Women in Kenya face significant barriers to accessing family planning (FP) services, including the most popular method in the country—injectable contraceptives. Learning from the successful experiences of other countries in Africa and around the world, Jhpiego and Kenya’s Ministry of Public Health and Sanitation, in collaboration with FHI, led a one-year demonstration program (2009–2010) in rural Kenya. This initiative aimed to show that trained volunteer community health workers could safely offer injectable contraceptives at the community level. The demonstration program was a great success—not only did use of depot medroxyprogesterone acetate (DMPA) dramatically increase, so did use of other FP methods, along with antenatal care coverage and facility-based deliveries. Bolstered by these results, and with support from the Bill & Melinda Gates Foundation-funded Advance Family Planning (AFP) project, Jhpiego led an intensive advocacy effort to amend the national FP service delivery guidelines. Jhpiego built on its excellent relationships with key individuals in the Kenyan health system and utilized innovative approaches, using a technique in which stakeholders worked together to develop a targeted plan of action, in its advocacy efforts.
As a direct result of this advocacy, the Ministers of Medical Services and Public Health and Sanitation signed a circular amending the guidelines in November 2012 to allow trained community health workers to offer injectable contraceptives at the community level. Through its ongoing programming in Kenya, Jhpiego is working with the Ministry of Health to implement this new policy. According to Rose Maina, Jhpiego’s lead staffer on the AFP project, the new national guidelines will ensure that all women can now benefit from such services, saying, “This truly is a great day for our women.”
Changing this nationalpolicy sets the stage for significant expansion of FP uptake in Kenya, and could have far-reaching impact in strengthening community access to all health care services through improved community-clinic linkages. This policy change will have tremendous long-term impact on the health and prosperity of Kenyans for years to come and can serve as a model for other countries.