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"Know the Truth"

Revitalizing IUD Use in Kenya

When Priscilla Kenagwa, a nurse, first became an IUD provider, she quickly learned that the contraceptive needed to be demystified among her fellow villagers. A 40-year-old mother of four, Priscilla has been using the IUD for the past 13 years. She says that her experience with the contraceptive has been completely positive, but among people in Kenya, “there are so many rumors and misconceptions about the IUD. People don’t know the truth. They don’t know about the IUD’s advantages.”

Fahamu ukweili wa mambo (“Know the Truth”) was the slogan of the campaign launched by the ACQUIRE Project (of which EngenderHealth was managing partner), in partnership with the Kenyan Ministry of Health’s Division of Reproductive Health. Aiming to reintroduce the IUD as a safe and effective family planning method, the campaign also supports the health system by increasing the IUD’s availability. At participating hospitals, health centers, and dispensaries, providers such as Priscilla have received training in contraceptive technology, IUD insertion and removal, and client counseling. Facilities’ supplies and equipment have also been upgraded.

The IUD is one of the most effective, safe, and convenient methods of family planning. Worldwide, it is the second most commonly used family planning method. In 1984, nearly one in three Kenyan women using contraception relied on the IUD, but by 2004, this had dropped to fewer than one in 10.

This dramatic decrease can be contributed to widespread misinformation about the IUD. The main rumors are that it must be surgically removed, and that if a woman becomes pregnant while using the IUD, the device will come out during childbirth stuck on the baby’s body. Other myths claim that the IUD is often ineffective, causes harmful medical complications such as cancer, or interferes with sexual intercourse.

Priscilla herself has inserted more than 80 IUDs since May 2006. “I want to make clients comfortable and help them to make the best choice for them,” she says. “The IUD has so many advantages. It is so convenient and it works so well.” Since first becoming involved in the project in 2005, Priscilla has attended an IUD skills training, a training-of-trainers for community-based distribution agents, and a training on family planning counseling.

The Fahamu ukweli wa mambo communications campaign is designed to address the myths and misperceptions that are commonly associated with the IUD, capturing the general public’s attention and in turn educating both potential users and others who play a role in family planning decisions, such as health care providers, spouses, and peers. The message about the IUD’s unique benefits is being spread through radio ads, posters, brochures, and community-level activities such as barazas (meetings led by local chiefs). ACQUIRE is also sponsoring a weekly radio call-in program that provides a forum for women and men to discuss myths and misperceptions about the IUD.

In addition, the campaign includes satisfied users and “peer educators”—women, couples, and providers—standing up for the truth and tackling myths and rumors about the IUD head-on. They serve as information sources in their communities and as a link between women and the newly strengthened family planning services. Priscilla is both a satisfied user and an enthusiastic counselor and provider: “I am super grateful for this program, for the training it has given me,” she says.

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