Born here and back to serve
What forty years of community care can teach us about organisational resilience
One of the children born at Provide International’s clinic now serves there as a volunteer nurse.
The team shared this story during AFWAG’s Boots on the Ground visit to Komarock, Nairobi. It gives a human timescale to organisational sustainability: a child born, growing up and returning to contribute, with the organisation still present throughout.
For AFWAG, understanding what makes that continuity possible is central to walking alongside community organisations. These visits help us learn how members sustain their work, document knowledge developed through practice and identify where relationships within the network could support their next steps.
At Provide International (PIO), that conversation drew on four decades of community care.
An approach shaped by connected needs
Established in 1986, PIO serves families in Korogocho, Dandora and Kayole through two facilities. Its Korogocho facility focuses primarily on social support and empowerment, while Komarock operates as a hospital.
During our visit, co-founder Lena Kitheka and Programmes Lead Job described an approach that connects maternal healthcare, child nutrition and women’s livelihoods.
PIO provides antenatal and postnatal care, vaginal and Caesarean deliveries, and family planning education and services. Healthcare is subsidised, with fees waived in some circumstances. Community health workers identify households facing difficulties and connect them with services.
Alongside healthcare, women and girls can access skills training, while partnerships have enabled some participants to receive seed funding for businesses. A feeding programme supports children from households experiencing hardship.
For peers within AFWAG, this approach raises useful questions about programme design. How can organisations respond when the circumstances affecting a woman’s health also involve food and income? Which services can they provide directly, and where do partnerships become essential?
PIO’s experience offers a starting point for examining those decisions together.
Experience does not remove the pressure to sustain services
PIO reports that more than 6,000 mothers have delivered vaginally through its services over the years, with additional mothers supported through Caesarean deliveries. It also reports reaching more than 35,000 children through its feeding programmes. These are cumulative figures shared by the organisation.
Yet forty years of service has not removed the difficulty of financing continuity.
Limited funding has reduced the feeding programme to weekends. Meanwhile, demand for maternity services has prompted ambitions to expand the maternity wing. The team also identified establishing a neonatal intensive care unit as a priority requiring infrastructure, equipment and further resources.
These pressures make organisational resilience concrete. It affects how regularly a child can receive a meal, how much maternity capacity is available and whether an organisation can develop services in response to community needs.
For AFWAG, this is the context organisational support must address. Understanding a member’s systems and resources becomes more useful when connected to the services those foundations sustain.
Turning practice into shared learning
PIO’s experience holds knowledge that could be useful to other members: how community health workers connect households to care, how an organisation manages subsidised services and how health programmes operate alongside livelihoods and nutrition support.
A visit allows us to begin exploring the decisions behind that work. Documenting those conversations preserves lessons that might otherwise remain with individual staff members or within one organisation.
Case studies give that knowledge a wider life. They provide material for peer discussions in which members can examine an approach, question its assumptions and consider what could work in their own settings. They also help AFWAG identify relevant connections between organisations facing similar challenges or bringing complementary experience.
PIO enters that exchange with substantial knowledge to contribute and priorities of its own. Continued engagement can help clarify which peer relationships, organisational resources and partnership opportunities would be most useful. These are pathways to develop following the visit.
Bringing community experience into wider decisions
The learning also matters beyond the network.
PIO’s reduced feeding schedule shows how a funding constraint changes the frequency of a service. Its maternity expansion priorities show why sustaining an established organisation may require investment in additional capacity as community demand grows.
Documenting such experiences gives AFWAG a grounded basis for contributing to funding, partnership and policy conversations. It allows us to carry members’ practical knowledge into discussions about what support should look like and which conditions help organisations sustain their work.
The nurse who returned to the clinic offers one glimpse of what that staying power can mean. AFWAG’s task is to help preserve the knowledge behind it, connect it with others’ experience and ensure it informs decisions about the future of community-led work.
