Health and Family Planning in Kenya Jane Kishoyian

“Promoting Access to quality healthcare”

Celebrating 70 years of Quality Health Care

(1946-2016)


CHAK REPRODUCTIVE HEALTH/FAMILY PLANNING

PROGRAM Presented by; Jane Kishoyian

Christian Health Association of Kenya

CCIH 30th Annual Conference 2016: Johns Hopkins University, Baltimore, MD, USA



Outline • Kenya context • Program goal and objectives • Program motivation • Program support • Achievement • Challenges • Way forward



Kenya context • TFR – 3.9 KDHS 2014 – down from 4.6 in 2009. (Rural

women have more children than urban women)

• Unmet need for family planning - 23%. (KDHS 2014). • Most popular method is injectable at 26%, implants

10% and pills 8% • The Government offers 60% of modern contraceptive

while private and FBO offer 40%. • CPR -58% (KDHS 2014) • IMR-39/1,000 live births • Under fives MR – 52/1,000 live births • MMR – 400/100,000 live births (WHO 2013)



Program Goal To improve reproductive health through:

Increased CPR Reduced unwanted and mistimed pregnancies Lowerered incidence of unsafe abortion Reduced maternal morbidity and mortality Decreased fertility rates over time



Objectives • Capacity building of HCW and CHVs on

RH/FP • Sensitization of Religious Leaders to

champion RH/FP • Increase supply of FP commodities and RH

services • Create and sustain demand for RH/FP • Advocate for resource allocation • Disseminate lessons learnt



Program Motivation • CHAK’s commitment to support member health

facilities to address; • Poor access and utilization of RH/FP • The unmet need for FP services • Declining attitudes towards FP use

• capacity building needs (skills) to improve service delivery

• Lack of men support and involvement • Need to enhance supply and demand side

interventions



Motivated staff Staff team building



Increase uptake of

RH/FP services at

Health Facility & Community

SERVICE DELIVERY-HF

& COMMUNITY

ADVOCACY/POLICY

ENGAGEMENT & INFLUENCE –

National & County

MONITORING, evaluation &

DISSEMINATION

CAPACITY BUILDING

INFORMATION

PROVISION/DEMAND CREATION

CHAK RH/FP Program Model


Achievement • Trained 250 Religious leaders on advocacy

and 150 CHVs for service delivery at community level

Kendu Adventist Mission Hospital Maua Methodist Hospital



Equipping health facilities • Eight (8) facilities were supplied with

implant , IUCD and BTL Kits. IEC and guideline distributed

ACK Maseno hospital and Monianku health center



Capacity building of HCW


Basic emergency obstetric care (BEmOC) and long acting FP methods training • 120 HCW trained and review meetings

follow up and on job trainings



Training of Religious Leaders to improve family planning service demand


Achievement • Baseline survey conducted that indicated

low uptake of FP in the faith based facilities • A total of 250 Religious Leaders trained and

engaged in giving FP health messages and services respectively.

• A total of 1,424 community meeting organized by religious leaders in 6 counties

• A total of 16,824 people received FP messages from Religious Leaders in 6 counties in Kenya.



Achievement

• 4,635 clients referred to health facilities for FP methods by religious leaders

• Improved method mix • Improved FP uptake • Community based distribution of pills and

condoms • Improved support for FP commodities from

the County Health Departments as a result of advocacy


achievements • 32 dialogue days have been conducted in the 8 facilities • Effective referral for clients for BTL – 52

women supported to undergo BTL services – last 16 months

• Increased male involvement - More men accompanying and paying for their spouse to receive FP services.

• 2 out of 8 HF reported stock out-initially 6 • 38,611 new FP accepters in 8 facilities



Engaging CHVs in FP 150 CHVs trained

Community dialogue day Training of CHVs



Experience sharing forums


Faith-based increase in new FP users; Seven folds in three years -384 to 2839 Namasoli Health Center, Vihiga County, Kenya 2012-2015

Kenya won excellence in leadership for FP award during the ICFP 2015 in Indonesia- CHAK was

represented and shared best practise

Challenges

• Staff turnover • Cultural and religious biases against

contraception • Occasional erratic supply of commodities • Many health facilities lack equipment to

support BEmOC • Inadequate skilled personnel - on LAM • Inadequate funding


Way forward • Continue with capacity building through

mentorship • Continue support in commodity

management to ensure no stock-outs • Address myths and misconceptions • Strengthen the data collection and

reporting system • Source for more funding



Acknowledgement • Gates Foundation – Eastern & Central region • Packard Foundation- Nyanza & Western region • Bread for the World – All other regions • CCIH • MOH • County Health Departments • Religious Leaders • Communities



Thank you


Health & Medicine

Health and Family Planning in Kenya Jane Kishoyian