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FHI 360 announces Kenya policy change that expands access to family planning

November 15, 2012

RESEARCH TRIANGLE PARK, NC — A demonstration project conducted with FHI 360 funding from the U.S. Agency for International Development (USAID) has led to a policy change announced this week by the Kenya Ministries of Health. The new policy allows trained community health workers to provide injectable contraceptives (depot-medroxyprogesterone acetate or DMPA) in areas of the country where access to contraceptives is limited. The ministries' announcement said the change was, "based on the findings of the successful demonstration project and subsequent consultations with key stakeholders."

The demonstration project was done in Eastern Province in collaboration with Jhpiego (a nonprofit organization affiliated with Johns Hopkins University that works in developing countries to train health professionals in modern reproductive health care), through a USAID Kenya bilateral project — AIDS, Population and Health Integrated Assistance (APHIA).

FHI 360's PROGRESS (Program Research for Strengthening Services), a project that focuses on improving family planning services among underserved populations in developing countries, has worked closely with the ministries and others (including Jhpiego) in recent years to achieve this policy change. With funding from the Advance Family Planning project, Jhpiego/Kenya coordinated the final stages of the advocacy efforts toward expanding this service.

"Dr. Bashir Isaak, head of the Division of Reproductive Health, has been a tireless leader for this change," said Dr. Baker Maggwa, director of the FHI 360 PROGRESS project. "In recent years, we have worked closely with Dr. Bashir, Kenya's Chief Nursing Officer Chris Rakuom, our partners at Jhpiego and other stakeholders in the country to support expansion of this service. Dr. Wamae, head of the Department of Family Health, has also been an important leader in this action. This groundbreaking policy change will help Kenya move toward its family planning goals, which will help save women's lives."

The population of Kenya increased by about one million from 2000 to 2010 and is now — at more than 40 million — one of the most populous countries in Africa. The announcement of the policy change noted that the two Ministries of Health, the Ministry of Public Health and Sanitation and the Ministry of Medical Services, "remain committed to improving access to quality family planning services." The announcement cited the family planning goals outlined in major national documents, such as Vision 2030, of a target of 56 percent contraceptive prevalence rate by 2015. In 2009, the latest Demographic Health Survey data available, the contraceptive prevalence rate was 46 percent, requiring an increase of 2 percent per year to reach the goal.

Injectables are by far the most commonly used contraceptive method in Kenya, used by 22 percent of all married women of reproductive age, according to the latest Demographic Health Survey. The policy change will allow more women to choose this method in hard-to-reach and underserved areas where women have little or no access to clinical services from highly trained health care providers. The policy announcement emphasizes that only community health workers who have been trained and certified by the Division of Reproductive Health shall be authorized to provide DMPA. Also, the change emphasizes the importance of training and supervision, "preferably by a trained nurse or other cadre who would be adequately trained in the supervision of provision of DMPA by community health workers." Supervision and training are important aspects of community-based family planning.