Sexual Reproductive Health and Rights (SRHR) is both a fundamental human right and a critical development issue. At its most foundational level, SRH is about safeguarding women’s agency over their individual sexuality and fertility, including autonomous decisions over whether to have children, how many children to have, with whom and the timing of each pregnancy. In developing countries, reproductive health problems are a leading cause of morbidity and mortality for women and girls of childbearing age. Underprivileged women suffer from unintended pregnancies, unsafe abortions, maternal death, sexually transmitted infections (STIs), gender-based violence and disability among other adverse outcomes.
Kenya has made considerable progress in improving Sexual Reproductive Health. However, the unmet need for family planning services has remained high. Poor rural women and girls, those living with disabilities and those who have recently delivered are especially affected. Recent FP2020 estimates show that 18% of women who want to stop pregnancy or stop having children all together don’t have access to modern contraceptive information and services. The youth are most vulnerable, facing considerable barriers to accessing sexual and reproductive health information and care. According to a United Nations Population Fund (UNFPA) report, one in five Kenyan girls aged 15-19 have already had a baby or are pregnant. This exposes them to a myriad of risks during childbirth, dangers of unsafe abortions and disruptions to their education and future economic prospects. In addition, Female Genital Mutilation/Cutting (FGM/C) remains a key challenge in improving Sexual Reproductive Health and Rights (SRHR) and consequently exacerbates poverty.
Our goal is to ensure that the sexual and reproductive health and rights of all individuals are respected, protected and fulfilled. To achieve this, we use a multi-pronged approach to address knowledge, attitudes, behaviour and social norms SRH and around family planning. We also collaborate with other actors to create an environment that supports the provision and continued use of SRH services.
We support programmes tailored to the various challenges and needs of our target communities. To identify barriers impeding individuals from accessing high-quality, safe and effective SRH services, we have embraced the use of human-centred design tools. For example, we co-created an online youth platform with young people https://www.af-rika.com/ that provides fact-based SRH information as well as linkages to service points. These tools include various social innovations in constructive male engagement and structured dialogues with community gatekeepers.
Partnerships with the public and private sectors have ensured that girls and women have access to mixed methods of safe and effective voluntary family planning. Amref is at the forefront of championing the Quality Improvement in family planning service delivery including through the ‘Kenya Quality Model for Health Care’ and through easy tools such as the Plan-Do-Study-Act, part of Continuous Quality Improvement. Our service delivery approach emphasizes the integration of SRH services with other programs such as MNCH, Nutrition, and Immunization. Through Community Based Programs, we work closely with Community Health Promoters to provide family planning counselling messages, alongside other health messages to individuals at the household level. These services are often through facility in-reaches and community outreaches.
To enhance quality and accessibility, we train health care workers on Family Planning Counselling and the provision of sexual reproductive health services. We train health care workers across the health care system emphasizing competence and performance, on-the-job practice, mentorship, coaching and supportive supervision. This ensures that our target clientele (women, children, adolescents etc) access services from respectful and knowledgeable providers.
We work closely with the National Government, County Governments and other stakeholders to build a strong enabling environment. Amref’s contributes in drafting policies, preparing costed implementation plans, and service delivery guidelines. We support County Governments to contextualize policies and to co-develop innovations in family planning/sexual and reproductive health and rights and costed implementation plans. We ensure that these efforts are backed by social accountability mechanisms and legislative work. Notably, Amref supported the development of the Anti-Female Genital Mutilation/Cutting Act in Kajiado County, was the lead partner in the deployment of the motion tracker for FP2020 at the national level and is part of the organizations that are advocating for family planning to be taken up as a strategic commodity.
