Maximizing Opportunities: Family Planning and Maternal, Infant, and Young Child Nutrition Integration in Bondo Sub-Count
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FROM THE FIELD
Maximizing Opportunities: Family Planning and Maternal, Infant, and Young Child Nutrition Integration in Bondo SubCounty, Kenya Chelsea M. Cooper1,2 · Angella Ogutu3 · Everlyn Matiri4,5 · Hannah Tappis1,2 · Devon Mackenzie1,2 · Anne Pfitzer1,2 · Rae Galloway1,6
© The Author(s) 2017. This article is an open access publication
Abstract Purpose This article shares learning from an innovative demonstration program integrating maternal, infant, and young child nutrition (MIYCN) and family planning (FP) services in western Kenya, providing recommendations for future work to expand MIYCN and FP integration. Description Six health facilities reorganized to integrate MIYCN and FP services and community health volunteers (CHVs) promoted MIYCN and FP in adjacent communities in Bondo Sub-County over a 1-year period. At the facility level, each provider was directed to provide both sets of services in a single room during FP, antenatal care, postnatal care, or child consultation visits (a “one stop shop” approach). At community level, CHVs were to conduct household visits equipped with new integrated materials and incorporate MIYCN and FP within community activities. Assessment Although the “one stop shop” approach, where one provider offers all integrated services in one room, was initially proposed for all facilities, this worked most effectively in the dispensary and health centers. The sub-county hospital adapted the approach such that integrated services were offered by more than one provider during a visit, with clients linked from one provider to another through same-day intra-facility referrals. CHVs were generally able to incorporate MIYCN and FP content
within household visits and community activities; however some knowledge gaps were noted after initial training, necessitating additional refresher training. Conclusion This demonstration experience revealed that future replication efforts should enable sub-county team leadership, assess facility readiness, streamline data collection, build local buy-in, and prioritize dispensaries and health centers with high client loads.
* Chelsea M. Cooper [email protected]
Family planning (FP) and maternal, infant, and young child nutrition (MIYCN) are critical components of care for women during pregnancy, childbirth, and their child’s first 2 years of life. Optimal FP and MIYCN practices have mutually beneficial effects on maternal and child health and nutrition. Meta-analyses demonstrate that close birth intervals increase the risk of neonatal, child, and maternal mortality; stunting in children; and poor pregnancy outcomes (Conde-Agudelo et al. 2006; Rutstein 2005). Additionally,
1
Maternal and Child Survival Program, Washington DC, USA
2
Jhpiego, Baltimore, USA
3
Jhpiego, Nairobi, Kenya
4
Maternal and Child Survival Program, Nairobi, Kenya
5
PATH, Nairobi, Kenya
6
PATH, Washington DC, USA
Keywords Integrated service delivery · Family planning · Maternal nutrition · Infant nutrition · Kenya · Breastfeeding · Lactational amenor
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