Data Sheet 3_Strengthening Kenya's public health response to reproductive coercion and intimate partner violence in family planning clinics: applying the FRAME + IS approach.pdf

Background Reproductive coercion (RC) and intimate partner violence (IPV) undermine reproductive autonomy and are prevalent among women seeking family planning (FP) services. In response, Kenya's Ministry of Health (MOH) selected ARCHES (Addressing Reproductive Coercion in Health Settings), an evidence-based intervention (EBI) integrating universal education, screening, and support on RC and IPV during routine FP counseling, for national adaptation and scale-up within a hybrid implementation-effectiveness trial. Institutionalizing such interventions within public health systems requires careful adaptation to ensure contextual fit while preserving core functions. Methods We developed and applied FRAME + IS, a unified adaptation-tracking framework that integrates the FRAME and FRAME-IS tools, to systematically document modifications made to the ARCHES intervention and its implementation strategies. The adaptation process was guided by adaptive management and the ADAPT-ITT framework and included formative research, national and county-level workshops, iterative piloting, and implementation planning, led by the Kenya MOH. Results We identified 12 key adaptations: six related to intervention content and six related to implementation strategies. Most were planned (75%) and occurred prior to implementation (83%). Adaptations addressed feasibility, sustainability, and alignment with government systems. Examples include integration into national FP counseling protocols, namely the Balanced Counseling Strategy Plus, a shift from paper-based tools to a mobile app, and a formalized provider mentorship schedule. While the majority of adaptations were consistent with the original ARCHES intervention core strategies (58%), several, including removal of discreet contraceptive use counseling from official provider training materials and job-aids, were not consistent with the original model and reflected necessary trade-offs due to political sensitivities and implementation realities. The Kenya MOH was the final decision-maker on ...