Increasing Domestic Workers Access to SRHR through Door-to- Door Integrated Services. Presented at: Amref Health Africa International Conference From Evidence to Action: Lasting Health Change for Africa 25th November 2014 Job Odoyance Akuno Manager, Preventive and Promotive Health NOPE-Kenya 27 November 2014

National Organization of Peer Educators (NOPE KENYA )  Founded: in 2000, registered 2000, becomes international  Vision: A world with healthy communities and sustained social development.  Mission: ‘To build capacity of communities and organizations for delivery of quality health and social services.’  Strategic Goal: NOPE is a premier international organization with strong integrated systems and structures to build the capacity of communities towards delivery of diverse quality services.  NOPE MOTTO: “Building Capacities, Changing Lives”

Background  Estimated that half of the 2.3 million households in Nairobi use the services of a domestic worker.  Four in every five of these workers are female, commonly referred to as house girls.  Others are gardeners, cleaners, guards and drivers  Most of them live with the family that employs them.  They have limited assess to sexual and reproductive health information and services.

Description  NOPE conducted Social Mapping and size estimation of DWs  Equipping DW with life skills: to improve their Sexual and Reproductive Health (SRH) knowledge and practices.  Provision of appropriate package of Services: These included Post-Abortion Care, Post-Rape Care, Family Planning/EC, HTC services and financial literacy.  Increasing accessibility of services: Due to restrictions on movement and time, NOPE provided convenient services around the streets junctions where they prospect for work, within the gates or doors of their work places and operated at hours and days that are acceptable to domestic workers sub-populations.

Description-  The project used the triple E approach implementing the domestic workers sexual and reproductive health project, this included;  Empowering domestic workers to advocate for their sexual and reproductive rights through advocacy training and mentorship.  Engaging health facilities and other service providers in provision of sexual and reproductive health services to domestic workers and  Enhancing access to knowledge and information for behavior change amongst domestic workers

Achievements  The intervention trained 517 peer educators reaching 15,000 DW with integrated services,  Trained Health Service Providers and law enforcers to offer DW friendly SRH services;  Trained 30 DWS as health right advocates  Effectively referred 295 survivor of Sexual violence  Strengthened representation with 912 DW joining KUDHEIHA  Supported Formation of 54 table banking groups(1620), 18 groups linked to Micro-Finance Institutions

Products  Developed a Domestic Workers Sexual & Reproductive Health Communication Strategy  Developed Domestic Workers SRH Peer Education Facilitators Manual and Participants Hand-outs.  Targeted IEC materials on SRH information and services  Developed referral directory and inventory.  Popular versions of the HAPAC and SOA

Lessons learnt  Door-to-door integrated services are effective  Most domestic workers experience sexual violence but have no recourse and resources for redress.  Advocating with Health Care Managers can improve services to DWs- “opening on Sundays”  Through collaborative efforts between MoH, Trade Unions and PBOs, the rights of domestic workers can be protected and access and utilization of services improved.

Next Steps  There is need to equip DW with information and skills as well as resources to deal with GBV.  There is need to Scale Up domestic workers comprehensive package of friendly services.  Programs for domestic workers require collaborative partnerships to increase quality and range of services to the population.

Partners and collaborators  Funded by FHI360 with PEPFAR through USAID  Co-implementer, KUDHEIHA  Nairobi County Reproductive Health Team, the health facilities)  The Government of Kenya – the Kenya Police, the office of public administration  Post Rape Care Centre’s – Maria Immaculata, LVCT, MSF-France and MSF- Belgium  Religious institutions – the Catholic Church, the Madina Mosque, the Hindu Temple  Employers of DWs and the domestic workers.

Contact:  Presenter: Job Odoyance Akuno Cell:  Executive Director: Philip Waweru Mbugua  NOPE website: 