Community Health Volunteers Help Ensure Healthy and Safe Timing of Pregnancy
A CHV practices depo injection on an orange. 2019 World Vision, Inc. Photo: Melanie Lopez
Recently, community health volunteers (CHVs) in Kenya’s Isolo County learned to provide injectable contraceptives, often referred to as “depo.” These newly trained lay volunteers are expanding rural women’s access to safe, voluntary, and long-lasting contraception.
The three-week family planning training in February, led by the Kenyan Ministry of Health and World Vision, refreshed 30 CHVs’ and four public health officers’ skills on providing information on healthy timing and spacing of pregnancy, counseling for a range of contraceptive methods, and trained them to provide certain ones. Other topics discussed during the training were love for one’s child, family, spouse, partner, and self. “The training also gave me a chance to interact with clients and friends, which built trust between me and the rest of the community,” noted Ibrahim Ali, a CHV from the community of Sericho.
World Vision has been working with CHVs and health facility staff in five conservative, predominantly Muslim communities in the Garba Tulla sub-county of Isiolo County since 2014. The work is funded by a grant from the Advancing Partners & Communities (APC) project, which is led by JSI Research & Training Institute, Inc. with partner FHI 360. The project aims to improve maternal and child health in these communities. One strategy to achieve this is through teaching CHVs to provide counseling and referrals for voluntary contraceptive methods that allow healthy timing and spacing of pregnancies (HTSP). The CHVs may also provide clients oral contraceptive pills and condoms.
For many years, depo has been the most commonly requested modern contraceptive in Garba Tulla. Women appreciate that one depo injection gives them contraceptive protection for three months, which is particularly attractive because many families in this region lead a nomadic lifestyle. Also, women like that the method is discreet and does not require daily maintenance, such as taking a pill.
World Vision has supported community health strengthening as part of the APC project in Garba Tulla since 2014. Here, a mothers’ group in Garba Tulla discusses healthy timing and spacing of pregnancies. Photo: Kristen Devlin
The Kenyan government has permitted provision of intramuscular injectable contraceptives by trained CHVs in underserved, hard-to-reach areas of Kenya since 2011. Until February, however, CHVs in Garba Tulla had not received the training to do so. In recognition of the high demand for injectables and the benefits of task shifting, the Ministry of Health and World Vision selected six CHVs from each of the five health facilities where the APC-supported project works to train to administer depo as part of the method mix available to women at the community level.
The first week of training combined theory, role-play, case scenarios, and classroom-based practicums. While instruction covered an array of family planning methods, it focused on injectables: how they work, the benefits and side effects, and how to correctly administer them. After the trainers demonstrated how to administer depo, the trainees took a shot at it (pun intended) by practicing on oranges. During the second and third weeks of the training, they practiced on people under the guidance of mentors and nurses at selected health facilities.
“The training has sharpened me, I can now provide the necessary service required by the client in need. Sericho is one of the areas in Isiolo, which is faced with a lot of maternal [and] child health issues, and this skill will therefore help me to serve the women in my community so that they can space their pregnancies… I am happy that I can contribute positively to my community," said Ibrahim.
Sub-county public health nurse Fanny Mutuma is equally optimistic. “We feel it will bridge the gap in offering the family planning services at the community level. In addition, our community health volunteers' level of knowledge has been enhanced … which is a great privilege for them, as the community will appreciate them as trained personnel. We are sure that this training will lead to an increase in family planning uptake at the community level, which will lead to the improvement of maternal and child health."
World Vision conveys the importance and voluntary use of modern family planning methods to achieve HTSP to people of all faiths.