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YALI Voices with Meera Shah Podcast: Working to Bring Better Health Care to Kenyan Communities
November 30, 2017

Meera Shah’s 8 years in the public health sector have reinforced the old saying that “an ounce of prevention is worth a pound of cure.” As a medical health officer in Mombasa, Kenya, Shah works to promote good health with preventive measures like immunizing children and stopping the spread of HIV. “It’s a lot to do with education and creating that awareness so that you are creating the demand for good health,” Shah tells YALI Voices.

She particularly focuses on children, whom she calls “agents for change.” Much of her work takes place in schools. Shah and her colleagues teach children healthy habits and provide them with vaccinations and nutrition supplements. Shah believes that instilling knowledge in the children will help promote the health of entire communities in future generations.

Outside of schools, Shah works closely with community leaders to track the health of communities and promote scientifically based health information. She helps provide access to medical facilities, HIV medicine, tuberculosis treatment, and services for new and expectant mothers. Shah is sensitive to the fact that traditional practices sometimes conflict with modern medical knowledge. She believes that more education and better access to medical facilities will help overcome barriers to improving public health.

“It’s really preventive health that we want to focus on: going out into the community, making people aware, educating them on demanding for these health services,” Shah says.

Shah, who trained as a pharmacist, was selected as a 2015 Mandela Washington Fellow. She is currently studying for her master of science degree in health systems management at Kenya Methodist University. You can hear more about how Shah promotes public health by listening to her interview on YALI Voices or reading the transcript below.



“YALI Voices Podcast: Meera Shah”


MEERA SHAH: My name is Meera Shah. M-E-E-R-A. S-H-A-H.


♪ Yes we can ♪ ♪ Sure we can ♪ ♪ Change the world ♪

VOICE OVER: Welcome to the YALI Voices Podcast, your home for sharing the best stories from the Young African Leaders Initiative Network. Be sure to subscribe to the YALI Voices podcasts and visit yali.lab.dev.getusinfo.com to stay up to date on all things YALI.

Meera Shah has almost eight years of experience in the public health sector. Currently, one of the sub-county medical health officers in Mombasa county, she coordinates activities related to health, including overseeing the running of primary care facilities, and programs such as HIV/AIDS, tuberculosis, malaria, mother-neonatal-child health, nutrition, and disease surveillance. A pharmacist by profession, she is at the moment pursuing a master’s degree in health systems management. She is also a 2015 Mandela Washington Fellow.

MS. SHAH: I am working in the public sector in Mombasa with the County Government of Mombasa, in the Department of Health in the public health sector. So, it’s been 10 years now this year. And basically what we do is we focus on preventive health and promotive health, rather than curative. So we are out in the field mostly to promote good health, make sure children take their immunizations, make sure they’re well-nourished. And if not, then they’re given the nutrition supplements. Make sure all our people who are living with HIV are on ARVs, make sure women are on family planning methods, disease surveillance, you know, make sure if there — we have about 20 priority diseases in Mombasa, well, in Kenya, that we monitor on a regular basis. So make sure that if there are any cases that are reported which are of the high priority, then they are followed up and made sure that we contain any spread of infection and the sort.

Meera Shah posing for a picture
Meera Shah

MS. SHAH: So, basically what we do, we promote good health. Like I said, we promote immunizations for children to be fully immunized. We promote HIV in the sense we make sure that all people living with HIV are on their ARVs, and also preventive measures to spread the infection of HIV, like we have the PMTCT program, Prevention of Mother to Child Transmission of HIV. Now it is Elimination of Mother to Child Transmission of HIV. We are talking about TB, tuberculosis — make sure that everyone who has TB is on treatment for anti-TBs because remember, TB, tuberculosis, is curable. Yet we have people dying from TB. And why is that, considering that we have medicines available, but yet you find people are dying of TB. And what is worse than TB is multi-drug resistant TB, and then we have extreme drug resistant TB. So far in Mombasa, we have gotten a couple of cases of multi-drug resistant TB. We haven’t got any of XDR. Basically all that part of preventive health.

MS. SHAH: I think a lot of making people aware on good health or promoting good health is a lot to do with education and making the public aware on the impact of not having their children immunized or on the impact of a mother, a young mother, not being on any family planning method. It’s a lot to do with education and creating that awareness so that you are creating the demand for good health, you know, for a mother to go to antenatal clinics and make sure that the child or the fetus is progressing well into delivery and all that.

So it’s a lot to do with education. We are giving a lot of focus now to school health. So we want to instill good health or make children be aware that they should demand for good health. Remember children are the agents for change. So we really want to focus on school health and promote health education through the children. But apart from school health, we also go out into the community and have dialogues with communities on everything, on health. Like if there are diarrheal cases, then why they should wash their hands before eating food or after going to the toilet, or why they should immunize their children, why the women should go to a health facility as soon as they realize that they are going into labor, rather than going to a traditional birth attendant, who will probably complicate the matters and then the mother comes into a health facility when it’s already complicated and either we lose a child or we lose the mother.

So it’s really preventive health that we want to focus on: going out in the community, making people aware, educating them on demanding for these health services. And through school health, we would like to promote good health. I think that is the best avenue, education and knowledge.

VOICE OVER: We talked to Meera about how she deals with preconceived notions about health information and care. Having mentioned the use of midwives or other nonclinical spaces for childbirth, we wanted to know how she addresses traditional beliefs about health. We then followed that up with a question about what she considered some of the key elements she employs when developing a health education and awareness campaign.

MS. SHAH: For us as a country, we have a long way to go. Remember these midwives — or like you said, the nonmedical spaces that are available — they are right in the community. They are very — how do you say — strategically placed in the community, so that they’re able to reach the community, whereas we as a government, as a country, have a long way to reach all those geographical strategic locations. So until we can do that, until we are able to place ourselves at the right time, at the right moment, at the right place, I believe these nonmedical spaces will continue thriving. And for that, there has to be a policy change to mobilize resources or to allocate resources at the community level, at the ground level, to make sure that a health facility is within reach of a community so that the community does not have to go to these other nonmedical spaces to seek health services.


MS. SHAH: We use a variety of methods. We go through radio as well. We do print. Although, realize Mombasa still has a big rural population. Most of Kenya has a big rural population, and not everyone will be able to read and write. So radio. We also do a lot of mobilizing through the public address system, like we use — we mount a public address system on our vehicles, which go around a village, you know, through all these areas promoting the message on health or whatever it may be, that being the main avenue, the main channel, through which we get the message out. But yes, we do have print media. We have — nowadays, we are also focusing on the social media, although, again, like I said, it’s not everyone who accesses social media. So we try all channels. We also go through what we call the chief’s barazas. Remember the chiefs are the village — the elders, the community leaders, and they regularly, on a monthly basis, they have like a — how do you say — like a get-together in the community where they talk about security issues, whatever issues there may be. And we ride on that because they have mobilized a lot of people. We get about 100-200 people at such a gathering. And we ride on that as well, and get the message out to the people.

We also have community health volunteers who are part of a community unit. In some cases, we also support them to get the message out to the community.


MS. SHAH: As YALI Network members, I believe we have a huge role to play in promoting good health. I remember currently the YALI Network probably has so many people, about 1,000, 5,000, 10,000 — I’m not even sure how many people we have, but the bigger the group gets, we are able to reach more people. And remember, this is a group of diverse individuals coming from different backgrounds. And I would say promoting good health is not just the responsibility of a medical person. It’s the responsibility of everyone. It’s the responsibility of guys who are in education; it’s a responsibility for guys who are in politics; it’s a responsibility for guys who are in other sectors, in the transport sector, in the housing sector. And it’s a holistic thing. And so when all these ideas come together from different people and we are able to create something good, come up with some good ideas, some good policies that we would be able to implement, I think that is what will impact good health or quality health in the country or even in the continent.

I’m glad that I had this opportunity to network, to come across YALI, to come across MWF, so that I was able to come across a lot of people from diverse backgrounds. And like I said earlier, it’s good that we all come together, we formulate ideas. Everyone has a lot of ideas, but if you’re able to put even two of those ideas together to impact on the health sector, to impact on the education sector, to impact on agricultural sector, it would go a long way for the continent, for all us African countries. Yeah, it’s this coming together.

VOICE OVER: Thank you for tuning into another YALI Voices Podcast and thank you Meera Shah of Kenya for your insights and ideas. We encourage YALI Network members who are working to ensure that credible health information gets to those in their community to share their ideas and best practices with us. Be sure to share your thoughts on this podcast and other important topics on the YALI Network Facebook page at facebook.com/yalinetwork.

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