Engaging Decision-Makers in Nakuru County, Kenya, to Act on Family Planning Leads to Results

Dec 8, 2023

Written by Levis Onsase

Engaging Decision-Makers in Nakuru County, Kenya, to Act on Family Planning Leads to Results

Dec 8, 2023

Written by Levis Onsase

Nakuru County’s Health Management Team (CHMT) at the advocacy engagement forum.

Family planning is widely recognized as one of the most cost-effective health interventions. Decades of research have demonstrated that modest investments in family planning can save lives and dramatically improve maternal and child health. There is a growing push  for countries and local governments to reprioritize family planning because of its cross-cutting role in achieving broader development goals, including the Sustainable Development Goals (SDGs) and poverty reduction.

In January 2022, Nakuru County, Kenya, partnered with The Challenge Initiative (TCI) to implement a program focused on health system strengthening with high-impact interventions (HIIs), advocacy and demand generation for family planning services while utilizing data for decision-making.

Although contraceptive use is increasing within the county, the unmet need for family planning remains a persistent challenge. The county is still grappling with a high teen pregnancy rate, which stands at 17.3% (Kenya DHS 2022). As the desired family size is changing, more women and couples are seeking family planning services. Addressing obstacles such as access, affordability, and availability will help meet these needs and ensure that women and couples can meet their childbearing goals. Policymakers are key in addressing some of these obstacles.

To act efficiently, decision-makers need evidence-based outcomes, ideas and the will to implement them. In May 2023, TCI, in partnership with the Nakuru County Health Management Team (CHMT), organized an advocacy engagement forum with Members of the County Assembly to furnish them – as decision-makers – with accurate data, compelling stories and concise synthesis of outcomes from previous budgetary allocations in family planning. The CHMT is responsible for coordinating and overseeing healthcare services within a specific county. They plan and implement healthcare policies, allocate resources, coordinate services across facilities, monitor and evaluate programs, manage disease outbreaks, engage with communities, provide training/coaching, collect and analyze health data, advocate for county healthcare needs, and ensure emergency preparedness.

Hon. Njuguna Mwaura, the Chair of the Health Committee in Nakuru County, said:

By gathering us here as members of the health committee to share evidence-based outcomes and actionable information, like the resources allocated in family planning, we can help to ensure that more women and families are supported by policy environments that enable their access to and use of family planning.

 

As CHMT, you need to involve us in your activities at the community. As your ambassadors, we should know what is happening on the ground so that we can represent and defend you in the assembly.”

Through TCI’s multi-level SMART advocacy efforts with key decision-makers, the county has realized over 200% increase in resource allocation for implementation of FP/AYSRH HIIs from FY 2021/2022 to 2023/2024 within their annual budget. (note that expenditures for 2023 have not yet been calculated)

The county has been utilizing its allocations to implement HIIs such as integrated reproductive, maternal, neonatal, child, and adolescent health (RMNCAHoutreaches, family planning in-reaches, youth-friendly services, post-pregnancy family planning mentorship and whole-site orientation (WSOs), among many others. Coupled with TCI technical coaching, the county has made strides towards increased uptake of family planning and reduction of teenage pregnancies. Jacqueline Osoro, Nakuru County Executive Committee Member (CECM) for the Department of Health Services, said:

Evidence has shown that resources allocated to RMNCAH bore results greatly – Increased FP uptake and reduced teenage pregnancies. As our local leaders, we implore you to continually hold us accountable for the allocated funds to ensure the program’s success and its positive impact on the community.”

Family planning policy environments influence contraceptive demand, availability, access and use. They shape options and opportunities for the nearly two million men and women of Nakuru County. These dynamic, multilevel engagements with policymakers at the local government level are critical discussions about family planning and reproductive health issues to address difficulties women and families face in family planning access, affordability and availability. Njuguna noted:

We have seen results and are eagerly waiting for the RMNCAH bill so that we can pass it. This will have great benefit to the community at large.”

TCI identified Njuguna as a champion in family planning in advocating for increased funding allocation and release within the county government of Nakuru and also when it comes to engaging and orienting other counties on family planning advocacy.

Alongside TCI’s support in technical assistance provision, the CHMT’s efforts have led to significant progress in enhancing family planning uptake and mitigating teenage pregnancies. As of September 2023, TCI has contributed to more than 12,000 additional family planning clients. With a shared vision of sustainability and program longevity, the CHMT’s coordination, resource allocation and community engagement prove vital in maintaining these positive family planning and adolescent and youth sexual and reproductive health outcomes in Nakuru County.

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