Evidence to Action (E2A) and Pathfinder International have been implementing a new program for young First-Time Parents (FTPs) across Cross River State (CRS), Nigeria; the Greater Mahale Ecosystem of Tanzania; and the Eastern region of Burkina Faso.
As part of the Saving Mothers, Giving Life Initiative-Expanding Family Planning (SMGL-EFP) Initiative, E2A and Pathfinder International have been working in partnership with the CRS MOH since 2014 to increase the coverage and quality of maternal neonatal and reproductive health (RH) services and improve delivery outcomes in 148 public and faith-based health facilities across the state. An additional component of SMGL-EFP focuses on strengthening family planning (FP) services, including the provision of long-acting reversible contraceptives (LARCs).
With 18% of adolescent girls aged 15–19 having already begun childbearing in CRS and only 27% currently using a modern contraceptive method, the SMGL-EFP team noted a particular need to reach young mothers with reproductive, maternal, newborn, and child health (RMNCH) information and services. In response, E2A designed a new FTP-focused component that advances healthy timing and spacing of pregnancy (HTSP), FP, and gender-related outcomes for FTPs. Informed by a qualitative formative assessment conducted in 2017, this new FTP component centers on peer group activities with young first-time mothers (FTMs) to build their FP/RH agency and facilitate access to facility- and community-based FP services. The program also includes group activities with the male partners of FTM peer group members to foster healthy relationships and promote couple communication and joint decision-making. With the launch of FTP activities in May 2018, E2A conducted baseline surveys with FTMs and male partners participating in the program to understand more about their FP/RH situation and needs.
E2A and Pathfinder International, in partnership with the Tuungane project, a population, health, and environment (PHE program) in the Greater Mahale Ecosystem of Tanzania, have been working with the Government of Tanzania, The Nature Conservancy, and other partners to tackle some of the most complex development challenges faced by these extremely remote, marginalized, and vulnerable communities, including improving access to voluntary family planning (FP) services. Noting patterns of early childbearing and low contraceptive use among young people in Tuungane communities, E2A and Pathfinder saw an opportunity to advance healthy timing and spacing (HTSP) of pregnancies, FP, and related gender outcomes for FTPs.
This new initiative centers on peer group activities with young first-time mothers (FTMs)—defined as women under 25 years who are pregnant with or have one child—to build their FP and reproductive health (RH) agency and facilitate access to facility- and communitybased FP counseling and services. With the launch of FTP activities in May 2018, E2A collected information on the FP/RH situation and needs of FTM participants through a qualitative baseline and peer group intake forms.
In the Fada and Diapaga districts in the Eastern region of Burkina Faso, E2A and Pathfinder International have implemented a first-time parent project that includes both community-and facility level interventions with the goal of increasing family planning (FP) uptake and the use of reproductive, maternal, neonatal, and child health (RMNCH) care—especially antenatal care (ANC) and obstetric and neonatal services—among FTPs. E2A/Pathfinder selected the Eastern Region given the high frequency of early marriage and childbearing as well as poor maternal, neonatal, child health (MNCH) and FP outcomes for young mothers. The average age at first birth for women in the region is 19 years old, and 52% and 13.7% of women are married before age 18 and age 15, respectively. Furthermore, the region has a total fertility rate of seven children born per woman and low contraceptive use, with a contraceptive prevalence rate (CPR) of 18.8% and unmet need for contraceptive methods of 20.9%.1 At the start of the program, E2A collected information from FTMs interested in being part of the program.