title: Effectiveness of Ng'adakarin Bamocha model in improving access to ante-natal and delivery services among nomadic pastoralist communities of Turkana West and Turkana North Sub-Counties of Kenya.
abstract: BACKGROUND
  Access to maternal and child health care services among the nomadic pastoralists community in Kenya and African continent in general is unacceptably low. In Turkana, only 18.1% of the women had seen a nurse or a midwife for antenatal care during pregnancy while only 1.3% of pregnant women reported delivery at health facilities in 2005. Ng'adakarin BAMOCHA model, based on migratory routes of the Turkana pastoralists and container clinics was adopted in 2007 to improve access to maternal and child health services by the nomads.
  
  
  METHODS
  A cross-sectional study design was used to establish the effectiveness of Ng'adakarin BAMOCHA model on accessibility and uptake of ante-natal care and delivery services. A total of 360 households and 400 households were interviewed for pre-intervention and post-intervention respectively. The study compared the pre-intervention and post-intervention findings. Structured questionnaires and focus group discussion were used for data collection.
  
  
  RESULTS
  There was no improvement in the fourth ante-natal care visits between pre-intervention and post-intervention groups at 119(51.5%) and 111(41.9%) respectively (p < 0.05). Knowledge of the community on the importance of ANC visits improved from 60%-72% with significance level of p < 0.05. There was a significant increase 6%-17% of deliveries under a skilled health worker (p < 0.05). TBA assisted deliveries increased from 7.5%- 20.2% with a p < 0.05. There was significant reduction in home deliveries from 89.5%-79.5% with a p < 0.05.
  
  
  CONCLUSIONS
  The Ng'adakarin Bamocha model had a positive effect on the improving maternal health care among the nomadic pastoralist community in Turkana.
authors: Department of Health Systems Management and Medical Education, Kenya Methodist University, Nairobi, Kenya ; Amref Health Africa, Kenya Country office, Nairobi, Kenya.
authors: Jillo Ali
authors: JA
authors: Jillo
authors: Amref Health Africa, Kenya Country office, Nairobi, Kenya.
authors: Peter Obonyo
authors: PO
authors: Ofware
authors: Department of Health Systems Management and Medical Education, Kenya Methodist University, Nairobi, Kenya.
authors: Susan
authors: S
authors: Njuguna
authors: Department of Health Systems Management and Medical Education, Kenya Methodist University, Nairobi, Kenya.
authors: Wanja
authors: W
authors: Mwaura-Tenambergen
mesh_terms: D000293:Adolescent; D000328:Adult; D002662:Child Health Services / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D017144:Focus Groups; D006297:Health Services Accessibility; D006700:Home Childbirth / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya; D008427:Maternal Health Services / Q000458:organization & administration*; D008875:Middle Aged; D008880:Midwifery / Q000706:statistics & numerical data; D008962:Models, Theoretical; D011247:Pregnancy; D011295:Prenatal Care / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D014171:Transients and Migrants / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Ng´adakarin Bamocha; Turkana; health facility delivery; nomads; pastoralist; skilled delivery services; traditional birth attendants and container clinics