Beyond Immunization Boundaries

Inside Aisha’s journey as a community health mobilizer in Nairobi’s informal settlements

Aisha Hamisi, a community mobilizer for CORE Group Partners Project, presents in Swahili as she turns the pages of her flipbook discussing polio. / Gena Thomas, CORE Group Partners Project

First published March 12, 2024 by the U.S. Agency for International Development.

Fifty-two-year-old Aisha Hamisi sits on a straw-weaved stool in the middle of an open space inside Kamukunji with corrugated, rusted tin all around her, making up both the walls and the roofs of the homes in this informal settlement in Nairobi. At 10 a.m. on a Thursday, she is in the center of a circle of 12 mothers.

The mothers show their resilience and mindful focus, listening carefully to Aisha’s words, as their children — from newborns to toddlers — drop hats, cry for more breastmilk, sneeze, waddle, and grab their mothers’ faces. After all, the children are the very motivators who have brought them to this place.

Aisha, a community mobilizer for USAID’s CORE Group Partners Project (CGPP), presents in Swahili as she turns the pages of her flipbook discussing polio. One of the mothers interrupts her presentation and asks about tuberculosis and its vaccine, bacille Calmette-Guerin (BCG). “BCG reduces the chances of getting the disease, but it does not fully prevent it. Even if your child gets the disease, they will be stronger against it if they have the vaccine,” says Aisha.

Aisha gives this same talk to fathers groups as well.

“One thing about Aisha…,” says Omalo Orinda, known as Moses, “…is that she will always give you her time. The knowledge the community mobilizers [like Aisha] have due to capacity training is very high.” Moses, who serves as the senior project officer at Catholic Relief Services — an implementing partner for CGPP Kenya–adds: “When there are immunization campaigns, it’s definitely a full-time job.”

Aisha, a community mobilizer in Nairobi, is know for her commitment to encouraging mothers and fathers to get their children vaccinated. / Gena Thomas, CORE Group Partners Project

In the first seven months of 2023, measles-rubella 2 (MR2) vaccines reached less than 50% of the targeted population in Kamukunji each month. Often, mothers forget that they need to return for a second dose. Measles vaccination previously only required one shot for a complete dose.

Other factors of low uptake include generally low knowledge, awareness, and risk perception of MR2 vaccination, the number of needed doses, follow-up contact tracing largely not focusing on MR2 vaccination, and weak counseling by frontline health workers on the second dose’s importance.

Aisha works mainly in Kamukunji, a suburb of Nairobi where CGPP has 37 care groups with most mothers in their 20s and 30s. “We have seen very high impact with the locals with these groups,” Moses says.

Each group contains 14 to 18 mothers who are trained by community mobilizers like Aisha. The mothers then share the knowledge from the training with their neighbors. USAID helped create flipbooks for several vaccine-preventable diseases such as polio, measles, cholera, tuberculosis, COVID-19, and viral hemorrhagic fevers — such as Ebola, Marburg, Lassa, and Rift Valley fever. These flipbooks help community mobilizers maintain quality information while sharing with the mothers and fathers groups.

Aisha has been working as a community mobilizer for six years.

“It is important for me to continue serving the community as a community mobilizer despite high turnover since it’s a calling,” she explains. “It’s a sacrifice and it’s voluntary.”

Aisha says that health is a mutual responsibility: “If my neighbor is healthy, I will also be healthy, socially and psychologically.”

Mothers show their resilience and mindful focus — while also attending to their young children — as they listen to community mobilizer Aisha Hamisi’s presentation. / Gena Thomas, CORE Group Partners Project

Thanks to these efforts, from January — July 2023, an average of 36.71% of children were vaccinated with MR2 in the sub-county of Kamukunji where Aisha works, and an average of 60.43% of children reached full immunization.

Over half of the population of Kamukunji is made up of refugees from Burundi, Eritrea, Ethiopia, Rwanda, Somalia, South Sudan, Tanzania, and Uganda. CGPP, alongside the Ministry of Health, is recruiting community mobilizers from refugee populations to bridge the language and cultural barriers.

In Kenya, CGPP supports polio eradication, surveillance for zoonotic diseases that can jump from animals to humans, COVID-19 prevention and control, and response activities by training, equipping, and supporting 126 community mobilizers in seven counties.

“I feel good when I assist my community and help them support themselves — help them help themselves!” says Aisha. “It’s important to my community because they benefit a lot from my service and the networks I have.”

About this Story

The CORE Group Partners Project is a multi-country, multi-partner initiative providing financial and technical support for strengthening host country efforts to eradicate polio, strengthen surveillance of zoonotic diseases, and control the spread of COVID-19. For over 20 years, this USAID flagship project, which initially only focused on polio eradication, has since used its infrastructure to respond to existing and new health challenges to advance the U.S. Government’s Global Health Security Agenda.

About the Authors

USAID’s Office of Maternal and Child Health and Nutrition works to ensure that all women and children have the same chance of a healthy life, regardless of where they live or are born. CORE Groups Partners Project’s Gena Thomas, knowledge management and communications advisor, and Abubakar Salah, communications officer, captured this story and images on the ground in Kamukunji, Kenya.

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