"Kekeli" - Female Community Health Promoters
At the time I said I was ‘moving’ to Africa, but in retrospect it was more of an extended stay. That was ten years ago now, when in July of 2007 I relocated to the Volta Region of Ghana for four months to volunteer as a nurse at a clinic called Seva. This is where I first encountered a group of female community health promoters called Kekeli, which means brightness in the local language of Ewe. After witnessing first hand the power these women had to create change in their communities, I knew I wanted to support such an endeavor. My time in Ghana was pivotal in my decision to return to school and pursue a career in midwifery.
"Kekeli" (meaning brightness) female community health promoters, during one of the their training session
In 2011, I returned to Ghana with my husband and two of our friends. We attempted to continue supporting the powerful grassroots work that I had witnessed. Through relationship building and connection in the community of Akatsi, Rural Health Collaborative (RHC) began. In the past six years we have trained more than 50 women to be community health promoters, building on their basic skills of education to also include the Home Based Life Saving Skills (HBLSS) program which focuses specifically on maternal and newborn education and emergency care. The work has evolved slowly over time, just as we have. As we have trained more women in Ghana we have increased our funding in the States, with nearly 70 small-donor monthly supporters providing the majority of our funding and creating a truly grassroots organization on both sides of the ocean. It is the team of four Ghanaian staff that make the work possible, meeting with the now 47 Kekeli Women regularly to monitor, educate and encourage them in their work.
Until now, the work of RHC with the Kekeli Women has been low-tech to say the least. The Kekeli Women have a manual of information from which they learned basic community health skills, another manual of HBLSS skills, a tote bag, a blue t-shirt to identify themselves, a bike, a steady stock of wound care supplies, and a small monthly stipend to get their work done. The rest is up to them, finding creative and meaningful ways to engage their communities in ways they see fit. This August RHC is introducing two new programs that add another level of technicality and ultimately, we hope, creativity as well. These tools will assist the Kekeli Women in educating and tracking the pregnant women they are working closely with in their communities, as they encourage them to seek and receive care at the local clinics.
RHC has been working with InvestED over the last 6 months to help create a pregnancy narrative that incorporates important elements of pregnancy care through storytelling. This story is told through a series of videos that can be shared on a smart phone. Kekeli Women will be showing them at regular intervals throughout a woman’s pregnancy to support and encourage the woman’s use of professional pregnancy care with skilled midwives.
Mothers with their children attending an awareness raising session conducted by the "Kekeli" (meaning brightness) female community health promoters
The second way RHC is aiming to increase skilled midwives at delivery is through a partnership with Medic Mobile. The Kekeli Women will be able to use their smart phones to monitor pregnancies of women in their communities and encourage utilization of local clinics for pregnancy care and delivery. Estimates still show that as few as 50% of women deliver their baby with a skilled midwife in Ghana. While as community health promoters the Kekeli Women do not provide the care for pregnant women, they do provide the vital link to overcome some of the barriers women face in accessing the care they need. These two new programs are distinct, as are the organizations behind them, but the goals overlap in a significant and meaningful way to encourage delivery with a skilled midwife, an important factor in reducing maternal morbidity and mortality.
The writer of this article, Olivia Kroening-Roche is a Certified Nurse-Midwife and the Program Director and Co-Founder of Rural Health Collaborative. She just completed a year as a visiting midwifery lecturer in Tanzania through the Global Health Service Partnership and is currently in Ghana. She calls Portland, Oregon home.