Context and Pre-Intervention Reality:
Tsangatsini Dispensary is a primary health care facility located in Kaloleni Sub-County, Kilifi County, serving an estimated catchment population of approximately 15,000 people. The facility offers outpatient services, Maternal and Child Health (MCH) services, immunization, laboratory services, and preventive and promotive health services. On average, the facility conducts about 50 deliveries per month based on the health facility reports, although service utilization had historically fluctuated.
The facility is supported by two Community Health Units (CHUs); Tsangatsini A and Nyenzeni, comprising a total of 36 Community Health Promoters (CHPs). Governance and community oversight are provided through the Health Facility Management Committee (HFMC) and Community Health Committees (CHCs).
Despite the presence of these structures, Kaloleni Sub-County faced persistent RMNCAH challenges, including:
- Low antenatal care attendance, particularly completion of the fourth ANC visit
- Incomplete immunization coverage
- High reliance on home deliveries
- Weak follow-up of pregnant women and children
- Limited reach to hard-to-access communities due to distance and transport constraints
Outreach activities were irregular and largely dependent on ad hoc arrangements, limiting continuity of care and weakening community-facility linkages. These constraints undermined RMNCAH outcomes despite the commitment of health workers and community health actors.
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