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Helping Expectant Moms: P&G, SWAP, CDC, and Ministry of Health in Kenya team up for Deliveries

Pampers truck on ferry2I’m back in western Kenya in Nyanza Province.  This is where we started our not-for-profit effort to provide the P&G water purification packets through women to women selling and it’s been going strong since 2003.  I’m visiting today to see our latest effort to help Moms.

Collecting water2Western Kenya and specifically the area around Lake Victoria get a lot of attention because it’s a very poor area with a high population density and very unclean water.  For example, only 15% of households have piped water and more than half collect their water from rivers, ponds, or springs. 

Fisherman2I’m picked up before dawn by Nicholas Owino the transport coordinator for SWAP.  I’ve known Nicholas since 2005 and it’s always great to see his big smile.  We’re up so early because we’re catching the first ferry to Mbita.  It’s pleasant to escape Kisumu before the traffic jam and we watch the full moon set on our drive to Lake Victoria.

Fish 2 2I’m thrilled to see that Nicolas is driving the new P&G vehicle that was provided by the pilot effort lead by P&G Pampers R&D under the leadership of Tom Henrich.  I’ve written about the Pampers Baby & Family Care Center in the past.  It’s a kiosk using clean water as an outreach tool to communicate healthy habits and to extend the reach of P&G products including Pampers diapers, Always feminine pads, and Ariel detergent.

Pampers truck2I connected Tom with Alie Eleveld of the Safe Water and AIDS Program (SWAP) because I knew SWAP would do a great job with the kiosks.  SWAP is also the group that’s using women to women selling to provide the P&G packets, other P&G products, and a variety of other healthy products.  I connected SWAP with P&G Africa several years ago to start that effort and their sales of products like Pampers grows every year.  Based on their volume of sales, they’ve recently been designated a sub-distributor so they can purchase P&G products at a lower price. 

Washing and collecting water2Heh, I’m not the only match-maker around.  Dr Rob Quick of the CDC connected me to an ongoing effort by the CDC and the Kenyan Ministry of Health to help encourage pregnant women to visit the clinic before birth, antenatal visits, and to deliver in health facilities.  Rob had started an effort to provide a hygiene package for Moms consisting of soap and Waterguard, a chlorine water disinfectant for clear water, as an incentive to get mothers to go to clinic and he asked me to help them expand the effort to include the P&G packets because of the dirty water sources in the area.

Visit - Delivery2Now the P&G packets as well as buckets to prepare the treated water are provided as an incentive to get mothers to their first antenatal visit and to come to the clinic for delivery.  This is really important since currently three-quarters of women deliver outside health facilities.  Only half of women make 4 or more antenatal visits resulting in only about half of them having the two injections needed to prevent maternal and neonatal tetanus.  So, this is a real big deal because if we can get mothers to go to clinic then we can reduce the current high maternal mortality rate and help save lives.  The CDC is in the process of doing a formal evaluation but Rob told me that it’s pretty clear there’s been an increase in antenatal visits. 

SWAP products2Not only is Nicholas driving me to the clinic visits, but he’s also transporting another shipment of Pampers, Always, and Ariel for the SWAP store.  I’m very encouraged to see this partnership by our not-for-profit Children’s Safe Drinking Water Program leading to distribution and sales of P&G for-profit products because it’s making products that people desire and need available at a reasonable price.  Clearly the poorest people cannot yet afford some of our products but there’s a rapidly growing population of Africans that are quite capable of buying high quality products to meet their needs.  SWAP is finding that segment of the Kenyan population that can afford P&G products but may have a difficult time accessing them through P&G’s current distribution systems.

Ferry2So, that’s why Nicholas is driving the P&G, Pampers, CSDW, and SWAP branded vehicle onto the ferry and across Lake Victoria to Suba District.  Well, and to help me learn about our new collaboration. 



Steve Kola Maryline Okeeto Ibrahim Sadumah2At the SWAP store, I meet Steve Kola, Maryline Okeelo, and Ibrahim Sadumah who are supervising the research for the effort to help Moms.  At the SWAP store, they sell product out of the store and also use it as a distribution point for the women who do door to door selling.  Literally within minutes of when the Ariel and Pampers is unpacked, I see it going to other outlets to be sold. 

SWAP2We drive a short distance to Mbita District Hospital to learn about the effort to help Moms.  I meet the head nurse of maternity, appropriately for a nurse, called Florence.  In this case, her surname is not Nightingale but Lutiali.



Florence Lutiali2Florence explains how mothers are given the P&G packets to help encourage them to attend the clinic.  SWAP worked with the community health volunteers to help spread the word to expecting mothers about the incentives.  Then word of mouth took over from Moms who visited the clinic and received the incentives and then went back and told their friends.  I meet several of the recipients of the incentives and they tell me that they’re pleased.  They collect their drinking water from Lake Victoria and it’s good to see that their babies are happy and healthy.

Maureen and Chrisautios Ochien2Florence reinforces this when she tells me that they’ve seen a big decrease in women who are coming to the clinic with diarrhea and typhoid fever.  She said that before the water treatment products were available that she frequently admitted expectant mothers to the clinic to treat them for dehydration from diarrhea.  She says that’s very rare now and there’s only been a few in the last five months.
Every Friday, Florence reviews the data coming in from the 25 health facilities in Mbita and Suba District (2 district hospitals, sub-hospitals, clinics, and dispensaries).  The nurses use SMS text messaging to share the results.  Florence feels confident that the number of mothers attending antenatal visits has increased and also the number going to clinic to deliver their babies. 

Luceite Odiambo2After visiting the hospital, we travel to see some of the mothers who have benefitted from the program.  Luceita Odiambo will deliver soon and she tells us that she’ll go to the clinic to have her baby.  She’s been for all her antenatal visits and was pleased to receive the water purification products and other incentives.

Brenda and Whitney Atiambo2






Brenda Atiambo shows off her newborn Whitney to us and says that she also attended her antenatal visits and gave birth in the clinic.  And, she told her neighbors who were pregnant about the incentives and feels that this was the reason they started going to the clinic.
Back at the clinic, Nurse Florence shows me the individual record books of the expectant mothers to make the point that if they come to clinic, then they receive things like their tetanus vaccines and their antimalarial prophylaxis that will help ensure a safe delivery.  This also means that HIV/AIDS will be detected and that’s critical in this part of the world since the clinic can then take precautions to help ensure that the HIV virus does not infect the babies. 

Gladys and AnnCusti Atieno2And, all these benefits are on top of the benefits of preventing diarrhea and other waterborne illness like typhoid fever in the mothers and their families.  I’m eager to see the results of the CDC research so that we have a database to hopefully support scale-up of this newest part of the P&G Children’s Safe Drinking Water Program.  Thank you to SWAP, CDC, and the Kenyan government for collaborating on this work with us.


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