Enhancing Maternal and Child Health using a Combined Mother & Child Health Booklet in Kenya

Under Kenyan guidelines, HIV-exposed infants should be tested for HIV DNA at 6 weeks or at first clinical contact thereafter, as infants come for immunization. Following the introduction of early infant diagnoses programmes, however, many infants were not being tested and linked to care and treatment. We developed the Mother & Child Health Booklet to help relate mothers’ obstetrical history to infants’ healthcare providers to facilitate follow-up and timely management. The booklet contains information on the mother’s pregnancy, delivery and postpartum course and her child’s growth and development, immunization, nutrition and other data need to monitor the child to 5 years of age. It replaced three separate record clinical cards. In a 1 year pilot evaluation of the booklet in Nyanza province in 2007–08, the number of HIV DNA tests on infants increased by 34% from 9966 to 13 379. The booklet was subsequently distributed nationwide in 2009. Overall, the numbers of infants tested for HIV DNA rose from 27 000 in 2007 to 60 000 in 2012, which represents approximately 60% of the estimated HIV-exposed infants in Kenya. We believe that the booklet is an important strategy for identifying and treating infected infants and, thus, in progress toward Millennium Development Goal 4

Exploring the demand‐side factors associated with the use of implants in Kenya

We explore the demand‐side factors associated with the use of implants in Kenya given the notable rapid increase in uptake of the method in the country. Data are from a longitudinal study conducted among married or cohabiting women aged 15–39 years at the time of recruitment in one rural (2,424 women) and one urban (2,812 women) site. Analysis entails descriptive statistics and estimation of multivariate logistic regression models. The results show that the key demand‐side factors associated with the use of implants were low discontinuation of the method compared with alternatives and strong motivation on the part of the women for long‐term spacing of births. However, implants had no perceived advantages over the main alternative methods in terms of beliefs about possible damage to health or unpleasant side effects or in terms of satisfaction with use. The findings suggest that addressing concerns about safety for long‐term use and for health may increase demand for implants in particular and long‐acting reversible contraceptives in general in the study settings or in similar contexts, especially among women who desire long‐term spacing of births