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Packard Foundation to Support ‘Score Card’ Intervention for Family Planning in Kenya

July 3, 2019
Gillings School of Global Public Health

Katherine Tumlinson, assistant professor of maternal and child health and a fellow of the Carolina Population Center, wants to help women in low-income countries access family planning.

“Women must be able to safely achieve their desired family size,” she says, “but health care providers in low-income countries sometimes discourage family planning use by engaging in negative behaviors like being frequently absent from work, asking patients to pay unsanctioned fees and withholding family planning methods from young or unmarried clients.”

To begin to address this global problem, Tumlinson proposed the development of a Youth Community Score Card for young people to share concerns and challenges when accessing family planning services—and she has been awarded a $50,000 Quality Innovation Challenge grant from the David and Lucile Packard Foundation to support her work.

After developing and validating the score card, Tumlinson will use the scores with community members in Kenya to develop appropriate interventions.

“Recent research shows that these types of provider behaviors are reinforced by weak supervision and accountability, as well as by disempowered clients who lack knowledge about their patient rights,” Tumlinson explains. “Score cards are an easy-to-use tool that allow communities to monitor and evaluate public facility performance. The hope is that score cards will increase both patient agency and the accountability of service providers to their communities.”

She also hopes that activities related to the score cards will lead to increased attendance of health care providers, fewer demands for informal payments and reduced instances of providers refusing to offer family planning methods to young or unmarried women. This, in turn, is expected to increase the total number of women receiving family planning services across the country.

A similar activity conducted in Uganda about 15 years ago resulted in substantial improvements to community engagement and service provider performance, she says. The intervention also increased overall utilization of health care services and achieved a stunning 33 percent reduction in mortality among children under five years.

“I’m excited to see if we can begin to replicate some of those results in the Kenyan context,” Tumlinson shares. “I’m especially excited to implement these activities in close collaboration with Dr. Dickens Onyango, the health director for Kisumu County in Western Kenya, who is a trained medical doctor and epidemiologist with extensive research experience. If the project is successful, I hope to work with Dr. Onyango to scale up the score card approach in additional communities and facilities within his county as well as in neighboring counties in Kenya.”

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