Co-creation with community members using human-centered design methods to adapt the Adolescent Chamas+ program.
The Arnhold Institute for Global Health at Mount Sinai leads the adolescent health initiative within its AMPATH Kenya partnership, and has a strong focus on reproductive health for women and adolescents.
“Collaboration with our Kenyan colleagues is at the core of what we do, and they are critical partners in so many things that are going on in the AMPATH Kenya reproductive health program,” says Wan-Ju Wu, MD, MPH, AMPATH Kenya Associate Site Director in Reproductive Health, and Assistant Professor of Global Health, and Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai.
Centering Adolescent Voices to Design Chamas+
Dr. Wu recently represented AMPATH Kenya’s Maternal Newborn and Child Health Innovations team at the FIGO World Congress of Gynecology and Obstetrics in Cape Town, South Africa. She presented the team’s work on building life skills and financial literacy for pregnant and parenting adolescents through a pilot program called Adolescent Chamas+.
Adolescent Chamas+ is adapted from AMPATH’s longstanding Chamas for Change program, which uses community-based support groups–known as chamas–as health, social, and financial resources for pregnant women and new mothers. Women who partipicate in the program are more likely to attend prenatal visits, deliver in a health facility, and breastfeed exclusively. In addition to health education about pregnancy and caring for their babies, participants gain financial skills and participate in microfinance.
Adolescent Chamas+ builds on this model to address the distinct health, social, and financial challenges that pregnant adolescents face. Its goal is to teach pregnant and parenting adolescents in western Kenya about health and personal finance and connect them to social support so they transition to adulthood with education and a path to leading healthy lives. Young people co-designed the program, using a human-centered design approach, to meet their unique needs.
Wan-Ju Wu, MD, MPH, presenting a team member’s poster at the FIGO World Congress of Gynecology and Obstetrics in Cape Town, South Africa.
“Adolescents have unique vulnerabilities,” says Dr. Wu. “Girls especially are often not seen as agents of change or are not heard when they describe what they need. The purpose of the Adolescent Chamas+ model is to listen to the needs of the community you are designing for and making sure their voices are integrated into solutions that will impact them.”
Building Gynecologic Surgery Capacity at Moi Teaching and Referral Hospital
The Obstetrics and Gynecology Department at Moi Teaching and Referral Hospital (MTRH) in Eldoret, Kenya, aims to address western Kenya’s reproductive health needs through facility and community-based care, education, and research programs. Through the Arnhold Institute’s AMPATH Kenya partnership, Dr. Wu works closely with the department to advance collaborative projects.
Dr. Wu is collaborating with MTRH gynecologists to grow minimally invasive gynecologic surgery services including laparoscopy, which is performed through small key-hole incisions on the abdomen. This is the standard of care for most gynecology surgeries in high-resource settings. The team is using a systems-level quality improvement approach by engaging a multidisciplinary team of nurses, surgeons, biomedical technicians, and emergency department staff.
“There is good data that minimally invasive surgery is linked to decreased stay in the hospital, decreased infection risk, and decreased blood loss,” Dr. Wu says. “These benefits are particularly relevant to low resource settings because there are less blood products and less space in hospitals. Also, many people in Kenya do so much more manual labor, and women especially also have physical responsibilities related to childcare. So getting back to the home and to work sooner is really important.”
Providing Reproductive Health Education and Training Through Project ECHO
In addition to improving care through peer support programs and enhanced women’s hospital services, Dr. Wu and gynecologists at MTRH are strengthening reproductive health knowledge for providers in peripheral health centers.
In 2024, the AMPATH Kenya partnership launched the Reproductive Health ECHO program, using the Project ECHO (Extension for Community Healthcare Outcomes) platform to train reproductive health providers in obstetrics and gynecology through monthly virtual sessions. A subject matter expert from MTRH presents a topic, which is followed by a case presentation and discussion. These sessions reach more than 100 participants across the region each month.
“Project ECHO is well-received and has good attendance,” Dr. Wu says. “The next step our team is looking forward to is translating the knowledge from education and training to measurable improvements in health care quality and practice.”
About the AMPATH Kenya Partnership
Mount Sinai leads the adolescent health initiative within AMPATH Kenya—a 35+ year partnership between Moi University, Moi Teaching and Referral Hospital, the Kenyan Ministry of Health, and the AMPATH Consortium of global academic partners.
Chloe Tenn, MSc is the Digital Communications Manager for the Arnhold Institute for Global Health at Icahn School of Medicine at Mount Sinai