The Garba Tulla HTSP Project: Increasing Contraceptive Uptake in Northern Kenya
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The document summarizes a project in Garba Tulla, Kenya that aimed to increase contraceptive uptake. It provides background on the low contraceptive prevalence and high fertility rates in Garba Tulla. The project trained community health workers and engaged community members like faith leaders and men. Early results showed increases in family planning counseling sessions, integrated services, and number of current contraceptive users over time. Challenges included the remote, scattered nature of the area and socio-cultural factors like child marriage. Lessons highlighted the importance of engaging men and addressing social norms to increase contraceptive use in conservative communities.
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The Garba Tulla HTSP Project: Increasing Contraceptive Uptake in Northern Kenya
- 1. Sub- awardee logo here Devina Shah, MPH Jan 28th 2016 www.worldvision.org/our-impact/health The GarbaTulla HTSP Project: Increasing Contraceptive Uptake in Northern Kenya International Conference on Family Planning Nusa Dua, Indonesia
- 2. Sub- awardee logo here Overview • Background/Context • Program Interventions • Early results/Lessons Learned
- 4. Sub- awardee logo here Background/Context: Where in the world is GarbaTulla, Kenya?
- 5. Sub- awardee logo here Background/Context: Some numbers Indicator National Isiolo Total Fertility Rate 3.9 4.9 Contraceptive Prevalence 58% 26.3% (GT: 10.7%) Unmet Need for Contraception 18% 29.9% Source: Kenya DHS, 2014
- 6. Sub- awardee logo here Background/Context: What does Garba Tulla look like?
- 7. Sub- awardee logo here Background/Context: What does Garba Tulla look like? Programmatic Activities Focused on all Persons of Reproductive Age Type Age Range Number of Beneficiaries WRA 15-49 11,641 Married WRA 15-49 10,791 Men 15-49 21,990 Total Number of Beneficiaries 43,118
- 8. Sub- awardee logo here Background/Context: Starting Strong Project Starting Strong (2012-2017) is a five-year, $2 million Maternal and Child Health and Nutrition (MCHN) initiative privately funded byWV Canada. • Improved uptake of MCHN services by mothers and their children • Improved nutrition andWASH practices at community level • Improved environment for MCHN services.
- 11. Sub- awardee logo here 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
- 12. Sub- awardee logo here SO 1: Capacity Building of CHEWs and CHVs
- 14. Sub- awardee logo here Background/Context: What does Garba Tulla look like?
- 15. Sub- awardee logo here SO 2: Community Mobilization: Male engagement
- 16. Sub- awardee logo here SO 2: Community Mobilization: Faith Leaders
- 17. Sub- awardee logo here SO 2: Community Mobilization: WRA
- 18. Sub- awardee logo here Results 0 100 200 300 400 500 600 Capacity Building, Male-FP counseling/services for CHWs Capacity Building, Male-FP counseling/services for other providers working in health facilities Cacacity Building, Female-FP counseling/services for CHWs Capacity Building, Female-FP counseling/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
- 19. Sub- awardee logo here 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)
- 20. Sub- awardee logo here Results 0 500 1000 1500 2000 2500 3000 3500 4000 4500 10-14 15-19 20-24 25+ March 2014 - Dec 2015 Number of clients of reproductive age receiving FP counseling, disaggregated by gender, age Male Female
- 21. Sub- awardee logo here Successes 0 100 200 300 400 500 600 700 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 information integrated into MNCH services at the same location and time, disaggregated by sex Male Female
- 22. Sub- awardee logo here 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
- 23. Sub- awardee logo here 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
- 24. Sub- awardee logo here 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
- 25. Sub- awardee logo here Challenges • Hard to reach area: very tough terrain, scattered habitation, very low levels of literacy • Socio-cultural factors: early child marriage, multiple marriages, religious factors,
- 26. Sub- awardee logo here 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 family planning 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 methods like LAM and SDM. Introducing LARC and LAPM later in the program is much more effective, once communities are comfortable with and have reduced myths/misconceptions about 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
- 27. Sub- awardee logo here Acknowledgements Project Staff: • Cynthia Nyakwama – WV Kenya • Shano Guyo – WV Kenya • Adrienne Allison – WVUS We thank: • USAID • Advancing Partners & Communities • Ministry of Health - GOK
- 28. Sub- awardee logo here Thank you! Asante! Shukriya! Terima Kasih! Dhonyawad!