Revitalizing family planning in Christian Health Associations through community health workers and religious leaders Lauren VanEnk, MPHInstitute for Reproductive HealthGeorgetown University

Reach of CHAs across Africa

CHAK’s dream:• That family planning (FP) education and

options will become easily accessible through a community-based distribution system

• That FP will cease to be restricted to hospitals where it is offered as medical treatment but instead will be transformed into an opportunity for Family Centered Health Care

• That FP will become a right for every woman and family

- Dr. Samuel Mwenda, Director of CHAK and ACHA Platform

Mobilizing FBOs to expand access to and choice in FP

Strengthen the capacity of Christian Health Associations to improve access to FP information and services, emphasizing opportunities for regional scale-up.

World Bank

Institute for Reproductive Health (IRH)

Christian Health Association of Kenya (CHAK)

Christian Connections for International Health (CCIH)

Goal

Don

or

Part

ne

rs

Project Objectives

1. Strengthen FP service delivery– TOT for master trainers– Facility-based Trainings– Community-based Trainings

2. Sensitize Religious Leaders– Develop IEC materials for FBO context– Informational workshops for pastors

3. Strengthen reporting process– Develop CHW reporting tools– Ensure supportive supervision provided to CHWs

4. Develop capacity building strategy for regional implementation – Introduce project at regional conference in Ghana– Disseminate model at an end of project workshop

Pilot introduction of community-based FP through CHAK facilities• 67 community health workers

(CHWs) trained to provide FP information and methods

• CHWs distributed pills, condoms, Standard Days Method® (SDM)/ CycleBeads®, Lactational Amenorrhea Method (LAM), referrals to facility for all other methods

• SDM was introduced for the first time as a new method, bringing new users to FP

5

com

pon

en

ts Training

This capacity building strategy relies on a training curriculum for CHWs based on the WHO flipchart for FP provision.

Supervisors are equipped to provide this training as well as ongoing supervision to CHWs.

To create a supportive environment for FP provision at the community level, a one-day workshop with pastors is conducted.

Pastors create action plans detailing how they will use this information with their congregations.

CHWs attend supervision visits monthly to submit reporting forms, receive resupplies of FP commodities (if possible), and receive support and refresher instruction on knowledge gaps.

In order for project to be successful, CHWs must have access to FP supplies.

Project managers/ supervisors must ensure CHWs are able to complete FP reports.

It is equally important that facilities readily receive CHW reports and record them in their service statistics.

Create a Supportive

Environment

Ongoing Supervisi

on of CHWs

Establish Supply Chain

Establish Reporting

Mechanism

• CHW Curriculum• Presentations,

including HTSP• WHO flipchart for FP

provision• Client cards

• Bible Study guide

• WHO flipchart for FP provision

• HTSP presentation

• Supervision checklist

• Knowledge Improvement Tool

• Reporting forms

Cap

acit

y B

uild

ing

S

trate

gy A

cti

vit

ies

Tools

Capacity Building Strategy

Establish Supply Chain

Must Haves:• Pills, condoms,

and CycleBeads at the community level

• Stakeholder involvement

Training

Must Haves:• Work with existing

cadre of CHWs

Tools:• CHW Curriculum• Presentations,

including HTSP• WHO flipchart for FP

provision• Client cards

Establish Reporting Mechanism

Tools:• Reporting forms

Must Haves:• Tested reporting

forms• Facility staff

understands their role

• MOH buy-in

Create a Supportive Environment

Must Haves:• Pastors willing to

share health information with their congregations

Tools:• Bible study guide• WHO flipchart for

FP provision• HTSP presentation

Must Haves:• Stakeholder

involvement• Incentive for CHWs• Capable

supervisors equipped to support CHWs

Ongoing Supervision of CHWs

Tools:• Supervision

checklist• Knowledge

Improvement Tool

5

com

pon

en

ts Training

This capacity building strategy relies on a training curriculum for CHWs based on the WHO flipchart for FP provision.

Supervisors are equipped to provide this training as well as ongoing supervision to CHWs.

To create a supportive environment for FP provision at the community level, a one-day workshop with pastors is conducted.

Pastors create action plans detailing how they will use this information with their congregations.

CHWs attend supervision visits monthly to submit reporting forms, receive resupplies of FP commodities (if possible), and receive support and refresher instruction on knowledge gaps.

In order for project to be successful, CHWs must have access to FP supplies.

Project managers/ supervisors must ensure CHWs are able to complete FP reports.

It is equally important that facilities readily receive CHW reports and record them in their service statistics.

Create a Supportive

Environment

Ongoing Supervisi

on of CHWs

Establish Supply Chain

Establish Reporting

Mechanism

• CHW Curriculum• Presentations,

including HTSP• WHO flipchart for FP

provision• Client cards

• Bible Study guide

• WHO flipchart for FP provision

• HTSP presentation

• Supervision checklist

• Knowledge Improvement Tool

• Reporting forms

Cap

acit

y B

uild

ing

S

trate

gy A

cti

vit

ies

Tools

Capacity Building Strategy

Change in Pill Use and SDM/CycleBeads Use Pre and Post Community-based FP Provision

Pills dispersed0

500

1000

1500

2000

2500

3000

3500

Statistics from Chogoria Presbyterian Hospital

CycleBeads dispersed

0

50

100

150

200

250

300

350

Jan-Feb 2011Jan-Feb 2012

Changes in Injectable, IUD, and Implant Use Pre and Post Community-based FP Provision

Implants dispersed

0

4

8

12

16

Statistics from Chogoria Presbyterian Hospital

Injectables dispersed

1000

1050

1100

1150

1200

1250

1300

IUDs dispersed0

5

10

15

20

25

Lessons Learned

• No Product, No Program

• Lay the ground work: advocacy and stakeholder involvement is crucial

• Expanding the method mix at the community level can increase method use and bring new users to FP

Thank you!