After giving birth to her fourth baby, 37-year-old Milian Aluoch decided not to have another child.
The Early Childhood Development teacher opted to go for tubal ligation, a permanent method of birth control in which the Fallopian tubes are removed or permanently blocked.
Aluoch started using family planning methods when her first child was four months old. She stopped after two years to get a second child. She did not experience her menstrual periods for two years and had to be put on pills to restart her flows.
A year later, she got pregnant.
“Having stayed for long without getting a second child, I did not plan to go for another contraceptive. I resorted to using the natural method until I got a third child,” says Aluoch, who lives on the outskirts of Homa Bay town.
She decided to go for contraception again after the third child, but there was always a shortage of contraceptives in the public hospital. She had to buy them from a private facility.
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“I always feared I could get pregnant again because at times private facilities are accused of stocking expired medication,” she says.
When using the injection method, Aluoch says, she gained weight because of the hormones and she was advised to change to the implant, which were in short supply.
After another three years, she chose to have another baby — and decided that would be her last child. So, she opted for tubal ligation.
Like Aluoch, many women seeking family planning services in public facilities face the problem of supply and access.
To overcome this challenge, an online tool has been created to monitor supply, provision and access to family planning services. Working with five county governments, the United Nations Population Fund (UNFPA) has introduced QualiPharm, an online data management and reporting system.
The app, which was introduced in Kenya late last year, is being piloted in Migori, Homa Bay, Isiolo, Nairobi and Kilifi counties, with plans to roll it out nationwide.
A total of 600 tablets have been distributed to the pilot counties.
Integrated system data from QualiPharm is synchronised with the Kenya Health Information System at the Ministry of Health and will also be linked to the Logistics Management Information System, which is currently under development at the Kenya Medical Supplies Authority.
Kennedy Oyar, a pharmaceutical technologist at the Migori County Referral Hospital, says the app is used for reporting at the end of every month.
The app has ensured timeliness and proper data management. The app auto-calculates once the data is entered.
Oyar says the app makes it easy to know the total number of commodities in a facility because of the automatic calculations. This was not the case when using manual records which are easy to manipulate.
Once data is entered, it cannot be changed.
Pascalia Ghati, a pharmaceutical technologist at Kuria West sub-County Hospital, is a commodity manager at the sub county and approves data sent from facilities. “Initially, when we were using manual methods of reporting, records would be carried physically from the facilities to the sub-county for checking and approval. It was a cumbersome and expensive process,” she says.
For Ghati, the process is now simpler because once data is keyed in at the facilities, she gets a notification and her work is to validate, approve or reject.
“Before introduction of this technology here, I had to go through the record books manually and key the figures into the Kenya Health Information System. Now, I only need to check, approve or reject, which saves time,” she says.
Winnie Akinyi, the clinical officer at Nyalkinyi Health Centre in Homa Bay, has used the platform for a year, and says "it helps project what we have used and what we may need, ensuring we do not suffer stock-out.”
Charity Koronya, who is in charge of family planning and commodity security at UNFPA, says the platform has reduced bureaucracy and time-wasting.
“We partner with counties that have committed to offer data bundles for use as well as ensure sustainability as this will offer quality data for future decision-making,” she says.