Listening to Community Voices: Effective program design with nomadic pastoralists

Wajir and Mandera counties have the highest total fertility rate (TFR) and the lowest modern contraceptive prevalence rate (mCPR) in Kenya; the modern contraceptive prevalence rates are 2.3 in Wajir and 1.9 in Mandera.1 This low use of family planning is attributable to a weak health system, policy, resource environment, and strong socio-cultural and religious norms opposed to the use of FP.2 Save the Children, with funding from the Bill & Melinda Gates Foundation, partnered with the London School of Hygiene and Tropical Medicine and the Centre for Behaviour Change Communication on the four-year (December 2017-April 2022) Nomadic Health Project (NHP) to increase use of quality family planning (FP) services among nomadic and semi-nomadic pastoralist populations in Kenya. Nomadic and semi-nomadic pastoralists have been largely missed by government and NGO-led implementation. As such, key to any success was to ensure the population’s comfort and trust in the activity. This brief describes how a phased approach including formative research, a facility assessment, and consultation with leaders and community members was used to inform the design and implementation of the Nomadic Health Project model.