A multi-pronged approach to increase access to family planning choices – Lessons from Oyani Sda Dispensary – Migori County

Migori, Kenya 05 June 2020 (F2A) – Oyani SDA dispensary, a faith-based organization, is located in a remote and hard-to-reach area in West Kanyamkago Ward of Uriri Sub County in Migori county. It is located in western Kenya and borders Homa Bay County, Kisii County, Narok, Tanzania and Lake Victoria to the West.

Faith to Action Network and Organisation of African Instituted Churches support the facility and its two nurses and one clinical officer in conducting Maternal, Neonatal Child Health (MNCH) integrated outreaches. Their aim is to reach poor rural women and adolescents and young women with MNCH information, education and services including Family Planning.  However, dispensing the Intra-uterine contraceptive (IUCD) method at the outreach site for women who wish to adopt it as a contraception method has not been possible due to lack of privacy, inadequate infection prevention control equipment and inadequate health care worker competencies. Women opting for this method have in the past been referred to the facility verbally with no proper referral documentation and tracking for successful linkage leading to missed opportunities.

Faith to Action Network trained thirty healthcare workers from supported facilities on the government’s new Family Planning module 1. One of them was a Nurse from Oyani SDA Facility. This was closely followed by a joint Project team and sub county reproductive health coordinator onsite support supervision and mentorship on the provision of Long Acting reversible contraception (LARC). The sub county reproductive health coordinator has worked closely with the facility including attaching a county LARC mentor to provide on-site mentorship to the trained health care worker. In addition to this, the sub county reproductive health coordinator has been involved in the outreach planning, coordination, supervision and execution of the outreach. To enhance couples’ access to family planning methods and reduce incomplete referrals, the facility has engaged a motorbike vendor to transport clients opting for IUCD insertion from outreach sites back to the facility for insertion during the outreach sessions. At the facility, the county LARC mentor works hand in hand with the facility staff, providing mentorship and coaching to dispense the IUCD contraception to the referred clients.

Faith to Action Network has compared Kenya Health Information system data for Oyani SDA dispensary family planning services for two equal periods during pre-intervention (Oct-Dec 2019) and post-intervention period (Jan-March 2020) to assess access to IUCD Contraception. This has shown an increase in access to IUCD in the post-intervention period from 54 to 133 clients respectively (246% increase). With corresponding decline in uptake of Depo Provera.

 

 

 

 

 

 

 

Figure 1 DHIS 2 report

 

My Story- Nicholas Odhiambo Nursing Officer in charge and FP service provider

As a facility, we engaged motorbike vendors because we realized that use of counselling cards issued to us by DESIP F2A increased the quality of our counselling skills on family planning methods and many women started opting for IUCD. However, due to lack of privacy and infection prevention control facilities, we used to refer them to the health facility but majority did not go hence missed opportunities. Women who have benefitted from this innovation are now our IUCD champions in the community, dispelling myths and misconceptions about IUCD and refer other women for the method. Because of these, we have seen a gradual decrease of workload in our Family Planning service delivery point. At individual level, I have had adequate practice on IUCD insertion and this has improved my skills. I feel competent and confident.’

 

 

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