Repeated use of emergency contraceptive pills rendered safe; can they also serve effectively as a regular contraceptive method?

The E pill

The E pill

The emergency contraceptive pill has aroused debates as to whether it can serve as a regular contraceptive method, client’s safety when used more than once in a single menstrual cycle and its side effects.

Much as it can be bought over the counter, its access in some places is limited to avoid cases of overdose as well as ectopic pregnancy risks among other perceived side effects.
This is quite a contentious subject given the high rate at which women go for the emergency pills all the time as they live with fear as to what risks to expect.

A recent research conducted by International Consortium for Emergency Contraception (ICEC) cites that using emergency contraceptive pills more than once is extremely safe.According to the research, the ECPs poses no risk of harmful overdose neither does it affect future fertility.

Quite often we are warned against using the ECPs more than twice a year to avoid risks of ectopic pregnancy. According to the ICEC fact sheet, ECPs can be used even more than once within the same menstrual cycle without an increased risk of ectopic pregnancy.

“There are no restrictions on repeated use of ECPs,” states WHO’s 2015 eligibility criteria while the American Congress of Obstetricians and Gynecologists (ACOG) states that “ Emergency contraception may be used more than once even within the same menstrual cycle.”

ECPs function by delaying the ovulation of a woman. If this same individual engages in unprotected sex again after taking ECPs, she is still at risk of pregnancy within the same cycle. She is also still safe to use ECPs again.

While this research could be a relief to many women who find themselves taking ECPs every weekend to avoid pregnancy, it will also be important to ask if it can be used a regular contraceptive method effectively.

The research clearly indicates that ECPs are less effective as a contraceptive method compared to the ongoing methods such as IUCD, implant or even depo. In fact, it says it is only more effective than the condom in preventing pregnancy but does not prevent HIV or any othe sexually transmitted disease.

Much as repeated use of ECPs has been rendered safe, the article acknowledges the efficacy of ongoing contraceptives for a regular method in preventing unplanned pregnancy. In cases where a regular method has failed, forced sex cases and even unprotected sex, one is free to use ECPs regardless of the number of times previously consumed.

‘While women should know that ECPs are less effective than ongoing contraceptive methods and do not protect against STIs, each woman can use ECPs every time she has unprotected sex and wants to avoid unwanted pregnancy,’ cites the report.

To download the full report click here.

Harnessing God’swill through healthcare financing


In 2001 Sammy Said and Janet Ogutu were retrenched by a leading international reproductive health NGO, the two nurses decided to invest in their own clinic. They settled on the expansive Nyalenda informal settlement as the site for the new health facility given its large population.

Sammy and Janet named the facility “God’swill Medical Centre” perhaps in acknowledgement of the need for divine intervention in their new venture. After renting two rooms for the clinic, the duo employed two other support staff.  The venture began very slowly. Since the facility had no laboratory, patients were referred elsewhere for lab tests.

“At the beginning we only saw five to ten clients a day but today we see up to thirty patients daily, said Sammy, The clinic opens at 8 am and closes at 5pm only on weekdays.”

The game changer came in 2010 when KMET introduced God’swill to a new quality healthcare financing program called the Medical Credit Fund (MCF).  KMET had just entered partnerships with PharmAccess Group from Netherlands whose Medical Credit Fund provides loans to doctors and clinics in the private sector, enabling them to improve the quality of their services, develop their business potential and serve more low-income patients.

The MCF program aims to contribute to a healthier investment climate and increase the bankability hence scalability of the private healthcare sector.  According to Janet, KMET offered God’swill technical assistance in developing business and quality improvement plans.

“The business plan enabled us to access an initial loan of 500,000 shillings in 2011 which we used to purchase drugs, a centrifuge machine, give the clinic a facelift and set up a laboratory.

A centrifuge machine purchased by the first loan obtained from MCF


The quality improvement plan that KMET supported Godswill to develop, has enabled the facility to improve its documentation, client safety, infection prevention and upholding patients’ rights.

“The MCF program integrates SafeCare, a step-by-step improvement path to a recognition system that promotes quality improvement and bench marking of health facilities,” explains Janet.

In 2012, God’swill received a second loan of 1,000,000 shillings, which enabled them to improve on safety, introduce immunization, offer – cervical cancer screening, youth-friendly services and carry out renovation of the clinic. With an increased client flow, said Sammy, “we are able to employ five new staff including a laboratory technician”.

At the beginning, the clinic made a monthly net income of 200,000 shillings but currently it makes up to 600,000 shillings.  Opening hours have been extended to 9 pm in the evening and all day during weekends.

In 2013,the Centre recorded an 11% healthcare service from 14,400 in 2011 to 16,200. With improved quality of services and good reputation, the clientele flow increased prompting Janet and Sammy to apply for a third loan of 1,000,000 shillings for expansion.  With this loan, Godswill acquired additional space for maternity services, an observation room and a youth-friendly clinic.   Patients seeking healthcare services have increased from 14,400 in 2011 to 16,200.

With improved quality of services and good reputation, the clientele flow increased prompting Janet and Sammy to apply for a third loan of 1,000,000 shillings for expansion.  With this loan, Godswill acquired additional space for maternity services, an observation room and a youth-friendly clinic.

In addition, the facility currently offers a range of out-patient services including reproductive health services, HIV/AIDS counseling and testing, laboratory services, male circumcision, antenatal services and cancer screening.  “The most common diseases we treat include malaria, typhoid, respiratory infections, STIs, diarrhea, minor surgical cases and minor injuries caused by motorcycle accidents”, said Sammy.


Meggy  Agola, a certified KMET SafeCare assessor rates God’swill as one of the most improved medium-health facilities in the network of 162 beneficiary facilities in Kenya. “SafeCare has five quality improvement levels and God’swill has gradually improved and we have certified the clinic as a Level 2 facility.

I see this facility reaching the fifth level in a short time” said Meggy. The ultimate goal of SafeCare is full standards compliance or accreditation.  To guide facilities along this path, SafeCare uses 13 service elements representing different levels of healthcare delivery ranging from how management is organized to how the cleaning staff operates.

“God’swill has received a third loan of 1,000,000 shillings which we have invested in renovating and equipping additional rooms for maternity’ said Janet.  The loan also facilitated procurement of a delivery couch, additional stock of essential drugs, purchasing of beds and resuscitation equipment.

Sammy and Janet have set a target to improve the clinic’s process and systems through computerization and eventually offering in-patient services.


Author: Sam Owoko

Eliminating missed of opportunities in integrated services

Linet Ngacho dresses up her baby in a church where a Huduma Poa health provider attended to her and her children.

Linet Ngacho dresses up her baby in a church where a Huduma Poa health provider attended to her and her children.

It is expected that all children below 9 years of age should undergo a series of immunizations against common but preventable diseases like Polio, Tuberculosis, Tetanus, Measles and whooping cough. These maladies can cause death or life-long disability among children, but it does not seem so for Linet Ngacho who has never immunized all the four of her children since birth.

The twenty six year old mother is a subsistence farmer in Misri Village, Chwele Sub County in Bungoma County, which has the largest number of deprived children according to a 2013 UNICEF report.

“None of my children were delivered in hospital and I have never attended any child clinic,” she confessed. Oddly, Linet lives less than two kilometers from Chwele Sub County Hospital, a government facility.

Her first-born is six years old, followed by a four-year-old second born, a three year old third born and a last born of two years.

Change came for Linet at a Huduma Poa outreach site, six kilometers from her home. She got word from a community health volunteer that health practitioners from Bewa Medical Clinic would be offering reproductive and child health services so she brought her children who had developed persistent ringworm with the last-born running a fever.

Beatrice Wafula, a nurse trained on the IMCI protocol who attended to Linet’s children reported that her case was one of ignorance and lack of awareness after immunizing the children who were still eligible.

“It is of great concern that there are mothers who still do not know the benefit of hospital delivery and child health clinics, this is why it is important to have a strong community strategy,” she said.

In addition, Linet adopted an IUCD after receiving family planning counseling saying: “I rarely have time to do other activities, I’ve always been taking care of my babies and I hope this coil will give me some break.”

Studies disclose that many sick children never receive proper assessment and treatment by healthcare providers, and that their parents are poorly advised. For this reason, Huduma Poa Health Network trains member clinics on the integrated management of childhood illness protocol to Improve case management skills of health-care staff and involve the community health volunteers to reach out to people like Linet in a bid to improve family and community health practices.


Joy Wambare

KMET presents the FP strategic plan to Homa Bay governor ahead of dissemination

Monica handing the strategic plan to Homabay Governor

Monica handing the strategic plan to Homabay Governor

Homabay governor Cyprian Awiti endorsed a five year family planning strategic plan, the only one of its kind in Nyanza region, supported by KMET in partnership with Homabay county health management team.

While receiving the document from KMET CEO Monica Oguttu, Cyprian expressed his concern about the low contraceptive prevalence rate in Homa Bay which stands at 45.5% against the 58% national rate.

The governor did not hesitate to note the high teenage pregnancies in his county and its related repercussions such as increased maternal mortality and school drop outs.

“This county is also notorious for high teenage pregnancies. I would call upon all partners to work together to curb this menace,” stated the governor.

In response to the concerns raised by the governor, KMET CEO explained that the strategic plan has factored in the needs of young people through youth friendly services.

She also emphasized that with proper budget allocation for family planning by the county government, the issue of commodity stock out would be addressed and a contraceptive prevalence rate of 70% achieved.

“We want women to have choices. They don’t have to go for injectables (depo) all the time when they can access long acting and reversible contraceptives easily. This is only possible if we don’t let this book gather dust in our shelves but implement its contents,” said Monica.

The governor also gave the KMET and Homa Bay County Health management team a go head to disseminate the strategic plan its eight sub counties for all stakeholders to understand its contents.IMG_9571

In his concluding remarks Cyprian applauded KMET’s intervention in Homa Bay and promised his government’s and other partners commitment in implementation of the strategic plan in a bid to reduce the negative maternal indicators in Homa Bay County.

The endorsement of the strategic plan was done at the county health offices in the presence of the Health Minister Lawrence Koteng’, Deputy Directors of health Kevin Osuri and Mr. Waringa and the county health management team.

Wide spread ignorance in most men: breast cancer


Many people assume that only women are diagnosed with breast cancer and top on the myth is men having breast cancer, as they assume they don’t have breasts .Statistics show that a larger percentage of men die of breast cancer compared to women as they are ignorant of the disease hence detected at a very late stage.

Men have a concentration of nonfunctional breast tissue directly behind the nipples on the chest wall just like breast cancer in women. This is then characterized by unregulated, out of control cell growth resulting in over 100 different types of cancers each classified by the type of cell that it initially affected.

The overgrown cells sometimes known as tumors can grow and interfere with the digestive, nervous and circulatory systems and can also release hormones that interfere with normal bodily functions. These dangerous tumors are known as Malignant tumors, however not all of the tumors are dangerous. Benign tumors stay in one spot demonstrating limited growth and very little or no interference with bodily functions.

Symptoms of breast cancer are pus from nipple that may have blood stains, swelling on breast, sore in skin around breast, nipple enlarged to breast and a lump under the arm are among the signs men should check for.

Cancer can be treated through surgery, radiotherapy, chemotherapy, hormone therapy and biological therapy. Men are therefore called to check themselves and seek treatment in case of any suspicion at the early stages of breast cancer.


by beryl onyango

A dream come true for all the infected and affected with Aids :stop Aids by 2030,but how?

Muhoroni mixed students during a girl to girl talk

Speaking at United Nations Headquarters in New York, the leaders of Kenya and Malawi co-hosted with the Joint UN Program on HIV/AIDS (UNAIDS) a high-level panel discussion on scaling up efforts to end the epidemic by 2030.While 2030 is only 15 years away this may seem like a dream, unless these efforts are trickled down to the community level together with support from the concerned authorities at the national level down to the county .
The World Health Organization said on Wednesday that all people with the HIV virus should be given anti-retro-viral drugs as soon as possible after diagnosis, meaning 37 million people worldwide should be on treatment.”According to UNAIDS estimates, expanding ART to all people living with HIV and expanding prevention choices can help avert 21 million AIDS-related deaths and 28 million new infections by 2030.”

Malawi led the world in revising the protocol for access to antiretrovirals for mothers. As many mothers living with HIV were lost to care due to delays in testing CD4 counts, it was decided that all mothers testing positive would be put on antiretrovirals without the CD4 count. Many other countries in the region and beyond are adopting this Option B+.

Reaching zero new infections in infants demands more attention to other aspects of the PMTCT programme. One of these is better access to contraception for women living with HIV so that they can plan their families better. Another is primary prevention in girls and women.Increasing prevention, testing, treatment and adherence are necessary conditions for ending AIDS.

IMG_0244 (4)

Addressing stigma and discrimination, especially about gay men and lesbian women, sex workers and injecting drug users, is essential. These conditions can only be achieved through sustained community mobilization and engagement.

“Sexual education should be encouraged for teens to avoid early pregnancies,unsafe abortion, awareness on sexual reproductive health rights and men also to take a fore front in this fight” urged Michele Sidibe ,Executive director of UNAIDS as he was launching a H IV Situation Room, programme aimed at ending adolescent AIDS in the country.

“But they cannot do it alone and they need all of us. Because an AIDS-free generation is not something we can [simply] create,” “It’s time to act boldly on what we already know. It’s time to end AIDS”,he added.

by beryl onyango.

KMET joins other partners in sponsoring the Kisumu Fashion Week

A model show casing various FP commodities

A model show casing various FP commodities

The Kisumu fashion week finally went down with local designers and models showcasing their talent and work at Tuff Foam mall.

The successful event attended by Kisumu First Lady Olivia Ranguma among other county stakeholders was supported by a number of organizations with KMET as the only Reproductive Health partner.

Prior to the event, KMET conducted informative reproductive health discussions with the models to sensitize them on their rights to access reproductive health information and services.

The models were also sensitized on the efficiency and convenience of Long Acting and Reversible contraceptives (LARC) in preventing unwanted pregnancies among young people hence, take part in reduction of maternal mortality as a result of unsafe abortion.

KMET did not only provide the RH education to the models but also felt obligated to sponsor the event given its varied engagements with young people on RH issues within the county.

The event was well attended by young people, partners as well as county officials.