Network News: Integrating tree conservation and mobile health clinics in Kenya

September 23, 2016


This month we feature an update on a new programme of our fellow Population & Sustainability Network member, CHASE Africa, an NGO working to improve access to family planning and healthcare, and increasing the resilience of the natural environment in Kenya and Uganda. CHASE Africa’s innovative approach, combining support for mobile clinics and tree planting projects, is helping to make this a reality. Robin Witt writes about his experiences in Kenya and the success of CHASE’s integrated health and conservation projects.

CHASE Africa, originally called the Rift Valley Tree Trust, was established in 2000 to encourage tree planting around the fast disappearing Mau forest in Kenya. Starting tree nurseries was easy but finding secure land to plant the trees on proved much more difficult. Many schools have relatively large plots and we have now completed tree planting projects at more than 90 schools, with plots ranging from a half to two acres. Some of the first schools to take part in the planting project are now beginning to harvest their trees. Some schools have chosen to sell the timber, some use it to cook the school lunch and two had the timber milled and built new classrooms.

One of the ideas behind the school tree project was that the timber produced would take some pressure off the indigenous forest. However, the forest seemed to be disappearing at an ever-increasing rate and the size of a farm holding was becoming ever smaller. The reason behind this was Kenya’s population was growing by around one million a year. This coupled with the fact that many rural women had no access to family planning, and were having more children than they wanted, we decided to shift the main focus of our work to helping meet the unmet demand for family planning. The Kenyan Government is now strongly in favour of ensuring family planning is available to everyone. However, in rural areas provision of services is weak due to economic and logistical difficulties. Today, we work with four partners in Kenya and one in Uganda, and over the last four years, we have helped over 54,000 women to have access to family planning.

One of our partners, Dandelion Africa, works in Baringo County in Kenya. This semi-arid county has a contraceptive prevalence rate of only 33%, which is the percentage of women who are currently using, or whose sexual partner is currently using, at least one method of contraception. Dandelion is enabling many women who have never had access to contraception the chance to plan their family size by running mobile clinics that come to their communities. Dandelion, working in conjunction with the Ministry of Health (MoH), decides which communities are to be visited by first holding a meeting with the area Chief and other relevant individuals, to discuss the forthcoming clinic. Key to the success of a clinic is the work of the community health workers who, in the weeks leading up to the clinic, spend time discussing all the benefits family planning can bring and dispelling many of the myths that abound. Local radio in these rural areas is a key form of communication and Dandelion advertises where and when clinics will be happening. On the actual day of the clinic, eight staff are contracted from the MoH on a locum basis. These include two doctors, three family planning and cervical cancer nurses, one antenatal care officer, one HIV/AIDS tester and counsellor and one pharmacist. Often a church hall or school buildings will be used to house the clinic but if these are not available small pop-up tents are taken.

A typical day-clinic comprises the following services, general GP services, immunization, deworming, cervical cancer screening, family planning, and HIV/AIDS testing and counselling, generally with over 1,000 people attending. Family planning patients can choose between different contraceptive methods, including the pill, a 3 month injectable contraceptive, Depo-Provera, a 3 or 5 year contraceptive implant, or an IUD. Female and male condoms are also distributed. The number of women attending for family planning normally varies between 100 and 200.

There are many benefits of enabling women to have the chance to choose family planning, the main ones being maternal health is improved, abortions are reduced and there is a positive impact on under-fives mortality. Traditionally in these rural areas, parents could often not afford to send their daughters to secondary school, sending their sons in preference. When parents can choose how many children they have, all of their children stand a much better chance of being educated and it is well known that one of the key things in reducing total fertility is the education of girls.

CHASE Africa is a small NGO with limited funds but what it has shown is there is a very high unmet demand for family planning in rural areas of Kenya, and for relatively modest sums, that demand can be met and a family’s fortunes, and perhaps the planet’s as well, can be changed for the better.