Date post: | 12-Apr-2017 |
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Healthcare |
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Melanie Lopez, MPH 21 June 2016
www.worldvision.org/our-impact/health
The Garba Tulla Healthy Timing & Spacing of Pregnancy Project: Increasing Contraceptive
Uptake in Northern Kenya
Healthy Mothers, Healthy Children: The Role of Faith Communities
Washington DC
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Background/Context: Garba Tulla, Kenya
Garba Tulla is a USAID-funded program, integrated into a larger Maternal and Child Health project (funded by WV Canada). Goal: To increase access to and use of voluntary Family Planning (FP) services through integration of Healthy Timing & Spacing of Pregnancies (HTSP) into a Maternal and Child Health (MCH) project in Garba Tulla District, Kenya • SO1: Increase access to FP services in the community • SO2: Increased knowledge & interest in HTSP/FP • SO3: Improved social & policy environment for FP services
and positive Reproductive Health behaviors
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Healthy Timing & Spacing of Pregnancies (HTSP). What does it mean?
• An intervention that focuses on healthy fertility to help women, men and families, time and space their pregnancies to achieve desired family size and the healthiest outcomes for newborns, children, and women.
• HTSP works within the context of free, informed and voluntary contraceptive choices.
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Where in the world is Garba Tulla, Kenya?
KENYA ISIOLO GARBA TULLA
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Points of integration to increase utilization for HTSP/FP
• Antenatal care: 73% of women get tetanus toxoid coverage during the fourth antenatal care visit
• Immunization: High immunization coverage (72.6 percent) for fully immunized children under 2
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Points of integration to increase utilization for HTSP/FP
• Faith Leaders: Sheiks and Imams
• Male Leaders: Chiefs, teachers, husbands, elders
• Community Health Volunteers (CHVs) and Community Health Extension Workers (CHEWs)
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SO: Community Mobilization –
Faith Leaders, Male involvement
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Results
0
100
200
300
400
500
600
Capacity Building, Male-FPcounseling/services for CHWs
Capacity Building, Male-FPcounseling/services for other providers
working in health facilities
Cacacity Building, Female-FPcounseling/services for CHWs
Capacity Building, Female-FPcounseling/services for other providers
working in health facilities
Number of community health workers (CHWs) and/or other health providers trained or supported, disaggregated by gender
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Results
0
200
400
600
800
1000
1200
1400
Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15
Number of community members reached with family planning messages by type of provider
By CHEW (Other service providers in health facilities) By CHVs (Community health workers (CHWs)
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Successes
0
50
100
150
200
250
300
350
400
450
500
Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15
# of clients receiving FP services integrated into MNCH services at the same location and time, disaggregated by sex
Male Female
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Successes
2870
0
1867
184
3
0
45
1098
1
605
0
514
724
0 500 1000 1500 2000 2500 3000
Male condom, Male
Male Sterilization, Male
SDM, Male
Emergency Contraception, Female
Female condom, Female
Female Sterilization
Implants, Female
Injectables, Female
IUD, Female
Female Lactational Amenorrhea
Male condom, Female
Oral Contraceptive Pills, Female
Standard Days Method (SDM), Female
# of current users, disaggregated by sex and method
# of current users by gender and method
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Successes
18 89
376
179
451
757
0
200
400
600
800
1000
1200
Sep-14 Dec-14 Mar-16 Jun-16 Sep-16 Dec,2015
Male condom, Male Male Sterilization, Male SDM, Male
Emergency Contraception, Female Female condom, Female Female Sterilization
Implants, Female Injectables, Female IUD, Female
Female Lactational Amenorrhea Oral Contraceptive Pills, Female Standard Days Method (SDM), Female
# of current users over time, disaggregated by sex and method
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Lessons Learned • The pivotal importance of men in FP programs
In traditional societies, where men are the gate-keepers who control all access to resources, the initial focus of FP programs must be on men – chiefs, elders, imams and fathers
• Increasing Contraceptive Use in conservative rural societies takes time In cultures with no tradition of contraceptive use, the initial step succeeds when it focuses on culturally compatible hormonal methods.
• Socio-cultural factors like early child marriage must be taken into consideration
Need to work on issues underlying child marriage through social norm-change interventions as well as economic interventions
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Acknowledgements Project Staff: • Cynthia Nyakwama – WV Kenya • Shano Guyo – WV Kenya • Adrienne Allison – WVUS
We thank: • USAID • Advancing Partners & Communities • Ministry of Health – Gov’t of Kenya