28 year-old, Eunice Adhiambo and her four children attended a Huduma Poa outreach event organized by KMET and the Ministry of Health in Masaria village. She had come for a Depo Provera  injection.

Masaria village is 30km away from Migori town and boarders Tanzania. Its population of a more than 500 people is served by one Ministry of Health facility that operates twice a month as an outreach site.

Personnel from other facilities are sent to offer services, which are tailored to pregnant women and children below five years. Clients are given appointment to come on specific dates within the two monthly visits. On rainy seasons, these services are disrupted due to the impassible road network.

After a group counseling on the benefits of LARC, Eunice divulged that she has been on injection and was told by a health provider that she cannot use any other method because she has “bad veins”. On physical examination, it was noticed that she was suffering from varicose veins on both legs.

For a long time Eunice was reportedly not using any contraceptive method and could not space her deliveries as desired. She delivered in 2007, 2009, 2011 and 2013 so when she delivered the fourth child she visited a private clinic in Migori  to seek for the best family planning method.

The provider in the clinic told her that she could benefit from injection but not implant insertion or the IUCD, since then she has been on depo injection from the same private clinic.

“I was advised that the IUCD would interfere with my sexual activity and my husband may feel it’s strings. I was not ready for the coil hence opted for the injection.”

Oscar Okoth, a Huduma Poa Quality Assurance officer says Depo Provera may make varicose veins worse and should never be recommended for clients like Eunice.

Once again, Eunice was taken through all the long acting and reversible methods of contraception and settled on the IUCD. She asked if she could be allowed to consult the husband and come back the next day.

Eunice was then referred to a Huduma Poa facility where she reported the following day with the husband and they were counseled again and finally the husband accepted and the woman went for an IUCD.

Her last born Brenda Asha a-two year old was suffering from malnutrition, she presented with  distended abdomen, silky hair and weighed 8.5kg,  moreover, the child had not gone for the measles vaccinations due at 9 and 18 months, and was never taken to any child welfare clinic for weight monitoring nor nutrition advice. The child feeds on the family diet.


Eunice Adhiambo and her daughter who was treated using the IMCI protocol on site during the Huduma Poa-Ministry of Health outreach.

When the child was treated using the IMCI protocol, she tested positive for Malaria parasites too and was given coartem, antibiotics and albendazole then referred to Nyamaraga Sub district hospital for nutritional supplements and monitoring.

It was a double win for Eunice who benefited from the efforts of integration of health services.

Nyathina ni nyaka ne nyuole pok ochanje sani en 3yrs kawuono we ochanje  erokamano Huduma Poa’ ( This my child is 3yrs and has never been vaccinated , today let her get vaccinated; thanks to Huduma Poa)

Oscar Okoth