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Family planning during the COVID-19 pandemic: The important role of community health volunteers in ensuring continuity of care

As R4S works to produce and use evidence to improve voluntary family planning programs, efforts are also under way to document the impact of the COVID-19 pandemic on family planning programs, the changes stakeholders are making to ensure continuation of care, and the efficacy of these changes.

Interviewee:
Abdullahi Aden, Project Manager, Nomadic Health Project

Interviewers:
Njideka Ofoleta, Stanback Fellow, R4S, FHI 360
Aubrey Weber, Technical Officer, Research Utilization, FHI 360


Research for Scalable Solutions (R4S) is a new, USAID-funded implementation science project that aims to increase the production and use of evidence to improve voluntary family planning programs around the world. Specifically, R4S focuses on generating evidence related to self-care and client-driven approaches for family planning, increasing information about the cost and cost-effectiveness of implementing high-impact practices, and addressing equity within programs. Led by FHI 360 in partnership with Evidence for Sustainable Human Development Systems in AfricaMakerere University School of Public Health (Makerere SPH) in Uganda, Population Services International, and Save the Children, R4S works with a range of country-based stakeholders to strengthen research and research utilization capacity and support countries in their journey to self-reliance. For R4S’s fourth blog post, we spoke with Save the Children about the use of community engagement and other platforms to reach the marginalized and the impact of COVID-19 on their care delivery programs.

As R4S works to produce and use evidence to improve voluntary family planning programs, efforts are also under way to document the impact of the COVID-19 pandemic on family planning programs, the changes stakeholders are making to ensure continuation of care, and the efficacy of these changes. R4S recently interviewed Abdullahi Aden, Project Manager of the Nomadic Health Project funded by the Bill & Melinda Gates Foundation and led by Save the Children in partnership with the London School of Hygiene and Tropical Medicine and the Center for Behavior Change Communication. This four-year project seeks to increase the use of high-quality family planning among nomadic and semi-nomadic populations in Kenya and around the world by engaging regional stakeholders to share lessons on effective, scalable approaches.

Abdullahi shared that COVID-19 is having a tremendous impact on family planning and other health programs. Most notably, there has been a decrease in opportunities for contact between health workers and clients, suspension of elective medical procedures, and a newfound necessity to schedule appointments for those seeking family planning but wishing to avoid crowded health facilities. To respond to the current crisis, the Nomadic Health Project has found itself carefully coordinating and communicating with county governments to ensure that activities such as mobile outreach care can be conducted safely and in compliance with COVID-19 guidelines.

An attempt to navigate national COVID-19 guidelines has highlighted the importance of community health volunteers (CHVs) in efforts to reach marginalized populations. These volunteers are a critical part of mobile community units established to reach nomadic or semi-nomadic communities by providing care in the community and at the household level. During the pandemic, volunteers have expanded their traditional services (including treatment of minor ailments and distribution of products like zinc and oral rehydration salts) to include COVID surveillance and contact tracing, referrals, and scheduling appointments. Save the Children had begun training CHVs to offer a broader range of products, including some contraceptive methods, but the COVID-19 pandemic interrupted the training; in the interim, CHVs have offered information on health timing and spacing of pregnancies, safe delivery, and breastfeeding, among other topics. Mobile outreach has continued on a monthly basis and has included contraception. Trainings of CHVs are scheduled to resume in July and August 2020.

COVID-19 restrictions have also caused CHVs to adapt by meeting in small groups and conducting household visits outdoors while maintaining physical distancing to share health information and messaging. With poor phone and Internet network coverage in Wajir and Mandera counties, nomadic and semi-nomadic populations have extremely limited access to virtual technologies that may be used to distribute important health information. The project has countered this limitation through innovative practices and broad-reaching platforms, such as the distribution of solar-powered radios within nomadic and semi-nomadic communities to encourage listening to health education programs. Abdullahi notes the need to develop family planning approaches that can be implemented at the community level, including self-care options, to reduce the burden on static facilities.

As the global pandemic continues and responses evolve, R4S will continue to follow how programs are affected and what new practices emerge as most effective and sustainable in order to ensure that communities can still receive the care and education they need most. R4S is undertaking detailed process documentation of programs across several countries and will be sharing lessons learned in the coming months. Stay tuned!


Photo: Jessica Scranton/FHI 360


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