Saving Kenya's Environment Through Family Planning

*Not their real names

Nalobisho* could not stop herself from grinning each time she got closer to the clinic tent. She was here to get her first 5-year implant contraception method. The mother of six could not imagine having even one more child. Her husband, Nakuli*, sells charcoal, and Nalobisho is a housewife, but on market days, she sells tea and ‘mandazis’ (donuts) to traders. They do not have much to go around and live-in abject poverty.

CORP Susan met Nakuli by the roadside looking for customers. She took the opportunity to explain to Nakuli the effects making charcoal has on the environment, he responded that if he did not burn that charcoal, where would his family get food? “I have a family of 8. I did not go to school and have no economic skills except how to make charcoal. How will I feed, clothe and educate my children?” he asked. “My wife mostly stays at home taking care of our children as I try and find the money. At times I can go for days without selling even half a bag!” he exclaimed. Susan suggested that it was time to find another way of making money. Maybe helping his wife sell tea full time at the shopping centre would bring a steadier income.

Susan requested if they could go home to visit Nalobisho and talk to her more. They found the woman busy with chores while caring for her two little children. One is 3 years and the other a year and a half. This was no easy task. When she saw her husband and a guest, she thought of the task ahead to entertain them, which wore her down instantly. Susan asked her not to prepare as they were there to talk. She told them about the different FP contraception methods and their benefits. They thought it would be a good idea as a family to try the five years implant pregnancy protection method as it would give them a more extended period to get their affairs in order.

Since the CHAT motor mobile clinic was visiting their village, they agreed to meet there the following morning. After getting her implant, Nalobisho could not contain her joy. She was grateful to the organisation for enabling the mobile clinic to get to them and urged them to continue visiting to help more people in her community. She promised that whenever she heard the news of the vehicle coming, she would at least bring 3 women for the same service.

Thanks to GG support, in the past three months, CHAT was able to reach: a total of 13,862 individuals with behaviour change information (bcc), with 4,004 family planning clients receiving different contraception methods, of which 3,008 chose the long-term methods of 3 & 5 years’ protection against unwanted pregnancies.

“Every second, every day, every year, we fail to address demand for reproductive health and family planning services. Lives are lost, and girls' opportunities to thrive and contribute to their country's development shrink. These are real people.” Jenny Shipley

*not real name

As *Mzee Lkaseti was seated inline between women waiting to choose a FP method, Jackeline, CHAT’s Community Own Resource Person (CORP) partner could not understand why he was there sitting with women in the ‘FP’ line! This was at a motor mobile clinic in Suradoru, in Samburu. He was in no hurry to leave and as the line got closer to the tent Jackeline decided why not direct him appropriately. Upon asking him what he needed, he said that he would love for them to go home together with the team. This was a request he was making since he left his wife *Nashami doing her chores thus no opportunity for her to attend the clinic. When the team finished up with what they were doing, they followed Mzee to his home. They found his wife, Nashami, washing their last-born baby who was just two years old.

Mzee Lkaseti and Nashami have four children. Two are in school. One in the fields taking care of animals and now the two-year-old baby. “We have lost a lot of cattle and camels due to the drought. There are no rains and food. The water is not enough for both the animals and human consumption. Food has become more expensive and we barely have enough to feed on. With no sign of improvement, it’s time we started planning our family to the size that we can manage comfortably. I heard you people offer medicine that women use to help in the prevention of pregnancy. I would like to learn more from you then take it.” Mzee explained. He then excused himself to go look at their goats least one of them died. “They have been dying almost every day now. I am worried.” He said as he stepped out of the door

CORP Jackeline explained to Nashami the different methods of FP and their benefits as well as their disadvantages. She demonstrated how they are used and their different span of time they are for Nashami decided to use the three years implant and gauge if it suited her. With this, she was ensured that they would stay for the next 3 years without the worry of the family expanding. She got her three-year implant from the motor mobile nurse and being so happy she treated the team to some tea from the little milk she had.

‘Many men are starting to see the importance of managing their family sizes. They are allowing their women to get FP more and more. Out of this, I can see the change that is going to happen in a few years. It really makes me happy to see my job being well appreciated.’ Jackeline shared.

Thanks to GG support, in the past three months, CHAT was able to reach: a total of 12,911 individuals with behaviour change information (bcc) with 3,004 family planning clients receiving different contraception methods, of which 2,738 chose the long-term methods – 3 & 5 years’ protection against unwanted pregnancies.

‘There is a huge need for contraception in our communities. Women do not go to the hospital nor do they have adequate knowledge on the use of contraceptives. It will take a lot of intervention to ensure that they are aware of their right to contraception.’  CHAT CORP Eunice Karimi

*Not their real names

As the CHAT motor mobile team was settling into camp in Ntepes in Samburu after a days-long work, Nurse Ann noticed CORP Ntoijoni was seated at the furthest end with a woman. They were in deep conversation. She was curious thus decided to approach them. She found *Lesempa looking all scared but at the same time hopeful.  She wanted to know why the lady had taken her time to come to the clinic only to sit there reluctantly, not sure what to do. She led them to the tent so they could talk more.

*Lesempa had come to the clinic to find a solution. She is 35 years old and has ten children. She doesn’t want any more. She was married at 20 years, which was an achievement since her sisters and peers mainly were married at only 15.

Her reason for getting FP was that she wanted to be able to send all her children to school, all the way to the end. Her youngest child is just 1 ½ years old, and she says she is scared if she has any more children, she won’t be able to afford school for them all. She had seen how Ntoijoni was able to educate her children and had learnt that recently, one had just finished high school and was attending computer classes in Maralal town (That was such a big deal to *Lesempa) . From the frequent interactions CORP Ntoijoni had with *Lesempa, she always encouraged her to plan her family whilst consideration of her recourses. Once Ntoijoni correlated the success of her children to how she planned her family, Lesempa started to see the light. She began to understand that the most significant benefit of FP is for her children’s future.

She was initially scared that her husband would be adamant and say that she had to continue having children. But to her surprise, he was in full support of her going for FP which was so admirable. She had never used FP before and said she used to fear because she heard lots of stories that it would do bad things to the body and make one sick. At the end of it all, Lesempa was able to get a five-year implant that would protect her from getting more children.

Thanks to GG support, in the past three months, CHAT was able to reach a total of 12,134 individuals with behaviour change information (bcc)  with 3,912 family planning clients receiving different contraception methods, of which 3,001 chose the long-term methods - 3/5-years protection against unwanted pregnancies.

“Family planning is an integral part of development planning. It is an essential part for the reason that you cannot hope to plan other forms of production if you cannot plan the production of the main resource – the human beings.” Mwai Kibaki

* Not their real names

Mutunga*, a father of two was close to leaving Katse because of the pressure from the family to have more children. He is a farmer and with the continuous dry spell in Katse, he had little to no harvest. He and his wife Nduku* had agreed to have a small family after being sensitized on the importance of family planning and how it could help them organize their finances, they agreed to use the five-year implant. It had only been two years and his parents kept asking if his wife had suddenly become barren.

Mutunga did not want to explain to anyone why he was not having more children but at the same time, he felt pity for his wife who was being ridiculed for not having more children. He knew that the backward-mindedness of his old folks would not let them rest till they had more children so he decided to leave the village. He shared this with his friend who asked him why not have Mbuli- CHAT’s CORP - to go talk to his parents. Mutunga was skeptical though he agreed to try it as the last resort before he moved.

He and Mbuli planned a day and went to his parents’ home. At first, they were surprised why their son was going to visit them with Mbuli. They knew her from the time she taught them about C-19 prevention. They decided to listen to what she had to say this time around. Mbuli explained to them how Mutunga and his siblings did not get the best kind of education and upbringing because they were too many and did not have a great source of income. That is why Mutunga had decided to have a small family that he and his wife could easily manage.

His parents agreed that having and raising 10 children with their little wealth, was a struggle. They now understood why their son was reluctant to have more children. They decided to support his idea and encouraged Mbuli to visit Mutungas’ brothers to advise them so that they too would plan their families and lives sensibly.  

Thanks to GG support, in the past three months, CHAT was able to reach a total of 12,233 individuals with behaviour change communication (bcc) information with 4,511 family planning clients receiving different contraception methods, of which 3,783 chose the long-term methods - 3/5-years protection against unwanted pregnancies.

“Every second, every day, every year, we fail to address demand for reproductive health and family planning services. Lives are lost, and girls’ opportunities to thrive and contribute to their country’s development shrink. These are real people.” Jenny Shipley

“When he first visited my boma early in the morning, I suspected that something had gone wrong,”narrates Lenarte*. “According to our culture, when an unusual guest checks in that early in the morning, it rings a bellthat all is notwell,” Heexplainsfurther.

His wife was the first to see him as she was milking her cows when he entered their homestead in ayellow t-shirt and bag at his back. Just after they had their usual Serian (Maa greetings), theunexpected visitor explained to the wife that he would so much appreciate having a brief conversationwiththecouple.

"Our daktari, is anything the matter? Just tell me" begged the wife looking so scared that probablytheir daktari did not have good news for them. His confident response was meant to assure her thatnothinghadgonewrong,thoughthewife'sfaceexpresseddissatisfaction.Afterofferinghimaseat,she went to finish up milking and came back to wake up the husband to meet the somewhat unusualguest.

Since his engagement with CHAT as a CORP, Eturen had made up his mind to always conducthousehold visits within the communities especially early in the morning, since his focus was to reachboth men and women for sensitization. "I realized my community is paternalistic,hence a prudent idea is to ensure that men are also involved in the family planning decisions as they are the family heads and enlightening them on the importance of family planning enablesthem to approve and make FP decisions together with their wives, which could not be the case if theywerenotengaged," heexplains further.

Lenarte and his wife joined the guest who was waiting for them outside the manyatta. (Eturen waskeen to remind them to have their masks in adherence to the MoH protocols). Up to this time, Lenartehadn't yet conceptualized what news Eturen had for them that earlymorning.Assoonastheyweresettledanddonewiththeir‘Serian’,Eturenwentaheadandintroduced the subject matter. As he was explaining the FP intervention (using CHATs PHE approach)he could notice both Lenarte and the wife nodding in agreement. “Whenever our human population ismanaged, we are capable to have access to quality health and the environmental resources aresufficient enoughtosustainour livelihoodsandfuturegenerationsas well”Eturen recalls.

As he concluded his sensitization, Lenarte would not help but suggest to his wife about embracing the5years implants amongst the other contraception methods they had been sensitized about. “I amgrateful, that daktari visited us and my husband warmly supports this. Women go through a lot during child delivery and some of us even die in the course. I am lucky for having an understanding husband. I hope he becomes a model for many others in the community,” wife confirmed.

“What a joy! Every time I wake up, I think about steering change in our community andconserving our natural resources,” Eturen commented as he filled the referral forms for hisnew friend’s wife, as he hadpromised to accompany his wifetothefacility for services.

Thanks to GG support in the past three months, CHAT was able to reach a total of12,217 individuals with behavior change communication (bcc) information with4,467 family planning clients receiving different contraception methods, of which 3,562 chose the long-term methods- 3/5-years protection against unwanted pregnancies.

Overpopulation is a root problem of all the environmental issues. If you can control the population, you can control almost anything.” Rinkesh Kukreja, Founder – Conserve Energy Future.