Video Spotlight

"'I'm a Health Worker' - Abduaraman Gidi" made by IntraHealth International.

Pamela A. Juma, Namuunda Mutombo, and Carol Mukiira

In African countries including Kenya, contraceptive use, fertility rates and other reproductive health indicators in rural areas lag behind urban areas. Even though Kenya's fertility rate declined from 8.1 in 1978 to 4.6 in 2008, the figures are much higher in rural areas, 5.2 compared to an urban rate of 2.9. The persistent high fertility rate has been attributed to many factors including inadequate provision of family planning services. To address these challenges, there is need to accelerate family planning services particularly in rural areas where these services are not adequately provided. This would allow for, reduced unintended pregnancies (which accounts for more than 40% of pregnancies in the country and unsafe abortions (which results to about 2,600 deaths in Kenya annually), among other benefits. 

In order to effectively scale up family planning service provision to meet the current and future needs, an adequate number of trained health workers must be available. However, the shortage of health workers hinders family planning service provision especially in rural areas. Task shifting and sharing of family planning service provision with community health workers (CHWs) is a means of increasing family planning service utilization without adding excessive burden to the already seriously strained health sector. 

In Kenya, CHWs play a big role in enhancing primary health care services including family planning services. The majority of CHWs in Kenya had been trained by non-governmental organizations (NGOs) in the context of primary health care from the early 80s. However, there has been minimal government support and recognition for CHWs leaving this mainly to NGOs.

This paper describes the perceptions of women towards family planning service provision by CHWs in four rural districts of Western Kenya. It is based on baseline survey data from a three-year, rural community-based family planning project funded by The David and Lucile Packard Foundation.

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