CHAK implemented the ACHAP Afya project in five sub-counties in Kilifi County from July 2020 to July 2023. The project’s goal was to reduce maternal and child morbidity and mortality in Kenya and Uganda. To increase uptake of family planning (FP), the project engaged and empowered community-based distributors of FP methods to reach clients at household level.
A total of 19 Community Health Assistants (CHAs) were trained as Community Based Distributors to provide family planning commodities to underserved and hard to reach populations. To address the unmet need for family planning in the project area, ACHAP Afya expanded access to FP method mix at community level and engaged in commodity advocacy at the county level through Technical Working Groups. The Sub County Health Management Team supported the community-based distributors of FP with commodities, support supervision and mentorship.
For social behavior change leading to demand creation for FP services, the project worked with religious leaders, young people and community resource persons who encouraged women of reproductive age to take up family planning.
Esther Rua is a Community Health Assistant (CHA) who worked with the ACHAP Afya project as a family planning Community Based Distributor (CBD) in Ganze Sub-County.
To ensure the family planning needs of each household under her care were met, she worked closely with the Community Health Volunteers (CHVs) under her supervision.
The CHVs counselled family members eligible for family planning during their monthly household visits and then informed her when any of the people counselled chose a method. She would give the method to the client during the next support supervision visit with the CHVs. She says the CHVs have been effective mobilisers and the uptake of family planning in her community has been on an upward trend.
According to Jackline Ngala who also worked as a CHA and FP CBD in Ganze Sub-County, community forums such as chiefs’ barazas, outreaches, women’s group meetings and community dialogue days provide valuable opportunities to take the FP message to both men and women.
Teenage pregnancies are common in Kilifi County. According to KDHS 2014, the teenage pregnancy rate stood at 21.8 per cent against a national average of 18.1 per cent. Jackline adds that for teenagers 15-17 years old who cannot make decisions on family planning uptake, it is crucial to involve the parents.
Many parents with teenage girls allowed their children to take up a family planning method as counselling on abstinence had not been effective in preventing teenage sex. However, there are parents who felt that allowing teenagers to take up family planning allowed them to have careless sex.
Jackline, together with the CHVs under her supervision, held meetings with the teenagers monthly to advocate for abstinence, safe sex and family planning.
“We avoid giving hormonal FP methods to teenagers although many parents prefer Implano as it lasts the whole school term,” she adds.
Regina Muli, a CHA and FP CBD working in Kilifi South Sub-County, reached teenagers affected by early pregnancies through maternal child health clinics. When the teenagers visited the clinic with their babies, she would invite them for a chat on family planning.
“Many teenagers did not have the right information about family planning and after counseling, they were able to choose a method with the consent of their parents where applicable,” said Regina.
William Zoka, a community health assistant working in Kaloleni sub-county added that they integrated family planning services in mother-to-mother support groups and outreaches.
To reach more men, Zoka says he conducted community health dialogues targeting them. He also did health talks in the health facility during morning hours when clients came for services. Additionally, he was able to reach the men in entertainment joints and other places where they congregated.
ACHAP Afya supported the community-based family planning distributors with training, support supervision and data quality audits.