In Kenya, R4S is engaged in four activities: 1) conducting Performance Monitoring for Action surveys with a new self-care module, 2) assessment of the integration of PrEP into FP services, 3) capturing COVID-19 adaptations to FP programs, and 4) country research and learning agendas. These activities are part of the four R4S portfolios below. 

Self-Care Portfolio

R4S’ Self-Care Portfolio includes activities aimed at deepening understanding of self-care through a people-centered approach. Countries increasingly seek to integrate self-care into FP policies and programs. But there is little evidence available to create an enabling environment for self-care programming, despite the growing appreciation that self-care is a culturally relative concept. R4S has designed and implemented studies to capture attitudes, preferences and intentions regarding FP self-care from women, men and providers. 

1. For this activity under R4S’ Self-Care Portfolio, R4S collaborated with Johns Hopkins University to add a self-care mini-module to the Performance Monitoring for Action (PMA) surveys in Nigeria and Kenya with 21 questions on women’s interests and preferences regarding FP information and selected contraceptive methods (oral contraceptive pills (OCPs), emergency contraception (EC), self-administered injectable contraceptives) that women can administer on their own, without necessarily interacting with healthcare providers. The survey was conducted in February – March 2022. Among the key findings, the study revealed that there is high demand for information related to fertility and FP that can be accessed through voice/text and through social media. While the health facility is a preferred source of accessing FP, was also some interest among women in accessing self-administered products through non-traditional channels such as drug shops and pharmacies, and other sources including home delivery. 

FP/HIV Integration Portfolio

This portfolio groups together activities examining if and how other self-care health platforms can serve as vehicles for reaching sub-groups of the “most left behind” (for example, people living with HIV) and thereby open more channels for women to access FP and within a context that caters to their specific needs/realities. R4S works very closely with national partners and stakeholders so that the study designs produce quality and applicable results.  

 2. As part of the FP/HIV Integration Portfolio, R4S worked with the Kenya MOH on an assessment of the integration of PrEP into FP services, to understand the demand for PrEP among FP clients, the FP clients reactions to PrEP services being offered within FP services, the providers’ and managers’ experiences delivering PrEP within FP services, and perceptions of any changes in FP service delivery with the addition of PrEP. Finally, the study also measured the incremental cost of adding PrEP to FP services. The study goal is to provide decision-makers with evidence to guide programming for the provision of PrEP services within public sector FP programs nationwide. 

COVID-19 Portfolio

The COVID-19 Portfolio was developed in response to the COVID-19 pandemic. R4S designed and implemented studies aimed at capturing the pandemic’s impact on FP service delivery and use, as well as documenting and disseminating the lessons learned from program adaptations. Knowledge generated can be used to support mitigation strategies for COVID-19 and future epidemics and emergencies.  

3. As part of the activities under the COVID-19 Portfolio, in 2020 R4S began systematically documenting adaptations across eight FP programs in Nigeria, Kenya, Uganda, Zimbabwe and India using a qualitative approach. An Excel documentation tool captured a total of 64 adaptations over a six-month period. An interactive site was developed to showcase adaptations and experiences of eight family planning programs in five countries. Since its launch, the interactive site has received nearly 900 views from at least 37 countries. 

Country FP Research and Learning Agendas 

This activity supports countries to develop FP research and learning agendas (FPRLAs) that will help them meet their national FP program goals.  It also helps to identify research questions that R4S can answer and programmatic and policy areas for which R4S can help produce, synthesize, or apply evidence to improve outcomes. 

4. Activities to develop the reproductive health research and learning agenda (RHRLA) for Kenya took place from March to June 2022. The multi-phase process involved meetings with the MOH, an ideation workshop and two multi-day workshops. As with other country RLAs, the process involved review and analysis of data, consultation with local experts, and convening stakeholders to define concrete questions to guide family planning research and ultimately programming. Kenya’s RHRLA was officially launched in August 2022, with attendance from various MOH agencies, counties, civil society, associations, development partners and the media. Dissemination of the RHRLA has continued in 2023. Details about the process, country context, and main takeaways is found here: FP Research and Learning Agendas, and summarized in this blog: Towards 2030 and Beyond.

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