Adapting High Impact Practices in Family Planning During the COVID-19 Pandemic: Experiences From Kenya, Nigeria, and Zimbabwe

Morrisa Malkin; Alexandria K. Mickler; Theophilus O. Ajibade; Alexis Coppola; Eden Demise; Esinath Derera; Joy Otsanya Ede; Meghan Gallagher; Lucia Gumbo; Zorodzai Jakopo; Kristen Little; Absolom Mbinda; Gladwin Muchena; Nyaradzo Debra Muhonde; Khesiwe Ncube; Fifi Oluwatoyin Ogbondeminu; Shannon Pryor; Elsie Nzale Sang

doi:10.9745/GHSP-D-22-00064

Key Findings

The documented adaptations primarily consisted of small adjustments to existing activities and approaches in direct response to challenges posed by COVID-19.
Across each High Impact Practice (HIP), the ability of projects to be flexible and quickly respond to challenges as they arose supported continuous service delivery and helped meet family planning clients’ needs.

Key Implications

Program managers should disseminate the lessons learned from implementing these adaptations, as well as seek to incorporate them into resources such as planning and preparedness guides. Where synergies exist, the lessons learned may be packaged with those of similar efforts to maximize the application of learnings.
Program managers and national stakeholders should use these and other learnings from the global community of practice to inform continued implementation of HIPs as the global health community works to evolve approaches to become more effective and resilient in the face of present and future challenges.

ABSTRACT

Background:

We describe how High Impact Practices (HIPs) in family planning (FP) were adapted across Kenya, Nigeria, and Zimbabwe to maintain access to services in response to the coronavirus disease (COVID-19) pandemic.

Methods:

Using a qualitative data collection tool structured around 3 HIP categories (service delivery, demand creation, and enabling environment), adaptations in FP programs during the pandemic were documented. We describe adaptations made to 3 specific HIPs: mobile outreach, community health workers, and digital health for social and behavior change.

Program Experiences:

In Zimbabwe, the Mhuri/Imuli project adapted its mobile outreach model integrating community-based outreach with facility-based outreach. The number of outreach clients served per week peaked at 1,759 (July 2020) from a low of 203 (May 2020). Clients choosing long-acting reversible methods increased from 22% to 59% during the 3 months before and after lockdown, respectively.

In Kenya, a program addressed youth’s hesitation to visit health facilities through youth community health volunteers, who provided counseling, community dialogues, contraceptive pills, and condoms. Over 6 months, the program reached 1,048 youth with community dialogues, and 4,656 youth received FP services. In Nigeria, peer mobilizers provided services through a socially distanced community-based program to help adolescent girls access contraceptive self-injection when movement restrictions limited youth’s ability to travel to facilities.

In Nigeria, Adolescents 360 adapted sexual and reproductive health information programs for virtual delivery through WhatsApp. A contraceptive education Facebook campaign gained more than 80,000 followers, reached 5.9 million adolescents, and linked 330 adolescents to program-supported facilities from January to March 2021. In Kenya, the Kibera-based project used WhatsApp to reach youth with discussion groups and health workers with skills strengthening.

Conclusion:

Monitoring how projects adapt HIPs to ensure continuity of care during the COVID-19 pandemic can help inform the implementation of successful adaptations in the face of present and future challenges.

Footnotes

Received: February 17, 2022.
Accepted: July 20, 2022.
Published: August 30, 2022.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit https://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-22-00064

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