CCIH 2015 Devina Shah Breakout 2A

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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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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

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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

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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, MaleMale Sterilization, Male

SDM, MaleEmergency Contraception, Female

Female condom, FemaleFemale Sterilization

Implants, FemaleInjectables, Female

IUD, FemaleFemale Lactational Amenorrhea

Male condom, FemaleOral 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

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200

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600

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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

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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

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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?