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Success Story
USAID program helps Susan Kajuju make an impact as a family planning nurse
Promoting Family Planning in Rural Kenya
Photo: The Capacity Project\Linda Fogarty
Nurse Susan Kajuju, Ijara District Hospital
“You really have to sacrifice
a lot of time. You have to go
down into the community,
then become very known,”
said Susan Kajuju, a nurse
tasked with educating
patients about family
planning
In Kenya’s remote North Eastern Province, a woman nervously
approached the Ijara District Hospital. She wanted to learn about
family planning but feared for her privacy. In her deeply religious
community, comprised mainly of ethnic Somali Muslims, households
have an average of eight children and family planning is viewed
with suspicion. “Are you going to keep the secret?” she asked the
young nurse.
Nurse Susan Kajuju accepted a post as a family planning nurse
at Ijara through a USAID program aimed at helping solve Kenya’s
severe shortage of health workers. Already certified as a nurse,
Kajuju received additional special training through USAID; she was
among 830 health workers recruited and deployed to 219 key sites
across the country. Kajuju began by meeting with local groups,
visiting people in their homes and attending social events.
Since she heard that the men in the community needed to be
involved in family planning decisions and men would be more likely
to accompany their spouses to the clinic during the evening, she
started an evening shift—and even sheiks started to show up with
their wives. But Kajuju faced many challenges. In North Eastern
Province (population: 1.3 million) only 7% of women and just
0.6% of men approve of family planning, according to the Kenya
Demographic and Health Survey.
However, Kajuju knew that both women and men were interested
in her services. Local men began to confide, “My wife has had this
number of children and I want you to assist, but I don’t want people
to know.” Confi dentiality was clearly a major concern. To earn
clients’ trust, Kajuju offered services at her home and at unusual
hours. She also shared her own story with clients, “I can tell the
mother I also have this, I show them—and they take the method.”
Kajuju has vastly increased the number of women taking family
planning methods at Ijara District Hospital. “I have gone up to
100, sometimes 170 a month,” a huge jump from five or 10. “You
really have to sacrifice a lot of time. You have to go down into the
community, then become very known,” she said.
Dr. Nancy Kidula, a former USAID-funded advisor to the Division of
Reproductive Health, lauded Kajuju’s achievements. “She is doing
health talks, she is sensitizing people about the methods and she
is available.” Above all, Kidula said, Kajuju has discovered a major
key to success in Ijara: “She maintains confidentiality.”
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