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Improving Health of Mothers and Children_Blanchard_5.3.12

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  • 1. Integrating Maternal, Infant and Young Child Nutrition (MIYCN) and Family Planning (FP) Services in KenyaCORE May 3, 2012Holly Blanchard presenting for Chelsea Cooper
  • 2. The Approach KMOH through Divisions of Reproductive Health & Nutrition: linking FP and MIYCN in selected health facilities in Bondo District Integration occurring at facility and community levels Pilot with plans for potential scale-up to other regions 2
  • 3. Birth-to-Conception Spacing Among All Women Aged 15-49, All Non-first Births in the Last 5 years Kenya DHS 2008 11% 4% 11% <6 months 6% 6-11 months 50% of couples 12-23 months 11% in Kenya conceive 24-35 months too early after their last birth 36-47 months 35% 48-59 months 22% 60+ months N of Non-First Births=4,531 3
  • 4. Situation in Bondo District Bondo District Kenya (National)Maternal mortality ratio 620/100,000 488/100,000Under 5 mortality ratio 208/1,000 74/1,000HIV prevalence among 23.6 6.3adults age 15-49% of children 12-23 83.1 77months fully vaccinated% of children stunted 56 35(moderate or severe)Contraceptive Prevalence 37% 46% [1] Bondo District AOP5,Rate 2009/2010 [2] 2008-2009 Kenya DHSTotal Fertility Rate 5.4 4.6 [3] Kenya National Health Information System. http://hiskenya.org/. AccessedBirth to pregnancy 27% 22.6% May 2011.intervals < 14 months 4
  • 5. Approach to MIYCN-FP integration• Stakeholders National and Regional (Nut. & MH)• Opportunities to compliment existing materials• EBF-win-win• Child-spacing benefits health of mother & baby• Assessment of beliefs among providers, CHWs and community• TIME (multiple stakeholders) 5
  • 6. Facility-level Both FP and nutrition services are provided: same room, same HW for ANC &PNC clients- integrated service without referral Job aid & poster used 6
  • 7. Community-level• MIYCN-FP messages included in routine CHW home visits, mother support groups and health action days)• Counseling cards, brochure, poster used to support integration & complement to existing community-level RH and Nutrition materials 7
  • 8. Process Overview National/ Develop Formative Pre-test Regional messages and assessment materials advocacy materials Monitor, Finalize Train service Begin program provide materials providers implementation supportive supervision Complete pilot, Adapt for scale- assess results, uplessons learned 8

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