From Project to Program: Tupange’s Experience with Scaling Up Family Planning Interventions in Urban Kenya

Figures & data

Table 1 Project versus program approach to effecting change.

Key Dimension	Project Approach	Program Approach
Major purpose	Proof of concept	Proof of implementation
Government participation	Relatively limited	Extensive
Role of project staff	Implementers	Facilitators Technical assistance Mentorship
Emphasis on external resources and creation of parallel systems and structures	Extensive	Limited
Emphasis on mobilizing existing resources	Limited	Extensive
Focus on institutionalization and sustainability	Limited	Extensive
Preparing for large scale implementation from the outset	Limited	Extensive
Time frame	Relatively short	Long
Collaboration with non-project partners	Limited	Extensive

Table 2 Demographic and family planning service provision and use for Tupange cities.

	Nairobi		Mombasa		Kisumu		Kakamega		Machakos
	Baseline (^†)	Endline (^‡)	Baseline (2)	Endline (3)	Baseline (2)	Endline (3)	Baseline (2)	Endline (3)	Baseline (2)	Endline (3)
Population (1)	3,138,000		939,000		410,000		92,000		150,000
Modern contraceptive prevalence rate (CPR) urban (%)	43.7	54.8	29.4	43.8	44.4	58.7	46.0	53.8	45.3	57.8
Modern CPR urban poor (two lowest quintiles %) (2)	41.2	59.8	26.4	43.5	46.0	60.4	46.8	61.7	47.6	63.9
Method mix (urban %)*
Oral contraceptive pills	11.1	9.9	6.3	4.7	5	3.3	4.2	5.7	9.2	10.5
Condoms	7.2	5.5	3.9	7.2	9.6	8.9	6.2	4.4	5.5	2.7
Injectables	17.7	22.1	13.6	17.8	20.8	18.8	25.1	21.3	19.5	23.5
Long-acting and permanent methods (LAPM – includes implants, IUCD, male and female sterilization)	6.1	15.8	4.1	13.5	7.7	26.7	9.4	21.6	10.3	20.0
Number of health facilities covered by Tupange/total number reporting provision of family planning (3)	20 (234)	79 (339)	14 (114)	45 (147)	8 (52)	14 (52)	0 (19)	6 (24)	0 (27)	7 (30)
Number of Tupange-covered health facilities providing LAPM (4)	17	78	10	44	5	14	0	6	0	6

Table 3 Number and percent change in new family planning users.

	City	6 Months prior to implementation	2014 (Jan-Jun)	% Change
Number of new family planning users
Core^*	Kisumu	4,451	6,313	42%
	Mombasa	8,152	12,085	48%
	Nairobi	19,764	30,901	56%
Scale up^**	Kakamega	2,286	2,808	23%
	Machakos	1,088	1,704	57%
Grand Total		35,741	53,811	51%
New long acting or permanent method users
Core*	Kisumu	1,556	2,837	82%
	Mombasa	1,574	6,498	313%
	Nairobi	2,925	14,677	402%
Scale up**	Kakamega	520	1,306	151%
	Machakos	270	513	90%
Grand Total		6,845	25,831	277%

* Jan-Jun 2011 represents the period before implementation in the core cities,

** Jan-Jun 2012 represents the period before implementation in scale up cities.