Chamas for Change

Chama for Change is an integrated community-based strategy of peer support that groups women together in their pregnancies, developed by the MNCH team at AMPATH, the Academic Model Providing Access to Healthcare.

Central to their approach is the integration of a savings and loans program into a group model that focuses on health education and relationship strengthening using the chama as the service delivery platform. Translated from kiswahili as ‘groups’, chamas have a longstanding presence in the financial landscape of East Africa. They are highly gendered institutions that women have traditionally relied on for survival. Readily assembled in times of famines, floods and funerals, chamas are effective networks through which women can meet regularly outside the home and pool resources. Using this existing cultural script, they developed Mother-Child clubs (Chama cha MamaToto) in a rural district where the insecurities of pregnancy and infancy continue to threaten survival. Facilitated by Government of Kenya Community Health Workers, these groups meet twice a month,

Now in their second year of operation, chamas are a self-propagating, demand-led solution with significant maternal and newborn health benefits. Compared to a control group in the same communities, they have found that women in chamas had a 73% increase in attendance of 4 or more ANC visits, a 68% increase in facility deliveries, a 74% increase in exclusive breastfeeding, and a 100% increase in receiving a visit by a CHW within 48 hours of birth. Working through the county governments, they now propose to scale-up this integrated solution as a population-wide strategy to rapidly and sustainably achieve high coverage of facility delivery, long-term family planning and exclusive breastfeeding. Beyond these ‘traditional’ MNCH goals, their program aims to challenge the conditions of poverty and demonstrate the value of an early intervention program to safeguard children’s developmental potential.

This video, prepared by the MNCH team at AMPATH in Kenya, was shared by Alan D. Bocking, Professor at the Departments of Obstetrics and Gynecology and Physiology at the University of Toronto. ‘Leading with Care’, AMPATH is a consortium of universities and academic health centers that work in partnership with Moi University and Moi Teaching and Referral Hospital in Kenya. In 2007, the University of Toronto became the lead institution for building capacity in Reproductive Health. AMPATH has been recognized by the government as a ‘learning laboratory’ that can generate and test innovative solutions to health problems by drawing on its rich expertise in Clinical Care, Community Services, Research and Informatics.

The Chama cha MamaToto program received funding from Saving Lives at Birth through Grand Challenges Canada.


septembre 16, 2014




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