The Evangelical Association of Malawi (EAM) is taking the lead in campaigning for Malawi’s population growth management.  The church takes family planning messages to pulpits in churches with supportive scriptures from the bible to demystify the misconception that Family Planning (FP) disrupts procreation. It is projected that Malawi’s population is to reach over 42 million by 2050 if the current average of about four children per woman prevails, according to the United Nations Population Fund (UNFPA).  As Malawi’s population is rapidly increasing, the impact will be felt across diverse development sectors—requiring a multisectoral response to address the rapid population growth.  Pastor Howard Kasiya, The National Coordinator of the Health Commission, EAM told Kenyan journalists that one response is to engage faith groups in disseminating messages on the link between family planning, population dynamics, and development. “Religious leaders are essential tools for educating masses about benefits of family planning," he said. Pastor Kasiya was speaking during an interview conducted on the sidelines of a recent inter-faith leaders’ training conducted by Faith to Action Network, in Nairobi, to build their capacity to influence changes in policy and social norms in the State of African Women Campaign. EAM is implementing a project called “Encourage Responsible Parenthood” in Nsanje and Dowa districts, which focuses on building the capacity of church leaders to increase access to and demand for modern family planning methods.  Pastor Kasiya said consistent sensitization can significantly contribute to changing social norms around family planning and childbearing. Religious leaders equip young people with knowledge and empower them to make responsible sexual and reproductive health choices, access youth-friendly health services, and transform societal attitudes and practices to address population growth and development.      So far, they have reached out to about three hundred (300) religious leaders from its member churches and organizations through capacity-building regional meetings. Representatives were trained on how to effectively disseminate sexual and reproductive health information in the context of Biblical scriptures to congregants in their respective catchment areas. Nearly 70 religious leaders drawn from 72 denominations under the Evangelical Association of Malawi in Nsanje district, have been trained on how to reach their congregants with accurate sexual and reproductive health information including family planning and youth-friendly health services.  The main aim of the training is to motivate the clergies and give them the capacity to counter some myths, misconceptions, and prejudices that the church and congregants have been having towards issues of sexual and reproductive health rights (SRHR) and family planning. Currently, youth are facilitating dialogue on issues of youth-friendly health services and family planning among young people in the church and community, reaching over 2,500.  They also conduct HIV testing and counselling in churches, in a bid to break fear and stigma about congregants going to VCT Centers, an exercise that is normally spearheaded by church leaders. “What is very important is that we present all these from a biblical perspective, with supportive scriptures from the Holy Bible, as an obligation to God” Concluded Pastor Kasiya. Achieving this kind of commitment from faith leaders has not been easy. There has been constant training and capacity building of religious leaders, such as the one provided by Faith to Action Network with financial support from the European Union, to make faith actors effective amplifiers of the message that optimum health and wellness are a key part of God’s plan for humankind. EAM is among the faith-based organizations that is working within the State of African Women Campaign Project and the RightByHer Campaign to contribute to realizing and extending women’s rights as enshrined in Africa Union (AU) policies in African countries. The State of African Women Campaign is a three-year project funded by the European Union and implemented by IPPF, Faith to Action Network, YWCA and OAFLAD among others.

Delivering Quality SRH Services through use of SMARTCARE: FHOK’s experience with eCMIS In 2010, Family Health Options Kenya (FHOK) which is IPPF's Member Association in Kenya shifted from service-oriented data collection to the use of client cards, then to a fully client-based system (CMIS) that involves data capturing and reporting. This electronic data management system is called ‘SMART Care’. The rationale for the use of the electronic data management system was that, with stakeholders demanding accurate client-related data, and FHOK geared at moving towards performance-based funding, its clinic systems therefore needed to be those that could efficiently support providers in managing client flow whilst providing quality care. The implementation of the SMART Care system began with a pilot that was initiated in five FHOK clinics distributed across the country. They were: Family Care Medical Centre Nairobi West Family Care Medical Centre Nakuru Family Care Medical Centre Ribeiro Family Care Medical Centre Mombasa Family Care Medical Centre Meru Methodology Formation of a CMIS team to spearhead resource mobilization, training and implementation of the system. They included: Director of clinic services, the Monitoring & Evaluation team, GCACI Project Manager, IT Manager, accountant, internal auditor and Procurement Manager Selling the benefits of the system and demonstrating incentives for those involved in its implementation to utilize the system. This included showing them the reports generated by the system, analysis of data entered into the system and a user-friendly graphical user interface Creating a sense of ownership and addressing the psychological fears of the service providers before implementing the system. Some of the fears included not knowing how to use a software, possible loss of data, investigations and the general ‘fear of the unknown’                                                                                               Inclusion of customized reporting tools to assist in reporting to the various partners i.e. FHOK internal reports, IPPF, Ministry of Health and other donors Conducting on-the-job training as opposed to offsite training as the trainees were able to practice with real clients and hence gained hands-on skills Regular checking of data by the clinic manager and the team at the head office during facilitative supervisory visits which continues to ensure that service providers are keen to capture the correct data which improves quality Integration with SMS system for appointment reminders and client follow-up Results Currently, 14 out of 15 FHOK clinics are utilizing the SMART care system to capture financial, programmatic data and stock management (commodities) data. The use of SMART Care has significantly helped FHOK avoid cases of stock-outs The SMART Care system has enhanced accurate and timely collection of data from different service delivery points, which has improved data quality The data generated is actively used for decision-making at both clinic and Head office level. For example, the clinic can review data client trends and put necessary strategies to improve performance or make changes There has been an increase in service statistics in most clinics since the installation of the system                                                                                                                Minimized loss of data as the service providers can use one data collection system instead of many registers It has helped in the management of human resources at clinic level. Previously, the clinics would use client cards, daily activity register, prescription pads and lab request forms. But with the paperless SMART Care system, operational costs have now reduced as the clinic manager can monitor and analyze what is happening in the clinic from his/her office here has been reduction in the loss regarding follow up on clients as the system automatically sends Short Text Messages (SMS) to clients to remind them of their appointment Most of the FHOK clinics extended their operating hours after review of the system which showed some clients preferred to attend the services after working hours Reliability and accuracy of the information collected as it is easier to retrieve data and even verify “SMART Care has significantly reduced the workload of our service providers when it comes to capturing of essential data in real time, and consequent generation of reports. Through SMART Care, consumer specific reports -MoH, FHOK, IPPF and donor reports are readily generated at the end of each month by our health personnel within a very short time. The system has gone a long way in ensuring quality data and enhancing compliance to reporting timelines within FHOK,” says Esther Muketo, Director, Resource Mobilization at FHOK. ‘If I didn’t receive an SMS reminding me of my appointment, I wouldn’t have remembered to come for my family planning resupply” One FP client told a provider Conclusion The SMART Care system is one that can be adopted by other Member Associations as it saves immensely on time and money. It has enhanced accurate and timely collection of data from different service delivery points which has in turn improved data quality. Reduced workload is a huge incentive to service providers doing different reports for the different FHOK partners, including the Ministry of Health. Operation costs have reduced and the Clinic Manager can now monitor and analyze what is happening in the clinic from the comfort of his/her seat. FHOK's social franchising model was identified as one of the Member Association’s Good Practices during the 3rd Cycle of Accreditation. A Good Practice is an activity or practice that  has been proven to work and yields positive results. The  sharing of Good Practices by IPPF Member Associations offers learning experiences for their counterparts. See other Good Practices from our Member Associations: Social Franchising for Reproductive Health Services: The Experience of Family Guidance Association of Ethiopia (FGAE) Implementation of The Evidence for Contraceptive Options and HIV Outcomes (ECHO) Trial in Eswatini Partnerships for Improved Maternal Health: The Planned Parenthood Association of Ghana (PPAG) Experience Partnership with Armed Rebel Groups in the Provision of SRH Services in Crisis Situations: The Central African Republic (CAR) Experience Leading Efforts to End Child Marriage: The Case of Senior Chief Theresa Kachindamoto of Malawi Mobile Clinics in Cape Verde: Taking Services Closer to the People Awarding the Best Performing Clinics: Lesotho Planned Parenthood Association (LPPA) What’s in a Game? ABUBEF’s use of Playing Cards for Youth SRHR Education For more information about the work of IPPF Africa Region, follow us on Facebook and Twitter.

Liz Akoth* is 18 years old. She is currently attending a local secondary school within Shauri Yako, Homa Bay County, Kenya. She fervently dreams of becoming a nurse, one day. Will she realize her dream? Is a question that bothers her almost every morning she wakes up and night when she retires to bed. Sadly, the young ambitious girl will be forced to drop out of school because of her pregnancy. Her HIV status also makes her anemic. Her jaundiced eyes tell it all. “Please adhere to medication and follow the diet I gave you,” advised her nurse during her recent antenatal Care visit. Liz was impregnated by her 30-year-old boyfriend who lives in Rongo, an adjacent town. He not only made her pregnant but also infected her with HIV. When she shared the news about the pregnancy with the boyfriend, he told her to stop bothering him for he had already married another woman.  She later learned about her HIV status during her first clinic visit to Family Health Options Kenya (FHOK), Homa Bay Centre. She again shared the news with the now ex-boyfriend.  He insulted her and accused her of having ‘brought’ him a disease. He threatened to harm her if he ever came across her again. Her parents evicted her from their home for the embarrassment she had caused them. She is currently living with her brother, though she mentioned that life there is not easy. She appears quite strong on the outside but one would never know what goes on inside. But hers is a life of optimism and resilience. She hopes to give birth and re-enroll back to school in February 2019. She however said that if she had learned earlier about contraceptives, especially condoms, she would never have had sex without one. “If I knew the importance of condoms, I would not be pregnant and HIV positive. I would have used one.” The statistics HIV prevalence is high in Homa Bay County, Kenya. With a prevalence of 36%, it is one of the highest rates in Kenya according to the National Aids Control Council (NACC). According to the latest Kenya Demographic Health Survey (KDHS) report, teenage pregnancy in Homa Bay County stands at 33% and national prevalence at 18%. Driving factors Dinah Odoyo, Nurse at FHOK residing in Homa Bay attributed the high prevalence facts to the following factors: Non-adherence to antiretroviral therapy (ART) - Many residents living with HIV enroll and collect ART, but they do not take the drugs. They throw them away instead. This is because they do not want friends or family to know their HIV status. Sex for Fish - Homa Bay has a large share of Lake Victoria compared to other counties around the Lake. Many residents fish for a living. Shortage of fish forces businesswomen to have sex with fishermen to acquire whatever they have caught. The women enter sexual deals with particular fishermen for assurance of regular fish supply. The high HIV prevalence among fisher folk is due to the unprotected sexual interactions. Traditional birth attendants (TBAs) - Many expectant women give birth with the help of traditional birth attendants. More than 60 per cent of women in Shauri Yako, Misita and Sofia estates in Homa Bay Town deliver children their at the homes of TBAs instead of hospitals.  Poverty and Orphanage - Many homesteads lack either or both parents, leaving children to fend for themselves. Many children engage in sexual activities to get money for food and shelter. Other key drivers of high HIV prevalence, according to the Homa Bay Multisectoral AIDS Strategic Plan, are boda boda (motorcycle) riders and wife inheritance cultures. Sospeter Aloka, guidance and counseling teacher at Ogande Mixed Seconady school said that top disciplinary cases he struggles to manage are boy-girl relationships, teenage pregnancy and gender-based violence. He is however unable to manage out of school relationships where men, mostly bicycle riders and traders prey on the school girls.  He confirmed that in 2015 alone, 6 girls in their first year of secondary school got pregnant and dropped out of school. He also confirmed that the school was aware of 5 girls who disclosed their HIV status and that he has made it his responsibility to closely monitor their adherence to ART. He said, as teachers they realize that the students are sexually active. In Homa Bay County, most of the adolescents have sexual debut as early as at 13 years of age. He therefore advises those who cannot abstain to practice safe sex. He concluded by saying; “To win this war will require collective responsibility; teachers, parents and churches both need to talk to the adolescents and lead them to the right path” Said Sospeter. Advocacy Efforts Roselyne Atieno, FHOK trained Social worker works within Aruja Community in Homabay. She serves about 530 households and visits a minimum of 20 households every day. She also coordinates 10 Community Health Volunteers (CHVs) who operate within her jurisdiction.  Their main roles include; data collection, community education and sensitization, counselling for teenage mothers, psychosocial support, referral, follow-ups and creating linkages.  She said that community sensitization is key. “Young people are sexually active, but their parents do not want to talk to them, they too do not have knowledge about the risks that they face. We reach out to all these groups and provide not only appropriate information, but also necessary services” said Roseline Dinah Odoyo, who doubles up as the Facility in Charge said that FHOK focuses a lot on young people and adolescents and their reproductive health. “In fact, the clinic is quite youth friendly. It is a Youth Centre. Young people trickle in to learn more about how their sexuality and how they can practice safe sex” Said Dinah. Interestingly, a condom dispenser is hooked at the gate. “The condom dispenser at the gate supplies young people and the community around with condoms. It is refilled twice a week” Said Dinah She believes that young people are their own change agents. She has trained 20 youth volunteers- three quarter of whom are HIV positive-to speak to their peers within the community. “Young people prefer getting information from their friends and tend to do what their friends tell them. These trained lot speak to their friends about how to protect themselves from unplanned pregnancies and STI’s and advise those who are infected to adhere to medication” She added. Dinah also holds outreaches to reach the entire community with messages around contraceptives, cancer awareness, HIV-Aids among other STI’s. “I work with community leaders, religious leaders, teachers from the guidance and counselling department, parents, young people through a Social Behavior Change Communication (SBCC) program. Our main aim is to make these people understand the changes that adolescents undergo (puberty) for the guardians to know how to handle them and for the adolescents to understand how to handle themselves. We make them understand that these changes are normal and not a trigger to engage in sex, and if they do, they risk getting unplanned/unintended pregnancies and STI’s” She said. She concluded by saying that their main aim is to reduce risky sexual behaviors.  “When we reduce risky sexual behaviors, there will be less unplanned/unintended pregnancies and decline in unsafe abortion as well as reduced incidences of sexually transmitted infections” said Dinah.  Laws and Policies on Adolescent SRH Article 43 (1) of the Constitution of Kenya (2010) states that ‘every person has the right to the highest attainable standard of health, which includes the right to health care services, including reproductive health care’.  The National Adolescent Sexual and Reproductive Health Policy, 2015, shall support access to and provision of high quality and affordable adolescent-friendly SRH services at all levels of health service provision.   

On 19th October 2018, stakeholders in Kenya came together in the sprawling Kibera Slum to officially mark the International Day of the Girl Child. The theme for the year was With her: A skilled work force. International Day of the Girl Child is usually observed on the 11 of October each year and is a day that is marked to highlight the challenges that girls face. It is a day which the stakeholders take stock of the progress in terms of advancement of rights and freedoms for the girl child. Lucien Kouakou, Regional Director, International Planned Parenthood Federation Africa Region (IPPFAR) joined over five thousand girls and boys from primary schools around Kibera to commemorate this day. The joyous celebrations were held at Lutheran Church grounds, Kibera, Nairobi. United Nations Population Fund (UNFPA) Kenya and Polycom Development Program were the key conveners of the event. Polycom Development Program is a community-based organization that works to end Sexual and Gender Based Violence (SGBV) and empowers girls in Kibera, Nairobi, Kenya.  Also present at the event was the Nairobi Women Representative Hon. Esther Passaris - Women Representative, Nairobi County, H.E Nicolas Nihon - Ambassador, Embassy of Belgium, Mrs. Rahab Muiu - Chairperson, Maendeleo ya Wanawake, Dr. Francis Owino - Principal Secretary, Ministry of Public Service, Youth and Gender Affairs, Dr. Ademola Olajide – UNFPA, Kenya Representative and Women 4 Women platform members.  Speaking at the event, Lucien urged the girls to take charge of their lives, "Your future is now, take control of it!" he said. He expressed that he was aware of the challenges that they endure in their quest to achieve their dreams. These are challenges such as lack of quality healthcare services and sexual and gender-based violence. He pledged to work together with the other stakeholders that were present at the event to ensure that no girl is deprived of their rights. A call to speak out Nairobi Women Representative Hon. Esther Passaris, advised the girls to courageously SPEAK OUT by reporting cases of sexual and gender-based violence regardless of the status of the perpetrator. “Do not fear to report sexual violence cases to your teachers, parents and the police.” She said. “It doesn’t matter who the person is, be it your teacher, parent, neighbor; please report. Do not fear intimidation,” she pleaded.  She stressed on the urgency to address and end the rampant cases of SGBV that occur in our society and especially in Kibera. Esther mentioned that she was aware that most families solve gender-based violence cases amicably at home, thereby interfering with the rightful avenue for seeking justice for the victims. She called upon the police and the judiciary to diligently exercise their mandate by arresting and prosecuting offenders of SGBV. Esther mentioned that the county government of Nairobi is, at the moment, working on setting up safe houses around Nairobi to accommodate survivors of SGBV who flee their homes and those that require safety from their abusers. Curbing SGBV A speech read on behalf of the Permanent Secretary - Ministry of Public Service, Youth and Gender Affairs highlighted the projects that the government is currently focusing on to better the life of every child across the country. The projects included; free primary and secondary education, Universal Health Coverage and affordable housing under the current Big 4 Agenda that is under implementation by the National Government. The Principal Secretary recognized the importance of children in the society and their contribution to development. “Children are a sign of hope and continuity of generations, they are fundamental to the growth of any country, their rights must therefore be jealously preserved, ” read the opening remarks of the speech. The PS underscored the economic burden of SGBV and its ramifications to the economy of the country. “The economic burden of SGBV is estimated to be at KES 46 billion, the cost of post-rape care services in public health sector alone is estimated KES 236 million. These are monies that can be channeled into other development projects, if we end SGBV in Kenya,” read the speech The talking boxes To curb cases of SGBV, Polycom Development program uses talking boxes. Talking boxes are small metallic boxes where girls in primary schools drop secretive notes onto which they express issues that they may be going through, including SGBV. The notes are later retrieved and read by a school counselor. Follow up is then done to help curb/solve the case.

Her life in a slum in Nairobi At 23, Mercy Atieno has procured four unsafe abortions with the fourth one being nearly fatal. Mercy grew up in densely populated informal settlement in Nairobi. Access to basic needs was and still is difficult. To her, the possibility for a bright future is a fantasy. Her mother works hard to fend for her and her siblings. She struggles to buy food and to pay for their education. Her alcoholic father often comes back in the middle of the night; howling and scattering them from the living room that also functions as the bedroom for children. He hurls insults at them and her mother, curses at their existence and wishes that he had never brought them to this earth.  Their shanty - a mud-walled, iron-roofed single-roomed house clearly illustrates the scarcity of resources.  “I started being sexually active at 16. I joined a group of other tough girls in the hood. We call ourselves Maguangi*” She said. Being in this group shields them from sexual and physical violence from boys and men around Kibera. Atieno's multiple abortions Mercy remained confidential about her first three unsafe abortions for she considers them “successful”. She chose to speak about the last unsafe abortion that almost took her life away. “I had a boyfriend who claimed that he loved me and that he would marry me. I had sex with him a couple of times. One day I told him I was pregnant with his child. He said he was not responsible. He stopped calling, he stopped texting and even blocked my number. I was so disturbed. I did not want to disappoint my mother. After all, she had sacrificed a lot for me,” said Mercy Atieno.  “When I told my friends about it, they told me not to worry. We would get rid of the pregnancy the same way we did with the others. They took me to some woman who had earned a good name locally for successfully terminating ‘bigger’ pregnancies than mine.  At this point, mine was already five months and quite noticeable. They helped me raise the money that was required, KES 200 (USD 20). She narrated. The last straw On one evening, Mercy sneaked into the woman’s house. The woman gave her some traditional blend of herbs. She promised her that it would work well in few fours. She went home and took some needed rest. “That night I could not sleep, I was in so much pain and was bleeding a lot I thought I was going to die.” Mercy added. She became unconscious. Her mother rushed her to Family Health Options Kenya (FHOK) Kibera Centre, which is few meters from their home. Where she met Aggrey. She was admitted and given medical attention. “When I woke up, I was feeling much better, I was then given a few days of bed rest. Before I was discharged, I was counselled and advised me to take up a family planning method. I went for a long-term method - the implant. Nowadays, I also use condoms to protect myself from sexually transmitted diseases including HIV” She said. Mercy closed her story with a word of advise to her peers, “Family Planning is not here to destroy us, but to help us.’’    

Family Health Options Kenya (FHOK), which is IPPF’s Member Association in Kenya this week played host to a team of Program Directors and Directors of Finance drawn from different Member Associations (MAs) in the Africa region. The Directors are in Nairobi attending a strategic workshop aimed at enhancing their capacity for the improvement of the programmatic, financial and operational management practices of their MAs. During one of their activities, which included the visit to FHOK’s headquarters in Nairobi, the Directors received insights into the different programs that FHOK is currently implementing. With a rich experience spanning over five decades, FHOK is recognized as one of the leading service providers in Sexual Reproductive Health and Rights (SRHR) in Kenya. FHOK has 16 health facilities and 9 youth centers located in different parts of the country. During the learning visit, FHOK shared its experiences in the areas of: clinical services, finance and administration, project implementation, governance, networking, building partnerships, advocacy and human resource. Some of the projects that FHOK is currently implementing include those around the integration of SRHR issues with environmental stability and climate change, mitigating the impact of the Global Gag Rule (GGR) through the social enterprise model, and innovative youth programmes that target both in-school and out-of-school youth. The Directors also toured FHOK’s Nairobi West Family Care Medical Center & Maternity. The center, started in 1999, operates on a 24-hour basis and offers a wide range of in and out-patient services. They include: counselling, family planning, STI treatment and management, HIV services, pre-nantal and post-natal care, maternity services, well baby clinics, gynaecological services, curative services and specialist clinics, among others. The medical center has a well-stocked pharmacy and a well-equipped laboratory. The visiting Directors lauded FHOK for its innovative projects and passion for serving the Kenyan population with quality health services. “Indeed, there is a lot to learn from FHOK. Their intense resource mobilization efforts, that have resulted in funding for several projects is impressive. This is something that other MAs should emulate,” said Mr. Desta Kebede, Program Director at Family Guidance Association of Ethiopia (FGAE). “There is also plenty to learn from FHOK’s social enterprise model, which is fueled by the organization’s desire to shift its focus from traditional revenue streams -to that of using different entrepreneurial methods to create social impact,” he added. The Directors also commended FHOK for its electronic data management system -SMART Care. This is a system that has helped the organization effectively manage its operations such as in logistics, where it is able to use data to forecast and manage commodities. The use of SMART Care has helped the MA avoid cases of stock-outs. The paperless SMART Care system has also benefitted FHOK in the integration of finances and statistics, as well as in the management of human resources at clinic level. “SMART Care has significantly reduced the workload of our service providers when it comes to capturing of essential data in real time, and consequent generation of reports. Through SMART Care, consumer specific reports -MoH, FHOK, IPPF and donor reports are readily generated at the end of each month by our health personnel within a very short time. The system has gone a long way in ensuring quality data and enhancing compliance to reporting timelines within FHOK,” said Ms. Esther Muketo, Director, Resource Mobilization at FHOK. FHOK is also recognized as one of IPPFAR’s Learning Centers. IPPFAR’s Learning Center Initiative (LCI) is aimed at building capacity through its Member Association network by developing and sharing innovative and best practice approaches on Sexual Reproductive Health (SRH). Learning Centers such as FHOK are regarded as centers of excellence, technical hubs and technical advisory facilities. They assist in the cementing and positioning IPPFAR as a leading service provider in Sexual Reproductive Health and Rights (SRHR). Story by Maryanne W. Waweru, Governance and Compliance Officer, IPPF Africa Region. For more information about the work of IPPF Africa Region, connect with us on Facebook and Twitter.

IPPFAR and RHRN Africa team from 4 countries (Kenya, Uganda, Zimbabwe and Senegal) will be attending the 62nd Ordinary Session of the African Commission on Human and Peoples’ Rights (ACHPR62) in Noaukchott, Mauritania 22nd April to 9th May 2018. The NGO Forum by the African Centre on Human Rights and Democracy Studies (ACHRDS) will kick off the ACHPR62 and will provide the opportunity to the team to link with other advocates and Human Rights Defenders in Africa to share experiences on various issues including advocacy for SRHR of young people through panel discussions including one on Youth SRHR. IPPFAR and platforms will also hold a side event on the theme “Getting it ‘Right’: Debating the linchpin to fulfilling SRHR of Young People in Africa” to take place on Tuesday, 24th April at Hotel Khaima from 11:30 am to 1:30 pm. The team will share, explore and deliberate with participants on among others, embracing the Rights Approach in Youth SRHR Advocacy and the role of CSOs in pushing for accountability by decision-makers as well as highlight the status of the implementation of the Maputo Protocol in Africa.   

Amina, a 24 year-old lady has been a sex worker for years. Her operation base is Eldoret town, in Kenya’s Rift Valley province. During the implementation of the Shujaa Project by Family Health Options Kenya (FHOK) in Eldoret, Amina was identified and brought on board to be a lead contact to a group of sex workers in the town. She was also recruited to be a peer educator for the Access, Services and Knowledge (ASK) project, a three-year project which targeted young people in the age group of 10-24 years. Through ASK, she received respective training, which enhanced her capacity to reach out to fellow sex workers with reproductive health information and services.   Following the training, Amina became influential in mobilizing sex workers during campaigns and community outreaches. She says: "I have been doing this work for a while now. When I came in contact with the FHOK’s health center in Eldoret, I Iearnt a lot about sexual reproductive health, and the wide range of services that I can access from the clinic. This included HIV testing services through their Voluntary Counseling and Testing (VCT). My experience with them has been life-saving, literally!” Amina did well especially in distribution of condoms and attending girls forum that were conducted by the ASK project team. Besides learning from the SRH discussions, Amina would go out and share this information with her friends. She also referred many of them to access services at the FHOK clinic, where she was guaranteed they would receive quality services. The overall objective of the project was to improve the use of SRHR services by young people (10-24 years) through demand creation, provision of youth-friendly information and services (including commodities), and ensuring public private partnerships with a greater respect for young people’s sexual rights. It was implemented in the five countries of Senegal, Uganda, Kenya, Ethiopia and Ghana.

One day, while going about her daily activities in her home area in Nakuru, Kenya, 26 year-old Teresia Wangui happened upon a group of people providing medical services. They particularly seemed to be targeting women and since she had a few minutes to spare, she made way to the tent where they were. It was this decision that would save her life –literally. On offer at the medical camp were mobile cervical cancer screening services by the Family Health Options Kenya (FHOK) –Nakuru branch. FHOK is the IPPF Africa Region Member Association in Kenya. “When I approached the tent, I found out that they were offering free cervical cancer screening services, and I decided to get tested too because I felt that I needed to know my status,” says Teresia. It was a decision that paid off because Teresia was found to have pre-cancerous lesions. To help allay the development of these lesions into cervical cancer, she was referred for further treatment - cryotherapy, which is a treatment for abnormal cells on the cervix. Cancer of the cervix is caused by the Human Papillomavirus (HPV) through sexual contact, with most people acquiring the infection shortly after the onset of unprotected sexual contact. However, pre-cancer lesions of the cervix are easily detectable by a trained medical provider. Regular screening tests can lead to early detection and treatment, which makes cervical cancer highly preventable. “Had I not made that split decision to pop into the medical camp by FHOK, I probably would not be here sharing my story with you today. I’m glad that I was able to be screened and receive treatment. I would advise all ladies to go for cervical cancer screening even if you are young and have not had children, since it affects everyone who is sexually active. I would also like to tell my fellow women not to wait for services to be brought to their doorstep. Cervical cancer screening services are also offered in many clinics, so it is your responsibility to undertake regular checks. You are the one responsible for your own health,” she says. Cervical cancer remains a major public health problem in developing countries, especially in Africa where an estimated 53,000 women die of the disease every year, according to the World Health Organization (WHO). In response to this, FHOK implements the Cervical Cancer Screening and Preventative Therapy (CCSPT) Initiative in different parts of the country through its static clinics. The CCSPT Initiative is aimed at improving reproductive health outcomes for women, with specific regard to cervical cancer. The CCPT initiative aims at maximizing the number of cancer services offered to women through a validated, low-cost screening and preventative therapy approach. Screening is carried out using Visual Inspection with Acetic Acid (VIA) -an evidence-based and affordable alternative approach for cervical cancer screening in low-resource settings. The CCSPT initiative offers instant treatment for clients with pre-cancerous lesions using cryotherapy –a method that involves freezing of precancerous lesions.

By Beatrice Nguo Empowering a young girl is empowering the world. This is because women are the pillars of society, and today’s young girls are tomorrow’s mothers. It is therefore prudent to invest in girls and young women, as this is a key determinant to the development of any society. From July 2015 – March 2016, IPPF Africa Region successfully implemented a young girls’ empowerment project known as the 3E project: Empowerment + Engagement = Equality. Implemented in the three countries of Malawi, Uganda and Kenya, the project identified, trained and supported 25 and young women aged between 10 – 24 years from each country on issues surrounding HIV/AIDS advocacy. The 3E project was aimed at building the capacity of young girls to speak for themselves and advocate for their own reproductive health issues. The project enhanced their information-sharing skills among peers, and how to effectively champion their rights in wider circles. Following the initial training –conducted at the start of the project, the girls then formed small groups of peers, numbering about 20 girls each. It is in these groups that they would on a regular basis discuss issues affecting them most. The main issues that the girls explored included: HIV/AIDS, safe sex, early marriages, teen pregnancies, school dropouts, lack of safe spaces for young HIV positive girls to voice their issues, and lack of access to adequate SRHR and HIV/AIDS information and services. HIV treatment adherence, taking their peers back to school, running clubs in schools for the young adolescents, and boy-girl relationships also featured prominently in their discussions undertaken by the young ladies. To enhance their group communication, the girls formed WhatsApp groups, where they would consult each other frequently on related issues. We were able to witness such big changes in the ‘3E girls’. At the end of the engagement, some of the girls were selected to join county/district development committees in their countries –which was largely as a result of their advocacy activities following the initial training we gave them. In these platforms, they continue to campaign for the inclusion of issues affecting young girls in the development agenda. It is with such great pride that we have seen some of these girls go on to become motivational speakers to their peers –including those in schools. Their advocacy prowess has even seen some of the 3E advocates receive invitations to speak in regional and international conferences, such as the 18th International Conference on AIDS and STIs in Africa (ICASA) in Harare, Zimbabwe (November 2015), the Commission on the Status of Women (CSW), Women Deliver in Copenhagen, Denmark (May 2016), and the 21st International AIDS Conference in Durban, South Africa (July 2016). The girls have indeed become role models to many girls –not only in their communities, but in their countries and across the borders. Further, the 3E project was able to demonstrate a gap in spaces for young girls to represent themselves and articulate their issues. The project affirmed that when such spaces are created, it empowers the girls, and an empowered girl will be able to stand up for herself in whichever circumstance she finds herself in. An empowered girl is one who will not easily succumb to peer pressure. She will be less likely to be cheated into having sex, as she is aware of her rights and is empowered to make healthy choices regarding her sexuality. Empowered girls are those who are able to envision a bright future ahead of them, and not rest until they achieve their dreams. If we want to change the world today, girls’ empowerment is the way to go, and the 3E project was one such successful platform towards this. Ms. Beatrice Nguo is Programme Officer at IPPF Africa Region, and was centrally involved in the implementation of the 3E Project.