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Celebrate Solutions: What Does Patient-Centered Family Planning Care Look Like?

By: Claire Watt Rothschild and Catherine Owinga, Jacaranda Health

“I’ve heard it’s a huge metal thing,” Njeri, a new mother, told Jacaranda Health midwife and nurse-in-charge Catherine Owinga at a recent family planning consultation. Njeri was describing what she knew about the copper-bearing intrauterine contraceptive device (IUCD), or the “coil,” as it is called locally. Njeri’s fears about an IUCD – that it is so large that it has to be inserted under general anesthesia or can travel through your veins and get stuck in your heart – were familiar to Catherine. Read more...

Celebrate Solutions: Harnessing Peer Networks to Promote Family Planning

By: Claire Watt Rothschild and Shalmali Radha Karnad, Jacaranda Health

At Jacaranda Health, efforts to expand access to postpartum contraception have resulted in a rate of family planning that is more than three times higher than Kenya’s national average. Despite these successes, Jacaranda is still trying to understand why so many women do not adopt family planning at the recommended six weeks after childbirth. A key part of the human-centered program development is talking with clients – in focus groups, interviews, and informal chats – to understand their needs and build programs to address them. When postpartum clients were asked why they were not using family planning, the overwhelming response was that clients’ friends and family members told them six weeks was too early for family planning. Read more...

Celebrate Solutions: Engaging Men in Family Planning Decision-Making

By: Shalmali Radha Karnad and Claire Watt Rothschild, Jacaranda Health

On any given morning, the seats in the reception at Jacaranda Health’s Kahawa West maternity hospital are full – young mothers nursing newborns, pregnant women thumbing through antenatal care brochures, toddlers clambering over benches as they await their immunisations, and men – husbands, partners, fathers – all attending the maternity to support and care for their wives and children. Read more...

Celebrate Solutions: How Do We Encourage Healthy Birth Spacing?

By: Claire Watt Rothschild, Jacaranda Health

Nearly half of women in Kenya who are new family planning users stop within the first year of use. It’s called “contraceptive (or family planning) discontinuation” and the high numbers of women in Kenya who stop using contraception early is of major concern. Family planning discontinuation has been called a “leaky bucket,” and high rates are undermining gains made in the number of women who start taking contraception (called “uptake”). Last week, this blog series highlighted how Jacaranda Health is encouraging family planning among postpartum women to encourage healthy spacing of delivery and pregnancy. While focusing on uptake is important, it is only part of the story. Healthy birth spacing requires women not only to decide to start family planning before the return to fertility, but also to continue using family planning – consistently and correctly – for nearly two years or longer. Read more...

Celebrate Solutions: Creating a “One-Stop Shop” to Encourage Postpartum Contraception

By: Claire Watt Rothschild, Jacaranda Health

Everyone said she could not become pregnant while breastfeeding. This is what Wanjiru*, a new mother, told a nurse midwife at Jacaranda Health’s Ruiru maternity hospital.  When she became pregnant just 3 months after the birth of her first baby, she felt lied to. Family planning use in the first year after childbirth – known as the postpartum period – is both essential and rare in Kenya. At Jacaranda Health, the aim is to make family planning acceptable and convenient for new mothers and their families in a setting where 90 percent of women are not using postpartum family planning at all or until after they are already at risk of pregnancy. Read more...

 

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