Kenya Comparative Assessment of Long-Acting and Permanent Methods Activities. Final report. Draft 1.2.

In the past five years efforts have been made to ensure a range of contraceptive choice in Kenya. The most comprehensive interventions have occurred under the leadership of the Ministry of Healths IUCD Reintroduction Task Force which helped launch several interventions with the goal of increasing use of IUCDs and by extension long-acting and permanent methods of contraception (LAPMs). Three recent projects have embraced models incorporating LAPM advocacy stable supply and demand creation: AMKENI AMUA and ACQUIRE. All of these projects have similar end points (i.e. increase in LAPM use) which affords a unique opportunity to examine more closely the medium-term outcomes and impact of each intervention and to determine which combination of these approaches might be best for increasing LAPM use. The assessment reveals several important lessons. Implementing both supply-side and demand-side activities at the same time as conducting advocacy seems to be the best model for this kind of work. ACQUIRE an intervention targeted at one method seemed to yield more positive results. The implementation of the AMUA social franchising network of private providers may be a promising direction for future public-private partnership efforts if the costs can be controlled. The costs associated with targeted IUCD or broader LAPM/FP interventions have not been examined thus information on cost per CYP replicability and sustainability is lacking. Instead of primarily relying on donor funds LAPM efforts should be mainstreamed into the MOH structure and funded through the annual operating plans. Finally if they decide that LAPM efforts should continue to be prioritized the MOH and donors need to take a longer term approach to promoting LAPM utilization so that progress achieved during interventions can be sustained over time. (Excerpts)