Although the potential advantages of linked population and environment programs are increasingly acknowledged, evidence is still limited regarding the feasibility and acceptability of PHE initiatives. In some of the best known PHE models, such as those implemented in the Philippines and Madagascar, health promotion was added to environmental initiatives through the intervention of community health workers. Less is known about the ability of environmental workers to assume a direct role in health promotion. To help fill this evidence gap, the Program Research for Strengthening Services (PROGRESS) project, which was funded by the U.S. Agency for International Development to improve access to family planning services, teamed with the Green Belt Movement (GBM), a Kenyan nongovernmental organization dedicated to environmental conservation and community development. Leadership at both PROGRESS and GBM recognized that the latter organization’s community-based environmental initiative complemented the former’s efforts to expand family planning services to remote areas. Unknown was whether GBM’s frontline environmental outreach workers, known as Green Volunteers, could lead family planning promotion activities. Of particular interest was whether these volunteers, many of whom are semiliterate and have no health training, would be willing to take on added responsibility and whether they could master PHE concepts sufficiently well to convey related information to the community. Also unknown was how communities would react to Green Volunteers’ promoting potentially sensitive messages about contraception.

PROGRESS and GBM conducted a mixed-methods study to examine these issues. We used process monitoring and postintervention data collection to assess the feasibility and acceptability of Green Volunteers’ implementing a PHE intervention and to explore the potential of this approach for expanding access to family planning information and services. In addition, we examined the costs of the intervention to evaluate affordability.