E2A Newsletter, December 2014
E2A hosts series of events to advance programs for youth: focus on first-time parents
E2A recently held a series of events to advance the ability of adolescent and youth sexual and reproductive health and rights programs to reach first-time parents with services that would support them to space their future pregnancies in a way that ensures the healthiest outcomes for themselves, their children, and their families.The events complemented research on the first-time parent population published by E2A in a literature review. Through the events, experts sought to better examine the diversity of the first-time parent population and to develop an integrated package of services that can be applied to meet their sexual and reproductive health needs.
On October 27 and 28, E2A hosted a high-level consultative meeting that convened approximately 30 health and gender experts working on a range of health and human rights issues to review experience to date and shape a programmatic framework for responding to the specific needs of first-time parents. During the consultations, experts discussed the importance of addressing the needs of first-time parents, evidence related to their needs, and programmatic strategies that can be applied to address them; the diversity of first-time parents; critical components of a program for first-time parents; how to deliver information and services to the population; and opportunities for collaboration and next steps. They concluded that while any framework will have to be flexible for adaptation to working with different groups of first-time parents, it must include some essential components, such as:
- supporting integrated programs that address maternal, newborn, and child health and sexual and reproductive health;
- focusing on gender inequalities that limit women’s reproductive rights, drive intimate partner violence, and govern parenting roles and responsibilities; and
- intervening with first-time parents, their partners, families, and communities to shift norms and create an enabling environment.
Following the consultations, on October 29, E2A and the Youth Health and Rights Coalition (YHRC) co-hosted a dialogue that included a report out on conclusions of the high-level consultations and two presentations from programs in Uganda and India that have successfully included elements focused on first-time parents. The dialogue is the first in a series that E2A and YHRC will host to advance programming for first-time parents.
The next dialogue co-hosted by E2A and YHRC will be held Monday, December 15, from 2:30-5 pm at the National Press Club. That dialogue will focus on the launch of a special supplement to the Journal of Adolescent Health that takes a closer look at progress and priorities for future investments in sexual and reproductive health services for adolescents, intimate partner violence and sexual violence, comprehensive sexuality education, an enabling environment, and young people’s right to participation and leadership.
For more information, read a recent blog post by Regina Benevides, E2A’s senior youth advisor, pictured above, or contact Regina at email@example.com.
Three grants awarded to faith-based organizations in Ethiopia, Uganda, Kenya
E2A has awarded three grants to member organizations of the African Christian Health Association Platform (ACHAP) in Ethiopia, Uganda, and Kenya. The organizations—through their long histories of faith-based service in their respective countries—have the unique ability to connect faith-based values with the health benefits of using family planning services.
The three grantees—the Ethiopian Evangelical Church MekaneYesus Development and Social Services Commission (EECMY-DASSC), the Christian Health Association of Kenya (CHAK), and the Uganda Protestant Medical Bureau (UPMB)—operate networks of health facilities and community health worker cadres. They are largely working in underserved and hard-to-reach areas where the unmet need for family planning exceeds national averages and the use of contraceptives is particularly low.
The E2A grants are supporting the organizations to engage religious leaders and other community leaders to encourage support for family planning within the context of spiritual life, and working with community outreach workers to increase the demand for and use of family planning services among the populations they serve. The grants support the community-based provision of short-acting family planning methods and referrals to nearby health facilities for long-acting methods. The grantees are also supported to improve the quality of facility-based services, including providers’ skills to offer intrauterine devices (IUDs) and implants.
In Ethiopia, EECMY-DASSC is working in five woredas of East Wollega Zone in Oromia, the largest and most populous state. The grant in Ethiopia includes a focus on the community-based provision of injectable contraceptives by Ethiopia’s community health worker cadre, Health Extension Workers. Since the grant was awarded in June of this year, EECMY-DASSC has held five training sessions to sensitize religious leaders, community health workers, community leaders, and ministry of health officials to the value of family planning. EECMY-DASSC is working to improve service delivery in government health facilities, and clinical training for providers on IUD insertions and implants has just begun.
Also awarded in June, UPMB is working in post-conflict settings in the north of the country, with the urban poor in the Kampala area, and with rural populations in the east of the country. UPMB is applying the Improvement Collaborative approach to introduce best practices with the intention to scale up the best practices to additional areas. As with the other grants, E2A will support efforts to improve community- and facility-based family planning services and outreach, while UPMB will support and lead the scale-up effort. The UPMB grant focuses on nine UPMB health facilities and their surrounding catchment areas.
Awarded in September, the grant to CHAK will support the organization to work in eight CHAK facilities located in two regions: Nyanza and Upper Eastern. Nyanza is a rural region with a lower than national average contraceptive prevalence rate (37 percent), while Upper Eastern has a higher than average contraceptive prevalence rate (52 percent), yet a less robust community-based family planning program. Through the grant, CHAK is hoping to better understand this discrepancy and to apply learning from Upper Eastern in Nyanza.
ACHAP—an advocacy and networking platform for Christian Health Associations and Church Health Networks from sub-Saharan Africa, of which all three organizations are members—will be leveraged to share learning from each grant and to advocate for the increased use of the successful approaches and best practices applied. At ACHAP’s next biennial meeting in February, the three grantees will present lessons learned from their work conducted under their grants to all 23 ACHAP members.
New report assesses sustainability of health management approaches supported by Integrated Family Health Program in Ethiopia
For the past six years, the USAID-funded Integrated Family Health Program (IFHP) has been working with the Government of Ethiopia to ensure effective management, oversight, and performance of the national health program. With IFHP nearing its end, E2A, in a new report, assesses the potential and extent to which management approaches supported by IFHP can be sustained in the long-term.
At the time of this assessment, IFHP had worked in 292 woredas (districts)—in Amhara, Oromia, SNNP, Tigray, Beneshangul, and Somali regions—to assure broader service coverage and higher service quality among primary health care units, successful mobilization and behavior change at the community level, and referrals to health centers. At program end, responsibility for the management functions supported by IFHP will be transferred directly to Woreda Health Offices, which will either partially or totally take over the technical, logistic, and financial support.
Among E2A’s many findings, our researchers found that some capacity has been built in the different management approaches, with a large number of existing Woreda Health Office staff trained on the four different management approaches described in the report. Additionally, Woreda Health Offices demonstrated their commitment to sustaining the management approaches by their financial commitments, which tended to increase over time. The scale at which the management approaches could continue, however, varied; only three Woreda Health Offices reported an ability to continue the implementation all four management approaches described in the report.
Based on those findings, the report lists several recommendations to improve the sustainability of management approaches in the future, including engaging stakeholders in early discussions about the scale of programs, developing a timetable for graduation, where possible, and ensuring implementation standards for the management approaches are adequately defined and communicated to Woreda Health Offices.