Chamas for Change improves mother-baby health

The phrase ‘it takes a village’ may seem cliché, but there couldn’t be a more accurate phrase to describe AMPATH’s approach to improving mother-baby health in a country where maternal and infant death still remains a real threat.


Chamas in swahili translates to “groups.” Chamas have had a longstanding presence within the financial landscape of East Africa. Flexible and informal, they rely on social ties. They are highly gendered institutions that women have traditionally relied on for survival. Readily assembled in times of famine, floods and funerals, chamas are effective networks through which women can meet regularly outside the home and pool resources. Using this existing cultural script, Drs. Astrid Christoffersen-Deb, Laura Ruhl, and Julia Songok, co-leads for the AMPATH MNCH program in Primary Health Care, have developed a mother-child investment club called Chamas for Change. In a rural district where the insecurities of pregnancy and infancy continue to threaten women and infant survival, Chamas for Change is now in its second year. The fact is that one out of 10 Kenyan children die before their fifth birthday and two-thirds of those deaths occur during the first year of life. In addition, more than 50% of births in Kenya occur in the home without skilled medical assistance.


Facilitated by Government of Kenya Community Health Workers, these womens’ chamas harness the powerful cultural logic that when women work together, their communities are likely to survive and thrive. Central to Chamas for Change or Chama cha MamaToto (Mother-Baby Group) is the integration of a savings and loan program into the group model that focuses on health education and relationship strengthening using the chama as the service delivery platform. This way the group members not only have the money to pay for maternity medical services, but also they are receiving group support and encouragement to seek the recommended medical care. AMPATH’s goal, to use community to improve maternal and newborn health, seems to be working. After the initial intervention in the Lake Victoria community of Bunyala, AMPATH saw a 73% increase in members attending the 4 recommended pre-natal visits to a health care facility, 68% increase in women delivering in a health care facility rather than at home, 74% increase in women exclusively breast feeding for 6 months, and a 100% increase in women receiving a Community Healthcare Worker in-home visit within 48 hours of delivery.