By Mary Mwendwa
Nairobi, Kenya: Cindy Waswa aged 15 is eight months pregnant. Her frail body and protruding tummy seem to drain her energy as she lazily sits on a blue plastic chair to join fellow teenage mothers for a weekly training at a local based organization in Nairobi’s Ng’ando Village.
Here, at Tazama nia, a Community Based Group ( CBO), is where teenage mothers like Waswa come for psycho-social support. Teenage pregnancies from poor families have been on the rise.
“ The situation in Ng’ando needs a serious intervention because teenage girls from poor backgrounds are getting pregnant without any support. Many of the girls do not know the importance of attending antenatal clinics.” Says Lucy Wambui Kaigutha, founder of Toto Care Box Africa Trust.
Toto Care Box Africa Trust works closely with Tazama nia in promoting, protecting, and preserving the health of newborns among vulnerable teenage mothers in Ng’ando.
They give teenage mothers information on maternal and newborn health and encourage them to attend four maternal health clinic visits after which they are given a box famously known as a Toto Care Box, which serves as a baby crib made from a box containing essential newborn items.
Ng’ando Village is a densely populated informal settlement that is less famous, tacked in Dagoretti North Sub-County, west of Nairobi.
Here, poverty and other social problems including teenage pregnancies have taken a toll on the residents.
But, in the midst of this misery lies a shaft of light that beams among teenage mothers of Ng’ando.
‘’ I was not aware that I was expectant. My body started experiencing some changes which I did not understand. Later, I discovered I was six months pregnant. My world shattered.” A worried Waswa begins.
“ I was just in class 8 and had big dreams of becoming a professional career woman, here I was, a drastic change to my entire life had been knocked in. Everyone hated me, including my own parents. Life was tough.” I had no one to turn to!”, she intimates
But, Waswa has just received a comprehensive infant life-saving box, Toto care box which she appreciates a lot.
“ I haven’t started using the box yet, it came with the basic essentials that I will need when I get my baby next month, this box has come as a savior to me, I had no idea where I will get baby items, my boyfriend is a pupil in school and has no means to support me.”
In the same room, Juliet Shaniz, 17, holds her two weeks old infant. Shaniz confides to me that she got pregnant while in form three during the covid-19 outbreak when schools were closed.
‘’ I had mood swings and liked sleeping a lot, I just assumed that maybe it was a normal biological body change. My world changed when it was confirmed by a test that I was expecting a baby, I was six months pregnant,” she narrates.
Shaniz, who comes from a family of five with a single mother, felt that she had let down her mother who struggles every day to see her eat and go to school.’’ My mother was not talking to me, all my friends took off, including my boyfriend, who is the father of my baby. I have never seen him.”
Shanix confirms that she attended four antenatal clinics at a facility in Waithaka, she was checked and assured that her baby was growing well. “ I got encouraged to attend the clinic because I was assured of getting the Toto care box with baby items and also I was sure of accessing a health facility to deliver the baby.
“ When I got into labor I went to the hospital and delivered a bouncing baby boy two weeks ago. I had no one who could buy baby items for me. I was assured of a place for the baby to sleep, shawl, baby clothes, and other times to help the baby.”
Alphonsas Kabugu, who is 16 years with a seven months baby boy, praises the Totocare box project for the help that has rekindled hope in her fragile life.
“ I became pregnant while in form 2. I live with my stepmother and my dad. My dad never accepted the fact that I was pregnant and now I have a baby. Life has never been the same for me.’
Kabugu reveals that the training she got from Tazama nia and the Totocare box was a boost to her life as a teenage mother.
“ I was so naive and ignorant of motherhood, even I was not aware of how to attend the clinic. I attended four sessions and benefited from the Totocare box which has been very helpful to me and the baby.”
Caroline Kambi, Program coordinator at Tazama nia confirms that they work with teenage mothers from 12 -20 years. “ These teenage mothers are very vulnerable and when they come to use we do counseling, we give them information on maternal health and above all we have partnered with Toto care where we give them the boxes and encourage them to attend maternal health clinics and to deliver at a health facility.”
Kambi further reveals that the normal set-up for many families in Ng’ando is between 6-7 members sharing a very small room.
“ You can imagine an infant sharing a bed with 3 -4 members of a family, this is very dangerous and we are glad that the box helps a lot in securing the well-being of the baby.”
“People in this slum are poor, now with teenage pregnancies an extra burden is added and therefore some serious interventions have to come in to help them.”
Solomon Muraguri, the Senior Chief of Ng’ando Location, says that his location is very unique. “We have no public health facility, school, and social amenities. This place has no running water, people depend on borehole water that is at my camp. In fact, the office I am using was donated by a well-wisher,” Muraguri says.
“Covid-19 came with many challenges. In my location teenage pregnancies were on the rise as the disease soared. Poverty levels increased and this led to teenagers being duped by people with very small gifts like a packet of chips.’’
“Tazama Nia in partnership with the Toto care project has been very helpful to teenage mothers. In the cases I received I refer to them where they get the needed support. I am glad that this project is helping to save the lives of both the mother and the baby.”
At Mukuru kwa Njenga slum, Cynthia Atieno, a mother of three talks of how Totocare project was of great help to expectant mothers in her community. It has since suspended operations there.” Sometime back women here really benefited from the Totocare project, they could get baby items and training, we no longer get those items from them. I hear they faced some challenges, we hope they will resume soon.”
Grace Mwihaki, a 25 year old mother of 2 says that she wishes Toto Care continue operations in Mukuru.” We have so many deserving cases here, poverty is high here, expectant mothers could get a baby crib and few baby clothes to start them off.“
Mwihaki recalls how she was in dire need of clothes when she was expecting her child a few years ago. “A friend told me about attending a clinic at least four times to be able to benefit from that. I did and got a crib which is still in my house.
Toto care Box Intervention
Essentially Toto care box is a life-saving intervention for the baby and mother which aims at reducing maternal and newborn deaths in Kenya.
According to Lucy Wambui Kaigutha, the founder of Toto Care Box, they have given out 2427 boxes and reached out to over 5000 mothers from poor backgrounds.
“ For every box we give out, we save two lives, mother and newborn” Kaigutha says.
World Bank data reveals that the Kenyan infant mortality rate stands at 36 deaths per 1000 births, while the maternal death rate is 488 deaths per 10,000 live births as per Kenya Demographic and Health Survey.
These grim figures led Kaigutha to think of an innovation that would see the maternal and newborn deaths reduced in Kenya.
Kagutha reveals that the Toto care box which doubles up as a baby crib contains the following items.
- Waterproof mattress 10. Cotton wool to help in post-partum bleeding
- Under sheet 11.Cotton wool and surgical spirit for baby
- Blanket 12.Leso
- Mosquito net 13. Condoms
- Set of baby clothes 14.Diarrhea kit
- Three reusable nappies 15.Toto Care leaflet
- Three nappy liners
- Waterproof pant and nappy fastener
- Box that doubles up as crip
Kagutha believes that the Toto care box, which encourages a mother to attend maternal clinics and provides a newborn care box to mothers, helps reduce newborn and maternal deaths.