Translating Research to Practice: Community Based Distribution (CBD) of DepoProvera (DMPA) in Kenya Alice Olawo 1 , Jane Gitonga 2 , Elizabeth Washika 3 1. Family Health International, Kenya 2. USAID/APHIA II Eastern 3. Division of Reproductive Health, MOPH&S International Conference on Family Planning: Research and Best Practises Wednesday, November 18, 2009 A PH IA II EASTERN
Translating Research to Practice: Community Based Distribution (CBD) of DepoProvera (DMPA) in Kenya Alice Olawo 1 , Jane Gitonga 2 , Elizabeth Washika 3 Family Health International, Kenya USAID/APHIA II Eastern Division of Reproductive Health, MOPH&S - PowerPoint PPT Presentation
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Translating Research to Practice: Community Based Distribution (CBD) of
DepoProvera (DMPA) in Kenya
Alice Olawo1, Jane Gitonga2, Elizabeth Washika3
1. Family Health International, Kenya2. USAID/APHIA II Eastern3. Division of Reproductive Health, MOPH&S
International Conference on Family Planning: Research and Best PractisesWednesday, November 18, 2009
APHIA II EASTERN
Background on FP in Kenya
CPR increasing after a period of stagnation (39% for over 10 years but is now 46%)
High unmet need (25%) among currently married women in Kenya
Depo is most preferred method (45% of modern method users)
Renewed MOH focus towards provision of services beginning with the community level
Community-based distribution of DMPA
It is the provision of DMPA by competent and appropriately trained community-based health workers Research shows it is safe, feasible and acceptable, and is recommended by global technical experts. CBD of DMPA in Kenya is a research utilization introduction project and is part of a larger effort to address issues of family planning access and health worker shortages in Africa It aims to support the Kenya Ministry of Public Health and Sanitation (MOPHS) in its efforts to increase access to contraceptive services
CBD of DMPA introduction has taken time and is challenging
MOH Steering Committee
Strategy Development
ID of potential implementing partner
Advocacy meetings (Provincial and District)
Site ID for pilot study
Consensus Building
2006 2007 2008
Implementation plan, MOU with Jhpiego
Multi-sectoral advisory committee
Educational tour to Uganda
2009
Materials developmentCBD Training
Service provision
Consensus building process
Began by meeting with head of the Department of Reproductive Health (DRH), followed by DRH program managers
MOH steering committee led by DRH was formed, to guide related activities
Development of a strategy to introduce injectablesDevelopment of an advocacy kitConsultations with Professional medical associations
(National Nurses Association of Kenya, KOGS etc.)Meetings with MOH provincial level and district level officials
Addressing stakeholder concerns
South to south knowledge sharing: Educational tour to Uganda to see CBD of DMPA in action addressed professional medical associations’ concerns about safety and infection prevention Broader group of stakeholders’ meeting was held to consult key players
Stakeholder meeting advised formation of multi-sectoral advisory committee guide the program in Kenya
Implementation
Development of training materials (January to August 2009)
Identification of CBD agents in consultation with the community
7 days classroom training of 31 CBD agents, followed by 6 days clinical practicum (August 2009)
Provision of services at the community (August 2009)
Monitoring and evaluation visits (Monthly visits since August 2009)
Since August 2009, over 300 women have received DMPA injections.
Lessons Learned
It takes time to introduce a new concept that involves change in practice
There is need to contextualize evidence to facilitate buy-inMOH leadership and authority is critical in obtaining support for
the project at all level It is essential that partners work together hence synchronized
work plans for effectiveness
Kenya is successfully piloting an evidence-based strategy for addressing issues of contraceptive access. Additional research questions will be generated, along with lessons learned, which
can be applied to future in-country scale up.
Acknowledgements
Ministry of Public Health and Sanitation, Division of Reproductive Health