The problems people face in East Africa
Giving families a choice – how you can help
For only £5 a month you can give ten families in eastern Africa the gift of choice, allowing them to choose the number and spacing of their children.
According to published data, 42% of Kenyan people live under the poverty line, with dire consequences for health, nutrition, and education. There are many reasons for this, and one key factor is lack of access to family planning which means women have no choice over the spacing and number of children they have.
Below is a picture of Mary at a family planning clinic in Baringo County, Kenya. She is 24 and has 6 children. In her words, “Since my first born I have never had the time to do any economic activity. I have been solely dependent on my husband’s income.” Her family is likely to remain poor for some time, but now at least she can decide when her next pregnancy will be, as she has been able to choose to use a long term contraceptive implant.
Another result of low levels of access to family planning is that Kenya has one of the highest rates of unplanned and unwanted pregnancies. Kenya Government figures show that in 2012 there were over 450,000 abortions and the vast majority of them were unsafe procedures. About a quarter of these women end up with permanent damage as a result. Giving women access to family planning empowers them to make decisions about the children they actually want to have, and can afford.
Government figures show that overall 42% of women do not use any form of contraception. But in poor, marginalised and rural communities, this figure is much higher. There are many barriers to women using family planning such as culture and misinformation, distance from a clinic, myths, and cost, all of which mean women have more children then they want or can afford. The result is that large families in poor communities stay poor.
The increase in Kenya’s population is also putting natural resources under enormous pressure, perpetuating a cycle of poverty. The graph below shows Kenya’s projected population in 2100 under three scenarios.
In addition to poor access to family planning, many poor people lack access to even the most basic healthcare services. Many symptoms go undiagnosed leading to poor health outcomes.
CHASE Africa’s main focus is to try and meet the unmet demand for basic healthcare and family planning services.To do this our partners work very closely with the Ministry of Health. As well as delivering basic healthcare, they also follow the guidelines on cancer screening, and HIV/AIDS counselling and testing.
To help meet the unmet demand for family planning, we offer four main types of family planning commodities:
- 3 and 5 year sub-cutaneous implants
- 3 month contraceptive injection
- The pill
These family planning services are offered free of charge.
Prior to mobile clinics going out, local community health workers are selected and trained to communicate the benefits of using family planning to poor communities where there is a lack of knowledge and a high degree of mistrust. This myth-busting is vital to ensure that people have all the facts and can make an informed decision.
The mobile clinics are very low key and operate from tents or the back of vehicles, or in a school or church building.
Rapushere is 18 years old and has 2 children. Her husband does not know that she is coming for family planning services, and she says that he drinks too much! He wants her to have 15 children but she thinks that 4 is enough. She wants to space her children out and wants a longer gap between the first two and the second two. She thinks that the way to help people like her husband to change their minds about the number of children they want to have is through community awareness raising. She thinks that most people respond positively to this sort of communication and only a small proportion will not respond.
The work that we support incorporates a variety of delivery methods. For example, in hard to reach areas camels can be the best way to move the clinic. The camel team generally goes out for four weeks on a well-planned route which allows for resupply from a vehicle at certain points.
When road conditions allow, clinics can travel in a four wheeled drive vehicle, and sometimes the clinic nurse will take all the necessary supplies in a back pack, travelling by foot, bicycle, motorbike or minibus to the desired location.
All the organisations we work with employ qualified medical staff approved by the Ministry of Health on a locum basis. The important thing is to make the required services available on a regular basis.
By the end of 2017, our mobile clinic work had enabled over 108,000 family planning treatments to be given to women in Kenya. This is equivalent to 194,455 CYP – that is, giving more than 194,000 women one year of family planning. CYP (Couple Years Protection) is an effective and unified way of showing how the various different contraceptives (from the daily pill to a five year implant) we offer through our mobile clinics are reaching and impacting the communities that we serve.