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Through My Eyes: Access Afya Communications Fellow

by Access Afya

This month I  joined Access Afya as the new Communications Fellow! It’s been a month of “I am a communications fellow with Access Afya” to my friends and family. But, mentions of Access Afya are  accompanied with so many questions; “What’s Access Afya?” “A Social Enterprise, what’s that?” “How is Access Afya different?” I found that in my excitement of telling others about my new fellowship, many did not understand what we actually do as a health care social enterprise. So I starting telling people that our values: “At Access Afya, we believe every patient should feel cared about and understand what they are getting” makes us unique, fresh, and different from the norm.

Being new at Access Afya is very exciting. I went through orientation and handover with the former communications fellow and met the team at the head office and planned to visit the clinic staff later in two different villages of Mukuru Slum. The one thing that stood out while familiarising myself with the teams, programs and protocols was the emphasis on the patient: care should always be patient centered, our care teams and processes stand out against the competition, and we work to  provide a welcoming, comfortable, and friendly atmosphere for our patients.

I am a sociology major and I am interested in observation and research. The emphasis on patient centered protocols for the clinics was captive to confirmable objectivity. I needed to do a research with a clear baseline, to see what makes the organisation different and unique from other health care companies. I decided to visit the clinic staff to familiarise myself with the location and community but I decided that I was going to do it as a patient, rather than introducing myself as the new fellow. I wanted to experience Access Afya through the patient’s eyes.

I had my directions that I located on the website but also I wanted to try to get to the clinic from the main bus stage by asking the locals. I wanted to let the signposts for both clinics guide me. I also intended to call Access Afya and ask for direction; more than once.

First, I visited the Kisii Village clinic. I took a bus to South B. I alighted and asked for directions to Access Afya. I was pretty impressed that 11 out of the 13 people in Kisii Village that I asked for directions knew clinic location. With Sinai Village, only one person had no idea how to direct me. Interestingly, when I called the organization at both clinics after ‘getting the directions wrong’, they asked me if it would be okay if they called me instead and gave me a precise detailed direction. That was amazing! The signposts were also descriptive in terms of direction and distance. I did all that; the calling and asking the locals, for research purposes but the signs were enough to get me there.

I finally saw it. A small, blue and white clinic; similar to the colors used on the signposts. The clinic has clean white blue patterned tile, smells like spirits, antiseptic, giving an assuring hygienic scent. The clinic is small and has a waiting bay, a pharmacy that is right near the door; two other rooms for lab and consultation. . I was welcomed by a smiling receptionist who had a tablet in her hand. I found one patient in the waiting area and one just leaving the consultation room for the pharmacy. I really wondered why the patients weren’t  holding any paper for reference. I am so used to being sent to the Lab or Pharmacy or the consultation room with my documents! This, was all new and strange to me. I was asked for my bio data and they impressively noticed that I was a new patient and asked me how I found out about the clinic as she filled in the details.

I used my first name and surname. Then I realised they were using technology on my first stop at Kisii Clinic and my records would be in the system, it would be hard to visit Sinai with the same intent. To avoid getting caught’ I used a different name in Sinai Clinic.

I was then taken to the consultation room, had a sit down with the doctor, explained how I felt (gave out all the signs and symptoms of Malaria; I seriously hadn’t thought that bit out calculatingly!). He wrote some things on a tablet, had a chat with me about the possibilities of what was ailing me, excused himself and came back shortly after and explained what kind of test he was doing. A rapid test was done, and shortly he came back with the results; a negative malaria test. At the Sinai Clinic I was explained to, the possibility that I could be ailing on something other than Malaria because of my persistent tummy ache(a detail I added to Kisii clinics’ symptoms) and so, an intense lab test (stool test) was done in Sinai. This was also, unsurprisingly, negative.

The doctor addressed the headache concern, by giving me painkillers and advised me to come back, if it persisted. The medication was pretty cheap. He asked me to come back for a check up, the following week because I mentioned that I had a condition that needed regular check up. That was quick! The receptionist then asked me to confirm with her what date my check up was and wished me a good day as I left just as another patient got in; for consultation. No wonder, there was no queue!! I thought to myself as I left. I left the clinic smiling.

Then I finally let both clinics know that I am a new member of the team. They were surprised for a few seconds and welcomed me to the team just as warmly as they had when I was a patient in the clinics!  I went back to work in the head office satisfied. The one thing that caught me off guard was getting a call from Access Afya customer care 2 days later to check my progress. This made my heart smile because I had never received a call from any facility to check on me after a visit. Being an Access Afya patient made me feel a sense of relief and actually made me feel cared for. The fact that my tests and medication was explained to me gave me assurance that I would be okay! Overall, it was an experience, I’d go back to!

Exciting Plans for 2016!

by Access Afya

Before January ends, we’d like to update our friends, partners, and supporters on our plans for 2016. We’ve “hit the ground running” this new year, and we’re excited to expand, enhance, and improve the programs and health services we offer!

Here’s a sneak peek at what you can expect to see from us at Access Afya this year:

Micro-clinic Expansion

We will be expanding into three new communities with three new micro-clinics this year. We’ve welcomed Fred, our new Business Expansion Project Manager, who has been very busy researching and scouting out potential locations and communities that have the highest need for our health services.

This photo gives you a glimpse of the congestion - of people, buildings, activity -  in Kisii Village, where one of our clinics is located. We look forward to expanding into new areas that need our high-quality health services!

This photo, as well as one of our past blog posts that included a video called “A Walk Through Mukuru,” gives you a glimpse of the congestion – of people, buildings, activity – in Kisii Village, where one of our clinics is located. We look forward to expanding into new areas that need our high-quality health services!

Healthy Schools

The Healthy Schools Program, spearheaded by Jaclyn (Program Manager), Beatrice (Program Coordinator), and Patrick (Healthy Schools Nurse), has been working hard since last year to bring the program to more schools in the Mukuru community. They are looking to increase both the number of schools involved and number of students enrolled in the program. Through the Healthy Schools partnership with PharmAccess, the team will be conducting “experiments” to try to increase enrollment. These experiments will include offering different payment methods and various sign-on incentives to parents and their children.

The Healthy Schools Team is proud to have the first school, Safisha School, to be fully-enrolled for one full year! This is the first time we’ve had all students (about 50 at Safisha School) in a school be enrolled for a full year, and this is our goal for all of the schools participating in our program.

Dhahabu, our past Healthy Schools Program Coordinator, surrounded by some of our Healthy Schools students

Dhahabu, our past Healthy Schools Program Coordinator, is surrounded by some of our happy  Healthy Schools students

Healthy Factories

Similar to the Healthy Schools Program model of conveniently bringing health care and other health services to students at the schools themselves, we are doing research and making connections to launch a Healthy Factories Program in 2016! This program will involve Access Afya reaching out to factory workers in informal settlements at their place of work.

Improved Impact Reporting
Last year, in September, we realized the importance of measuring our “big picture impact” on the communities we serve. We wanted to answer the following three questions:

  1. How many unique patients have we served?
  2. Are our patients satisfied with the care we are giving them?
  3. What are the outcomes of the cases we see in our clinics?

With the help of Natasha, our Monitoring & Evaluation Fellow, we’ve developed a way to collect this impact data and showcase it on easy-to-understand dashboards. Keep an eye out for an overview of our impact that will be posted to this blog soon!

Community Outreach & Marketing
After our extremely successful medical camp in October last year, as well as several highly-attended outreach events, we’re excited to continue reaching out to members of the community through activities such as medical camps, market storms, and group meeting discussions. Fred, Ruth, our Quality Assurance & Marketing Project Manager, Dommy, our Community Outreach Coordinator, and their teams have been covering lots of ground – literally and figuratively – planning these events for 2016. Our first medical camp is set to take place this Saturday, January 30th!

Medical camp participants line up outside UHEAL's mobile eye check-up clinic. We will partner with UHEAL again and offer eye checks at our next medical camp this Saturday!

Medical camp participants line up outside UHEAL’s mobile eye check-up clinic. We will partner with UHEAL again and offer eye checks at our next medical camp this Saturday!

We talked with our October 31st medical camp attendees about the importance of breast cancer screening and used visual aids such as this one.

We talked with our October 31st medical camp attendees about the importance of breast cancer screening and used visual aids such as this one.

We didn't forget the children at our October 31st medical camp last year! Here is a photo of Jaclyn on face painting duty.

We didn’t forget the children at our October 31st medical camp last year! Here is a photo of Jaclyn on face painting duty.


We at Access Afya wish you all a happy new year! We have so much to look forward to, and we hope you do too!

New Year 2016


Healthy Schools Program: The Start of a New Term = Exciting New Updates!

by Access Afya

September was the start of a brand new term for schools in Kenya, which means our Healthy Schools Program has been very busy lately! We now have six schools enrolled in our programs, and teachers and parents at these schools have been very supportive and enthusiastic about helping us improve student health. Healthy schools produce healthy students who will grow up to be successful community members!

Healthy Schools students practice proper hand washing technique on Global Hand Washing Day, October 15! Did you know that washing your hands with soap can reduce the prevalence of life-threatening diarrhea by more than 33%?

Healthy Schools students practice proper hand washing technique on Global Hand Washing Day, October 15! Did you know that washing your hands with soap can reduce the prevalence of life-threatening diarrhea by more than 33%?

After a human-centered design work session, the Healthy Schools Program is launching a new health care package in response to feedback from teachers and parents. Our previous package offered a comprehensive check-up, one free consultation at the Access Afya clinic, regular deworming, and health education once a week.

The new Healthy Schools Program package highlights free medications and lab tests to confirm diagnosis at our clinics when recommended by an Access Afya clinician, regular doctor’s visits during deworming sessions at schools, a health club membership, and a comprehensive check-up at the beginning of every term to screen and baseline children. In addition, we went a step further to provide extra incentive measures for parents by partnering with MicroEnsure, an insurance company that provides insurance policies targeted to low-income families and individuals. Through this partnership, we are able to offer hospital cash for students who need extended hospital stays and fire insurance for families in case their homes burn down. Fires are so common in the informal settlement neighborhoods that our students’ families live in. The fires not only affect families as a whole, but a child’s education and health suffers without a secure place to live. We’re proud of this new package and how it specifically addresses the needs expressed by families and teachers.

Dhahabu, our Healthy Schools Program Coordinator, surrounded by some of our Healthy Schools students

Dhahabu, our Healthy Schools Program Coordinator, surrounded by some of our Healthy Schools students

We’ve recently hired a new nurse to join our Healthy Schools team and we’re excited to be starting this term with renewed energy and enthusiasm to bring personalized health care to the schools in our community!

5 Ways to Take Care of Your Mental Health

by Access Afya

October 10th is World Mental Health Day, and we at Access Afya want everyone to know that today and every day is the perfect day to think about your mental health. Although mental health is not talked very much about, it should be because it’s just as important as physical health! A healthy mind and well-being is equally important as a healthy body.

Here are five #AfyaTips for taking care of your mental health:

  1. Get some fresh air!

watotoSpending time outdoors and in nature has been shown to lower stress levels. According to environmental psychologist Judith Heerwagon, “there’s something about being in a natural setting that shows clear evidence of stress reduction, including physiological evidence – like lower heart rate.” Reduction in stress level and an increase in relaxation are related to simply the scent of many types of flowers (roses, lilacs, and jasmine, for example).

In addition to lowering stress, being in nature causes positive mood shifts. While the exact reason for this is unknown, leading theories say that human beings enjoy things that are inherently good for our survival. Trees are nature’s way of providing food, shade, protection, and comfort. This is why trees and other natural elements put us in a happier mood.

  1. Eat well.

Food is fuel for our bodies, and what we use as fuel impacts how our bodies – and minds – function. The types of food you eat and when you eat them can help improve your mental health.Florence window

Avoid skipping breakfast. It re-energizes your body and starts your metabolism for the day after you’ve gone without food for the entire night while you were sleeping. Skipping meals, especially breakfast, can lead to exhaustion and depression. If you’re not able to have a balanced meal for breakfast, eat some fruit, yogurt, and whole grain bread or granola bars for a good start to your morning. For all of your meals, eat a diet high in fruits, vegetables, whole grains, nuts, fish, and unsaturated fats (olive oil, for example). Compared to people who eat lots of meat and dairy products, people who follow this kind of diet are up to 30% less likely to become depressed.

  1. Get some exercise.

Exercise helps to prevent and improve a variety of health problems, like diabetes and high blood pressure. However, regular exercise doesn’t only help your physical health – it releases good-for-you chemicals that boost your mental health too!

Being physically active helps to ease depression and anxiety by: (1) releasing feel-good brain chemicals (neurotransmitters called endorphins and endocannabinoids) and (2) reducing immune system chemicals that may worsen depression. Exercise can also help you gain confidence, provide a way to take your mind off worries, and cope with anxiety and depression healthily, as other means of coping, such as drinking alcohol or dwelling on your problems, can lead to worsening systems.

  1. Make face-to-face connections.

It’s time to put down your cell phone and step away from the television! Studies have shown that having a social support system and staying connected with others is good for both physical and mental health. Maintaining in-person relationships may even help you live longer.

A longitudinal study published in the Journal of the American Geriatrics Society found that in people aged 50 years or older, those who communicated the least with friends and family through in-person, face-to-face greetings had a higher rate of depression. Dr. Carla Perissinotto of the University of California, San Francisco, states that “this is a reminder for all of us to stay connected. The human touch and human contact cannot be replaced.”

  1. Take a break!

All work and no play isn’t a very healthy way to live! Whether it’s a half-hour lunch break during the work day or a fifteen-minute pause from your everyday tasks, it’s important to have a change of pace or change of scene to help your body be re-energized, refreshed, and ready to tackle the rest of the day.

Take care of your mind, body, and spirit. You deserve happiness!


“10 Ways to Look After Your Mental Health.” Mental Health Foundation.

“Depression and anxiety: Exercise eases symptoms.” Mayo Clinic.

“Healthy Diet: Eating with Mental Health in Mind.” Mental Health America.

“Here’s Proof Going Outside Makes You Healthier.” Huffington Post.

“You Need Face-to-Face Contact for Your Mental Health.” Health Magazine.

Mental Health In Kenya: A Place For Traditional Medicine?

by Access Afya

Mental health is an often under-reported and under-recognized health issue in our world today. Much of the problem is our society’s failure to acknowledge mental health problems in loved ones and seek proper treatment for them. However, in places of the world such as Kenya, health care innovators are pursuing the unique blend of traditional and Western medicine to better serve people with mental health issues in a healthier and more culturally appropriate way than approaches of the past.

Kenya’s Mental Health Issue

The World Health Organization (WHO) estimates that the leading cause of ill health and disability on a global scale are mental and neurological disorders. However, because of cultural taboos and stigma, many mental health cases go untreated. WHO asserts that mental health issues should in fact be part of a larger development plan since they have a big effect on a country’s economy by adversely affecting people’s abilities to care for themselves and their families.

Part of the issue surrounding mental health is the lack of medical professionals trained to help, especially in poor and under-served areas of the world. In East Africa specifically, the problem is dire. There are only 79 working psychiatrists in the East African nation – one for every 500,000 people! In 2013, there were only 25 licensed psychiatrists in Kenya.

In developing countries, seventy to eighty percent of people with a mental health problem in developing countries receive either no treatment at all, or ineffective treatment, such as treatment given by waganga, or traditional African healers.

It has been recognized in Kenya that while some waganga approach healing with well intentions and have been trained to perform customs passed down for decades in the traditional medicine community, many are in the healing business for the ulterior motive of taking advantage of Kenyan’s who will pay large amounts to have their ailments cured the traditional way.

Private psychiatrist offices that many people in the Western world are used to are just not feasible in the urban areas and informal settlements in Kenya, where most of the country’s population is concentrated, the same types of communities that our programs and clinics at Access Afya serve. Trying to imitate Western psychiatric systems is problematic, as specialists and hospitals are in such short supply. So how do we get mental health services to people who need them, especially in a country where the stigma and taboo surrounding mental health issues are resounding?

One of Access Afya's clinicians listens intently as a patient chats with him.

One of Access Afya’s clinicians listens intently as a patient chats with him. Might clinicians be able to work in harmony with traditional healers to help their patients?

A Creative Solution

One outstanding organization has begun to tackle this question by incorporating traditional medical beliefs into long-standing Western practices. They are attempting to utilize waganga to reach populations that may not wish to try Western approaches to mental health at first. Basic Needs, an international development charity focused on mental health issues, has been working with a group of Kenyan traditional medicine and faith healers for the past five years to educate them in patient protection and human rights.

Basic Needs recognizes that their approach needs to be a two-way street. They are training traditional healers how to identify mental health problems and refer patients to licensed psychiatrists, and psychiatrists in Kenya have recently begun to recognize the need for some of their patients to seek traditional help. Each party must accept that the other has a presence and necessary position in the mental health treatment of many Kenyans.

Dr. Monique Mutheru is one of Kenya’s few psychiatrists. She believes that traditional medicine is an appropriate route for some types of mental distress. Cultural beliefs surrounding mental illnesses, such as possession by spirits, can often cause psychological distress that traditional healing may best alleviate.

However, Dr. Mutheru emphasizes cooperation between Western medical practitioners and waganga. She says, “The idea is to work together, to work as a team.”

Dr. Daphne Ngunjiri, Access Afya’s Medical Director, recalls a case at one of Access Afya’s micro-clinics during which the patient, a young girl, had been suffering from a septic (severely infected) leg wound, and Access Afya’s clinicians found out about her case when her brother visited the Access Afya pharmacy looking for pain medication. The family was having her leg wound treated using herbal medications for months with no signs of improvement. At Access Afya, clinicians recognized the problem was serious and referred her to a government hospital where she was diagnosed with cancer.

This unfortunate incident, Dr. Ngunjiri says, highlights that “patients need to feel comfortable to share all additional measures they are taking…[to] help doctors assess the benefits and risks and ensure patients are making informed decisions.” If doctors and health care workers do not acknowledge that traditional healers are still very active in our communities today, patients may not feel comfortable reporting any traditional healing techniques they may be simultaneously using.

International psychiatrists and experts on cultural psychiatry are agreeing that the most effective approach to health issues, especially mental health issues, may be to incorporate cultural beliefs and traditional medicine. Dr. Miscol Ascoli, cultural psychiatrist at the Newham Centre for Mental Health in East London, says, “I think we have to consider that in a globalized world explanatory models are sometimes multiple. It’s not like you either believe in spirits or you believe in mental illness. Sometimes you believe in both.”

This past Monday, August 31st, was African Traditional Medicine Day, and what better way to celebrate long-standing medical traditions in Africa than acknowledging that proper training of traditional healer may be able to bridge the needs gap for mental health in Kenya?