Role of community champions in promoting inclusion of adolescents and young persons in family planning services: a quasi-experimental endline evaluation

Authors

  • John Kutna Amref Health Africa, Nairobi, Nairobi County, Kenya
  • Anne Gitimu Amref Health Africa, Nairobi, Nairobi County, Kenya
  • Kennedy Wakoli Amref Health Africa, Nairobi, Nairobi County, Kenya
  • Herbert Barasa Amref Health Africa, Nairobi, Nairobi County, Kenya
  • Happiness Oruko Amref Health Africa, Nairobi, Nairobi County, Kenya
  • Yvonne Opanga Amref Health Africa, Nairobi, Nairobi County, Kenya
  • Paul W. Maleya Amref Health Africa, Nairobi, Nairobi County, Kenya
  • Abdiaziz Ibrahim Amref Health Africa, Nairobi, Nairobi County, Kenya
  • Baddasoh Raphael Amref Health Africa, Nairobi, Nairobi County, Kenya
  • Eunice Wandei Amref Health Africa, Nairobi, Nairobi County, Kenya
  • Aden Awle Amref Health Africa, Nairobi, Nairobi County, Kenya
  • Jamila Farah Supreme Council of Kenya Muslims (SUPKEM), Nairobi, Nairobi County, Kenya
  • Rose Wafula Monilary Research, Nairobi, Nairobi County, Kenya
  • Fatou Cissé Amref Health Africa, USA
  • Nicole London Amref Health Africa, USA

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20264055

Keywords:

Adolescents and young people, Contraceptive utilization, Community champions, Family planning, Religious leaders

Abstract

Background: Adolescents and young people (AYPs) face disproportionate barriers to family planning (FP), especially in conservative and underserved contexts. This study assessed the role of community champions in improving FP knowledge, attitudes and utilization among AYPs aged 15–24 in Garissa and Tana River Counties, Kenya, under the DEESIP project.

Methods: A quasi-experimental, mixed-methods design evaluated 673 AYPs, using surveys, interviews and focus groups.

Results: Overall, 74% reported FP awareness, higher in Tana River (61%) than Garissa (39%) (p<0.001). Attitudes toward FP were generally positive with youth in intervention areas reporting higher attitudes than controls. Utilization was greater in Tana River (76%) than Garissa (24%) (p<0.001). Exposure to champions significantly increased uptake (OR≈35, p<0.001), particularly with religious leader engagement.

Conclusions: Champions reduced stigma and provider bias but faced sustainability challenges. Strengthening peer-led and faith-informed strategies is vital for equitable FP access among AYPs in marginalized settings.

References

United nations population fund (UNFPA). Adolescent and youth demographics: Regional overview of challenges and opportunities. New York: UNFPA; 2022. Available from: https://www.unfpa.org. Accessed on 21 March 2025.

World Health Organization. WHO guideline on self-care interventions for health and well-being. Geneva: WHO. 2022. Available at: https://www.who.int/publications. Accessed on 21 March 2025.

Guttmacher Institute. Adolescent sexual and reproductive health in low- and middle-income countries: An overview. New York: Guttmacher Institute; 2020. Available at: https://www.guttmacher.org/fact-sheet/adolescent. Accessed on 21 March 2025.

Bongaarts J. United Nations Department of Economic and Social Affairs, Population Division World Family Planning 2020: Highlights, United Nations Publications. Popu Dev Rev. 2020;46(4):857-8.

Darroch JE, Woog V, Bankole A, Ashford LS. Adding it up: Costs and benefits of meeting the contraceptive needs of adolescents. New York: Guttmacher Institute; 2016. Available at: https://www.guttmacher.org/report/adding-it-up-contraceptive-needs-of-adolescents. Accessed on 12 March 2026.

Bankole A, Malarcher S. Removing barriers to adolescents’ access to contraceptive information and services. Stud Fam Plann. 2010;41(2):117–24.

Chandra-Mouli V, Lane C, Wong S. What does not work in adolescent sexual and reproductive health: A review of evidence on interventions commonly accepted as best practices. Glob Health Sci Pract. 2015;3(3):333–40.

Barden-O’Fallon J, Barry MA, Brodish P, Hazerjian J. Gender norms and family planning uptake in developing countries: A systematic review. Stud Fam Plann. 2020;51(1):51–70.

Marston C, Tabot M. How can we put rights at the core of global family planning. Lancet. 2023;29;401.

Mutea L, Ontiri S, Kadiri F, Michielesen K, Gichangi P. Access to information and use of adolescent sexual reproductive health services: Qualitative exploration of barriers and facilitators in Kisumu and Kakamega, Kenya. Plos One. 2020;15(11):241985.

Thomas D, Wanje G, Eastment MC, McClelland RS, Mwaringa E, Patta S, et al. The cost of implementing the Systems Analysis and Improvement Approach for a cluster randomized trial integrating HIV testing into family planning services in Mombasa County, Kenya. BMC Health Serv Res. 2022;22(1):1480.

Mwaura HM, Kamanu TK, Kulohoma BW. Sub-national disparities in indicators of maternal mortality in Kenya: insights from demographic health surveys towards attaining SDG 3. J Women Health Develop. 2024;7(3):29-40.

Akseer N, Phillips DE, Exemplars in Global Health Partner Network. Drivers of success in global health outcomes: a content analysis of exemplar studies. PLOS Global Publ Heal. 2024;4(5):3000.

High-Impact Practices in Family Planning (HIPs). Community group engagement: Changing norms to improve reproductive health. Washington, DC: HIPs. 2020. Available at: https://www.fphighimpactpractices.org. Accessed on 21 March 2026.

Sadore AA, Kebede Y, Birhanu Z. Effectiveness of engaging religious leaders in maternal health education for improving maternal health service utilization in Ethiopia: cluster randomized controlled trial. Front Pub Health. 2024;12:1399472.

Population Council. Religious leaders and SRHR: Evidence for engaging gatekeepers in Muslim communities. Nairobi: Population Council; 2022. Available at: https://www.popcouncil.org. Accessed on 21 August 2025.

Ahmed S, Li Q, Liu L, Tsui AO. Maternal deaths averted by contraceptive use: An analysis of 172 countries. Lancet Glob Health. 2019;7(3):320–9.

Hardee K, Jordan S. Advancing rights-based family planning from 2020 to 2030. J Contraception. 2021;9:157-71.

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Published

2026-10-30

How to Cite

Kutna, J., Anne Gitimu, Wakoli, K., Herbert Barasa, Oruko, H., Yvonne Opanga, Maleya, P. W., Abdiaziz Ibrahim, Baddasoh Raphael, Eunice Wandei, Aden Awle, Jamila Farah, Rose Wafula, Fatou Cissé, & London, N. (2026). Role of community champions in promoting inclusion of adolescents and young persons in family planning services: a quasi-experimental endline evaluation. International Journal Of Community Medicine And Public Health, 13(11), 6348–6356. https://doi.org/10.18203/2394-6040.ijcmph20264055

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Section

Original Research Articles