Wilson Center event: Government support key to expanding contraceptive options
Strong government support for family planning programs—particularly investments in innovative community-based service-delivery approaches—is essential to expanding the contraceptive options offered to populations who are fast outgrowing the resources available to support them, said a panel of experts representing Pathfinder International and the Evidence to Action (E2A) Project at the Wilson Center yesterday.
Representatives from Democratic Republic of the Congo, Ethiopia, Nigeria, and Tanzania presented successful service-delivery approaches their programs are applying to expand the contraceptive method mix for some of their most vulnerable populations at an event hosted by the Wilson Center’s Environmental Change and Security Program—Finding the Path: Increasing Contraceptive Choice in Africa’s Most Populous Countries. They expressed the need for continued and amplified government support to sustain and scale-up these approaches, including enabling policies and budgets that support activation of those policies.
“It is not only convincing the central government, but getting the local government to buy in and getting the necessary resources,” said Ann Hirschey, Chief, Service Delivery Improvement Division, USAID Office of Population and Reproductive Health who moderated the panel.
“We need to dig deep into how local governments are programming their money,” said Mustafa Kudrati, Pathfinder International’s Country Representative in Tanzania.
In Tanzania, Kudrati presented E2A’s work adding Standard Days Method® to the contraceptive method mix in Shinyanga region, where fertility rates exceed the national average and this natural family planning method suits the many Catholic families who live there. He said the support of Tanzania’s Ministry of Health and Social Welfare as well as the use of a mobile application by community health workers to deliver family planning counseling and services has been essential to the effort’s success.
Aben Ngay from Democratic Republic of the Congo said the E2A project is supporting the most substantive community-based family planning program in the country, in places where the unmet need for contraceptives is as high as 67 percent. He said the involvement of men, religious and community leaders, a vast cadre of community health workers, and active outreach to communities to generate demand for services are the bedrock of the program, which is still in its infancy.
In Nigeria, Farouk Jega described E2A’s efforts to expand access to long-acting reversible contraceptives through the engagement of the country’s Community Health Extension Workers (CHEWs). E2A is conducting a study in two states to determine the feasibility, safety, and cost-effectiveness of training CHEWs to provide implants. He said recent policy change has enabled clients to receive injectable contraceptives and implants from CHEWs, but that policy has not yet been put into action. Evidence from the E2A study may support activation of this policy.
Mengistu Asnake from Ethiopia, where E2A supports the Integrated Family Health Program Plus (IFHP+), also described efforts to boost access to long-acting reversible contraceptive methods, particularly among postpartum women. He said the government’s support for expanding access to long-acting methods has been instrumental to increasing access to them, and IFHP+ has been part of the effort. Of the more than 8,000 deliveries that took place at 49 health facilities where IFHP+ trained service providers on the insertion and removal of intrauterine contraceptive devices (IUCDs), 20 percent of postpartum women received an IUCD. Learning from IFHP+ will contribute to bringing IUCDs to scale at health facilities nationally.