Fostering Change in Medical Settings: A Holistic Programming Approach to “Revitalizing” IUD Use in Kenya

Roy Jacobstein ()
Additional contact information
Roy Jacobstein: EngenderHealth

Chapter Chapter 12 in Critical Issues in Reproductive Health, 2014, pp 243-264 from Springer

Abstract: Abstract This paper discusses strategies to accelerate the rate, extent, and sustainability of change in medical care settings, using as a case example a 2-year technical assistance project mounted by EngenderHealth to “revitalize” use of the IUD in Kisii District of Kenya’s Nyanza Province. This project followed a holistic programming model, which holds that a coordinated package of programmatic activities among the supply, demand, and policy/advocacy program areas can be not only efficacious, but mutually reinforcing. Attention was also paid to four important crosscutting elements in reproductive health programming: the fundamentals of care (safety, quality, and choice); use of local data for decision making; gender equity; and stakeholder participation. IUD use rose with each program intervention, e.g., training, community and male engagement, and district-wide multimedia demand creation campaigns. At project close in 2007, 142 IUDs were being inserted monthly at the 13 project sites, up from a baseline average of 28 insertions monthly, an increase of 507 %. Despite district restructuring and transfer of skilled staff, increased annual levels of IUD provision (over 300 %) were sustained for 30 months after project close. Other positive changes generated district-wide included: improvements in the supervision system; implementation of a CBD program, with increased linkages between the community and project sites; increased male engagement in FP; 33 % more new clients for all FP methods at project sites; and greater use of other RH services.

Keywords: Family Planning; Contraceptive Method; Pelvic Inflammatory Disease; Medical Setting; Family Planning Service (search for similar items in EconPapers)
Date: 2014
References: Add references at CitEc
Citations:

There are no downloads for this item, see the EconPapers FAQ for hints about obtaining it.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:spr:ssdmcp:978-94-007-6722-5_12

Ordering information: This item can be ordered from
http://www.springer.com/9789400767225

DOI: 10.1007/978-94-007-6722-5_12

Access Statistics for this chapter

More chapters in The Springer Series on Demographic Methods and Population Analysis from Springer
Bibliographic data for series maintained by Sonal Shukla () and Springer Nature Abstracting and Indexing ().