REPRODUCTIVE HEALTH

PREAMBLE

INVESTING IN FAMILY planning is fundamental to achieving Kenya’s health and development goals. When women in developing nations have the ability (access and right to contraception) to space out their pregnancies by at least three years, their babies are twice as likely to reach their first birthday.

There is also evidence of the anti-poverty effects of family planning. For example, women who space out their pregnancies are more likely to advance their education and earn an income to support their families.

PS Kenya employs cutting edge health interventions to address unmet reproductive health needs and disparities across the country to give women and families at large; power to decide when they would want to have children, how many and how much time in between one child and another. The overall goal of our Reproductive Health/Family Planning program is to contribute to the increase of modern Contraceptive Prevalence Rate in Kenya .

National indicators show some progress towards achieving the national targets by the year 2020. However, there still exists high disparities on these indicators with some counties having a very low modern contraceptive prevalence rate and a high unmet need for contraception.

The objectives of PS Kenya’s Reproductive Health/Family Planning program include:

  • Improve the adoption and maintenance of healthy behaviours related to family planning and maternal
  • health through social behaviour change communication;
  • Increase access to and demand for high-quality health products and services;
  • Strengthen ownership and stewardship of reproductive health initiatives at both at national andcounty levels; and
  • Support Reproductive Maternal Health Services Unit (RMHSU) at the Ministry of Health to gather evidence and stakeholder support to advocate for the gradual reduction of free supply of family planning commodities to the private sector, while engaging and supporting private sector players to play a bigger role.

PS Kenya reproductive health/family planning target audience

  • Sexually active unmarried youth aged 15-24 years.
  • Married couples aged 18 – 49 years.
  • Adolescents, persons with disabilities, and poor rural women in 19 Low Contraceptive Prevalence Rate (CPR) counties in Kenya

FAMILY PLANNING

Kenya has been recognized for its strides in increasing its modern contraceptive prevalence rate (mCPR) and satisfying demand, including receiving an EXCELL award in 2015. With such a high modern CPR of 58% we are faced with a twofold challenge; sustaining use among the high CPR counties and increasing use in low CPR counties. Improvements in health outcomes such as an increase in mCPR do mask vast disparities and inequities in access, service provision and quality of care across the country.

REPRODUCTIVE HEALTH FOR YOUTH
AND ADOLESCENTS

There are 9.2 million adolescents and young people aged 15 – 24 years in Kenya. This is close to 20% of Kenya’s total population. This is a Key demography whose health status directly affects the socioeconomic status of the country. Even though we would want this age group to contribute positively in the development of the country, they are instead held back due to poor reproductive health status. Sexual debut is early in teenage life, unprotected sexual activity continues as they transition to adulthood. Their rate of contraceptive use is low translating to high unmet need for contraceptives. PS Kenya has identified this as one of the priority target audience in dire need of specifically tailor made interventions which address their unique needs. This is because addressing their Sexual Reproductive Health (SRH) needs now would significantly improve the current national SRH indicators and guarantee a healthy future generation.

DESIP

DESIP is a UK aid funded programme focused on Delivering Sustainable and Equitable Increases in Family Planning (DESIP) in low Contraceptive Prevalence Rate (CPR) counties in line with KENYA ‘Vision 2030’. The goal of the programme is to ensure that women and girls can safely plan their pregnancies and improve their SRHR, particularly the young rural, and marginalized, with programme impact contributing to reduced maternal mortality, newborn, and child mortality, and increased mCPR in Kenya.

Find more information on the DESIP programme by clicking on the factsheet below.

DESIP FACTSHEET

ACCELERATE

Accelerate- Accelerate is a Sexual and Reproductive Health and Rights (SRHR) and Gender-Based Violence (GBV) program funded by DANIDA and implemented in a consortium led by Population Services Kenya (PS KENYA) in partnership with Gender Violence Recovery Centre (GVRC) and Population Services International (PSI). The program will contribute towards ICPD25 Promise of zero unmet need for contraception, zero preventable maternal deaths and zero gender-based violence and harmful practices hence working towards the three zeros. Accelerate seeks to build on the milestones that Kenya has achieved towards the realization of true universal access to quality sexual and reproductive health services (SRHR), prevention and management of Gender Based Violence (GBV) and reduction in Harmful Traditional Practices (HTPs). The program will focus on 13 underserved, hard-to-reach Counties of West Pokot, Elgeyo Marakwet, Homabay, Kajiado, Kwale, Nairobi, Samburu, Garissa, Mandera, Marsabit, Baringo, Kilifi and Narok. These counties share common challenges mentioned above.

Accelerate Objective and Theory of Change
The Goal of Accelerate-working towards the three zeros is contribute to the reduction in maternal mortality and morbidity, reduce the unmet need for SRHR (including FP) and decrease prevalence of Gender Based Violence (including HTPs). The objective of accelerate is to: a) Increase access and utilization of comprehensive, inclusive and integrated SRHR/ MCH services b) Increase access and utilization of comprehensive, inclusive and integrated GBV response and prevention services c) Strengthen respect for human rights.
The Theory of Change rests on assumption that ultimately, the effort to strengthen women and girls’ human rights, reduce GBV and improve SRHR are linked to prevailing discriminatory socio-cultural norms, attitudes, and beliefs. While legislative and policy reforms have established a basis for gender equality across all sectors, gaps still exist in addressing negative sexual and gender norms at the individual, institutional and societal level to facilitate sustainable and transformatory gender equality changes across Kenya. The underlying assumption is that these socio-cultural norms, attitudes, behavior, and beliefs will be amenable to change once individuals have been exposed to the program interventions that aim at increasing knowledge on human rights, promoting gender quality & prevention of GBV and engaging men and boys to shape their attitudes towards gender equality and foster greater respect for girls and women’s rights.

Outcomes: To accomplish this goal, Accelerate will focus on three outcomes: 1) Increased access and utilization of quality, comprehensive, integrated, equitable and inclusive SRHR/ MCH services for the project’s target audience 2)Increased access and uptake of comprehensive, quality, multi-disciplinary, efficient, equitable, inclusive gender-based violence response and prevention services for GBV survivors; 3)Strengthened respect for human rights to prevent and respond to SGBV including addressing domestic violence, sexual harassment and HTPs 4) Improved knowledge, attitudes, gender & socio-cultural norms and behaviors on Human Rights (women & girls rights)

Outputs: The following outputs will contribute to the outcomes outlined above: 1) Greater availability and access to quality, comprehensive, integrated and inclusive SRHR / MCH services 2: Increased access to quality, multi-disciplinary, efficient, inclusive and user-friendly SGBV response & prevention services; 3: Increased demand for SRHR/ MCH and GBV services; 4: Improved knowledge, attitudes, behaviors, gender and socio-cultural norms on Human Rights; 5: Strengthened national/ county government accountability, capacity, leadership, stewardship and ownership.

Target Groups: Adolescent /youth (girls): Accelerate will target this group so that they have an opportunity to plan their lives without the risk of unplanned pregnancies, GBV and HTPs that infringe on their rights and dignity; Women and girl survivors of GBV; Accelerate will increase their awareness and remove physical, socio-cultural and economic barriers to reporting abuse and accessing services. Boys and men will be engaged to shape their attitudes towards gender equality and to play a bigger role in protecting women and girls’ rights; Poor women, marginalized groups (including LGBT+ & PWDs) and those living in hard-to-reach (including rural) areas who are often left behind in many SRHR and GBV programs.
Link to SDGs: Accelerate will contribute to SDG 1 (no poverty), SDG 3 (good health and well-being), SDG 5 (gender equality), SDG 10 (reduced inequalities), and SDG 16 (peace, justice and strong institutions).

Binti Shupavu, A360 Kenya.

Funded by the Children Investment Fund foundation, A360 Kenya has built on learning from other A360 countries to co-design Binti Shupavu, supported by a global user journey, with and for girls. Binti Shupavu is being implemented in five counties that have low ASRH indicators: Kilifi, Kajiado, Narok, Homa Bay, and Migori. Binti Shupavu is anchored on key broad strategies geared towards its successful implementation, i.e.,

  1. Sustained impact through adaptations to strengthen effectiveness.
  1. Sustained implementation at scale through integration with government systems
  1. Sustained value through learning to advance ASRH


About Binti Shupavu: Binti Shupavu is a fresh take on providing information and access to contraception. The program is girl-led and joy-centered, which means that it starts by understanding the spirit of her adolescence and placing her needs first. Our journey towards agency begins with creating a safe space (Y-Facility) for young women to connect with peers, learn about contraception, and own their own stories of growth. The program engages and educates influencers in the community and those closest to young women (via Binti stories) so that they might collaboratively address misinformation and support the decisions girls make about their bodies and futures. We then pair this with opportunities for young women to co-create their path to self-determination with the help of mentors and role models. Community Fair Training and Co-Design programming pushes them beyond just learning about their bodies, towards feeling empowered and equipped with new skills that link them to economic opportunities. Through Binti Shupavu, young women have the right information and support to make decisions about their bodies and their futures with confidence.

The girls we are designing for and with

Binti Shupavu has worked to select the archetypes that present the greatest opportunity for impact and reach/scale, trying to find a balance between designing for girls who are harder to reach and achieving broader impact through scale. In examining the archetypes, the devoted wife and the resilient mother came through as the archetypes that presented the greatest opportunities. However, designing for these segments does not mean that A360 won’t be able to reach the other segments, as anything designed for one of these segments will likely have some resonance for the others.

Maverick Next Project

Maverick The next project, dubbed the Binti Biashara project, is a learning-based project funded by the Maverick Collective Fellows under PSI and implemented in Kilifi County, Magarini Sub County. The project brings together young women, their influencers, and key stakeholders to co-design, develop, test, and iterate concepts and models that will help young women feel more empowered to make decisions about not only their bodies, but their futures, finances, and potential career paths. Biashara program is born out of the adaptation process from global PSI A360 programming around EE/AYSRH done in Ethiopia, Tanzania, and Nigeria and testing within the Kenyan context. The program is based on the Binti Shupavu core AYSRH model with the key early prototypes layered being: aspiring together, community by in, learning and discovery followed by celebration. These components have been tested and we have seen evolution from round one to round two of the rough prototyping, resulting in the amalgamating of the approaches into two (2) more cohesive systems for testing – the Community Model and the Institutional Model – that are now ripe for live prototype testing as highlighted in the chat below; –


WHO ARE WE DESIGNING FOR

SAFE MOTHERHOOD

Through this program we advocate for the promotion of skilled and safe deliveries within our social franchise Tunza. The overall objectives of this program include: increasing demand for safe motherhood services within Tunza, increase access to safe motherhood services within Tunza and improving quality of care of private sector health providers within the Tunza Network through training and supervision.

PS Kenya has developed and disseminated information and education communication materials for the 3 audiences: women in the community, the community health worker, the health service provider in the first half of this year for BCC activities. Successful trainings in BeMONC & MPDSR have been carried out for Tunza facility providers to increase their skill in delivering babies safely. The program has also revised its data tools to capture adolescents and youth data.

CERVICAL CANCER

Through this program we advocate for the promotion of skilled and safe deliveries within our social franchise Tunza. The overall objectives of this program include: increasing demand for safe motherhood services within Tunza, increase access to safe motherhood services within Tunza and improving quality of care of private sector health providers within the Tunza Network through training and supervision.

PS Kenya has developed and disseminated information and education communication materials for the 3 audiences: women in the community, the community health worker, the health service provider in the first half of this year for BCC activities. Successful trainings in BeMONC & MPDSR have been carried out for Tunza facility providers to increase their skill in delivering babies safely. The program has also revised its data tools to capture adolescents and youth data.

OUR IMPACT

In 2016, we saw the numbers of adolescent girls and young women accessing contraceptive
services in Tunza clinics increase. A total 0f 59,781 FP methods were issued to adolescent
girls and young women. This accounted to 27% of all FP methods served through the Tunza
franchise. Over 3,800 IUCDs and over 11,200 implants were served to this demography.
Comparing these numbers the proportion of young women opting for long acting methods
were higher compared with the older generation.

161,344

Screened for
cervical cancer

161,344

Screened for
cervical cancer

HEALTH AREAS

Kitu ni Kukachora:Our understanding of the young people.
  • The current youths want to be real, feel empowered and make decisions by themselves. 
  • They want to break free from the existing norms. They want to influence their own future.
  • CASH is King to them, they want to get money. They value any avenue that would lead them into getting money. They would go for anything that appears to be the sure way to success.
  • They believe money facilitates a better lifestyle and freedom as well as happiness. This is what they would like to have.
  • To them money = happiness = SUCCESS
  • In short all what they want is to be successful and make it in life.
     

How we responded to this need

  • In order for us to make sense to them, we had to engage them around what is most important to them i.e What they value most – SUCCESS.
  • We believed that, the youth will only understand what we were proposing to them, if only they saw how it links to what they need most – SUCCESS.
  • We therefore created something that is more than just material, something that they can identify with – Linking their current choices in areas of Health, Education, Economic Empowerment, Social Issues and Governance to their FUTURE SUCCESS.

What is Kitu ni Kukachora?

  • Kitu Ni Kukachora was the life hack we created to speak success to our audience through a call to “Make a plan”.
  • Kitu ni Kukachora is derivative of the Swahili word “Chora ” which can be translated to mean “make a plan”. This was developed in conjunction with the youth after extensive surveys among target groups on what phrase best represents the call to “make a plan ” as youth.
  • The aim of the campaign is to give the youth the power to make the decisions and choices that determine how their future lives will be. Anchored on the four pillars of youth needs – Health, Education, Economic Empowerment and Social Issues. To increase acceptability and appeal of the campaign, we integrate interventions and messages through key touch points that appeal to youth i.e. music, sports, technology, fashion and entertainment with the focus being to get the youth to plan for the success that they so badly want.
  • Kitu ni Kukachora therefore holistically addresses the needs of the youth through responding to their interlinked needs across the main 4 pillars.

WASH

MALARIA

CHILD HEALTH

HIV/AIDS

REPRODUCTIVE HEALTH