Speaking at the CCIH 2015 Annual Conference, Devina Shah, MPH, Program Management Officer for World Vision US examines a World Vision program to integrate healthy timing and spacing of pregnancies with maternal, child and nutrition services in the Garba Tulla sub-county in Kenya. The program has built the capacity of community health volunteers and workers and begun to engage men and religious leaders in health.

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Devina Shah, MPH
Jun 27th 2015
Strengthening Health Systems in Kenya:
The Garba Tulla HTSP Program

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“John Nash's whole approach
involved painting a picture of
an idea--not simply stating a
few results”.
-- Maurice Ewing (risk and strategy consultant,
student of John Nash)

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Overview
• Background/Context
• Program Interventions
• Early results/Lessons
Learned

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Background/Context:
Where in the world is Garba Tulla, Kenya?

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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

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Background/Context:
What does Garba Tulla look like?

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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

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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 by WV Canada.
• Improved uptake of MCHN services by mothers
and their children
• Improved nutrition and WASH practices at
community level
• Improved Environment for MCHN services.

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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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awardee
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SO 1: Capacity Building of CHEWs and CHVs

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Background/Context:
What does Garba Tulla look like?

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SO 2: Community Mobilization: Male engagement

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SO 2: Community Mobilization: Faith Leaders

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SO 2: Community Mobilization: WRA

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Early Results
0
50
100
150
200
250
300
2014 Annual Targets Results (March 2014 - May 2015) Jul Aug
Number of community health workers (CHWs) and/or other health providers
trained or supported, disaggregated by sex
Capacity Building, Male-FP counseling/services for CHWs Cacacity Building, Female-FP counseling/services for CHWs

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Early Results
0
100
200
300
400
500
600
700
800
Jul Aug Sept Oct Nov Dec Jan Feb March April May
Number of community members reached with family planning messages,
disaggregated by type of provider
By CHEW (Other service providers in health facilities) By CHVs (Community health workers (CHWs)

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Early Results
0 200 400 600 800 1000 1200 1400 1600 1800
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
Results (March 2014 - May 2015)

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Early Results
0
200
400
600
800
1000
1200
1400
10-14 15-19 20-24 25+
Annual results: March 2014 - May 2015
Number of clients of reproductive age receiving family planning counseling,
disaggregated by sex, age
Male Female

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Early Results
0
20
40
60
80
100
120
140
160
Jul Aug Sept Oct Nov Dec Jan Feb March April May
# of clients receiving family planning services integrated into MNCH services at the
same location and time, disaggregated by sex
Male Female

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Early Results
0
50
100
150
200
250
300
350
400
Jul Aug Sept Oct Nov Dec Jan Feb March April May
# of clients receiving family planning information integrated into MNCH services at the
same location and time, disaggregated by sex
Male Female

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Way Forward for this & next year
• Religious leaders training
• Training school teachers and
creating school health clubs to
reach adolescents/youth

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Lessons Learned
• The pivotal importance of men in
FP
• Increasing Contraceptive Use in
conservative rural societies takes
time

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Acknowledgements
Project Staff:
• Cynthia Nyakwama – WV Kenya
• Shano Guyo – WV Kenya
• Adrienne Allison – WVUS
Donors:
• USAID
• Advancing Partners & Communities

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Questions?