reduction in home deliveries from 89.5%-79.5% with a p<0.05. Conclusion: The Ng’adakarin Bamocha model had a positive effect on the improving maternal health care among the nomadic pastoralist community in Turkana.

The study covered two divisions each in Turkana North and Turkana West Sub-Counties: Lokichoggio, Oropoi, Kaaleng and Kibish. The study design was a cross-sectional study for pre-intervention and post-intervention population with intention of establishing the changes in access to delivery services. The study population comprised of mothers with children aged 0 ≤ 23 months and Health care workers. The study population was drawn from the 17 Ng'adakarin covered by the intervention in four divisions. Convenience sampling was employed at Ng'adakarin level (17 Adakarin), resulting into eight study clusters. At the Adakar level simple random sampling was employed was used to select study respondents who are women with children aged below 23 months. 360 women were interviewed in pre-intervention while 400 women were interviewed for post-intervention. Four FGDs were conducted with women and men in the four divisions of intervention. Four key informants (1 chief, 1 member of local Community Based Organization, Sub-County Nursing Officer and Sub-County Medical officer of Health) were interviewed. Quantitative data was entered using Ms Access sheet. Data was managed and analyzed using SPSS version 21. Qualitative data was entered and grouped using Ms Excel. A bivariate analysis was carried out to relate socio-demographic variables to antenatal care use and other health-seeking behavior of the mother for her child between 0-23 months. Chi square test was used as appropriate with p-value set at the 0.05 level. Study limitation: the study covers the nomadic pastoralist community that make up 80% of the population therefore excluding sedentary community. The study used convenience sampling to select half of Ng'adakarin reached with intervention because of inaccessibility of some of Adakar to be studied as they migrate, even, across international borders in search of pastures and water for their livestock.

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• jillo, jillo ali
• ofware, peter
• njuguna, susan
• mwaura-tenambergen, wanja