From 2011 to 2013, FHI 360’s PROGRESS project formed a partnership with the Green Belt Movement (GBM) in Kenya to evaluate the feasibility and value of incorporating family planning promotion into GBM’s activities led by community-based environmental workers. Known as “Green Volunteers,” these forestry specialists were trained to share messages about the links among population, health and the environment and to educate the community about healthy timing and spacing of pregnancies through the use of family planning. The Green Volunteers were also charged with strengthening ties between the community and health facilities offering family planning services.

Research Results

The success of the population, health and environment (PHE) project was evaluated eight months after these new activities were introduced. A research brief summarizing the project and the research findings is available here [PDF, 443 KB]. Key findings include the following:

• Green Volunteers acquired adequate job knowledge to teach the community about the interrelations between family size and the health of families, communities and the environment.
• Green Volunteers embraced the promotion of family planning as an acceptable added responsibility, and they carried out their newly assigned tasks according to plan.
• Members of GBM and the larger community were highly receptive to the Green Volunteers’ messages about the links among population, health and the environment and they were keenly interested in information on available family planning methods. There were repeated accounts of increased knowledge about family planning, more favorable attitudes toward the use of modern methods, and actual increases in family planning use.
• Representatives from the health sector appreciated the project’s work to strengthen ties between the community and family planning services. They expressed interest in continuing the collaboration and in addressing logistical challenges so that the government health workers who are responsible for outreach services can play an even greater role in PHE activities.

Project Implementation Tools

A video about the project, background information, and project implementation tools are available below. These materials will be useful to environmental organizations seeking to introduce family planning information and encourage links to family planning services. The implementation materials were designed for low-skilled conservation staff who work in environmental or development organizations. Please acknowledge FHI 360 and GBM if you use or adapt the materials.

Video — Linking Population, Health and the Environment: The GBM Experience
Background Information on the Project
Training Manual for Green Volunteers
Job Aids

Video — Linking Population, Health and the Environment: The GBM Experience

This 10-minute video discusses how population, health and the environment are connected and demonstrates how this project operated. The video is designed primarily to expand awareness of the project within the broader health sector, the environmental sector, and other non-health sectors.

Background Information on the Project

Forty-two Green Volunteers participated in a five-day course designed to increase their understanding of the connections between population and family size and the health of individuals, households, communities and the environment. After participating in a training-of-trainers workshop led by FHI 360, GBM instructors conducted a training that focused on the importance of healthy timing and spacing of pregnancies for the health of women and children and how family planning use allows couples to have well-planned pregnancies. It also covered information about the benefits and drawbacks of the range of family planning methods available in Kenya. Importantly, the training offered skill-building instruction to prepare Green Volunteers to lead education sessions on these topics.

After the training, Green Volunteers conducted educational activities on family planning and its positive impacts on families, communities and the environment. There were three points of contact between Green Volunteers and GBM members and the community:

• Green Volunteers delivered education sessions on PHE to members of the GBM Tree Nursery Groups as part of their regular group meetings and activities. GBM Tree Nursery Group members, some of whom are older than reproductive age, were encouraged to pass on the messages to younger family members and other close contacts in the community.
• Green Volunteers organized community meetings and invited government-supported community health extension workers to communicate more complete information about family planning methods and services.
• Green Volunteers sought opportunities to reiterate messages at community events organized for other purposes, such as church and school meetings.

During these three points of interaction, Green Volunteers encouraged community members to seek family planning services from health facilities when they identified a need for that support. Building on GBM’s existing conservation program, the additional activities needed to implement this family planning intervention included:

• Developing simple messages, training materials and job aids (available below)
• Meeting with government health facilities to secure the participation of health outreach workers in the program
• Training the Green Volunteers to deliver the messages with the use of job aids and to link community members to family planning service providers
• Incorporating family planning messages into the meetings that Green Volunteers held with GBM and other community members
• Inviting and organizing community meetings with participating community health extension workers
• Providing ongoing supportive supervision and refresher trainings, as needed, for the Green Volunteers

Training Manual for Green Volunteers

GBM and FHI 360 developed this training manual [PDF, 2.5 MB] to prepare Green Volunteers to implement activities that link population, health and the environment. The manual was revised based on feedback from pilot project trainings and research findings. The training manual can be used to guide a training that introduces Green Volunteers to PHE and to family planning, covers healthy timing and spacing of pregnancies, offers skills-building opportunities, demonstrates how to use the PHE flip-book (described below), and reviews basic reporting requirements for the project. The training manual, which is written in English, includes participant handouts in both English and Swahili, reporting forms, and a post-training evaluation form.

Job Aids

Flip-book: This flip-book, available here in English [PDF, 13.3 MB] and here in Kiswahili [PDF, 8.7 MB] is printed as a heavy booklet for Green Volunteers to use during group education sessions on PHE. One side, with mostly photos and graphics, faces the GBM members and community members during a discussion. The other side, with summary information, faces the Green Volunteer.

Community health extension worker using the flip-book to discuss a family planning method.

Poster: This large adhesive poster, available here in English [PDF, 441 KB] and here in Kiswahili [PDF, 437 KB] has the tagline “Care for your family, care for your environment for a prosperous life.” The poster was developed to stimulate interest in and to inform the community about PHE themes and activities.

Family Planning Booklet: To supplement PHE discussions, Green Volunteers (or community health extension workers, when present at the meetings) distribute a small pocket-sized booklet with key evidence-based information about all available family planning methods to GBM members and community members. The booklet is available here in English [PDF, 614 KB] and here in Kiswahili [PDF, 711 KB].

Please contact us for more information on how to replicate the project in other settings.

PROGRESS (Program Research for Strengthening Services) was a five-year project awarded to FHI 360 by the U.S. Agency for International Development (USAID) in June 2008. The project sought to improve access to family planning among underserved populations by providing global technical leadership and working in selected countries.