In the southeastern part of Kenya lies Marungu, a village surrounded by highlands. Once a week, community members converge in a hall to discuss social matters, usually in the presence of an area chief and other local representatives. But this time a different kind of discussion emerged: one designed to bring men together to discuss community health and family planning topics. In the presence of the area chief, a community health assistant, nurse, and the Wildlife Works team, the dialogue focused on health services available, in aim to improve attitudes towards family planning services and the different methods of contraceptives.
“Why are you against our wives having children and what is wrong with multiplying the earth?” asked 30-year-old Majaliwa Baya, a father of eight. Following the discussion, another group of men snickered at a condom demonstration session by a community health assistant. When asked if the men knew what a vasectomy was, one replied that is a process to weaken men in bed. Others stared in amusement as a nurse explained more about the surgical procedure. The attending health officials looked at each other bemusedly, clearly intrigued by the community members’ remarks and reactions to their demonstrations.
Not Just a Woman’s Affair
The dialogue is part of a 3 month pilot program sponsored by CHASE Africa in collaboration with Wildlife Works and Save the Elephants to actualize basic healthcare services and provide in-depth information on family planning services to communities living in the Kasigau Corridor in Kenya. But bringing men together in one area for a health and family planning discussion wasn’t easy. “We had to bring them in a way that included important community topics, which traditionally have required their involvement. Without the inclusion of other information, many wouldn’t have shown up, because they view health and family planning as a woman’s issue,” said the area Assistant Chief, Drisilla Ngele. If an urgent community meeting is needed the area chief, through a village elder, visits village to village with a whistle, alerting community members. This method is effective because the authority of the chief’s request is respected and, on this occasion, they were able to gather over 40 men to attend the meeting. “We noticed a huge gap in access to information during health discussions with women and saw the need to involve men,” said Elizabeth Mesula, a community health assistant at Marungu Health Centre. Mesula emphasized that due to a historical lack of in-depth information provision and common misconceptions, there is now an urgent need to make sure men are able to get answers to some seemingly simple questions.
Alternatively, women are generally very receptive during dialogue sessions, and the attendance is higher. Mesula elaborated that, “We only had a few instances at the dialogue where several older women opposed our sensitization workshop, citing interference with their tradition.” Mesula and her team are trying to discourage misconceptions, break down barriers in communication, and encourage dynamic health discussions among both men and women.
Another core focus of the pilot program involves a network of locally-trained community health volunteers moving from door to door in different villages, giving out information on where the community can attend trainings and visit mobile clinics to access integrated outreach services such as immunization, cancer screening, COVID vaccines, HIV testing, and blood pressure and diabetes checkups. One community health volunteer can visit between 50 to 90 households in 2 weeks, giving a broad range of information to the families in their area of work.
Apart from family planning services, the local health centre is seeing increased attendance in antenatal care and deliveries in the health facility under the supervision of trained personnel, resulting in improved maternal health. There are also now increased sanitation measures and better access to other health services, thanks to the efforts of the community health volunteers.
“This program has helped improve our data collection, and we have had more referrals in family planning services. Also, men are beginning to approve of family planning. Our aim is for couples to be able to plan and space their desired number of children, allowing for financial planning and improved maternal and child health,” added Rachel Nyambu, a clinical officer.
This partnership with CHASE Africa and Wildlife Works has come at a critical time. The community health workers have been lacking adequate funding and support, with some even having to dig into their own pockets to facilitate their work. Additionally, many women have to deal with stigma and misconceptions in their communities, in tandem with being financially constrained themselves.
The research is clear; improving rural healthcare has the power to reduce illegal logging and conserve forests (Jones et al., 2020). When the needs of local communities are addressed, there is less reliance on extractive and unsustainable livelihoods that contribute to ecosystem destruction. The health of people, animals, and our shared environment are all interconnected, and an investment in the health of a community is just as much an investment into the forest and wildlife. We value and depend on the strong partnerships we have with value and culture-aligned organizations like CHASE Africa to co-develop community-based health programs at all of Wildlife Works’ conservation projects areas.