In 1994, Nekeki was registered as a non-governmental organization (NGO) in Kitale, a town in the Trans-Nzoia District of the North Rift province. Nekeki has three programs running concurrently: Problem Solving for Better Health® (PSBH®), which is active in the districts of Bungoma, Busia, Kilifi, Kwale, Laikipia (Nyala), Malindi, Nyandarua, and Trans-Nzoia; Adolescent Sexual Reproductive Health/Family Planning, supported by the German Foundation for World Population; and Community Pharmacies and Curative Services. Nekeki collaborates with the Kenyan government through the Ministries of Agriculture; Culture, Gender, and Sports; Education; Health; and Water, as well as with other agencies including Population Services International, Kenya AIDS Consortium, Grassroot Alliance for Community Education (GRACE International), and other grassroot community-based organizations.
In 2004, DHF initiated collaboration with TechnoServe in Kenya. TechnoServe was supporting a project for the dairy farmers of Nyandarua and Laikipia (Nyala) focused on collection, storage, and marketing of dairy products. The farmers requested external intervention on health problems affecting their communities. This led to the integration of the PSBH program which has led to 14 successful projects focusing on malaria, environmental sanitation, HIV/ AIDS, typhoid, drug abuse and immunization.
1) To ensure that projects generate and facilitate growth and development of the health sector.
2) To encourage networking between government, NGOs, community-based organizations, and private sectors to solve health problems.
3) To ensure that projects are replicated.
4) To empower individuals and communities to solve their own problems using available resources.
5) To encourage individuals and groups to seek information and knowledge through professionals and the Internet.
- Decreased waterborne diseases as a result of borehole construction for safe drinking water.
- Raised awareness of the importance of pit latrines.
- Reduced number of malaria cases as a result of clearing bushes, filling potholes, and using treated mosquito nets.
- Reduced violence against women as a result of increased awareness of women’s rights.
- Reduced teenage pregnancy.
- Reduced drop-out rate in primary schools.
- Raised awareness of the importance of health education.
During project implementation, there arose an interest among community members to address the community’s health problems on a wider scale. In March 2004, a Problem Solving for Better Health Initiative™ (PSBHI™) workshop was held with 38 participants from Kimilili, Matunda, Miendo, and Ndalu. Each of these geographical areas brought their own health problems to the workshop, with Matunda, Miendo, and Ndalu focusing on malaria and Kimilili focusing on HIV/AIDS.
- To create a sense of collective responsibility for solving community health problems.
- To broaden community involvement in solving health problems.
- To improve group dynamics.
- To implement projects that meet the needs of the larger community.
- An HIV/AIDS program implemented in Matunda .
- A decrease in the number of malaria cases in Matunda.
- A malaria project established in Miendo.
- A nutrition program involving dairy management and proper feeding of orphans implemented in Miendo.
- HIV/AIDS counseling and referral services established in Miendo.
- An HIV/AIDS program increases visits to the Voluntary Counseling and Testing (VCT) centers in Kimilili with support from the National Aids Control Council (NACC).
In December 2003, Dr. Mary Madumadu attended a PSBH workshop in the United States. She envisioned how the concept could be a real solution to the health problems so often thought of as unsolvable in her Mazeras, Mombasa village. The concept was presented to retired nurses whose mission was to address health issues in the community. In July 2004, a Problem Solving for Better Health - Nursing™ (PSBHN™) workshop was held in Mombasa with 45 retired nurses. The projects developed during this workshop focused on HIV/AIDS, waste management, malaria, typhoid, hypertension, malnutrition in children under five, and anemia in pregnancy.
- To utilize locally available resources (retired nurses) to improve health in the community.
- To harness and harmonize the skills, knowledge, and experiences of retired nurses and generate new ideas for better management of community health issues.
- To build a strong primary prevention base for common health problems.
- To recognize retired nurses as potential health providers in their community.
- A anti-retroviral treatment referral program for people living with HIV/AIDS.
- A feeding program for orphans in nursery schools.
- A sanitation program for waste collection and disposal in Malindi town.