The Challenge Initiative’s (TCI) East Africa team has published a new article in Frontiers for Global Women’s Health that assesses TCI’s impact on adolescent and youth sexual and reproductive health (AYSRH) services in Kilifi and Migori counties in Kenya. The article – published March 30, 2023 – also examines the institutionalization of TCI’s high-impact practices and other interventions (HIPs & HIIs) within both counties’ annual work plans, budgets and systems.
Kilifi and Migori counties are among the counties in Kenya with high rates of adolescent pregnancies, which is attributed to low contraceptive utilization among sexually active adolescents. After TCI began implementing in both counties, contraceptive uptake increased 59% in Kilifi among young adults ages 15 to 24 years, while Migori saw a 28% increase among the same age group. TCI’s efforts also led to a 60% increase in financial commitments for AYSRH programming from 2018 to 2021 from both counties, with the average expenditure for the committed funds was 116% for Kilifi and 41% for Migori.
The TCI platform requires local governments to contribute their own financial and human resources to participate in TCI. TCI then coaches local government staff and health providers in the implementation of HIPs & HIIs. After about three years, the local government graduates from direct TCI support. The authors believe the increase in adolescent contraceptive uptake in both counties may be due to health systems strengthening that occurred from the self-financing of AYSRH programs, the institutionalization of HIPs & HIIs, and TCI’s coaching.
TCI’s Sisi kwa Sisi coaching model of lead-assist-observe-monitor resulted in 20 master coaches being trained. The master coaches cascaded their training to nearly 100 coaches. These coaches will continue to strengthen their peers’ capacity to implement the HIPs & HIIs while also advocating for continued funding of AYSRH programs.
Among the HIPs and HIIs implemented in both counties were integrated outreaches, youth fixed days, whole site orientation, youth champions, intergenerational youth dialogues, and digital/media platforms.
The authors concluded that “local governments should allocate funds and ensure their utilization for AYSRH interventions.”
“Continuous advocacy will ensure allocation and release of funds for health programs by empowering local community-based organizations, civil society organizations and youth groups to hold the leaders accountable on their promises,” they continued. “Local governments should embrace public-private partnerships to leverage on resources in expanding family planning commodities and services availability.”