Huduma Poa Social Franchise Service Delivery Progress Report, Year 3 - Quarter 4

USAID Kenya (APHIAplus HCM Program)
Quarterly Progress Report

(July-September 2014)
REPORT: As at September 31, 2014
-2-
APHIAplus Health Communication and Marketing Program

Year 3, Quarter 4 Progress Report
(July September 31, 2014)
Submitted to:
Chief of Party
USAID APHIAplus HCM Program
PS/Kenya.
C/O American Embassy
United States Agency for International Development/Kenya
United Nations Avenue, Gigiri
P.O. Box 629, Village Market 00621
Nairobi, Kenya
Prepared by:
KMET
Prime Award Number
: AIDS -615-A-12-00002
P. O. Box 6805-40103,
Kisumu.
The authors views expressed in this report do not necessarily reflect the views of the United
States Agency for International Development or the United States Government.
Table of Contents
ACRONYMS AND ABBREVIATIONS ............................................................................................................... IV
1.0 EXECUTIVE SUMMARY .................................................................................................................................... 1
2.0 KEY ACHIEVEMENTS (QUALITATIVE AND QUALITATIVE IMPACT) ............................................. 2
2.1 COMMUNITY AND FACILITY BASED EVENT DAYS............................................................................................................... 2
2.2 COMMUNITY MOBILIZATION ............................................................................................................................................... 4
2.2.1 Lessons learnt......................................................................................................................................... 15

2.2.2 Challenges experienced during community mobilizations & Huduma Poa days .................... 15
2.3 BUILDING CAPACITY OF SOCIAL FRANCHISE MEMBERS ................................................................................................... 16
2.3.1 Contraceptive Technology .................................................................................................................. 16

2.3.2 Integrated Management of Childhood illnesses ............................................................................. 17
2.3.3 HIV Testing and Counselling .............................................................................................................. 18
2.4 BUILDING CAPACITY OF COMMUNITY HEALTH WORKERS .......................................................................................... 19
2.4.1 Community Health Strategy, FP and HTC ...................................................................................... 19
2.5 CONDUCT PERFORMANCE REVIEW MEETINGS WITH FRANCHISE PROVIDERS AND COMMUNITY HEALTH
WORKERS ................................................................................................................................................................................... 20
2.5.1 Provider & CHWs performance review meetings action points .............................................. 21
2.6 SUPPORT SUPERVISION VISITS, DATA QUALITY AUDITS AND LINKAGES ........................................................................ 22
3.0 PROGRAM PROGRESS .................................................................................................................................. 24

3.1 FAMILY PLANNING (FP) SERVICES ...................................................................................................................................... 24
3.2 HIV TESTING AND COUNSELLING (HTC) AND PMTCT SERVICES .............................................................................. 25
3.3 CERVICAL CANCER SCREENING SERVICES ......................................................................................................................... 26
3.4 CHILD HEALTH SERVICES (INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESSES ................................................ 26
4.0 ENGAGEMENTS WITH OTHER STAKEHOLDERS .............................................................................. 27

4.1 WORLD CONTRACEPTIVE DAY ......................................................................................................................................... 27
4.2 APPRAISAL OF AWP (2014/2015); AND FAMILY PLANNING STRATEGIC PLAN 2014 2018 SIAYA COUNTY .. 28
4.3 COMMUNITY HEALTH SERVICES TASKFORCE MIGORI ................................................................................................. 28
4.4 KISUMU COUNTY FAMILY PLANNING ADVOCACY FORUM........................................................................................... 29
4.5 COMMODITY MANAGEMENT FORUM-WESTERN KENYA REGION ................................................................................ 29
4.6 KISUMU COUNTY TASK FORCE FOR MATERNAL CHILD AND NEONATAL (MNCH)/RH ....................................... 30
5.0 SOCIAL FRANCHISE FACILITY BRANDING.......................................................................................... 31

6.0 PERFORMANCE MANAGEMENT PLAN .................................................................................................. 31
7.0 YEAR 3 QUARTER 4 WORK PLAN STATUS ......................................................................................... 34
8.0 HUMAN INTEREST STORIES....................................................................................................................... 35
8.1 AN ALTERNATIVE STRATEGY FOR UNDERSERVED BEACH COMMUNITY ........................................................................ 35
8.2 MORE TEENS SEEK FOR LONG ACTING AND REVERSIBLE CONTRACEPTIVES TO AVOID DROPPING OUT OF SCHOOL
...................................................................................................................................................................................................... 37
8.3 TAMING COSTS IN ACCESSING QUALITY HEALTH SERVICES ........................................................................................... 39
8.4 MAKING IT HAPPEN FOR THE COMMUNITIES WE SERVE .................................................................................................. 40
ii
Table of Figures:
Figure 1: Family planning service provider offering contraceptive education during Huduma Poa day ................... 2
Figure 2: Health Education session prior to service delivery during a program supported Huduma Poa day ....... 2
Figure 3: Huduma Poa community health worker reaching out to women at households with contraceptive
information ....................................................................................................................................................................................... 3
Figure 4: Huduma Poa providers collaborate with their counterparts in the MoH to increase access for
reproductive and child health services ...................................................................................................................................... 4
Figure 5: Huduma Poa CHWs reach to clients in remote communities with integrated reproductive health
information ....................................................................................................................................................................................... 4
Figure 6: Huduma Poa Program staff join franchise providers and CHWs in educating the community and
provision of RH services ............................................................................................................................................................... 4
Figure 7: Nursing Officer In- Charge at Mbale Rural Health Centre gives orientation to participants at the
practical area prior to the practicum sessions ...................................................................................................................... 16
Figure 8: A participant gives health education to clients at the practical area .............................................................. 16
Figure 9: Participant practicing to remove implant during practicums sessions ........................................................... 16
Figure 10: Participants assess a child under five years for dangers signs during IMCI practical experiences ........ 17
Figure 11: An IMCI course facilitator guides a participant at the pediatric ward to correctly assess, classify,
identify and treat ........................................................................................................................................................................... 18
Figure 12: Participants practice on couple counselling during HTC protocols session ............................................. 18
Figure 13: Participants practice on preparing blood spots on the filter papers for PCR ........................................... 18
Figure 14: KMET's Executive Director, Monica Oguttu encourages participants to implement the content of
the HTC training during the closure ........................................................................................................................................ 19
Figure 15: Participants keenly follow presentation on FP planning made by an RH Coordinator during the
training ............................................................................................................................................................................................. 19
Figure 16: Community Health Workers in group discussions to ventilate what they understand in Community
Health Strategy .............................................................................................................................................................................. 20
Figure 17: CHWs keenly follow sessions on key messages on HIV Testing and counselling.................................... 20
Figure 18: MoH Sub-County Community Health Services focal person (Bondo) make his contributions during
performance review meeting ..................................................................................................................................................... 20
Figure 19: Providers await to respond to performance issues raised on their facility data. ..................................... 21
Figure 20: MoH Officers issue certificate of outstanding performance to a CHW during a performance review
meeting ............................................................................................................................................................................................ 21
Figure 21: HCM program staff conducting support supervision at a franchise facility ................................................ 22
Figure 22: Sub-County Health information and records Officer (Right) joins Goldstar Kenya and KMET in data
quality audits ................................................................................................................................................................................... 22
Figure 23: HCM Quality Assurance Officer redistributes contraceptive and HTC commodities acquired from
the MoH to a member of the social franchise ....................................................................................................................... 23
Figure 24: FP Service provider documenting after providing a contraceptive method to a 16 year old client at
the franchise facility ...................................................................................................................................................................... 24
Figure 25: Parents and guardians await for child health services during a community based outreach ................. 27
Figure 26: CHWs, healthcare providers and partners participate in a procession during the world
contraceptive day celebrated in Nyando ................................................................................................................................ 27
Figure 27: KMET supported theatre group presents a play on family planning during the world contraceptive
day celebrated in Siaya ................................................................................................................................................................. 28
Figure 28:Dr. Elizabeth Ogaja, Cabinet Secretary for Health, Kisumu County addressing participants during the
forum ................................................................................................................................................................................................ 29
Figure 29: Recently branded huduma Poa franchise facilities ............................................................................................ 31
Figure 30: An outreach site at Kiumba Beach in Rusinga. .................................................................................................. 35
Figure 31: Beach Community clients waiting to receive services during Huduma Poa day ....................................... 36
Figure 32: Health education for clients a waiting integrated reproductive health services at a fish weighing
station at Utajo beach. ................................................................................................................................................................. 36
Figure 33: Clients queue for intergrated reproductive health services at Kopanga Dispensary .............................. 37
Figure 34: A family planning provider (left) fills in 16 year old Consolata's personal details after offering her a
contraceptive method .................................................................................................................................................................. 38
Figure 35: Community Health workers assist in regestering ckients at Ahero Medical Centre .............................. 39
Figure 36: The incredible efforts of HCM program staff to reach the underserved ................................................... 40
Figure 37: HCM program staff making their way through muddy roads to passionately reach the underserved
communities with integrated RH services .............................................................................................................................. 40
iii
ACRONYMS AND ABBREVIATIONS

CBO
CHEWs
CHWs
COCs
CME
SCHMTs
FP
HTC
HCM
IMCI
HIV
LARCs
MoH
POPs
PMTCT
USAID
USG
VIA
VILI
Community Based Organization

Community Health Extension Workers
Community Health Workers
Combined Oral Contraceptives
Continuous Medical Education
Sub-County Health Management Teams
Family Planning
HIV counseling and testing
Health Communications and Marketing
Integrated Management of Childhood illnesses
Human Immunodeficiency Virus
Long Acting and Reversible Contraceptives
Ministry of Health
Progesterone Only Pills
Prevention of Mother-to-Child Transmission of HIV/AIDS
United States Agency for International Development
United States Government
Visual Inspection by Acetic Acid
Visual Inspection by Lugos Iodine
iv
1.0 EXECUTIVE SUMMARY

KMET implements the APHIAplus Health Communication and Marketing (HCM) activities through its
Huduma Poa social franchise. The franchise currently comprises of 80 private facilities drawn from 15
counties of the Western Kenya region. Through the franchise, KMET strives to support providers ability
to improve the lives of mothers, children and their families in the areas child health (pneumonia, malaria
and diarrheal diseases), family planning, cervical cancer screening and HIV/AIDS. This facilitates quality
health preventive and care services, contributing to the overall APHIAplus HCM strategic objectives and
output targets. This report documents how social franchising approach has offered a significant opportunity
to integrate health services in the private health sector
During the quarter (July-September 2014), a number of activities were implemented, principally:
Capacity building of providers of 28 social franchise providers on contraceptive technology

Capacity building of providers of 24 social franchise providers on integrated management
of childhood illnesses
Support supervisions and quality assessments of facilities in the social franchise
Building the capacity of 24 social franchise facilities on HTC including new testing algorithm
Capacity building of CHWs on MoH Community strategy, FP and HTC
Mentorship of providers trained on PMTCT during the previous quarter
Performance review meetings with franchise providers and community health workers
Forging linkages for social franchise providers to access health commodities from MoH
Demand creation and community mobilization activities
Branding Huduma Poa Health Network facilities that were recently recruited
Facility event days and community based outreaches
Data quality audit together with the MoH for the franchise facilities
Engagements with county and sub-county health management teams with the aim of bridging
existing gaps in commodity security and leverage on existing resources
Production and distribution of IEC materials for demand creation
Monitoring and Evaluation activities.
Within the quarter, KMET participated in commodity management forum for western Kenya; family
planning advocacy forums for Kisumu County; Annual Work Plan and Family Planning Strategic Plan 2014
2018 appraisals; Community Health Services Taskforce forums for Migori County; Kisumu County Task
Force for Maternal Child and Neonatal (MNCH)/RH; world contraceptive day.
Fundamentally, a lot has been achieved within the quarter in line with program intermediate results. There
has been an improved access to integrated reproductive health services. Utilization rate of contraceptive
methods through Huduma Poa days improved by 224.2% compared to the previous quarter. More details
on achievements are captured in subsequent sections of this report.
2.0 KEY ACHIEVEMENTS (Qualitative and Qualitative Impact)

RESULT 1: Increased Use of Quality Health Services, Products and Information.
IR 1.1: Increase Access to and Demand for High Quality Health Products and Services
2.1 Community and facility based event days
Figure 1: Family planning service provider offering

contraceptive education during Huduma Poa day
During the quarter, KMET conducted Sixty

seven (67) Huduma Poa days ( 37 facility based
event days and 30 community based
outreaches) aimed at improving access to
quality health products and services, a total of
2062 clients received contraceptive methods
(1767 implant insertions, 91 IUCDs insertions,
178 Injectables, 26 oral contraceptives) during
event days. Forty (40) clients had implants
removed, whereas 6 had IUDs removed during
event days. Different reasons were cited as the
reasons for removal including, inadequate
counselling at different facilities where they
accessed the methods, side effects and desire to conceive.

Event days data is exclusive data generated from daily service provision across franchised facilities between
July-September 2014. Franchise services
delivery data is discussed in subsequent
sub-sections of this report.
The utilization rate of contraceptive
methods through event days improved by
224.2% compared to the previous quarter
when only 635 clients received family
planning methods. Unlike in the previous
quarter when only 729 clients were
counseled and tested on HIV during event
days, the number increased to 1627
(123% improvement). Considerably, 39
clients turned HIV positive and were
referred to patient support cantres for
initiation of care and treatment.
Figure 2: Health Education session prior to service delivery

during a program supported Huduma Poa day
Overly, there was remarkable improvement of service provision within the reporting period through
event days compared to previous quarter. The table below compares this quarter event day
achievements with that of the of the previous quarter
Table 1: Community and facility based event days achievements
Integrated reproductive health Services
Event day achievements
Quarter3 Versus Quarter 4, 2014
Quarter
Q3
April-July
Implan
ts
IUCDs
Injectable
s
Oral
contraceptives
Cervical
cancer
screening
Suspicious
for cancer
Via/Vili
Positives
Cervical
polyps
Referred
for
treatment
HTC
HIV
Positive
clients
493
52
67
23
871
17
34
51
729
21
1676
39
1767
91
178
26
1537
18
43
61
258 %
75 %
165 %
13 %
76%
123 %
26 %
58.8%
129.9%
85.71
Quarter 4
%
Improveme
nt
Up to 1537 women who turned for event days were screened for cervical cancer in an effort to enhance
integration of reproductive health services. Among them, 43 turned positive for VIA/VILI whereas 18
exhibited suspicious lesions for cancer of the cervix. Significantly, 61 of the clients screened clients were
appropriately referred for treatment.
Community Health workers (CHWs) helped on demand
creation activities as well as forging linkages between
communities and Huduma Poa network facilities. There
were 1,976 door to door visitations including reaching out
to women in church, markets, farms, barazas; and women
groups with integrated reproductive health information.
Figure 3: Huduma Poa community health

worker reaching out to women at
households with contraceptive information
Stemming from more mobilization sessions, there were

more event days (67) conducted within the reporting
period compared to the previous quarter at which, only 50
event days were conducted.
Facility and community based event days have

continued to promote accelerated uptake of
the much desired method mix in family
planning and created an opportunity to mentor
providers to acquire prerequisite competence
and skills for insertion of LARCs, interpreting
VIA/VILI cervical cancer screening results, and
improved contraceptive cancelling.
Figure 4: Huduma Poa providers collaborate with their

counterparts in the MoH to increase access for
reproductive and child health services
The 30 community based outreaches/event days

conducted were observed to have greatly helped to
expand the reach of underserved communities. More
clients turn up for program supported services at
community based outreaches compared to in-reaches
(facility based). Consequently, community based
outreaches has become invaluably critical service delivery
option for KMET to reach the remote communities.
Figure 5: Huduma Poa CHWs reach to
Nearby fields, churches or schools provided amenities for
clients in remote communities with
integrated reproductive health
service provision in an effort to deliver reproductive
information
health and family planning services to target populations
with an unmet needs. The MoH in various sub-counties have come in handy to offer support in ensuring
the in- and outreaches are successful.
2.2 Community mobilization

Demand creation and mobilization for HCM program supported areas has continued through the hard
work of community health workers.
Up to 183 community mobilizations
sessions were conducted at community
units, youth groups, community barazas
and CBO reaching out to 11,178 clients
(3439 males and 7739 females)-The figure
is 12.64 % higher than that of the previous
quarter when only 9,923 persons were
reached through mobilization activities.
This may be attributed to increased
mobilization activities geared towards
behavior change.
Figure 6: Huduma Poa Program staff join franchise
providers and CHWs in educating the community and
provision of RH services
Men constituted 30.76% of the attendees. A majority (69.24%) of attendees were women. The sessions
were aimed at equipping target communities with accurate and reliable information on family planning, child
health, cervical screening and HIV/AIDS. The sessions have been very helpful in demystifying myths and
misconceptions that have profoundly hindered the utilization integrated reproductive health services.
Table 2 below presents basic information community mobilizations conducted, community units, number
of clients reached and the health education area covered.
Table 2: Community mobilizations sessions
SubCounty
Community
Unit
Mbita
Waware
Sabatia
Chavogere
Mbita
Kasgunga
Mbale
Chavakali
Kisumu
East
Ndhiwa
Obunga
Nyando
Kobong'o
Kisumu
East
Mbita
Nyalenda B
Kisumu
East
Nyalenda B
Osani
Wanyama
Obunga
Nyando
Kakmie/Kobong'o
Sindo
Nyatoto
Mbita
Chavakali
Uhaga
Wanondi
Kisumu
East
Sindo
Nyawita
Nyatoto
No. of people
Health Education Areas Covered
reached
Male Femal
e
63
115
Community benefits of integrated Family
Planning, HIV Testing & Counselling; and
cancer Screening services
26
65
Benefits of long acting FP methods, HIV
Testing & Counselling; and cancer Screening
23
129
Benefits of IUCD; and importance of
cervical cancer screening
29
46
26
118
Family planning and Cervical cancer
screening
43
124
22
54
Couple HTC and male involvement in
reproductive Health
68
156
Benefits of long acting FP methods and
integrated cancer screening
23
44
Benefits of long acting family planning
methods
48
108
33
109
Clarifying on Myths and misconceptions
associated with IUCDs
23
105
Couple HTC and male involvement in
reproductive Health
116
246
Advantages of LAM of Family planning and
HTC/HCM activity areas
16
42
Benefits of cervical Cancer screening
24
76
Integration benefits of Family Planning, HTC
and cervical cancer screening
16
58
Integration benefits of Family Planning, HTC
and cervical cancer screening services
321
533
Access to integrated Family Planning, HTC
and cervical cancer screening services
5
SubCounty
Mbita
Community
Unit
Kasgunga
Nyando
Magina
Ndhiwa
Wayara
Mbita
Lwanda
Chavakali
Wanondi
Nyando
Sabatia
Township
Chavogere
Kisumu
East
Bondo
Obunga
Kisumu
West
Siaya
Oware Village
Bar Chando
Majiwa A Village
Bar Chando
Asigo Market
Bar Chando
women group
Mageta
Fishermen group
(Mahanga CU)
Maseno Shopping
centre (west
Karating CU)
Bar Ding CU
Ohuru Market
No. of people
reached
12
46
Clarifying on Myths and misconceptions
associated with IUCDs
24
58
Community benefits of access integrated
Family Planning, HTC and cervical cancer
screening services
22
36
Family planning methods, HTC and Cervical
cancer screening
24
35
Benefits & Limitations of Long Acting and
Reversible contraceptive methods
78
162
screening services
56
176
Advantages of LAM of Family planning
14
44
Experience sharing on FP use and cancer
screening
31
106
cancer screening
10
25
Key health Messages on Family planning,
Cervical cancer screening and child health
13
24
Couple HTC and importance of knowing
ones HIV status
2
11
Key health Messages on Cervical cancer
screening and HIV Testing and Counselling
8
24
Benefits of integrated reproductive health
services offered at the social franchise facility
22
3
Importance of knowing ones HIV status
Condom use and sexuality
28
18
Cervical cancer screening

Benefits and limitations of short term
methods of Family Planning versus Long
Acting and Reversible contraceptives.
12
29
One on one counselling on Family Planning

methods
Importance of couple testing
Methods of Family Planning
Cervical Cancer Screening
Child Health Services in the context of
IMCI
Benefits of integrated utilization of Family
Planning and HTC services
Ngiya Girls High

School
48
Ugunja
Sigomere market
14
28
Gem
Madeya (Nyabeda
CU)
12
SubCounty
Kisumu
West
Community
Unit
Sagam
Community
Hospital
(Marenyo CU)
Orom Kyombe
CU
No. of people
reached
10
22
Key health Messages on Family planning,

HIV Testing and Counselling and; Cervical
cancer screening and child health
Information on Cervical cancer screening
and nearest hospitals for offering the
service
Sensitization on Huduma Poa Day and
services to be offered.
Importance of spacing and family planning
Couple HTC and importance of knowing
ones HIV status
Cervical Cancer screening
Importance of CA cancer screening
Long term FP methods
HTC in couples
screening services
Importance of couple HIV Testing &
Counselling
Methods of Family Planning
Importance of child immunization
Follow up on Cervical cancer screening
20
17
Lela Shopping
centre
10
28
Ugenya
Sihay market
12
29
Rarieda
Omia Malo CU
Omia Diere
6
4
15
24
Omia Malo
Bar Chando
women group
20
8
33
24
Omia Mwalo
Maseno Shopping
centre (west
Karating CU)
Bar Ding CU
Ohuru Market
Ngiya Girls High
School
2
28
18
48
12
29
48
Ugunja
Sigomere market
14
28
Gem
Madeya (Nyabeda
CU)
12
Sagam
Community
Hospital
(Marenyo CU)
Orom Kyombe
CU
10
22
20
17
Lela Shopping
centre
10
28
Sihay market
12
29
Bondo
Rarieda
Kisumu
West
Siaya
Kisumu
West
Ugenya

service
Sensitization of services offered by Masaba
Hospital to the community in relation to
integrated reproductive health services.
Modern contraceptive Methods and client
medical eligibility based on the WHO
eligibility criteria
SubCounty
Community
Unit
Ligega Market
No. of people
reached
14
30
Ugunja
Kisumu
West
Bondo
Ugunja Market
Ojolla
29
12
12
33
MagetaWakawaka
10
22
Siaya
Kisumu
West
Ohuru
Lela Market
12
7
26
21
Chulaimbo High
school
20
34
Ebusikhale
14
Hatiko
17
Ekamanji
19
Ekamanji
14
21
Ebusilaro
Itumbu
Chulaimbo
Ngow
Chiefs Baraza
(Roho)
Dialogue Day
(Chulaimbo)
12
15
0
57
10
54
67
34
112
28
26
Maliera
12
Maliera
21
29
Malanga
58
74
Maliera (Siranda
Chiefs Baraza)
33
40
Luanda
Kisumu
West
Gem
Benefits of immunizing your children

Types of family planning methods
Cervical cancer screening benefits
Effects of late cervical cancer diagnosis
Benefits of seeking Integrated Family
Planning and HIV Testing and counselling
services.
Family Planning methods
Importance HIV Testing and counselling
Types of family planning methods
Importance of Family planning
HIV Testing and Counselling
Types of Family Planning
Benefits of seeking Integrated Family
Planning and HIV Testing and counselling
services.
Importance of Family Planning
Importance of Cervical cancer screening
Types of Family Planning methods
Cervical Cancer screening
Family Planning medical eligibility.
Ruling out signs of pregnancy.
SubCounty
Bondo
Community
Unit
Nyabeda (Miracle
church)
Nyabeda Market
Ass. chief Baraza
Nyabeda primary
(parents day)
ACK Church
Ndere
Mageta island
No. of people
reached
13
20
Importance of HIV Testing and Counselling
19
31
33
26
36
42
Types of Family Planning

Importance of individual and couple HIV
Testing and Counselling
Key Messages in cervical cancer screening
34
40
Importance of child spacing
22
17

services at the social franchise facility
Importance of cervical cancer screening
HTC and cervical cancer screening services
18
Ingolomosio
28
14
Sibanga
23
42
Biribiriet
16
34
Namanjalala
31
27
Kesogon
10
17
Bumula
Namatotoa
23
52
Bungoma
South
Maliki-Tuuti
10
23
Namasanda
19
40
Nandolia
10
10
Bungoma
South
kakamega
East
TransNzoia East
Kwanza
Bukembe
TransNzoia East
Baraka
24
NandiHills
TransNzoia East
Bungoma
Central
Kipsamoo
20
Sindua
10
15
Chwele CDDC
25
87
Cervical cancer screening and family

planning
Family planning and cervical cancer
screening
Embracing integrated family planning and
cervical cancer screening
Sensitization on Cervical cancer screening
and family planning
Benefits of cervical cancer screening and
family planning
screening
screening
Cervical cancer screening and family
planning
Benefits of Cervical cancer screening ;and
modern methods of family planning
Family planning, cervical cancer screening,
child welfare
SubCounty
kakamega
East
Mumias
West
Bungoma
South
Community
Unit
Kisaina
Bungoma
East
Mahanga
Township
Namamuka
Mihuu
No. of people
reached
0
32
18
32
screening.
5
10
2
5
screening.
7
9
Sensitization on Cervical cancer screening
and family planning
20
50
Sensitization on long term family planning
methods
15
30
screening
30
40
screening
12
23
Cervical cancer screening and its benefits
Bumula
Khasoko
Kitale East
Sibanga
Kwanza
Matisi
Kitale East
Biribiriet
Nandi
South
Kosiage
30
60
Nandi East
Township
14
25
Bungoma
south
kakamega
East
Namasanda
10
13
12
Makuselwa
Kiptere (3)
8
52
10
102
Kakibei (2)
34
67
Kapchebinya (4)
12
71
Gesore
21
Konare
04
13

Family planning
Hormonal Contraceptives
Keera
09
18
Importance of HIV Testing & counselling
Kebirigo
08
11

Kericho
East
Nyamira
Bulovi
10

screening
screening
screening
Cervical cancer screening and its benefits
Family Planning and its benefits
Cervical cancer screening its importance
SubCounty
Community
Unit
Bomondo
Kerenda
Mategara
Gekora
Borabu
Kericho
West
Chepilat
No. of people
reached
04
22
30
40
05
17
07
14
IMCI services (Pneumonia, Malaria and
Diarrheal diseases); FP methods ,Cancer
screening and HTC
08
22
Family Planning
Mwongoria
11
28
Ekige
07
16
Mogusii
09
29
Matutu
14
20
Nyagacho
00
45
Set Light
12
23

screening.
Why every woman should be screened for
cancer
screening and HTC
Family planning and its benefits
Mjini
11
29
Majengo
07
32
Matobo
07
22
Mombasa ndogo
10
15
Kisumu Ndogo
13
35

screening.
screening and HTC
Non Hormonal contraceptives methods
Mulango
18
25
Chepkolony
05
26
Vatena
07
37
11
Economic importance of FP in community

Advantages of family planning and cancer
screening
Advantages of Cervical cancer screening
SubCounty
Makimeny
Community
Unit
Sisei
Siongiroi
Kapsimba
Mogor
Lugumek
Rongo
No. of people
reached
12
21
screening and HTC
8
17
screening.
23
30
7
23
Male involvement in Family planning
9
28
Areyet
Riosiri
14
11
34
23
Osodo
07
18
25
Kodero
06
33
Nyakianga
15
32
Nyimumbo
14
34
Kanyingomb
16
28
Midida,
10
33
Katieno,
26
12
32
22
Okonyo mine
Uriri
Lela,
Moso,
Oyani,
12
45

Advantages of FP
Benefits of Long Term FP
cancer screening
Family planning and its Benefits
Benefits of Cancer screening, Hormonal and
non-hormonal methods
Effects of HIV/AIDs to the countys
economy
Benefits of integrated Family Planning, HIV
services
screening
Benefits of integrated Family Planning, HIV
services
Advantages of integrating family planning
and cancer screening

screening and HTC
12
SubCounty
Community
Unit
Aedo,
Lela
Kambogo
No. of people
reached
15
30
18
43
screening and HTC
12
38
Demonstration of condom
Nyasoko
34
68
Kajulu B
11
45
Mudhariu
21
39
Got Kodero
19
48
Kolwal
Suna West Nyabukemo,

screening
Nutrition and FP
Male involvement in Family planning
16
32
Bondo,
12
29
Oreri
22
49

Effects of HIV/AIDs to the countys economy
Prevention of HIV
Nyalganda
26
44
Obembo
05
34
Wiga
21
45
Manyera
15
55
Giribe
12
67
Ogada
21
78
Magongo
15
49
Masurura
23
56

cancer screening
service
13

service
FP as a family affair and not womens affair
SubCounty
Community
Unit
Kilgoris
Nyamusi
Oljapaso
20
21
58
54
cancer screening
Male involvement in FP
Benefits of FP services
Eldonyo
15
33
Town ship
12
34
Moora
14
29
Mosasa
10
18

screening and HTC
Male involvement in FP
Marani
19
34
Bogecho
23
52
Nyanchwa
17
31
32
Nyakobaria
10
12
Chief Camp
(Township)
21
17
Nyangena
10
21
3439
7739
Kisii
Central
Bogecho
Total #
Clients
served
No. of people
reached
HTC and cancer screening

screening and HTC
Sensitization on Cervical cancer
screening and family planning
Effects of HIV/AIDs to the countys
economy
Family Planning and HIV/Aids

IUCD and Cancer Screening
Benefits of FP
Why do we plan our families?
Within the reporting period, 4873 clients were directly referred from the community to access integrated
reproductive health services (FP, HTC and cervical cancers screenings) at the social franchise. The number
of men participating in reproductive health education during mobilization increased by 8.34% (3439) from
the previous quarter when only 3,152 men took part.
14
Community mobilization activities have helped to promote awareness on reproductive health issues at the
community level and mitigate on social and cultural issues that promote or inhibit use of reproductive
health products and services. More people are now turning for event days (as reflected in section 3.0
below). The sessions focused on improving clients understanding of various contraceptive methods
enabling them draw distinctions between facts and myths associated to the specific methods.
Communities around Huduma Poa clinics have had immense opportunities to freely discuss reproductive
health issues at community barazas, dialogue days and during other forms of mobilization sessions. It is no
longer a sole affair for women. This been evident across the 183 community mobilizations held during the
reporting period.
2.2.1 Lessons learnt

1. Communities have some information on reproductive health, and we should never assume that
they are completely unaware. During mobilization sessions, we have established the need to
always give them time to express what they know and build on their knowledge.
2. Health education/talk prior to commencement of service provision during event days helps
clients clarify reproductive health related issues and gives them courage to ask questions that
have not been clarified to them for a long period including the myths.
3. It is important to give clients an opportunity to cite and share their satisfactions, concerns,
worries, experiences in family planning including myths to create a platform for clarifications for
improved uptake.
4. Community mobilizations sessions targeting both men and women are important avenues for
promoting contraceptive utilization.
2.2.2 Challenges experienced during community mobilizations & Huduma

Poa days
1. Weather: Heavy rains experienced during the quarter marred some planned field activities
particularly in Trans-Nzioa, Kisii, Migori, Nyamira & Kericho counties. These made roads mudy
and occasionally impassable, at times making program staff walk long distances in the muddy or
push the vehicles to reach the underserved clients.
2. Seasonal Calendar: In regions dominated by farming as a social economic practices, most
clients could only be reached during late in the afternoon after they had left their farms. This
contributed to Huduma Poa days ending late in the night.
3. Lack of Equipment
Inadequate equipment for community based event days-Blood pressure machines and portable
weighing scales
15
2.3 Building capacity of social franchise members

2.3.1 Contraceptive Technology
KMET collaborated with the local Ministry of
Health in vihiga to train 28 healthcare providers
from facilities recently recruited on contraceptive
technology to build up their capacity to offer
comprehensive contraceptive services; and
accelerate quality integration of HIV testing and
counselling (HTC) and cervical cancer screening
services. The training embraced both theory and
practical sessions. Practicum were done at Mbale
Rural and Vihiga County Hospital. Providers were
drawn from 11 counties: Kericho, Vihiga, Kisumu,
Bungoma, Kakamega, Kisii, Nyamira, Migori, Homa- Figure 7: Nursing Officer In- Charge at Mbale
Rural Health Centre gives orientation to
Bay,Trans-zoia and Siaya counties.
participants at the practical area prior to the
practicum sessions
Figure 8: A participant gives health education

to clients at the practical area
Providers received training on contraceptive method

mix (Permanent, Long Acting and Reversible
Contraceptives; and short term methods). The
training greatly focused in ensuring providers
correctly provide balanced contraceptive information
to their clients to enable them choose methods that
best suits them. Making a wide range of methods
available improves quality of care. To date, all the 80
franchise providers have been trained on Family
Planning.
During practicum sessions, 110 clients received

contraceptive services. Significantly, 81 clients
accessed implants whereas 12 accessed IUCDs.
Virtually, 87% of all clients served were screened
for cervical cancer screening and tested for HIV in
an effort to impart integration skills to participants
Figure 9: Participant practicing to remove

implant during practicums sessions
16
Table3: Training Practicum Sessions

Contraceptive Technology Training
Practicum Sessions
Mbale Rural & Vihiga County Referral Hospital
Implants
Contraceptive
Method
#
Clients
served
Injectables
IUCDs
Inserted
Removed
Inserted
Removed
81
11
12
Oral
contraceptives
Integrating cervical cancer and HIV counseling and testing services to family services across franchise
facilities guarantees prudent utilization of scarce resources while ensuring clients receive integrated services
under one roof without placing an undue burden on health care service provision. It creates opportunities
for clients to access multiple services simultaneously resulting to more efficient services, better treatment
adherence, and more holistic care
2.3.2 Integrated Management of Childhood illnesses

In collaboration with the department of family health, unit of neonatal, child and adolescent health in the
Ministry of Health, KMET facilitated a training
aimed at strengthening the ability of Huduma Poa
health facilities to offer improved prevention and
integrated management of childhood illnesses
(IMCI), 24 providers were trained. The training
focused on equipping providers with desirable
knowledge and skills to accurately assess, classify,
identify treatment and treat ill children using the
IMCI Strategy.
The strategy provides an
integrated approach for standard management of
major causes of childhood morbidity and mortality
like Pneumonia, Diarrhoea, Malnutrition,
Neonatal problems, Measles and Malaria. This
approach offers simple and effective methods to
Figure 10: Participants assess a child under five
years for dangers signs during IMCI practical
comprehensively prevent and manage the leading
experiences
causes of serious illness and mortality in children.
This is expected to greatly contribute reducing child mortality and avert significant child disability.
Providers who were trained have already rolled out implementation of the trained strategy. KMET has
continued to support social franchise providers and community health workers attached to the social
franchise to reduce childhood mortality and morbidity by improving family and community practices for
the home management of illness, and improving case management skills of health workers across the social
franchise. Providers will be mentored, given technical support and linked with MoH and other partners to
access commodities including: Zinc Sulphate, ORS sachets, Vitamin A supplements, Anti-Malaria Drugs and
appropriate antibiotics.
IMCI has been shown to improve health worker performance, but constraints have been identified in
achieving sufficient coverage to improve child survival, and implementation remains sub-optimal. At the
17
core of the IMCI strategy is a clinical guideline whereby health workers use a series of algorithms to assess
and manage a sick child, and give counselling to care givers.
When evaluating the training, social franchise
providers rate the training as being interesting,
informative and empowering. There was consensus
that it improved their skills in managing sick children.
They appreciated the variety of learning methods
employed, and felt that repetition was important to
reinforce knowledge and skills. Facilitators were
rated highly for their knowledge and commitment, as
well as their ability to identify problems and help
participants as required. Providers increased
Figure 11: An IMCI course facilitator guides a
confidence in managing sick children was identified at
participant at the pediatric ward to correctly
the practicum/clinical areas.
assess, classify, identify and treat
In the subsequent quarter, there is going to be joint
KMET-MoH follow-up visits to all providers trained to ensure acquired knowledge and skills are
implemented; and that providers perfect their counselling skills in an effort to accelerate quality roll out of
the services.
2.3.3 HIV Testing and Counselling

Considerably 24 healthcare providers were trained on HIV testing and counselling to strengthen
their capacity to accelerate quality integration of HIV testing and counselling (HTC) services to
reproductive health and other general healthcare
services. The training was conducted for six (6)
days based on the existing MoH curriculum.
There were sessions for observed practice where
trainees counselling skills were assessed at the
clinical site on three individual counselling
sessions each and one couple counselling session.
Group work exercises, group presentations and
discussions were used to elicit participants Figure 12: Participants practice on couple
counselling during HTC protocols session
experiences on different aspects of their clinical
work at franchise facilities and elsewhere in relation to the course.
Trainers covered all the theory topics and also
conducted practical demonstration on blood
harvesting and HIV testing. Participants
practiced blood collection and HIV testing
during the training. Participants exhibited
ability to perform HIV testing and interpreting
test results. They had the opportunity to
practice on the use of new Rapid HIV testing
kits: KBH and 1ST Response test kits serially.
They also learned on TIE BREAKING though
Unigold test kit.
Figure 13: Participants practice on preparing blood
spots on the filter papers for PCR
18
The training also focused on diverse HTC approaches in Kenya aimed at enabling clients to select the
approach that suits their interests and conveniences. Participants gained knowledge on HIV infection,
transmission, progression, management and prevention according to the national guideline. Emphasis was
given on the application of acquired knowledge and skills to manage psychosocial issues in HIV and AIDS
to provide effective services to clients.
Case studies and scenarios were used to facilitate discussion on the different professional issues in
counseling like confidentiality and ethics in counseling. Use of triads consisting of counselor client and
observer ensured adequate practice and mastery of skills. Mini lectures were used for the theoretical
aspects of the course this was preceded or followed by exercises to enable participants to relate theory
to practice.
Integrating HIV counseling and testing services to
already existing health care services across franchise
leverages existing and scarce resources, without placing
an undue burden on health care service provision. It
creates opportunities for clients to access multiple
services simultaneously resulting to more efficient
services, better treatment adherence, and more holistic
care.
Figure 14: KMET's Executive Director, Monica
Oguttu encourages participants to implement
the content of the HTC training during the
closure
2.4 Building capacity of Community Health Workers

2.4.1 Community Health Strategy, FP and HTC
Fifty nine (59) Community Health Workers
(CHWs) identified and engaged to forge
linkages facilities for newly recruited social
franchise facilities underwent a 3 days training
on the wider concept of community health
services in line with Kenya Essential Package for
Health (KEPH). The training focus on varied
areas including: community strategy, pillars of
primary health care, roles of community health
workers and their position in the community
strategy, community based health information
system (CHIS), basic information on modern Figure 15: Participants keenly follow presentation
family planning methods, contraceptive and HIV on FP planning made by an RH Coordinator during
Testing and counseling; and community the training
mobilization strategies aimed at enhancing their capacity to proficiently engage communities to strengthen
facility-community linkages in promoting sustainable demand and utilization of quality healthcare services.
Key community messages in relation to cervical cancer were also tackled.
19
The training also focused on documentation,

reporting and community referral mechanisms.
Community Health Workers were issued with
referral documents and quick contraceptive
reference books to ease their work during
demand creation. To date, there are 160 CHWs
who have been engaged and trained for
efficacious program implementation across 80
social franchise facilities in line with the Ministry
of Health Community Strategy.
Two (2) CHWs are attached to each social
franchise outlet to forge linkages between the
facilities and target communities in line with the
MOH community strategy; and mobilize
surrounding
communities
in
ensuring
Figure 16: Community Health Workers in group

discussions to ventilate what they understand in
Community Health Strategy
sustainable demand and utilization of

quality health care services that are
accessible and affordable to consumers of
health services accessing care. Within the
reporting period 4873 clients were
referred from the community to access
services at the social franchise.
At the conclusion of the training, Huduma
Poa Community Health Workers drew
their
action
plans
ready
for
implementation. They undertook to give
feedback to their colleagues in respective
community units and be role models by Figure 17: CHWs keenly follow sessions on key messages
utilizing family planning, cervical cancer and on HIV Testing and counselling
HIV Testing counselling services. Their fears and anxieties were now cleared, they left loaded with
integrated reproductive health talk the facts.
2.5 Conduct performance review meetings with franchise providers and

Community Health Workers.
Figure 18: MoH Sub-County Community

Health Services focal person (Bondo) make
his contributions during performance
review meeting
Unlike in the past quarters where performance review

meetings for CHWs and providers were conducted
separately, the approach was different in the current
quarter (July September, 2014). Performance review
meetings for both franchise providers and community
health workers were jointly conducted to enable them
jointly reflect on their joint efforts and contribution to
Health Communication and marketing program
deliverables.
The reviews focused on facility and
community performances for a period of 1 year (year 3 of
HCM implementation). Franchise facilities in Huduma Poa
20
health network are divided into two regions. Review meetings were conducted for 2 regions. The
remaining two regions will hold their performance reviews in the 1st month of the subsequent quarter
(October-December 2014).
Demand creation and service delivery data generated from various communities and franchised facilities
respectively was discussed. A line was drawn between providers who are performing exemplary well and
those performing fairly low alongside assigned
community health workers. Franchise providers
and community health workers outshining in
service delivery and demand creation were
recognized and certified for outstanding
performance. Best practices and strategies used
by well performing providers were discussed,
creating a perfect opportunity for low
preforming provides to learn with the intention
of borrowing and replicating best practices.
Figure 19: Providers await to respond to
performance issues raised on their facility data.
The forums enabled both community health

workers and franchise providers to review their joint effort and progress in the provision of FP, cervical
cancer and HTC services. In addition,
they shared experiences, success,
challenges and possible solutions to
perceived and expressed challenges. This
was aimed at establishing and putting in
place mechanisms that will accelerate
demand and access for quality integrated
services at franchised facilities.
The teams jointly identified gray areas
and suggested new methodologies in
heightening quality service provision
across social franchise facilities.
Provider listed a number of challenges
Figure 20: MoH Officers issue certificate of outstanding
that affect performance including:
performance to a CHW during a performance review
inadequate
equipment
for
key
meeting
procedures i.e. insertion kits; staff
turnover, occasional commodities stock out, inadequate space for service integration.
The plenary session provided an arena to ventilate on possible solution to community and/or facility specific
challenges that deter positive progress. Following the plenary, numerous action points were agreed upon:
2.5.1 Provider & CHWs performance review meetings action points

a) Social franchise providers to nurture and sustain a good working relationship with CHWs for
successful referral of clients and demand creation.
b) Social franchise providers to continuously submit their performance reports, forecasting and
commodity order reports to MoH to ensure reliable and continues supply of commodities.
c) Providers to charge affordable cost for service provision; cost that is pocket friendly to clients
d) Social franchise administrators to hold regular joint meetings with service providers and CHWs
to address challenges within facility aimed at improving service performance
21
e) CHWs and social franchise providers to take a lead role in demystifying myths and misconception
that hinder utilization of services. Providers to comprehensively explain procedures to clients
and assure them.
f) KMET to issue starter kits to the newly recruited facilities
g) Quality Assurance Officer to offer OJT to those providers who are not trained on cervical cancer
screening before IUCD insertion.
h) Performance of CHWs to be pegged on successful referrals and adequate community
mobilization for supported services.
i) Service providers to ensure proper documentation of MoH reporting tools in enhancing quality
health provision; providers to liaise with SCHMTs to acquire revised reporting tools
j) Providers to conduct routine data review to ensure data accuracy and consistency.
k) Every social franchise facility to uphold integration of services FP, HTC/PMTCT, cervical cancer
screening and child health services making clinics one stop shop for clients.
l) Social franchise facilities to conduct regular CME to strengthen areas of identified need,
mentorship; and where possible, it should be done in consultation quality assurance officers
2.6 Support supervision visits, data quality audits and linkages

Quality Assurance Teams have continued to collaborate with the MoH in conducting structured support
supervision across social franchise facilities. Forty (40) routine quality assessments were conducted and
eighteen (18) joint MoH-KMET facilitative supervisions. Both routine social franchise assessments and
support supervision were aimed at
ensuring quality and uninterrupted
service delivery across the franchise.
In addition, KMET and Gold star Kenya
jointly conducted data quality audits to
9 facilities implementing ART/PMTCT
services. Providers were supported to
practice and embrace correct and
accurate documentation, reporting,
forecasting/quantification and ordering
of ART/PMTCT pharmaceuticals.
Figure 21: HCM program staff conducting support
supervision at a franchise facility
Support visits to most of newly recruited facilities

into the franchise revealed that most of the
facilities were previously not reporting to the
MoH. Efforts by Huduma Poa team has made
facility providers realize the importance of
reporting to their Sub County for data
aggregation. Most of the Sub County Health
Records Information Officers are now impressed
to be receiving data from most of those facilities.
The Officers across board have promised to
support the facility in acquiring reporting and Figure 22: Sub-County Health information and
records Officer (Right) joins Goldstar Kenya and
related registers.
KMET in data quality audits
22
Numerous linkages were forged with the MoH and other reproductive health implementing partners. The
linkages were intended to ensure successful implementation of planned activities within the quarter. Due
to impressively sustained linkages, KMET has
been used by MoH to redistribute
contraceptive and HTC commodities across
franchise facilities. A total of 38 meetings were
held with local Ministry of Health at different
sub-counties to discuss HCM program
progress, jointly organize for community based
integrated
reproductive
health
event
days/outreaches, CHWs orientation, provider
review meetings, jointly plan for World
Contraceptive day.
Within the quarter, KMET partnered with
MoH and SEARCH (Sustainable East Africa
Research in Community Health) to conduct
mobilization and offer contraceptive services at
Sindo Sub-County, Homa-Bay County. This area of outreach largely serves the beach community.
Figure 23: HCM Quality Assurance Officer

redistributes contraceptive and HTC commodities
acquired from the MoH to a member of the social
franchise
23
3.0 PROGRAM PROGRESS

IR 1.1: INCREASE ACCESS TO AND DEMAND FOR HIGH QUALITY HEALTH PRODUCTS AND
SERVICES
3.1 Family planning (FP) services

Cumulatively, 7672 clients
received family planning
services up from 5633 in the
previous quarter (36.2%
higher). Significantly, 2,627
implants and 215 IUCDs
were inserted through the
social
franchise
and
community based outreaches.
Up to 3,688 clients accessed
injectable contraceptives up
from 2,968 in the previous
quarter,
539
received
condoms whereas 401 were
issued with pills (combined
oral contraceptives and
Figure 24: FP Service provider documenting after providing a
progesterone only pills).
contraceptive method to a 16 year old client at the franchise facility
Compared
to
previous
quarter, utilization of implants improved by 24.25 % whereas utilization of IUCDs improved by 20.11%.
Table 4: FP service provision
Social Franchise FP service provision (July September 2014)
# Social franchise facilities = 76
CONTRACEPTIVE METHOD
Month
July
2014
Aug
2014
Sep
2014
Total
IUCD
Implants
EC Pills
Injections
Condoms
POPs
COCs
#
Insertions
#
Removals
#
Insertions
#
Removals
# Clients
# Clients
# Clients
# Clients
# Clients
77
645
28
1,299
162
15
135
55
846
43
32
1,206
204
121
83
1,136
38
31
1,183
173
33
91
215
21
2,627
109
72
3,688
539
54
347
24
3.2 HIV testing and counselling (HTC) and PMTCT services

KMET integrates HIV testing and counselling services to other reproductive health services offered at
facilities in the social franchise as an entry point to prevention, diagnosis and management of HIV and AIDS.
Throughout the reporting period (July-September 2014), up to 8,908 clients (8451 individuals and 457
couples) were counseled and tested of HIV through the social franchise. A total of 565 individual clients
and 17 couples (both) tested HIV positive whereas 29 couples tested discordant.
Table 5: HIV testing and counseling (HTC) services
HIV testing and counselling (HTC) services (July-Sep 2014)
# Social franchise facilities = 76
Month
July
2014
Aug
2014
Sep
2014
Total
HTC - Individuals
HTC Couples
Counseled
Tested
HIV +ve
Referrals
Counseled
Tested
Both HIV
+ve
Discorda
nt
2,486
2,486
192
192
97
96
2,759
2,753
201
201
174
174
3,217
3,212
172
172
189
187
14
8,462
8,451
565
565
460
457
17
29
Table 6 below shows quarter achievements in PMTCT

Table 6: PMTCT service provision
Franchise provision of PMTCT Services
July
2014
Aug
2014
Sep
2014
Total
Infants
Counseled
Tested
HIV +ve
Total
Referrals
Tested
270
253
16
249
224
17
335
316
14
13
854
793
47
17
26
HIV +ve
-
1
1
Considerably, 793 pregnant women accessing antenatal services were counseled and tested for HIV as the
start point for PMTCT interventions, out of whom 47 turned positive. Women who turned positive were
referred to PMTCT service providers to access comprehensive PMTCT intervention services.
25
3.3 Cervical cancer screening services

Huduma Poa Health Network greatly focuses in the integration of family planning, HIV testing and
counselling, and cervical cancer screening to all women seeking reproductive health services across
franchise facilities.
Within the reporting period, 1,421 women of reproductive age got screened for cervical cancer, out of
whom 231 turned VIA/VILI positive whereas 14 exhibited positive findings for suspicious for cervical cancer.
A total of 245 clients were referred through the social franchise for treatment at various central sites.
Among those referred included clients with VIA/VILI positives results and suspicious for cervical cancer
cases.
Table 7: Cervical Cancer screening services
Month
Cervical Cancer Screening July-September 2014

# Social franchise facilities =76
Community based outreaches=30
# Clients Screened
July 2014
Aug 2014
Sep 2014
Total
# Positive
283
415
723
1,421
77
40
114
231
# Suspicious
# Referrals
5
9
14
10
7
16
245
Partners are currently working toward closing an existing gap for women who turn VIA/VILI positive and
suspicious for cervical cancer. Counties and sub counties in western Kenya region are being encouraged
to create a database documenting organizations providing screening and/or treatment of cervical dysplasia
to improve collaboration and referrals between different organizations. This will lead to improved
networking for cervical cancer screening and prevention in the region.
3.4 Child Health Services (Integrated Management of Childhood Illnesses

Within the quarter, additional providers were trained and started implementing the learnt integrated
approach for standard management of major causes of childhood morbidity and mortality like Pneumonia,
Diarrhoea, and Malaria among other childhood illnesses like Malnutrition and Measles.
There has been a remarkable improvement in the roll out of IMCI services across the facilities that have
been trained. Between July and September 2014, 715 under-fives (< 5 years) were accurately assessed,
classified and treated for pneumonia. Significantly, 426 under-fives were treated for diarrheal, of whom 86
received only ORS whereas 319 were administered with both ORS and Zinc sulphate for diarrheal
management. Up to 2,297 under-fives were tested and treated for Malaria using Artemisinin-Based
Combination Therapy (ACT) up from 1007 from the previous quarter. Up to 1,546 under-fives seeking
child health services were dewormed whereas 944 received Vitamin A supplementation in line with the
child welfare schedule.
26
The IMCI has been paramount in offering

comprehensively management aimed at
preventing and managing the leading causes of
serious illness and mortality in children.
Implementation in earnest is expected will
continue in the subsequent quarters.
Figure 25: Parents and guardians await for child health

services during a community based outreach
Table 8: Child Health Services (Integrated Management of Childhood Illnesses

Child Health Services (Integrated Management of Childhood Illnesses )
July-September 2014
Age Ranges
#Treated
for
Pneumonia
#Treated
for
Diarrhea
#Treated
for
Diarrhea
with ORS
#Treated for
Diarrhea
with ORS
and Zinc
Sulphate
#Treated
for
malaria
with ACT
#Vitamin A
supplementation
#Dewormed
0-2 Months
>2-59
months
Total
38
677
27
399
4
82
18
301
178
2119
5
939
0
1546
715
426
86
319
2,297
944
1,546
4.0 Engagements with other stakeholders

4.1 World Contraceptive day
KMET joined other reproductive health implementing partners in Siaya, Migori, Kisumu & Homa-Bay
Counties to celebrate world Contraceptive day (WCD) on September 26th, 2014. The Theme of this years
WCD was, 'Its your life; its your future; know your options'. Its mission was to improve awareness
of contraception among young people, so that
they can make informed decisions about their
sexual and reproductive health (SRH).
There has been unprecedented upsurge of
contraceptive services in most Sub-counties
where APHIAplus HCM activities are being
implemented. A recent survey conducted by MoH
health in Siaya County revealed an improved
contraceptive prevalence with Bondo ranked 1st
among 6 sub-counties, with a prevalence of 72%,
this being the highest recorded in county. The
Figure 26: CHWs, healthcare providers and

partners participate in a procession during the
world contraceptive day celebrated in Nyando
27
broader range of modern contraceptive options offered by Huduma Poa facilities has also been key to
fuelling demand. Huduma Poa Health Network draws its highest franchised clinics from Siaya County. Out
of the 15 counties of franchise presence (80 franchise clinics), Siaya contributes 16 clinics (20% of network
facilities.
Huduma Poa network is determined to close
the family planning gap in the regions where
the franchise has feasibility and accelerate
efforts aimed ensuring Women of
Reproductive
Age
(WRA)
access
contraceptive methods of choice and balanced
information.
Different stakeholders used the day to pass
accurate and unbiased information on
contraception; and to provide young people
with the contraceptive information they need
and encourage them to speak with their
partners and healthcare providers about the
contraceptive options available to them, Figure 27: KMET supported theatre group presents a
including long acting reversible contraception play on family planning during the world
contraceptive day celebrated in Siaya
(LARC).
4.2 Appraisal of AWP (2014/2015); and Family Planning Strategic Plan

2014 2018 Siaya County
KMET participated in the development and appraisal of zero drafts of Siaya County consolidated Health
Annual Work Plan (2014-2015); and Family Planning Strategic Plan (2014 2018) .The documents are
anticipated to provide Medium Term Sector Strategic focus towards successful implementation of Health
Services in line with the new constitution and to the realization of health related goals of Vision 2030.
The Annual work Plan (AWP) is highly anticipated to provide annual operational focus for 2014/2015 .This
document spells out a one year strategic direction with a mission statement and vision. The plan is in line
with New Kenya Essential Package for Health (KEPH) which focuses on and is anchored on three basic
elements that mark the priority of service delivery. KMETs planned activities within the county, in the
implementation of APHIAplus Health Communication and Marketing (HCM) Program are well outlined in
the document.
4.3 Community Health Services Taskforce Migori

Within the reporting period, KMET took part in two crucial meetings evaluating the contribution of
community Health Services in Migori County. In the APHIAplus HCM Program, KMET uses Community
Health Strategy to strengthen linkages between franchise facilities and target communities through existing
Community Units (defined catchment areas). During the meetings, stakeholder proposed additional
intervention elements that would improve both demand and supply aspects to improve access to health
care thus improving health service indicators. Emphasize was given to principles of intersectional
collaboration, community participation and empowerment to enhance access to health care. The Taskforce
recommended establishment of Community Health Units where they didnt exist, governance and linkage
structures, structured training of the health workforce within community health services, establishment of
Community Based Information system in all community units and using it for regular dialogue at community
and health facility levels leading to decisions and health actions.
28
4.4 Kisumu County Family Planning Advocacy forum

Within the reporting period, KMET among other Family Planning (FP) implementing stakeholders in Kisumu
County, local Ministry of Health (MoH) and selected Civil Society groups came together to establish family
planning advocacy committee aimed at establishing and maintaining active engagement with County
governments to bridge the resource gap in family planning services provision. Other organizations on board
include: Centre for the Study of Adolescents (CSA), Tupange, Network of Adolescents and Youth of Africa
(NAYA), Omega Foundation, AMPATH, APHIAplus, FHOK, Red Cross, Pathfinder , Maseno University;
and Faces-KEMRI-FACES)
Advocacy also focused on enhancing development and implementation of policies that provide the
foundation for a basic level of interaction between the private and public health sector in strengthening
integrated RH services.
The committee is currently working towards providing technically efficient and effective support to Kisumu
County Health Committee in ensuring sufficient allocations for integrated reproductive health services.
Unmet need for family planning in Kisumu County has been largely due to inadequate service provision
resulting from limited access to family planning commodities and lack of support for contraceptive security.
4.5 Commodity Management forum-Western Kenya region

Within the quarter, KMET participated in a partners forum that brought together the MoH and key
partners supporting various elements of service
delivery in the Western Kenya region in an attempt
to address challenges facing commodity security.
Partners congregated together to discuss possible
solutions to the long standing challenge. Twenty two
partners organizations (22) were represented.
Overall, support for commodity management in the
region has been weak, fragmented and
uncoordinated with duplication of efforts further
aggravating pre-existing challenges.
While a
coordinated and harmonized approach to supporting
the MoH has been the mantra for all partners,
implementing partners and MOH, have never jointly Figure 28:Dr. Elizabeth Ogaja, Cabinet Secretary
for Health, Kisumu County addressing
met to try and ventilate of the matter with the aim
participants during the forum
of finding a lasting solution. The forum largely
focused on:
Seeking consensus on the need for a coordinated and harmonized approach in supporting MoH to
improve commodity management
Addressing the need to find common ground, define roles and responsibilities as well as improving
collaboration and partnership for commodity management support
The Forum had been organized and convened by Management Sciences for Health/Health Commodities
and Services Management (MSH/HCSM), a USAID/Kenya health systems strengthening project with the
mandate for strengthening commodity management systems at both the national and peripheral level.
Provision of quality and appropriate healthcare services requires an uninterrupted supply of health
commodities within the healthcare system. Without these commodities, no services can be rendered and
29
without services, desired health outcomes cannot be attained. Kisumu County intends to establish a
directorate that deals with all health commodities
Key areas assessed during the forum include:
Health facility management and infrastructure
Inventory management
Availability and use of health commodity management tools and reference materials
Health commodity availability
Order fill rate
HIV Rapid Test Kits End Use Verification
Key findings highlighted in the forum include:
HR challenges-numbers, roles & responsibilities, capacity, turnover

Infrastructure challenges especially storage
Poor inventory management practices including poor record keeping, documentation and
accountability
Poor availability of some commodity management tools, job aids & reference materials
Inconsistent commodity availability
Poor commodity reporting rates and data quality issues
4.6 Kisumu County Task Force for Maternal Neonatal & Child Health
(MNCH)/RH
During the quarter, KMET became a member of County Maternal Child & Neonatal Health/ Reproductive
Health (MNCH/RH) taskforce constituted to advise the county government and partners on planning,
strengthening and development of programmes for the expansion of quality MNCH/RH services that are
accessible, sustainable and evidence based. The taskforce coordinates activities of the various partners in
the area of MNCH/RH to ensure that the availability and utilization of critical MNCH/RH services is
increased and that these services are integrated/linked with other prevention and care services. Specific
roles of the taskforce include:
a) Promoting collaboration between different MNCH/RH stakeholders in the county
b) Promoting synergy and linkage between MNCH/RH and other programmes like HIV/AIDS, TB,
malaria, child health and community health strategy
c) Monitoring MNCH/RH data collection, analysis and use for decision making
d) Facilitate bi-annual MNCH/RH stakeholder meetings
e) Supporting dissemination of MNCH/RH policy, MNCH/RH strategies, guidelines and best practices
f) Overseeing capacity building activities at County and Sub County levels (pre- and in-service)
g) Provision of technical support to the Sub-Counties in MNCH/RH planning, implementation and
monitoring
h) Advocating for increased resources for reproductive Health (RH) interventions
i) Conducting quarterly Maternal and Perinatal Death Review meetings
j) Determining the formation of special working groups or sub-committees for specific purposes from
time to time, agree their terms of reference and monitor their performance
The taskforce sessions conducted within the quarter provided an opportunity to review MNCH/RH
indicators performance, comparing last years (2013) performance with the achievements this year (1st and
2nd Quarter 2014).
30
Kisumu County has registered slow progress in the reduction of maternal and newborn mortality and
universal access to Sexual Reproductive Health compared to the national targets; the proportion of
deliveries attended by a skilled provider in quarter 1 of 2014 is at 59% (target is 90% by 2015), maternal
mortality ratio is 488/100,000 (target 147/100,000 by 2015), unmet need for FP is 56% (target is 70% by
2015), neonatal mortality is 23/1,000 live births (target 11/1,000 live births by 2015), hence the need to
establish the task force who will spearhead the implementation of RH policies and strategies in County.
5.0 Social franchise facility branding

During the quarter, the organization commenced on branding
social franchise facilities that were recently recruited. Branding
adopted the format of wall painting and fixing of branded
signposts or light boxes. Branding is integral part of marketing
and demand creation for program supported services. 25
service delivery were branded. To date, 70 out of 80 social
franchise have fully been branded. Branding will be concluded
in the subsequent quarter.
Figure 29: Recently branded huduma Poa

franchise facilities
6.0 Performance Management Plan

Table 9 below presents basic data on project progress towards the achievement of targets set for year 3.
31
FP
services
Provided
Capacity
building of
social
franchise
members
Health
workers
trained
Services
provided
in
affiliated
franchise
facilities
HTC
services
provided
PMTCT
services
provided
Oct
Dec
Jan Mar
Apr
Jun
Jul- Sep
Achieveme
nt Yr 3 %
Indicator
Yr 3 Target
Output
Achieveme
nt Yr 3
(12 months)
Year 3
October 2013- September 2014)
Source
AOP
Activity
Reference
Table 9: Performance Management Plan
Achievement
Yr
1
Yr
2
Yr 3
KMET
HCM
Reports
Percent of USG supported service

delivery that provide FP counseling/or
services
48
51
76
80
80
100%
N/A
90%
100%
KMET
HCM
Reports
Number of health care workers who

successfully complete an in-service
training program through a social
franchise
24
49
30
76
179
119
150.42%
N/A
76%
150.0%
KMET
HCM
Reports
Number of Health Care workers

trained in child health
26
24
50
60
83.3%
N/A
N/A
83,3%
3271
1
3920
1
5633
74
7672
47
20496
123
21960
240
93.3%
51.25%
N/A
N/A
N/A
N/A
93.3%
51.25%
576
482
716
793
2567
4896
52.43%
N/A
N/A
52.43%
4729
0
0
0
5276
0
0
0
7047
329
1007
306
8451
426
2,297
715
25503
755
3304
1021
20304
4020
2820
1680
125.61%
18.78%
117.16%
60.77%
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
125.61%
18.78 %
117.16%
60.77 %
4729
5276
7047
8,451
25503
20304
125.61%
N/A
N/A
125.61%
576
482
716
793
2567
4896
52.43%
N/A
N/A
52.43%
KMET
HCM
Reports
KMET
HCM
Reports
KMET
HCM
Reports
FP
PMTCT
Number of individuals
Preg.
receiving
services
women
(disaggregated by sex
C&T
and
health
area)
HTC
through
social
Diarrhoea
franchise
Malaria
Pneumonia
Number of individuals who received
HTC services for HIV and received
their test results (PEPFAR P11.1.D)
through a social franchise
Number of pregnant women with
known HIV status (PEPFAR P1.1.D)
32
Yr
4
PMTCT
services
provided
KMET
HCM
Reports
ART
services
provided
KMET
HCM
Reports
ART
services
provided
KMET
HCM
Reports
ART
services
provided
KMET
HCM
Reports
Number of HIV-positive pregnant

women who received anti-retrovirals
to reduce risk of mother-to-childtransmission through a social
franchise
Number of HIV-positive adults and
children receiving a minimum of one
clinical service (PEPFAR C 2.1D)
Number of adults and children with
advanced HIV infection newly
enrolled on ART (PEPFAR T 1.1 D)
Number of adults and children with
advanced HIV infection receiving ART
(PEPFAR T 1.2 D) through a social
franchise
Jan Mar
Apr
Jun
74
47
20
32
77
146
45
45
33
Jul- Sep
123
Achieveme
nt Yr 3 %
Oct
Dec
Yr 3 Target
Indicator
Achieveme
nt Yr 3
(12 months)
Output
Source
AOP
Activity
Reference
Year 3
October 2013- September 2014)
Achievement
Yr
1
Yr
2
Yr 3
68.3%
180
68.3%
N/A
N/A
146
640
23.81%
N/A
N/A
35
94
400
23.5%
N/A
N/A
35
94
240
39.16%
N/A
N/A
23.81%
23.5%
39.16 %
Yr
4
7.0 YEAR 3 QUARTER 4 WORK PLAN STATUS

Table 10: Actual work plan status (July-September, 2014)
Planned Activity
Capacity building of 25 providers in
Huduma Poa Health on CTU
Achievement
28 network providers trained on contraceptive technology to

build their capacity to offer comprehensive contraceptive services
During practicum sessions, 110 clients received contraceptive
services; 81 clients accessed implants ; 12 accessed IUCDs
Capacity building of 25 Huduma Poa

Health Network on IMCI in
collaboration with Ministry of Health
24 providers trained
Majority have rolled out IMCI services including setting up
functional Oral Rehydration Therapy (ORT) corners fully
equipped with required commodities, equipment and registers
documented in the implementation of IMCI services.
Capacity building of 24 Huduma Poa

Health Network on HTC including new
testing algorithim
24 healthcare providers were trained on HIV testing and

counselling
Participants practiced on the use of new Rapid HIV testing kits:
KBH and 1ST Response test kits serially.
Participants learned on TIE BREAKING by use of Unigold test
kit.
Capacity building of 56 CHWs on MoH

Community strategy, FP and HTC
59 CHWs were trained on the wider concept of community

health services in line with Kenya Essential Package for Health
(KEPH). They are currently utilizing acquired knowledge to
intensify mobilizations and integrated reproductive health
promotion
With GSK, collaboratively follow up 13

facilities trained in quarter 3 on PMTCT
13 facilities followed up
Functional linkages forged in 9 facilities
Data quality audits done in 9 facilities
Support supervision to 24 facilities in

Huduma Poa Health Network
Conduct performance review meetings

with franchise providers and CHWs
Forty (40) routine quality and eighteen (18) joint MoH-KMET

facilitative supervisions conducted. Both routine social franchise
assessments and support supervision were aimed at ensuring
quality and uninterrupted service delivery across the franchise.
2 Review meetings already conducted
2 review meetings are rescheduled to 1st Month of subsequent
quarter
Brand 28 Huduma Poa Health Network

facilities that havent been branded in
accordance with the branding and
marking guidelines
Facilitate 108 event days/Community
outreaches
25 facilities branded. Branding will be concluded in the

subsequent quarter
67 Event days conducted

5321 clients served during event days
2062 clients accessed contraceptive methods
Facilitate documentation of Huduma Poa

case study
Documentation concluded. Awaiting lay out and publication
Conduct data quality audit together with

the MOH for the frachise facilities
Data quality audit conducted in facilities drawn from Kuria West,

Suna East, Nyando, Siaya, Kadongo, Rarieda, kisumu &Siaya subcounties
34
8.0 HUMAN INTEREST STORIES

8.1 An alternative strategy for underserved beach community
One of the unique strategies used in the Huduma Poa Health Network to reach out to clients is facility
based event days conducted within franchise facilities. This involves community health workers
mobilizing potential clients and community members to turn up for health days where franchise
facilities offer services at subsidized rates.
The introduction of community based outreaches as an extra strategy has provided a unique
opportunity to reach communities that were hitherto unreached with the aim of delivering integrated
reproductive and child health services. Previously, most clients from the beach communities could not
find time to attend facility based event days held in nearby Huduma Poa clinics because of the nature
of their work. The fisher folk on the island of Rusinga are an example of such communities.
Rusinga Island is one of the 16 islands of Lake Victoria found in Homa Bay County compounded with
a high total fertility rate of 5.2 children per woman, which, compared to other counties in Nyanza, is
the 4th highest and low CPR at 33% among women of reproductive age compared to the national
CPR of 46%. (Kenya National Bureau of Statistics 2013)
Rusinga Healthcare Medical Clinic is one of the Huduma Poa franchise facilities in the island that has
experienced low turnout of clients during event days. Community Health workers explain that clients
are always pre-occupied in the beaches throughout the day as that is where their livelihood is.
Some of the activities that take place at the beaches are: fishing, which is done by both the men and
women; and drying the fish (especially dagaa) an activity that pre-occupies the women more than the
men.
Reaching the people at their place of work became an option of the quarter. This would evade
disruption of their normal livelihoods and eliminating distance barrier.
An outreach site at Kiumba
Beach in Rusinga.
How does it work?
Potential clients pick preprinted cards with numbers at
the site of service provision
and continue with their work
as they await their turn to
receive the service. This means
that they do not line up as they
would have done in the facility
as one only comes for services
when their turn is close.
Figure 30: An outreach site at Kiumba Beach in Rusinga.
35
The Beach Management Unit, an

administrative body that manages
the beach operations, is instrumental
in ensuring that private rooms are
availed to offer integrated family
planning services including cervical
cancer screening. The unit also
assists the CHWs in mobilizing for
the activity
Figure 31: Beach Community clients waiting to receive

services during Huduma Poa day
Figure 32: Health education for clients a waiting

integrated reproductive health services at a fish weighing
station at Utajo beach.
The beach management unit leaders are an

important aspect in the success of the outreaches
since they wield authority and are easily agents of
change. Coupled with the support of the unit is
the Ministry of Health goodwill in availing
contraceptive commodities and staff. It is a way of
ensuring that the people can get services without
losing their daily bread.
In the months of July, August and September the
clinic recorded 14 clients who came for implant
insertion against a record of 71 clients who were
reached with the same service through two
outreaches within the same period.
Author: Mercy Anyango,
Quality Assurance Officer,KMET.
36
8.2 More teens seek for long acting and reversible contraceptives to
avoid dropping out of school
In a village, 30 kilometers away from Migori town, a mother and her daughter of 15 years walks into
a dispensary for family planning services.
Benta Aoko, a housewife and mother of eleven children visits Kopanga Dispensary after getting word
from Huduma Poa Community Health Worker that there is a health event offering reproductive
health services.
Bentas worry is not only her expanding
family but her 15 year old daughter who
she believes is sexually active and may end
up with a pregnancy.
My daughter is in class seven and I would
not like her to drop out of school, please
talk to her, she appeals.
The Daughter-Immaculate Achieng is the
second born of eleven children while the
first born, a boy aged 17, had dropped out
of primary school.
The nurse counsels Benta who settles on a
non-hormonal IUCD for birth control
saying that she likes the fact that it can help
Figure 33: Clients queue for intergrated reproductive
her avoid pregnancy for over 10 years.
health services at Kopanga Dispensary
The daughter while having a separate session with the nurse confesses that she has a boyfriend having
a sexual relationship.
Immaculate and her boyfriend who is also a student havent been using any contraceptive.
She says, she knows of friends who use injectable contraceptives but she has never tried it herself.
Some girls around here go for Depo but I havent tried it, she acknowledges.
After undergoing a pregnancy test and counselling on sexual reproductive health, Immaculate also
choses an IUCD as her preferred method of contraception.
I am happy because I know I will give birth only when I want and I thank the nurse for talking to the
girl, Benta beams.
She however, expresses fears that her husband would not be pleased to find out that their daughter
is on birth control.
Elsewhere in Siaya County, 16 year old Consolata Adhiambo walks into Ngiya Dispensary
purposely to get a contraceptive. Like her counterpart in Migori County, she has ever had that talk
with her mother regarding early pregnancies.
Consolata Adhiambo is a form two student and says she has seen a number of her peers drop out of
school never to resume again due to pregnancies. She does not want to go down that path. She wants
to complete her studies uninterrupted and one day become a teacher though she has a boyfriend.
She tells me that her mother has always insisted that prevention is better than cure and advised her
to come to the dispensary and seek for a birth control method.
37
Consolata is lucky because on the

particular date, a team of health
providers from an indigenous
NGO, Kisumu Medical and
Education Trust had come to the
Dispensary to support provision of
family
health
services
and
reproductive health education.
She was attended and chose on an
implanon to prevent her from
conceiving for 3 years.
According to the 2008-2009 KDHS
data, 42% of women aged 15-19
Figure 34: A family planning provider (left) fills in 16 year old years in Migori County have begun
Consolata's personal details after offering her a
childbearing while at least one in
contraceptive method
ten (10 per cent) women aged 1549 years have had a live birth before age of 15 in Siaya County.
Each year worldwide, an estimated 13 million births take place among young women between the
ages of 15 to 19. In Kenya every year up to 13,000 girls leave school due to pregnancy. In fact, teenage
pregnancy is one of the reasons why girls leave school in many parts of this country.
Author: Emmanuel Oyier,
Marketing Officer, KMET.
38
8.3 Taming costs in accessing quality health services

Prohibitive costs often affect access to quality healthcare services. In public health facilities where the
costs of accessing care is relatively lower as compared to the private sector, congestion and higher
patient to doctor ratio causes general apathy for clients accessing services thus leading to more time
being spent on long queues and exhausted medical staff. This may compromise quality of services in
these facilities.
In private health facilities, accessing quality healthcare is a function of ones ability to afford the same.
Huduma poa health facilities being in this
category of private facilities are also faced
with the same challenge. Apart from
corporate clients who can access
healthcare with the support of health
insurance covers, the rest of the clients
who visit these facilities pay for services
directly from the pocket.
When KMET established the Huduma
poa social franchise, the goals towards
which this vehicle was driving, were;
Figure 35: Community Health workers assist in
access to healthcare; Quality in service
regestering ckients at Ahero Medical Centre
provision; Equity, and Cost-effectiveness.
The costs of accessing healthcare is increased by different factors, key among them being cost of labor
(staff), procurement of commodities and rent for facilities that do not have permanent structures.
KMET has sought to link its network of providers to the Ministry of Health to procure commodities
for the supported services or directly to KEMSA.
Ahero Medical Centre has embraced a strategy that ensures its clients get intra-natal and family
planning services at subsidized rates. Unlike in most private facilities countrywide where the cost for
utilization of long acting and permanent contraceptive methods (LAPMs) range from Ksh200 to Ksh
5000, the Output Based Activity (OBA) cards used at Ahero Medical has made access for easy. Clients
only pay registration fee of Ksh 100 to utilize the integrated reproductive health services.
Huduma Poa community health workers from two community units (Kakmie and Kobongo) help in
the mobilization of clients and recruitment of clients to acquire the OBA cards. The use of these cards
have greatly improved the access to long acting methods of family planning at the facility among other
reproductive health services. Prohibitive costs are no longer a challenge in the provision of quality
family planning services at Ahero Medical Centre. The use of the OBA cards is a revolutionary strategy
that other private facilities can borrow in order to tackle the costs of providing quality services.
Author: Joshua Adhola
Program Officer, KMET
39
8.4 Making it happen for the communities we serve

When I was a student, my mathematics teacher used to motivate us to work harder by saying Once
you make a decision, the universe conspires to make it happen, and its only until recently when
working as a community Demand Creation officer that I comprehended the meaning of these
words.
Heavy rains experienced in the months of
September in Trans-Nzoia interfered with
most of the activities my team and I had
scheduled for the region.
My team comprises of one quality assurance
officer who is a nurse, one driver and I who
makes sure that women in the remote
areas get equipped with adequate
information on contraceptives as well as get
access to those services.
I work closely with community health
workers to organize community outreaches
Figure 36: The incredible efforts of HCM program staff to and health event days where
reach the underserved
hundreds of women learn about and access contraceptives

in each sitting.
Unfortunately the rains have been starting too early in the
day inconveniencing clients who have to travel long
distances to come meet us. The roads became impassable
and at times we have to walk long distances in the mud or
push the vehicle to access our clients.
Remarkably I remember this day that we had scheduled a
community health event day at a remote slum in
Namanjalala location Kwanza Sub-county known as St.
Emmanuel. Most of the people here do odd jobs or work
in farms to eke a living.
We had invited representatives from the Ministry of
Health to come complement our service delivery team in
Figure 37: HCM program staff making their way
the area.
through muddy roads to passionately reach the
It rained heavily that morning that even our four-wheelunderserved communities with integrated RH
drive program vehicle could not make it through the
services
treacherous road. We had to remove our shoes to wade
through the mud and at one point were contemplating canceling the event.
At second thought and knowing how fundamental the services that we offer are to the community;
we walked over 3 kilometers to get to the service provision site.
I had carried along my 7 month old baby-Sollace, who we took turns to carry along the way with the
other team members who also had to carry commodities on their heads.
When we eventually made it to the outreach site we were overwhelmed to see a large number of
patients who had braved the bad weather and were eagerly waiting for us.
It was a great feeling though beat at the end of the day knowing we had extended our olive hands to
people who really needed it.
Author: Joy Wambare
Program Officer, KMET
40

Huduma Poa Social Franchise Service Delivery Progress Report, Year 3 - Quarter 4

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USAID Kenya (APHIAplus HCM Program)

Quarterly Progress Report

REPORT: As at September 31, 2014

APHIAplus Health Communication and Marketing Program

2.2.1 Lessons learnt......................................................................................................................................... 15

2.3 BUILDING CAPACITY OF SOCIAL FRANCHISE MEMBERS ................................................................................................... 16

2.3.1 Contraceptive Technology .................................................................................................................. 16

2.4 BUILDING CAPACITY OF COMMUNITY HEALTH WORKERS .......................................................................................... 19

2.4.1 Community Health Strategy, FP and HTC ...................................................................................... 19

3.0 PROGRAM PROGRESS .................................................................................................................................. 24

4.0 ENGAGEMENTS WITH OTHER STAKEHOLDERS .............................................................................. 27

5.0 SOCIAL FRANCHISE FACILITY BRANDING.......................................................................................... 31

ACRONYMS AND ABBREVIATIONS

Community Based Organization

1.0 EXECUTIVE SUMMARY

Capacity building of providers of 28 social franchise providers on contraceptive technology

2.0 KEY ACHIEVEMENTS (Qualitative and Qualitative Impact)

2.1 Community and facility based event days

Figure 1: Family planning service provider offering

During the quarter, KMET conducted Sixty

accessed the methods, side effects and desire to conceive.

Figure 2: Health Education session prior to service delivery

Figure 3: Huduma Poa community health

Stemming from more mobilization sessions, there were

Facility and community based event days have

Figure 4: Huduma Poa providers collaborate with their

The 30 community based outreaches/event days

2.2 Community mobilization

Cervical cancer screening

One on one counselling on Family Planning

Ngiya Girls High

Health Education Areas Covered

Key health Messages on Family planning,

Information on Cervical cancer screening

Health Education Areas Covered

Benefits of immunizing your children

Health Education Areas Covered

Importance of HIV Testing and Counselling

Types of Family Planning

Importance of child spacing

Benefits of integrated reproductive health

Cervical cancer screening and family

Benefits of long acting FP methods, HIV

Importance of HIV Testing & counselling

Community benefits of integrated Family

Community benefits of integrated Family

Community benefits of integrated Family

Family planning and cervical cancer

Economic importance of FP in community

Modern contraceptive Methods and client

Benefits of long acting FP methods, HIV

Diarrheal diseases); FP methods ,Cancer

Benefits of integrated reproductive health

Male involvement in Family planning

Key health Messages on Cervical cancer

Family planning methods, HTC and Cervical

Information on Cervical cancer screening

IMCI services (Pneumonia, Malaria and

Health Education Areas Covered

HTC and cancer screening

Modern contraceptive Methods and client

Family Planning and HIV/Aids

2.2.1 Lessons learnt