STREET FAMILIES AND FAMILY PLANNING: A neglected and yet a vital aspect for urban programming

Background In Kenya, Street families are usually associated with community crimes hence they are often discriminated. Despite their dire need for health services, street families do not access mostly due to the fear of... [ view full abstract ]

Background

In Kenya, Street families are usually associated with community crimes hence they are often discriminated. Despite their dire need for health services, street families do not access mostly due to the fear of harassment by police and members of the public. A key component of the Kenya Urban Reproductive Health Initiative “Tupange” – a 5-year project funded by the Bill and Melinda Gates Foundation – was to improve access to family planning (FP) for the urban poor such as street families.

Methodology

Tupange trained and worked with community health volunteers (CHVs) who then identified street families living around the Majengo area of Nairobi. The CHVs mapped the street family “bases” and identified their base commanders, who made decisions and provided security for the base. Despite early suspicion, the CHVs persisted and created a good rapport with base commanders. The CHVs then provided general health information and eventually FP method information. Three integrated outreaches targeting the street families were conducted by two local health facilities between April 2014 and June 2014: the base commanders assisting in the mobilization. The street families received quality health services without any stigmatization. Data was collected through an integrated outreach report, CHV referral booklets and testimonies from the street girls and women.

Results

One of the base commanders volunteered to serve as a CHV for street families; providing health messages and condoms. During the outreaches, 71 street women received long acting and reversible methods and 146 children received health services (immunization, deworming, treatment of skin infections, food supplementation). The street families started seeking health services from the two health facilities.

Conclusion

Street families, usually ignored when designing interventions for health services, can be reached and will accept the services. This experience by Tupange project can be modeled to provide street families with other services.