Best Practices in Reproductive Health
Best practices: “array
of evidence-based tools, materials and practices, including
guidelines, norms, standards, experiences and skills, among
others, that have proven their worth in the field of reproductive
health” IBP Initiative
Introduction
Several attempts have been made to have a standard
definition of ‘best practice’ in reproductive health,
and several definitions exist. However, there is consensus that
these include methods, tools and materials that have been demonstrated
as effective, as well as innovative in reproductive health. They
can be approaches that have been applied successfully in a given
setting, and which can be replicated elsewhere.
The UNFPA defines best practices as planning or operational
practices that have four common characteristics in particular
circumstances and which are “used to demonstrate what works
and what does not and to accumulate and apply knowledge about
how and why they work in different situations and contexts.
Advance Africa (www.advanceafrica.org)
defines a best practice, as a practice or programme that has substantial
evidence of impact, or which has successfully met its program
objectives. A best practice must show evidence that it has been
transferred to or replicated in various settings.
Recognising and Supporting Best Practices
in Kenya
The DRH is an active member of the Kenya Implementing
Best Practices (IBP) Initiative, an interactive forum through
which policy makers, program managers, implementing organisations
and providers convene to identify and apply evidence-based practices
that can improve reproductive health outcomes in their countries.
The IBP Initiative (www.ibpinitiative.org)
is a global network led by the World Health Organization and supported
by several development partners, to respond to challenges in the
reproductive health community in low resource settings including:
- the lack of targeted and coherent information
on what works and what does not work
- costly duplication of efforts
- costly implementation of ineffective programs
- limited access to evidence-based tools, materials
and strategies
- Limited opportunities to share new knowledge with
local and international colleagues.
Through the initiative the DRH is looking into improving
its services by identifying and promoting existing best practices
in the country in the national priority areas of reproductive
health. A deliberate effort is being made to refocus attention
on the challenges and critical programmatic needs in these priority
areas and to apply proven best practices.
Collaborative initiatives on promoting best
practices
On inception, the Kenya IBP Initiative had set as
one of its goals to increase family planning uptake by 5% in selected
facilities in a sample of eight pilot districts, and to increase
contraceptive commodities buffer stock in those districts to three
months. An 18-month intervention was planned and implemented in
eight focus districts (Meru South, Nyeri, Malindi, Migori, Homa
Bay, Kisii, Nakuru and Bungoma). The intervention included demand
creation activities, strengthening the knowledge and skills of
service providers in FP, and improving the procurement and distribution
of FP commodities. The intervention resulted in significant achievements
including increased demand for FP services in the focus districts,
and improved perception of FP in the local communities. A 38%
increase in Family Planning uptake in all districts was recorded,
surpassing the original target of 5%. The number of IUD insertions
in the pilot district doubled, from 139 in 2004, to 280 by 2006.
In addition, no stock-outs of at least three modern FP methods
were reported in any of the focus districts, during the intervention
period. District reporting on logistics also improved significantly.
Despite these successes, the IBP initiative in Kenya
faced significant challenges, including the limited funding that
was available for the program, dropping out of some partners,
and the need to strengthen the contraceptive logistic system to
ensure commodity security.
Next steps
DRH intends to roll out the IBP
Initiative countrywide, through the following interventions:
- Ensuring an efficient and effective logistic system
from national level to facility level
- Updating service providers on FP
- Strengthening support supervision
- Mobilizing communities to create demand for services,
with emphasis on long-term reversible and permanent methods
- Continuing stakeholders’ involvement to
enhance partnerships
