E2A Newsletter February-March 2018

Congolese youth press forward with building a national youth movement for sexual and reproductive health

At an August 2017 workshop led by E2A in Kinshasa, the Democratic Republic of the Congo’s (DRC) national program for reproductive health officially launched a platform for engaging Congolese youth leaders in adolescent and youth sexual and reproductive health (AYSRH) policymaking and program planning. The workshop adopted a methodology E2A and partners used with the nine Ouagadougou Partnership countries in May 2017 to analyze Costed Implementation Plans for Family Planning in an effort to make them more conducive to improving AYSRH.

Since the workshop in DRC, Congolese youth leaders have been exploring ways to better network with each other to build a stronger youth movement for AYSRH that spans their vast country.

Several youth leaders, for example, took initiative to develop “ALLO CUP,” a mobile app. Since developing the application with funding from the International Planned Parenthood Federation earlier this year, 3,000 young people in DRC have accessed it.

“ALLO CUP allows young people to express themselves freely and to get in touch with other young people to exchange on sexual and reproductive health,” said Marie Musifu. Marie is a 23-year-old youth health and rights advocate from Kinshasa who has been instrumental to progressing the youth movement around improved AYSRH in DRC. Marie has shared her experiences in this blog and short video.

Beyond the mobile app, Marie and other youth leaders are specifically seeking support to:

  • Connect with the Ouagadougou Partnership Youth Think Tank to learn from them about networking and creating a youth network.
  • Create a robust association of youth associations in DRC.
  • Launch a social media campaign to recruit Congolese youth leaders to participate in national and provincial AYSRH decision-making processes.

At the August workshop, E2A built the technical capacity of youth leaders from Kinshasa and Lualaba, Lomami, and Kasai Central provinces to understand evidence-based practices in AYSRH that could be incorporated into national and provincial family planning plans. Youth sat at the table with ministry officials, civil society organizations, and implementing partners to examine these plans and arrive at ideas to make them more conducive to youth needs.

E2A has continued to assist the DRC government with better aligning the National Adolescent Health Strategic Plan (2021-2025), and annual provincial AYSRH plans with global best and promising practices.

Youth leaders have been instrumental to this effort.

“In February, we participated in a workshop led by E2A/Pathfinder on development of provincial operational plans,” said Carlin Pinzi, a youth leader from Kinshasa. “This workshop reinforced the roles and responsibilities to be played by young people in concrete strategies for sexual and reproductive health and rights.”

First-Time Fathers: Understanding men’s perspectives on raising and planning for their new families in Cross River State, Nigeria

On February 28, at USAID/Washington, E2A staff presented research findings from E2A’s formative assessment in Cross River State (CRS), Nigeria, on the family planning and maternal child health needs of first-time parents (FTPs)—young women, under 25 years, who are pregnant with or have their first child, and their male partners.

E2A conducted the formative assessment to inform interventions in CRS that are seeking to ensure FTPs can access critical information and services at the start of their reproductive lives. The interventions will be conducted as part of the Saving Mothers Giving Life Initiative (SMGL), a private-public partnership seeking to reduce maternal and newborn deaths in CRS.

Anjala Kanesathasan, E2A’s Senior Gender Advisor, presented E2A’s “SRH Lifestages Framework,” which lays out the different stages of sexual and reproductive activity over an individual’s lifetime and was used as a guide for developing the research protocol. She focused specifically on the FTP lifestage, using the framework to highlight the wide range of health needs and complex socio-economic factors that influence FTPs as they transition into parenthood.

“While becoming a parent for the first time is a universal phenomenon, the experience of an FTP is shaped by local factors which range from the family planning and maternal and child health services that are available to the social norms that define what it means to be a mother or father,” said Kanesathasan.

The research was conducted through 24 focus group discussions and 41 in-depth interviews with young first-time mothers, male partners of first-time mothers, mothers of first-time mothers, and other important influencers in the life of the first-time mother. The research study sought to explore:

  • First-time mothers’ experiences with family planning/reproductive health and postpartum care services;
  • Providers’ experiences in offering services to first-time mothers and their partners;
  • Knowledge, attitudes, and behaviors of first-time mothers, their male partners, and other household and community influencers and decision makers related to health and health-related outcomes; and
  • FTPs’ acceptability and interest in participating in FTP programming.

Gwendolyn Morgan, E2A’s Deputy Director, presented select findings from the research.

For example, she noted that married first-time mothers often experience uncertainties and worries about their marriages, linked to their husbands’ commitment, and social and financial difficulties.

She said that in terms of fertility intentions, most first-time mothers and their male partners wish to wait three to five years before having their next child. However, among young mothers who had never used contraception, those who were married generally perceived contraception as safe and beneficial, while those who were unmarried were less likely to hold that positive view. Most male partners said they did not believe contraception was safe, but would approve of their wives using a method if they wished to do so.

“It is really ideal to use contextual, user-centered perspectives and information to design a health communication program like a first-time parents’ program,” said Morgan. “Findings from formative research can help design messages and content which are more relevant for participants, and ultimately, more effective in improving program outcomes.”

This research is part of E2A’s portfolio of work that addresses the sexual and reproductive health needs of FTPs.

The presentation was the first in a series of presentations that E2A will give to USAID/Washington staff this year on key areas of E2A’s work. The next series of presentations to USAID/Washington staff will focus on use of systematic approaches to scale-up.

Importance of collaboration, and stronger data collection and reporting emphasized during March workshop on expanding method choice for youth

The Expanded Method Choice for Youth Working Group, the World Health Organization, and the Full Access, Full Choice Project co-hosted a technical workshop, from March 6-8, 2018, at the Pathfinder/E2A office. The workshop sought to arrive at a global learning agenda that will improve access to and use of an expanded range of contraceptives among adolescents and youth.

Over 45 participants attended the workshop, including researchers, program experts, international organizations, donors and foundations.  During the workshop, a variety of subject matter experts led plenary sessions. In breakout sessions, participants discussed topics including: measurement and data needs, data collection, how to create change at policy and program levels, and how to best examine adolescent and youth programs.

Each day of the workshop focused on one specific theme:

  • Day 1: Measurement needs
  • Day 2: Learning needs
  • Day 3: Prioritization of measurement and learning needs

On March 6, the first day of the workshop, attendees discussed measurement and data needs of countries and potential actions that stakeholders can take to strengthen data collection through improved indicators and data collection methods,  analysis, and reporting. Plenary sessions focused on identifying countries’ measurement and data needs, as well as how to improve indicators and data collection methods. Additionally, they detailed potential ways to improve the analysis, reporting, and the use of data to examine adolescent and youth programs and outcomes.

Dr. Venkatraman Chandra-Mouli and Dr. Doris Chou of WHO led a session on framing indicators and data collection needs. In his presentation, Dr. Chandra-Mouli emphasized the importance of collaboration among researchers.

“Everything we do here needs to be cognizant of what's going on elsewhere,” he said.

Emily Sonneveldt from Avenir Health led a session on framing data use needs by assessing how data is currently being analyzed, reported, and used. She discussed the reliability of data and how data can be used to help countries understand why it’s important to have youth programs that target various age groups and their specific needs.

On March 7, the focus was on developing an updated global learning agenda to improve access to and use of an expanded range of contraceptive methods for adolescents and youth. Participants discussed how expanded method choice can contribute to the Sustainable Development Goals. They identified current programs and research that are working to expand method choice internationally.

Gwyn Hainsworth of the Bill & Gates Foundation led a session on the importance of expanded method choice to global and country-level family planning goals and the role that evidence plays in shifting policy and programs.

Patricia MacDonald of USAID led a conversation about the importance of holistic programming for young people and their families and communities, taking a client-centered approach to understanding research findings.

Ilene Speizer of the Full Access Full Choice Project emphasized the importance of creating a range of research questions, training providers, and systematically reviewing evidence to ensure sustainability and scalability.

Fariyal Fikree of E2A presented major learning themes related to expanding method choice for adolescents and youth. She discussed the role that research, programs, and policy play in ensuring all sexually active young people can choose and effectively use a method of contraception.

On March 8, the last day of the conference, Cate Lane of Pathfinder International pointed out the difficulty of creating change at a policy and programmatic level.

“There is not a magic bullet that works for all countries,” she said. A solution that works for one country may not work for another, and therefore assessment and data collection are essential.

The objective of the last day of the workshop was to prioritize evidence and measurement needs, along with key players to implement identified priorities that will improve information about, access to, and voluntary use of an expanded range of contraceptive methods among adolescents and youth. In their final breakout sessions, participants prioritized evidence and measurement needs in the short, medium, and long term. Some examples include:

  • In the short term:
    • Identify what resonates with adolescents and youth to better avoid sexually transmitted infections and pregnancy.
    • Establish a common definition for how we define and measure expanded method choice.
  • In the medium term:
    • Work to establish a link between expanded method choice and outcomes among adolescents and youth, such as uptake, discontinuation, and switching.
    • Identify influencing factors and barriers related to postpartum family planning uptake and method selection among adolescents and youth.
  • In the long term:
    • Identify characteristics of quality counseling with adolescents and youth, what the client learns from counseling, and how counseling can drive behavior change in adolescents.
    • Determine what features of service delivery channels are attractive and important to young people when they are seeking contraceptive advice and services.

After breakout sessions, participants reconvened to share their observations in a plenary session led by Shawn Malarcher of USAID.