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E2A newsletter July-August 2017

Technical Convening Unites Development Sectors to Discuss “Scaling Up”

On August 15, two communities of practice jointly hosted a technical convening, “Scaling Up Health and Development Outcomes,” which united different development sectors to discuss scaling up.

Those communities were the E2A/International Best Practices Consortium-led Community of Practice on Systematic Scale-Up of Family Planning and Reproductive Health Best Practices and the Management Systems International (MSI)/Results for Development-led Community of Practice on Scaling Up International Development Interventions.

During the convening, attendees analyzed the implications of scaling-up efforts from multiple sectors, using case studies. Presentations were followed by a series of plenary and small group discussions, allowing participants to delve into critical scale-up questions to deepen understanding and consider collectively how to advance the field. Presenters and attendees came from a wide array of institutions, including: Pathfinder International, CARE, ExpandNet, the Fogarty International Center, Grand Challenges Canada, Jhpiego, Gates Institute of the Johns Hopkins University SPH, the Bill & Melinda Gates and MacArthur Foundations, Save the Children, USAID, the World Bank, and World Vision.

Laura Ghiron, Vice President of Partners in Expanding Health Quality and Access and a member of the ExpandNet Secretariat, defined scaling-up as “deliberate efforts to increase the impact of innovations successfully tested in pilot or experimental projects to benefit more people and to foster policy and program development on a lasting basis.”

Using this definition as a launching point, presenters examined a variety of health and development country case studies where scaling-up efforts had been implemented, in countries including Bangladesh, Kenya, India, Russia, Senegal, and Zambia.

One key question raised by presenter Larry Cooley, President Emeritus/Senior Advisor at Management Systems International and co-convener of the meeting, was: “what are characteristics of innovations, value chains, and enabling environment that facilitate scaling up?”

The group discussed the characteristics that facilitate scaling up in the private sector, what obstacles exist, and what public and NGO-sector programs can learn from the experience. The challenges ranged from national and regional policies, community characteristics, leadership and ownership factors, to incentive structures.

Taking these considerations into account, attendees considered the best methods to facilitate application of a systematic approach to scale-up to ensure lasting impact. Subsequent discussions reinforced the need to better plan and document the scale-up process for greater transparency and learning.

Presentations illustrated the application of frameworks for systematic scale-up, such as ExpandNet’s methodology, the University Research Company’s Wave Sequence Spread Approach, and MSI’s approach, all of which can be used to design and scale interventions and document their scalability. As mentioned by Kojo Lokko, Deputy Director of the Challenge Initiative for the Gates Institute at Johns Hopkins University School of Public Health, frameworks should be considered flexible roadmaps that can provide guidance.

Powerpoint presentations from this meeting are available here. Videos of the presentations are likely to be aired at a future date via the E2A-led Community of Practice webinar series. To be informed of when these and other opportunities of interest to the scale up community arise, please consider registering to join the Community of Practice.

Government of DRC announces creation of first national platform for engaging Congolese youth in AYSRH decision-making

Regina Benevides and Elham Hassen with participants at the DRC national youth workshop

Among immediate results emanating from the youth workshop, held August 23-24 in Kinshasa, was creation of the first national platform for officially engaging youth in decision-making processes about adolescent and youth sexual and reproductive health (AYSRH).

The workshop, which focused on planning and budgeting for AYSRH interventions in Democratic Republic of the Congo (DRC), was held by E2A Project and Pathfinder International, in collaboration with the DRC’s Ministry of Health, and with support from USAID and the Bill & Melinda Gates Foundation.

The participation of senior Ministry of Health officials, nongovernmental organizations, and donors paved the way for creation of concrete platforms for involving youth in AYSRH planning and policymaking.

A representative of DRC’s “National Family Planning Multisectoral Committee” announced the creation of a “youth subgroup” to the Committee, which will officially engage youth in AYSRH-related decision-making. The National Family Planning Multisectoral Committee is charged with national and provincial sexual and reproductive health and family planning policies and programming.

“It is absolutely necessary that youth be involved…in the planning, implementation, and evaluation of these [family planning and sexual and reproductive health] programs,” said Muanda Mbadu, Director of DRC’s National Program for Adolescent Health.

During the workshop, participants—youth, senior government officials, NGOs, and donors—learned about evidence-based practices in AYSRH that can be applied to overcome existing barriers to young people’s attainment of sexual and reproductive health. One of those evidence-based practices is youth leadership and involvement in AYSRH planning and decision-making, which the creation of the youth subgroup to the National Multisectoral Committee seeks to address.

“It is a reality that the majority of adolescent girls, 15-19 years old, have an unintended pregnancy in DRC. And very often, when they don’t want the babies, they have abortions…or they stop pursuing their education and other life plans.” said Marie Musifu, a youth leader from Kinshasa. “Based in evidence like this, it is necessary that other young people understand that this situation is very serious.”

“I am very happy to be here with the leaders of these [AYSRH] initiatives and other youth leaders to know there are others in the same battle as me,” she continued. “We are discussing what can we do together to create a youth network that can help to improve AYSRH and how we can coordinate to share these ideas [we have learned here] and change the mentality and social norms.”

The youth and government officials at the workshop came from Kinshasa, as well as the three provinces where E2A operates a community-based family planning program: Lomami, Lualaba, and Kasai Central. On the second day of the workshop, participants split into groups: one group from each of the three provinces, two groups from Kinshasa, and two national groups. The groups then analyzed their respective Plans d’Actions Operationelles (PAOS)—budgeted plans for adolescent health, including family planning and sexual and reproductive health. During their analysis, they determined how the PAOs can be improved to better meet youth needs and formulated concrete recommendations. These recommendations, including creation of the youth subgroup to the Multisectoral Committee, are intended to be applied when the PAOs are redrafted in October-November 2017 for the upcoming year.

In October, E2A will release reports from the technical workshop and a pre-meeting youth workshop, held on August 21 and described here.

E2A contributes to Ethiopia’s National Obstetric Fistula Elimination Strategy

Hawa Kadir

Hawa, 17, and a fistula survivor in Ethiopia, was identified, referred, and transported to her life-saving obstetric fistula repair surgery through E2A support to Pathfinder’s Integrated Family Health Program (IFHP).

“Pathfinder helped me greatly. Not only did they cover the transport costs for me and my sister, who accompanied me [to the hospital]. They also gave me important sanitary items, like diapers, as well as soap and new clean clothing, so I could make the journey with dignity,” said Hawa.

Learn more by reading Hawa’s story here.

From 2014-2017, Pathfinder’s IFHP, through E2A, assisted the Government of Ethiopia in reaching its ambitious goal of eliminating obstetric fistula by 2020. E2A support contributed to three activities that have intensified efforts to identify, repair, and rehabilitate women with obstetric fistula:

  1. Establishment of the National Fistula Elimination Task Force and Strategy for Elimination of Obstetric Fistula in Ethiopia by 2020.
  2. Building the organizational capacity of Hamlin Fistula Ethiopia through E2A’s core partner Management Sciences for Health.
  3. Rehabilitation and reintegration of women who have undergone obstetric fistula repair surgery through a sub-grant to a local organization Healing Hands of Joy.

Since IFHP ended earlier this year, the Government of Ethiopia and Healing Hands of Joy are sustaining this work.