Bigile Mkama, 38 years old, is a mother of 3 children from Nyamongo village at Nyangoto ward, Tarime district in Mara region, working as a Community Health Worker (CHW) in Nyangoto Health Centre. Bigile was recruited by the Nyangoto Health Centre in 2017 and trained to provide home-based care before being promoted to CHW two years later to provide health promotion and basic curative services to their communities. According to the national health strategies, CHWs perform various tasks, including implementing health interventions, collecting and analyzing community-based data, conducting household visits and community education, identifying patients needing referral, and collaborating with other community-based cadres (such as volunteers and peer educators) as well as local government structures and community groups to promote community primary health care.
Following the launch of You(th) Care project, in July 2022, Bigile and other 39 men and women in Tarime district were selected to work with the project in promoting self-care among adolescents and young people. Bigile, and her fellow selected CHWs, received training on promoting youth self-care and their access to SRHR services using PATA’s Community Clinic Collaboration toolkit. From the training, Bigile learned on the role CHW can play in collaboration with peer educators to promote young people and adolescents sexual and reproductive health rights and services. This was a training of its own kind to Bigile as she had never received specific training targeting to increase her knowledge on working with adolescents and young people especially on promoting their access to SRHR. She remarked “I participated in government organized training to CHWs but I never got opportunity to be trained on working with the adolescents and young people. This training has helped me understand that young people are a special group with their own demands, needs and interests and it needs high level of professionalism, empathy, and self-discipline when working with them. Their trust to service providers and health facilities is not strong therefore, limiting their health seeking behavior.”
Following the training, Bigile decided to use the knowledge to reach adolescents and young people in her community with knowledge on their rights to SRHR. Among the adolescents she met was a 17 years old pregnant girl who has never attended RCH clinic. Bigile narrated “This girl had a four months old pregnancy and she has never been to RCH. So I spoke to her about the importance of visiting RCH clinic which will equip her with knowledge on taking care of herself and her unborn baby.” Bigile said she had managed to convince the girl to attend RCH where she was also tested and found to be HIV positive. She continued “When she was at the clinic, she was counselled and tested for HIV. She was found to be HIV positive and as the facility does not have a CTC, we agreed to refer her to a facility that has CTC so she can receive further counselling and support to prevent the transmission of infection to the child. She was also provided with ARVs so that she can start her treatment.”
Bigile narrated that they had agreed that they will make follow-up after whether she will attend clinic on the date that she was advised to get back to see how she is progressing and whether she continues with treatments. Unfortunately, Bigile said they found out that the girl never came back for treatment and therefore wanted to know the reason. She continued “when talking to the girl, she showed that she has given up on her life as there is no opportunity for her and her to survive. She was of the opinion that the medication will not do anything of help and that she will surely die anytime soon. So, despite the advice she got at the CTC, she still had this feeling and fear. So we talked to her and advised her that it is not the end of life and if she adheres to the ART and heed all the advice on take good care of her health, then her baby might be born without infection and she will also continue to live. We talked to her of people who had lived with HIV for up to 20 years and more.”
Bigile did not hide her joy and excitement of helping the girl to continue attending CTC and RCH clinic and acceptance that being HIV positive is not the end of her life. She concluded “I am really excited to have helped this young girl. But I am also happy that the project has built us capacity on supporting the adolescents. I am thinking if I was not trained maybe I could have not helped this girl. And to see hope in her eyes gives me the desire to reach more adolescents. I can see myself now as a true change maker for the welfare of adolescents and young people.”
