From Allocation to Expenditure: Tackling Teen Pregnancy in Nyamira County

by | Oct 11, 2019

Contributors: Njeri Mbugua and Tom Maritim

Despite having a family planning program, Nyamira County had a limited budget and capacity among health workers to meet the sexual and reproductive health needs of adolescents and youth. This challenged the county’s ability to consistently deliver high quality youth-friendly services for many young girls. But, when the Tupange Pamoja team was invited to Nyamira to explain The Challenge Initiative’s (TCI) adolescent and youth sexual and reproductive health (AYSRH) program, – the County Health Management team immediately allocated funds to address teenage pregnancy.

According to the Kenya Demographic and Health Survey (2014), more than 28% of girls in Nyamira between 15-19 years have already begun childbearing, which is considerably higher than the national average rate of 18%. Specifically, 4.3% are pregnant with their first child and 23.5% have ever given birth compared to 3.4% and 14.7%, respectively, at the national level.

In response to these challenges, TCI helped the county conduct integrated outreaches at all their health centers targeting first-time parents ages 15 to 24. The county bought a vehicle to drive community health volunteers through urban centers to talk to young women about modern child birth spacing methods, including addressing myths and misconceptions.

“During the outreaches, the crowds have been swelling from about 15 people a day to even 65. Most of them are young girls and mothers. Some already carrying their children. We listen to them and explain to them the different methods available at the health facilities,” said Nelson Osoro a community health volunteer based at the Nyankongo community unit.

Although services were available, commodities were in short supply as well as trained providers who could offer youth-friendly services. Using the Commodity Management approach from TCI University, commodities were redistributed and the team was trained on forecasting and re-ordering of stock. At the beginning of the year, the Reproductive Health Coordinator mobilized all key personnel to refine their strategic plans and annual work plans to:

  • Strengthen the capacity of the health teams to effectively offer youth-friendly services
  • Increase access to accurate information on contraception services through radio programs
  • Integrate family planning into routine RMNCH services
  • Revive community health units to create platforms to talk about family planning at the community level


After successfully conducting 15 integrated outreaches in Nyamira, the county’s efforts are starting to produce results (see chart below). Over 2,900 first-time mothers received services at all sites supported by TCI. According to HMIS data, 4,595 women ages 15-24 years received a family planning method, an 82% increase from the previous year.