Mobile medical teams increase access to long-term family methods

Afya Uzazi Nakuru-Baringo Program
4 min readFeb 27, 2019


Christine, 37, says she has peace of mind to care for her seven children. She chose a permanent family planning method at an outreach supported by USAID’s Afya Uzazi Program in Baringo, Kenya.

Christine: Learnt about family planning from mother-to-mother support group. Photo: Denise Akun

Christine Tuitoek, 37, is a farmer and a single mother of seven. She is a resident of Kimalel village Baringo County.

Christine got her first child when she was only 13. She did not have any information on how to take proper care of the baby.

She dropped out of school to care for her child. It was a struggle. The young mother relied on her parents to help care for her baby. It did not take long before she got married to a much older man.

In Baringo County, many young girls suffer a similar fate to Christine’s.

According to the Ministry of Health, about one in ten (13%) girls aged 15–19 years in Baringo County have begun childbearing. Specifically, 2.7% are pregnant with their first child and 10.5% have ever given birth compared to 3.4% and 14.7%, respectively, at the national level.

Many teenage mothers get pregnant again because few of them have knowledge of contraceptives. In Baringo County, about one in 10 (only 8%) of currently married girls aged 15- 19 use modern contraceptives, lower than the national rate of 37%.

When Christine delivered her lastborn son, she joined a mother-to-mother support group that local health workers formed with support from USAID’s Afya Uzazi Program.

The support group sessions are a platform for mothers to share experiences, exchange ideas, and receive information on proper nutrition for mother and child.

During one of the group meetings, Christine learnt of long-term and permanent family planning methods. She did not act immediately despite knowing the benefits of family planning.

She did not want to have children. Her husband had left her, and she could not afford to provide for another child on her own.

Christine later asked a community health volunteer (CHW) to tell her more about the permanent methods of family.

The CHV counseled and invited her to outreach at the Kimalel health center, a few kilometers from her home.

During the outreach, Christine sat down for a counseling session with a health worker. After listening to the pros and cons of all options, she chose tubal ligation. The operation was done on the same day.

Christine says she was convinced this was the right choice because she did not want to get more children.

“It has been very difficult for me to provide for my family. My children need food, soap, books and sometimes I don’t even have the money. They ask me for new clothes, but I cannot buy them because I am saving for school fees.”

Her eldest son is 25-years-old and due to sit his high school exams this year. The other siblings are in primary school except for the last born, who just marked his first birthday.

For a long time, Christine used short-term methods like the three-month injectable and pills, but she sometimes skipped appointments. She would go without a method and get pregnant when she did not intend to.

“Am happy because I will be able to work even harder and take good care of my family,” says Christine. “Even if I get married again, I would not want to get other children. Am contented.”

Christine is just one of the mothers who benefitted from outreach services supported by USAID’s Afya Uzazi program in Baringo and Nakuru counties between 2016 and 2021.

During the outreaches, mobile teams provided long-acting and permanent methods that would otherwise be out of reach for most people.

A doctor explains the tubal ligation procedure. The process works by blocking the fallopian tubes so that eggs released from the ovaries cannot move down the tubes, and so they do not meet sperm. Photo: Denise Akun

Alfred Kibet, a nurse at Kimalel hospital says that the number of people accessing family planning methods has increased tremendously since the outreaches began over two years ago.

Kibet says community education has helped to address myths and misconceptions that discouraged women from receiving the services.

Afya Uzazi has trained community health volunteers (CHVs) to provide accurate information on family planning and to refer women and couples for services.

Some of the women were given extra training to become “super mobilizers”.

Beatrice Akinyi and Lydia Chesang provide information on family planning options as they mobilize communities to visit health facilities for services. Photo: G. Obanyi

Afya Uzazi program improved access to quality reproductive health care services by working closely with the local health facilities and community health workers.

By the end of the project in March 2021, 43 percent of women of reproductive age were receiving family planning, up from 26% in 2016.

Story by Denise Akun and George Obanyi (USAID’s Afya Uzazi Nakuru-Baringo Program).



Afya Uzazi Nakuru-Baringo Program

Afya Uzazi Program works to improve access to quality health services for mothers, children, adolescents and youth in two counties in Kenya with USAID support.