700 unwanted pregnancies avoided in 6 one-day clinics

Kenyan mother and child

PopOffsets has just released figures from its latest Dandelion Africa project, reporting that it helped Kenyan families avoid 700 unwanted pregnancies through six one-day clinics at a cost of just over £5000.

With no availability and means to provide themselves with effective contraception, PopOffsets and Chase Africa provide these desperately needed services, free of charge, together with support and education.

By investing in Family Planning, the families that are helped are no longer under immense stress that large families can bring.  The families are smaller, happier, children are better cared for. They have a brighter future and parents have more time to spare. This then means the environment is under less pressure from larger numbers of people.

Pop Offsets invests in family planning around the world, in the name of people and the planet.

More information on the latest project can be found here: https://popoffsetssite.wordpress.com/2016/01/23/2/

(2869 CYP @ 0.25 per CYP =  717 pregnancies using Guttmacher Institure calculations https://www.guttmacher.org/pubs/2011/01/24/Guttmacher-CYP-Memo.pdf

 

 

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Dandelion Africa 2015 report

ChaseAfrica

Report by CHASE Africa to PopOffsets

Grant for 6 one day clinics from September to November 2015

Dandelion Africa has a well-established procedure for operating one day clinics. Key to success is effective mobilisation before the clinic happens.  Many people in rural areas have a negative attitude to family planning and it is essential that Community mobilisers spend enough time in the community trying to dispel the many misconceptions and highlighting all the benefits family planning can bring. The clinic is further publicised with posters displayed around the community and with announcements on the local radio station.

Six one day Clinics were held in the following communities:

Athinai 26th Sept, Lomolo A 16thOct , Oterit 23rd Oct, Lomolo B 5th Nov, MajaniMingi 12th Nov and Alfega on the 26th Nov.

Steve Bown a board member of Population Matters visited Dandelion twice in 2015 seeing a clinic in operation in February in Lomolo B and one in Gaakwen in September. His report on Dandelions activities was very informative and encouraging.

The staff on a one day clinic comprises two doctors, up to three nurses, two mobilisers, and two of Dandelion Africa’s staff to organise the day. Each of the nurses or doctor work from a small pop-up tent to provide privacy for the patient. A range of different services are offered including basic healthcare, family planning counselling, family planning treatment, anti-natal care, HIV/AIDS counselling and testing, cervical screening, immunisation, deworming and a small pharmacy. If any of the patients present with a case that is too serious to be dealt with they referred to the nearest hospital.

The table below gives the results of the family planning element of the six clinics;

Type of family planning Quantity Couple Year Protection
5 year implant, first time 185 703
5 year implant, repeat 60 228
3 year implant,first time 566 1415
3 year implant, repeat 114 285
Depo-provera, first time 355 88
Depo-provera, repeat 163 41
Depo-provera, repeat 163 41
Contraceptive pill 46 3
CYP without condoms 2763
Condoms 12,826 106
Total Couple Year Protection 2869

In our original application we stated that we hoped to achieve a CYP of 2910 without including condoms. If condoms are included this figure was nearly reached but we feel the CYP figure of 2763 still represents very good value for money.

Other clinical results

The most common symptoms which presented were chest infections, indigestion, diarrhoea and backache. Women have to carry heavy loads of water and firewood and backache is a common ailment.

Worms in children are a big problem and to encourage lots of children to attend the clinic hires 2 professional artists/peer educators for the day. They keep the children laughing and running around while their parents attend the clinic. But they also talk to them about other issues such as hygiene, discipline and abstinence.

Children Immunised 128
Children de-wormed 7004
Patients receiving primary health care 2911
HIV/AIDS VCT 553
Number of people testing positive for HIV 17

Budget Report.

The actual spend was slightly higher than was anticipated and this was covered by an under spend from another Dandelion project supported by CHASE.

Details for 6 one day clinics Budget for 6 day clinics. £ Actual for 6 day clinics. £
Medical supplies (FP commodities provided free by MoH)              699 589

 

Outreach, mobilisation and training              279 667
Salaries and other allowances for 5/6 free clinic days           1,157 1366
Materials and publications              471 379
Logistics, implementation, transport, communications, monitoring           2,471 2376
Subtotal           5,077 5377
UK contribution to management @ 8%              406 406
 Total           5,483 5783

Monitoring and Evaluation

Data collection is an important and routine part of every clinic. The data helps Dandelion to understand the needs of the community and plan accordingly. It also helps Dandelion to understand what to focus on in the area e.g. behaviour change and communication based on the number of people who test positive for HIV, or addressing stigma and discrimination depending on the number of people who agree to be tested for HIV.

The data collected is passed on to the Ministry of Health to be included in the compilation of national records.

Across Kenya, especially in urban areas, the acceptance of family planning is rising but there are still many barriers to uptake in rural areas.  Women are often reluctant to discuss what their husbands think about family planning  but in the privacy of the tents the nurses will often get the their patients to talk about the issues they face at home.

Challenges and lessons learned

Dandelion operates in remote rural areas where conflict between communities is quite common leading to security problems. They try and mitigate this by involving the local authorities and getting support from community leaders. Access to these rural areas can also be difficult as the roads are not metalled. In wet weather, what was a relatively easy trip in dry weather, can become very time consuming and sometimes not possible.

In rural areas family planning still has many obstacles to overcome.  Many people still see Children as a sign of wealth hence the reason many women have around 8 children.  Dandelion places great emphasis on engaging with men to discuss the issues surrounding sexual reproductive health. It is still a widely held belief that modern methods of family planning can make you infertile. They try to convince men that by having fewer Children women have more time for productive work. This will mean the whole family will be better off and the children have a much better chance of finishing school. It is estimated that a girl who finishes secondary school will have around half the number of children compared to a girl who does not attend secondary school.

The one day clinics carried out by Dandelion with the generous support of PopOffsets are changing the lives of many families, giving them a chance to escape poverty.