Modern family planning is arguably one of the greatest public health achievements of the last century, it enables couples to choose the timing, number and spacing of children, and can prevent pregnancy and birth complications that are a leading cause of death for women in developing countries. However, over 1 in 5 women in Africa are unable to choose the number and timings of births. We seek to enable women to realise their rights, averting unintended pregnancies.
By 2050 the global population is expected to grow to over 9 billion people, an increase of more than 50% over 2005 levels. We recognise that every unintended pregnancy exacerbates health inequalities for women and children, puts pressure on social services and resources and contributes to the global burden of disease, environmental degradation, poverty and conflict. We believe focussing our efforts in some of the world’s most fragile rural areas, where there is unmet need and limited access to health services as well as huge pressure on natural resources, is the best investment we can make for families, communities and the environment.
Our Unique Approach
In order for our vision to be realised, all women and men need to know about and have access to quality basic healthcare including voluntary family planning in fragile rural environments. To implement this, we work through carefully selected local partners and in collaboration with the Ministry of Health in such environments to design, develop and deliver our programmes, which integrate basic community health (including family planning) and natural resource management. Through our programmatic model:
- We provide high quality basic health education (including family planning) at household level by trained Community Health Workers.
- We fund high quality basic health services (including family planning) through mobile outreach clinics in rural communities in partnership with Ministry of Health clinicians.
- Our partners and the communities they work in identify local environmental issues and develop and implement projects that address these.
- CHASE Africa provides technical assistance, project management support remotely and face to face; we also create opportunities to share learning between our partner organisations.
CHASE Africa believes that every individual has the right to health, where standards and conditions are in place for the realisation of the highest attainable standard of health. The key health principles we maintain in our health care are:
- Availability – the sufficient supply and appropriate stock of health workers, with the competencies and skill‐mix to match the health needs of the population;
- Accessibility – the equitable distribution of these health workers taking into account the demographic composition, rural‐urban mix and under‐served areas or populations;
- Acceptability – health workforce characteristics and ability (e.g. sex, language, culture, age, etc.) to treat all patients with dignity, create trust and promote demand for services;
- Quality – health workforce competencies, skills, knowledge and behaviour, as assessed according to professional norms and as perceived by users.
Executive Director, UNICEF
CHASE Africa believes that universal access to voluntary Family Planning is a fundamental right and the best investment we can make to improve the quality of life of women, their families and their communities.
In addition to the 4 Health Principles of Availability, Accessibility, Acceptability and Quality, 6 additional Rights-Based principles related to Family Planning complete the approach that we aim to achieve:
- Agency and autonomy – Individuals have the ability to decide freely the number and spacing of their children. To exercise this ability, individuals must be able to choose a contraceptive method voluntarily, free of discrimination, coercion or violence.
- Empowerment – Individuals are empowered to make decisions about their reproductive lives, and can execute these decisions through access to contraceptive information, services and supplies.
- Equity and non-discrimination – Individuals have the ability to access quality, comprehensive contraceptive information and services free from discrimination, coercion and violence. Quality, accessibility, and availability of contraceptive information and services should not vary by non-medically indicated characteristics, such as age, geographic location, language, ethnicity, disability, HIV status, sexual orientation, wealth, marital or other status.
- Informed choice – Individuals have the ability to access accurate, clear and readily understood information about a variety of contraceptive methods and their use. To exercise full, free and informed decision-making, individuals can choose among a full range of safe, effective and available contraceptive methods (barrier, short-acting, long-acting reversible and permanent).
- Transparency and accountability – Individuals can readily access meaningful information on the design, provision, implementation and evaluation of contraceptive services, programs and policies, including government data. Individuals are entitled to seek remedies and redress at the individual and systems level when duty-bearers have not fulfilled their obligations regarding contraceptive information, services and supplies.
- Voice and participation – Individuals, particularly beneficiaries, have the ability to meaningfully participate in the design, provision, implementation, and evaluation of contraceptive services, programs and policies.
More than 1 billion people live in ecological hotspots, where communities are closely linked to conservation of biodiversity. In rural areas, livelihoods depend on, and often put pressure on natural resources. This can lead to unsustainable exploitation – which has consequences for ecosystem and community health and wellbeing. CHASE Africa recognises that communities in the remote, rural areas where we work often suffer from ill health because of limited access to health services (including family planning) as well as poor nutrition, access to clean water and sanitation.
We seek to create healthier communities and ecosystems by bringing quality basic health services and family planning to remote, fragile environments, and supporting communities to sustainably manage their natural resources. The synergies of human and ecosystem health consequently improve livelihoods, food security and nutrition whilst at the same time conserving biodiversity.
How we work
We work through local partners in Kenya and Uganda empowering women to choose the number of children they want and the spacing of births. Working alongside the Ministry of Health, our partners provide high quality basic health services, sexual and reproductive health education, and a range of family planning commodities, to communities who would otherwise have very limited access to any of these services.
Door to Door
Our partners work alongside the Ministry of Health to recruit, train and manage a network of passionate, local Community Health Workers. These CHWs provide basic health education in the privacy of people’s homes to create awareness and demand for life-saving health services such as vaccinations, maternal and new-born care and family planning. They also provide comprehensive SRH education to help couples make informed choices about the size and spacing of their family. In order to make an informed choice, CHWs make them aware of all available methods, the advantages/disadvantages of each, common side effects and help dispel common myths and misconceptions surrounding family planning. CHWs also provide condoms and in some circumstances are trained to administer the pill.
In addition, they raise awareness of upcoming mobile outreach clinics. CHWs can also refer community members to local health service providers or request for a backpack nurse to visit the community. In some instances these CHWs engage with people about broader ecological and social issues that impact the community’s overall wellbeing.
Where CHWs have requested a backpack nurse to attend a household, he/she can provide family planning services (including barrier, short-acting, long-acting reversible methods), immunisations, cervical cancer screenings, antenatal/postnatal care and family planning services.
Our partners identify areas where communities have limited access to health facilities. With our funding, our partners organise mobile outreach clinics in the rural communities we work in and employ Ministry of Health clinicians to provide a range of basic health services. These include HIV counselling and testing, immunisations, nutrition screening, treatment for malaria, diarrhoea, respiratory infections, skin complaints, worms, some cancer screening and referrals.
- On average, our CHWs sensitise 20 households per week (800 per year).
- On average, each day clinic provides over 1,000 basic health care services and to date we have provided over 750,000 services.
- To date we have provided 12,300 FP services in 2019, adding to a cumulative total of over 170,000 since 2012.
We were established in 2000 by Robin Witt as the Rift Valley Tree Trust (RVTT). RVTT’s first partner was FOMAWA – Friends of the Mau Watershed – who shared a desire to protect and conserve the Rift Valley’s beautiful, but shrinking, bio-diverse environment. We spent the first 12 years working with partners involved in tree planting, water harvesting and fuel-efficient stove projects. Over this time, we met many women who were having more children than they wanted due to a lack of family planning, trapping the family in a cycle of poverty.
In 2012, we started working with a new partner, CHAT, who were using an integrated community mobilisation and mobile clinic model to provide family planning and primary healthcare services in remote and marginalised areas of Kenya. We changed our name to Community Health And Sustainable Environment (CHASE) to reflect the new focus on community health programmes alongside our existing environmental and tree-planting projects.
We now work with 7 partners across Kenya and Uganda to deliver tree-planting and ecological restoration programmes alongside family planning and healthcare services.
Meet the Team
CHASE Africa is composed of a small core team based in Somerset, UK.