Adrienne Allison, MA, MPA, Technical Advisor for Family Planning, World Vision discusses a World Vision program in Kenya to train Christian and Muslim religious leaders on how holy scripture supports healthy timing and spacing of pregnancies.

1. Timing, Spacing, Immunization Integration Project
West Pokot and Isiolo Counties, Kenya
CCIH Conference, Baltimore MD
July 15, 2017
Adrienne Allison, MA, MPA
SeniorTechnical Adviser Family Planning / Reproductive Health
WorldVision
Funded by Pfizer Foundation
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2. Outline
• Baseline data – West Pokot, Isiolo
• Challenges
• Responses
• Results to Date of Integration

3. Increase the uptake of family planning and
immunization by providing integrated services
at health facilities

4. Family Planning - Immunization Indicators
Abbreviations: CPR, Contraceptive Prevalence Rate;WRA,Women of Reproductive Age; CU2,
Children Under 2Yrs. Old;TFR,Total Fertility Rate; FP, Family Planning
Indicators West Pokot
%
Isiolo
%
Kenya
% (KDHS 2014)
Children Fully Immunized
(12 – 23 months)
32.3 51.2 67.5
CPR 25.1 27.5 58
CPR – WRA with a CU2 20.5 23.8 -
TFR 7.2 4.3 3.9
WRA counselled on FP at
ImmunizationVisit
4.2 3 -
FP acceptors at
ImmunizationVisit
2.9 2.5
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5. Holy Bible
• Genesis 1.28
• “Be fruitful and multiply and fill the earth and subdue it and
have dominion over the fish of the sea ….”
• Genesis 1.28 and the child grew and was weaned; and
Abraham made a great feast on the day Isaac was weaned
• Hosea 1.8 When she was weened, Not pities she conceived
and bore a son
Holy Qur’an
• Q.S. Al Baqarah 2/233 And mothers shall suckle their
children for a full two years.

6. Challenges to Integrated Services
Service delivery
• MoH staff are not trained to provide HTSP counseling
and contraceptive services.
• Facilities do not have adequate resources - space for
private counseling and services, and staff with time to
counsel and provide contraception.
• Vast distances between facilities in sparsely populated
nomadic-pastoral communities hinder service delivery.
Communities
• Many faith leaders raise barriers around reproductive
health – and dictate which behaviors are prohibited or
adopted.
• Community leaders are unaware of the services the
community is entitled to.
• Men value the quantity, not the quality of their children.
Health facility staff provide immunization and counseling
for a new mother and her child.

7. Facilitating Integrated Services
Services
• Train providers to counsel on Healthy Timing and Spacing
of Pregnancies (HTSP) and provide contraceptive
services.
• Provide contraception and immunization same day, co-
located services at 13 facilities in West Pokot and 8
facilities in Isiolo.
• Train CHVs to counsel and record uptake of HTSP/FP
and immunization during monthly household visits
Communities
• Use Channels of Hope (COH MNCH/ HTSP)
methodology with Christian and other faith leaders in
West Pokot and Muslim leaders in Isiolo.
• Educate community leaders to advocate for increased
resources for the Ministry of Health (MoH).
An Imam in Isiolo county, holding a community
conversation on HTSP.

8. Faith Leaders Catalyze Change
Faith leaders:
• follow the teachings within the Bible
and the Qur’an to meet the needs of
the most vulnerable
• influence the values and mores of the
community
• encourage congregations to reconsider
long-held attitudes and beliefs that have
been barriers to reproductive health
and family planning
• inspire men and women to time and
space their pregnancies
• encourage men to be active partners in
supporting the healthcare of their
families
Faith leaders participating in COH.

9. Current Family Planning Users By Sex, Method
0
100
200
300
400
500
600
700
800
900
Mar Apr May June July Aug Sep Oct Nov Dec Jan Feb
March 2016 - Feb 2017
Male condom, Male
Implants, Female
Injectables, Female
Female Lactational Amenorrhea Method (LAM)
Oral Contraceptive Pills, Female
Standard Days Method (SDM) Male/Female
Data for < 20 users omitted i.e
-Male/Female Sterilization
-Female Condom
-Emergency Contraception Pills
-IUD
-Male condom, Female

10. 213
173 171
238
322
215
232
648
614
596
214 214
0
100
200
300
400
500
600
700
Mar Apr May June July Aug Sep Oct Nov Dec Jan Feb
March 2016 - Feb 2017
Total Number of Children Fully Immunized

11. Integrated Service Uptake
Number of Women Counseled on Family
Planning During ImmunizationVisit
Number of Women Receiving Co-Located,
Same Day Contraception
7
20 18 13
356
340
362
186
166
0
50
100
150
200
250
300
350
400
June July Aug Sep Oct Nov Dec Jan Feb
June 2016 - Feb 2017 No record between Mar 2016- April
129
206
90 82
1333 1358
1474
748
973
0
200
400
600
800
1000
1200
1400
1600
June July Aug Sep Oct Nov Dec Jan Feb
March 2016 - Feb 2017

12. Integration of immunization and family
planning services increases the uptake of both
A new mother with her newly immunized
infant accepts contraception.