226388 Reaching the hard to reach with family planning services: Introducing a culturally and religiously acceptable, modern FP method into Kenya

Monday, November 8, 2010

Trinity Zan, MA , Research Utilization Department, FHI 360, Durham, NC
Caroline Mackenzie, MA , Family Health International - Kenya, Nairobi, Kenya
Marsden Solomon, MD , Kenya, Family Health International, Nairobi, Kenya
Susan Igras , Institute for Reproductive Health, Georgetown University, Washington, DC, DC
Abdullahi Mahat Daud , North Eastern Province, AIDS, Population and Health Integrated Assistance (APHIA) II, Garissa, Kenya
Abdikadir Ore , North Eastern Province, AIDS, Population and Health Integrated Assistance (APHIA) II, Garissa, Kenya
Fatuma Iman , Not Available, Ministry of Public Health and Sanitation, Garissa, Kenya
Katherine M. Tumlinson, MA , School of Public Health, Carolina Population Center at the University of North Carolina at Chapel Hill, Chapel Hill, NC
David Adriance , North Eastern Province, Population and Health Integrated Assistance (APHIA) II, Nairobi, Kenya
Cultural and religious resistance to modern family planning (FP) methods accounts for approximately one-third of method discontinuation and up to 40% of reasons for non-use of FP in Kenya. In North Eastern Province (NEP), the majority of the population is strongly influenced by Islamic religion and Somali cultural practices which have contributed to a modern contraceptive prevalence rate of 4% compared to 39 % nationwide. The Standard Days Method (SDM), a new, natural FP method, was introduced into FP services in seven health facilities in rural Ijara district in NEP by APHIA Project and Provincial Ministry of Health staff in close collaboration with local religious leaders who often act as gate keepers for use of MCH/FP services. Leaders were educated on the method and the concept of healthy birth spacing, approved the SDM given its compatibility with Islam, and then sensitized their communities on SDM and birth spacing benefits. From January-June 2009, providers offered SDM and recorded demographic information about new users. Among 254 acceptors, 95% were Muslim and 93% were new FP users. Providers reported in post-intervention interviews that the SDM was appealing to most clients, easy to use, culturally and religiously acceptable. Subsequent successful expansion into new districts in NEP and the research results led national stakeholders to recommend scale-up of the SDM into provincial FP services nationwide. A government task force will guide the process, and districts will involve religious and other community leaders in promoting healthy birth spacing, generally, and the new SDM option.

Learning Areas:
Diversity and culture
Implementation of health education strategies, interventions and programs

Learning Objectives:
Describe the Standard Days Method, a modern, natural FP method, and its introduction into one district in Kenya in an area resistant to family planning. Identify strategies and lessons learned in engaging religious leaders in efforts to introduce a new FP method.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I provided technical support to the project and have technical expertise in the SDM.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.