Join FP2020 by Making a Commitment

• With support from USAID, the Bill & Melinda Gates Foundation, and other donors, FHI 360 is implementing a wide variety of projects to expand the evidence base for safe and effective family planning and translating high-quality evidence into policy and practice. For instance, a new award from the Saving Lives at Birth program will seek to synchronize immunization visits with family planning re-supply to improve immunization coverage, promote a more logical infant growth-monitoring schedule and raise contraceptive prevalence. Under the Advancing Partners & Communities (APC) Project, FHI 360 is studying self-injection of the contraceptive DMPA in a subcutaneous formulation and delivery system known as “Sayana Press” in Malawi. Also under the APC project, FHI 360 advocates for the scale-up of community-based family planning programs and supports the implementation and monitoring of national costed implementation plans (CIPs).

• Support to the family planning strategies of local governments and for scale-up of evidence-based practices is provided by FHI 360 in multiple countries, including India (Uttar Pradesh state), where FHI 360 leads the Urban Health Initiative. FHI 360 also conducts systematic reviews on family planning for the Cochrane Collaboration, an important source of evidence for the WHO Medical Eligibility for Criteria (MEC) Guidance.

IPPF shared the following update on progress in achieving its FP2020 commitments:

IPPF has committed to significantly increasing the number of family planning services—a trebling of services from 2012 to 2020. IPPF is on track to reach the FP2020 targets to enable 120 million more women and girls to use contraception by 2010. By 2020, IPPF will increase family planning services to save the lives of 54,000 women, averting 46.4 million unintended pregnancies and preventing unsafe abortion. Results from 2014 show significant progress towards achieving this ambitious target:

• Delivery of 60.2 million contraceptive services through 54,000 service delivery points. The number of contraceptive services provided in 2014 includes 8.9 million new users. Over 5.7 million contraceptive services were deliver to young people under 25 years of age.
• Averted 5.9 million unintended pregnancies and 677,000 unsafe abortions through a CYP of 14.6 million. The number of couple years of protection (CYP) provided in 2014 increased by 21 percent to 14.6 million, which averted an estimated 5.9 million unintended pregnancies and 677,000 unsafe abortions. In the Africa and Arab World regions, the percentage increases from 2013 were 83 and 37 percent, respectively. In Africa, the growth was predominantly due to injectables, intrauterine devices, and oral contraceptive pills. In the Arab World, it was due mainly to intrauterine devices and implants.
• Delivering an Integrated Package of Essential Services. IPPF remains committed to providing a range of contraceptive choices to service users. The services in the package are proven by WHO to deliver high impact in resource-poor settings and when combined these services have the ability to transform the lives of women, girls and other poor and vulnerable populations. Our Integrated Package of Essential Services requires IPPF Member Associations to provide short- and long-acting reversible methods, as well as emergency contraception. Within IPPF’s CYP for 2014 of 14.6 million, 44 percent was provided by short-acting methods; 42 percent by reversible long‑acting methods; 14 per cent by permanent methods.

By 2015, we expect to double the number of comprehensive and integrated SRH services annually by:

• Investing in countries with the greatest need. The majority of IPPF’s unrestricted investments are made in countries with the greatest need for SRH information, education and services. These countries, identified by the Human Development Index as having low or medium levels of human development, have disproportionately high levels of maternal and child mortality, unmet need for contraception, HIV prevalence, and early marriage and childbearing. In the 73 countries identified as having low or medium levels of human development3 and where there is an IPPF Member Association or collaborating partner, the total number of sexual and reproductive health services provided in 2014 reached 122.4 million, an increase of 13 per cent from 2013. The most common categories of services provided were contraception, maternal and child health, and HIV-related services;
• Reaching poor and vulnerable groups. In 2014, IPPF reached 52.6 million poor and vulnerable service users with sexual and reproductive health services, 3.7 million more than in 2013. The estimated proportion of all service users who are poor and vulnerable is 85 percent, the highest ever achieved by IPPF. These results illustrate IPPF’s commitment to serving those most in need of sexual and reproductive health services. IPPF has more than 54,000 service delivery points, and 59 per cent of them are located in peri-urban or rural areas. This enables Member Associations to provide information, education and services to people living in hard-to-reach areas where there are few, if any, other service providers. Member Associations provide services to under-served groups who are not reached by other public or private providers, due to a reluctance to work with such marginalized populations, the additional costs involved or an absence of the specialized skills needed. Such groups are often those with greatest need, and include young people, sex workers, men who have sex with men, people who inject drugs, sexually diverse populations and prisoners.
• Adolescents and young people. In 2014, IPPF provided 66.6 million sexual and reproductive health services to young people. This represents 45 percent of all services provided, and illustrates our commitment to the largest generation of young people ever. Over the last five years, IPPF has focused on the needs of young people, with the proportion of sexual and reproductive health services provided to youth rising from 35 per cent in 2010 to 45 per cent in 2014. The most common services accessed by young people in 2014 were contraception (37 percent), HIV-related services (22 percent) and gynecology (10 percent).

Throughout 2014, IPPF continued to invest in and strengthen organizational systems and business processes to support a strong culture of performance, effectiveness, learning and accountability. Being part of a large Federation means that many Member Associations have the opportunity to learn from and share their expertise with others. While IPPF Regional Offices provide technical support to Member Associations in their regions, there is a growing trend to promote capacity building directly between Associations. In addition, as experts in the field of implementing sexual and reproductive health and rights programmes, Member Associations are also asked by external private and public health organizations to share their knowledge and experience.

• Learning Centers in the Africa Region. The Africa Regional Office has supported nine Member Associations to become designated Learning Centers. These Centers offer training and other forms of technical assistance to organizations, both within and outside the Federation. Based at the Member Associations of Cameroon, Côte d’Ivoire, Ethiopia, Ghana, Kenya, Mozambique, Swaziland, Togo and Uganda, the Learning Centers promote peer-to-peer learning by transferring expertise in how to design innovative programmes. These Member Associations consistently demonstrate their capacity to provide quality SRH information and services, and have the expertise, skills and systems to provide technical support to other Member Associations. Each Centre reflects the acknowledged strengths of that particular Member Association.
• Engaging volunteers and staff. In 2014, volunteers and staff of the Member Associations with Learning Centers took part in refresher training in their core areas of expertise to strengthen their ability to provide support on topics in demand. These included family planning, with a focus on long-acting and permanent methods; public–private partnerships; and how to deliver integrated SRH including contraception. Member Associations were supported to convert areas within their facilities into meeting spaces, and to develop or adapt training modules based on national sexual and reproductive health policies and curricula. Exchange visits involving the Member Associations in Cameroon, Ghana and Uganda offered valuable opportunities to share experiences in the day-to-day management of running a Learning Centre.
• Member Association exchange. Reproductive Health Uganda (RHU) demonstrates one example of a Learning Centre building the capacity of multiple Member Associations across the region. RHU provided training to Member Associations from Ethiopia, Kenya, Malawi and Mozambique on how to design and manage surgical camps, as well as training for Member Associations in Ethiopia, Kenya, Malawi, Namibia, Swaziland and Tanzania on a parent-focused intervention exploring the sexual and reproductive health and rights of young people. In 2014, three Member Associations with Learning Centers were successful in generating income from training public or private health providers. The Family Guidance Association of Ethiopia trained 2,628 health professionals from public and private clinics, generating 16.7 million Birr (US$816,000); Family Health Options Kenya trained 300 service providers, generating 3 million Ksh (US$32,000); while Côte d’Ivoire’s Association Ivoirienne pour le Bien‑Être Familial trained nearly 200 service providers and generated 62.6 million FCFA (US$100,000).

IPPF is currently building on the work previously undertaken across the Federation to support client-centered, integrated, rights based quality family planning services within a comprehensive approach to SRH. IPPF is building a strong civil society response to strengthen national health systems. Member Associations are part of the grassroots movement in their respective countries. They play a critical role not only as service providers within the health system, but also as a significant contributor to strengthening the health system by disseminating new guidelines and technologies, building the capacity of other peers working within the health system, and advocating for supportive policies. Below are highlights from our work in 2014:

• IPPF is reinvigorating our International Medical Advisory Panel to respond with best practice and clinic based guidelines and to share our experience amongst communities of best practice, and provides timely guidance to IPPF on critical issues related to SRH and family planning. IPPF Medical Bulletins are produced to address gaps in bio-medical evidence or critical issues relating SRHR programming.

IPPF’s commitment to quality of care is demonstrated through our Quality Assurance Package which also guides Member Associations on establishing the Integrated Package of Essential Services (IPES). In 2014, quality of care was included as a key principle for Member Associations accreditation, underpinning our continual quest for quality. Evidence from our safe abortion and family planning programmes shows that satisfied clients are one of the top three sources of referral for new clients. IPPF’s Quality of Care Technical Working Group provides global technical leadership in quality of care, along with information and policy updates, sharing guidelines and best practice, training and resources.

IPPF remains committed to building the advocacy capacity of Member Associations in 40 countries to advance rights-based family planning, within a comprehensive approach to SRH. IPPF defines capacity building as development of IPPF’s core skills in order to enable the organization and individuals to address weaknesses, to bring about change and increase effectiveness. IPPF Regional Offices are the hub of capacity building activity in the Federation and provide technical assistance to Member Associations in every aspect of organizational life, depending on their needs–including advocacy capacity building.  Our Regional Offices provide on the spot assistance, regional training workshops, publishing toolkits and arranging south to south technical assistance. Specific examples in 2014 include:  

• IPPF worked to increase Member Association capacity to advocate on sexual rights—including access to contraception—through the Universal Periodic Review Mechanism. IPPF supported Member Associations to press their governments for change, including training for Member Associations from Austria, Albania, Bosnia-Herzegovina, Bulgaria, Estonia, Kazakhstan, Spain and Tajikistan to use the UPR process. Most recently, two Member Associations who participated in the workshop have submitted shadow reports that will be reviewed by the Human Rights Council over the next year. The Macedonian and Bulgarian Member Associations also attended the adoption of their respective country UPR reports in Geneva and made oral statements on the recommendations that were adopted or rejected.
• Advocacy with the UN. Every year, IPPF successfully advocates for progressive language to be included in UN documents, including the conclusions of the Commission on the Status of Women (CSW) and the outcome document for the Commission on Population and Development (CPD). IPPF supports Member Associations to participate in these UN processes, and hold their governments in capital to account on key issues related to SRH and rights-based family planning.
• Joining Voices. IPPF’s Joining Voices project plays an important role in supporting civil society advocacy on family planning to make sure commitments are delivered. As part of Joining Voices, Countdown 2015 Europe is a consortium of 15 leading European non-governmental organizations, of which over half are IPPF Member Associations, working to ensure funding for sexual and reproductive health and rights in developing countries. Coordinated by IPPF’s European Network and working with European Union institutions, Countdown 2015 Europe holds donors to account for their policy and funding commitments to achieve universal access to reproductive health and to address the unmet need for family planning.
• Tracking advocacy progress. In 2012, new questions on advocacy were included in the Global Indicators Survey to provide additional information on advocacy progress made by Member Associations. However, certain Member Associations suggested a new approach to gathering information on advocacy progress. Currently, we are providing support for Member Associations to assess their advocacy capacity better, through a tool based on a self-assessment checklist to identify strengths and areas that need improvement.

• 959 prestataires formés en Technologie contraceptive  depuis 2015 jusqu’en juin 2016. La formation en TC est une  nouvelle approche basée sur les compétences pour dispenser toutes les méthodes contraceptives en générale et particulièrement la pratique humaniste de pose et de retrait de l’implant et DIU en utilisant les modèles anatomiques adaptés , la prévention des infections ,la gestion des effets secondaires et le counseling.
• Depuis 2015 Jusqu’en mai 2016, 49 003 DMPA ont été administrés au niveau communautaire par les Techniciens de promotion de la santé,
  • 487 646 personnes sensibilisées dont 207 646 femmes par les Agents de santé communautaires.
  • 6066 cycles de pilules et 137 739 préservatifs ont été distribués par les agents de santé communautaire en 2015.
  • 33 Postes secondaires ont été mis en place dans les zones inaccessibles géographiquement et à proximité des Centres de santé confessionnels   qui ne proposent pas de méthodes de contraception modernes pour  augmenter l’accès aux  services de planification familiale.
• Le gouvernement du Burundi s’est engagé à intégrer ces services à d’autres programmes, comme l’immunisation et le VIH :
  • Le renforcement des capacités des prestataires travaillant dans les services de maternité en technologie contraceptive.
  • 60% des femmes opérées des fistules obstétricales adoptent une méthode contraceptive avant la sortie du centre de traitement
• Le gouvernement du Burundi s’est engagé à augmenter les services communautaires en mobilisant la communauté et en fournissant des méthodes de planification familiale, y compris le transfert de tâches en formant des techniciens de promotion de la santé et des agents sanitaires de collectivité (ASC) pour proposer des injections :
  • 338 TPS ont été formé sur l’administration du  DMPA au niveau communautaire et 3940 Agents de santé communautaire ont été formés  sur la distribution à base communautaire des contraceptifs (Pilules et Condoms).
  • Depuis 2015 Jusqu’en mai 2016, 49 003 DMPA ont été administrés au niveau communautaire par les Techniciens de promotion de la santé,
  • 487 646 personnes sensibilisées dont 207 646 femmes par les Agents de santé communautaires.
  • 6066 cycles de pilules et 137 739 préservatifs ont été distribués par les agents de santé communautaire en 2015
• Des émissions radiophoniques sur la SR mettant un accent particulier sur la PF et la SSRAJ ont été récoltées au cours des réunions régionales de coordination, des campagnes sur la PF  et diffusées.
• Les campagnes de sensibilisation des leaders en planification familiale et l’introduction du DMPA dans la distribution à base communautaire des contraceptifs. Au total, plus 2750 leaders proches de la communauté ont été sensibilisés et vont disséminer les messages sur la PF jusqu'au niveau communautaire pour susciter l'adhésion et utilisation des services de PF. Selon les statistiques de service, le taux de prévalence contraceptive est passé de 34,3% en 2014 à 37,4% en 2015
• Elaboration de la stratégie Condom, campagnes zéro grossesse, intégration de la SSRAJ dans les curricula de l’école Fondamentale (8ème) 9ème pour 2015 et révision pour la 7ème en 2016.
• En collaboration avec les opérateurs des Téléphonies mobiles et avec l’appui des partenaires techniques et financiers ,le gouvernement a assuré l’information et la référence aux services de santé sexuelle et  reproductive en faveur des adolescents  et jeunes grâce aux nouvelles technologies de l’informations et de la communication .C’est notamment par l’envoi périodique des SMS média sur la santé .La promotion des groupes virtuels à travers les réseaux sociaux permettant à plus de  10000 Jeunes d’échanger et partager leurs idées et informations sur la  SSRAJ .Exemple : Adv4Youth sur facebook  et Watch up.
• Le Gouvernement vient d’initier, en 2016 et pour une période de 5 ans, un programme conjoint (regroupant 3 ministères clés : santé, éducation, jeunesse et mis en œuvre par 4 partenaires : UNFPA, CARE, CORDAID, RUTGERS en santé sexuelle et reproductive des adolescents et jeunes.
• Le MSPLS vient d’élaborer une stratégie nationale de financement de la santé et est entrain de cheminer vers la mise en place d’une couverture sanitaire universelle à l’horizon 2018, intégrant les différents mécanismes de financement de la santé dont le Financement basé sur la performance. Dans cette perspective, la mise en œuvre du FBP est en train d’être repensée pour s’orienter vers un FBP seconde génération centré sur le renforcement de la qualité des soins et la levée des principaux goulots d’étranglement du système de santé.

In July 2016, the Government of Zimbabwe shared an update on progress in achieving its policy, financial and program and service delivery commitments to FP2020.

The government reports performing the following activities in support of its program and service delivery commitment:

• The government of Zimbabwe has engaged in various efforts to promote the use of long-acting and reversible contraceptives (LARCs). These activities include training of health service providers to administer LARCs and awareness campaigns. Trainings have been conducted in implant insertion and removals and Implanon insertion for doctors, midwives, and registered general nurses from selected districts across the country. The uptake of these services has increased as shown by the preliminary results of the ZDHS 2015, which shows an increase in the use of implants from 2.7% in 2010 to 9.6% in 2015. The government also began the postpartum IUCD program. A training of trainers workshop was conducted for facilitators and the program is being piloted in one province. In addition, the government conducted an IUCD study to determine the reasons for low uptake of IUCD and the results will inform future activities.
• In an effort to revitalize and scale family planning services for adolescents, more service providers have been trained and provided resource materials on ARSH. The government has also conducted an evaluation of the Health Facility Approach and facilitated the development of the community level training package and its rolling out in Hurungwe District. Additionally the government of Zimbabwe also coordinated the review of ASRH interventions by the John Hopkins Bloomberg School of Public Health and rolled out the adolescent fertility study. Regional documentation exercises on ASRH best practices in Zimbabwe have begun.
• The Ministry of Health has also strengthened collaboration with the gender department in the Ministry of Women Affairs, Gender, and Community Development. The head of the RH program is a member of the Anti-Domestic Violence Council (ADVC). The ADVC is a statutory body established in terms of Section 16 of the Domestic Violence Act (Chapter 5:16). The overall function of the Council is to ensure effective implementation of the Domestic Violence Act. This is achieved through the establishment of partnerships coupled with the provision of all necessary support to various stakeholders to ensure comprehensive multi-sectoral response to domestic violence in Zimbabwe. The council successfully coordinated commemoration of the 16 days against gender based violence campaign.
• The government made efforts to ensure that male and female condoms are always available for free especially in public places. This was augmented by massive advocacy and campaigns for dual protection through the development of IEC material in the form of pamphlets, fliers, banners and T-shirts that were distributed during annual commemorations. All these activities contributed to a 15% increase in the uptake of male condoms and 19% for female condoms during the year.

• Le Sénégal dispose désormais d’un plan de communication SR/PF et Survie de l’Enfant et son plan fait budgétisé mais l’accent sur la création de la demande. De même un plan de communication spécifiquement adressé aux jeunes est en cours d’élaboration. Les deux premiers seront validés au cours du mois d’aout 2016. Les religieux sont aussi parties prenantes du plan PF 2016 -2020. Présentement ils organisent des émissions à la radio pour soutenir le programme PF.
• L’IPM est généralisé dans le pays et les ruptures de stocks sont très rares et la durée est très réduite. Le Ministère à travers la PNA est entrain de s’en appropriée. Le passage du témoin entre le projet et la PNA débute cette année selon un scénario proposé par le Ministère
• La quantification des besoins se fait régulièrement au niveau national (2 fois par an). Avec l’appui des partenaires les régions seront formées sur le Reality Check afin de faire leur propre quantification.
• Dans le nouveau plan PF, les propositions faites multiplient le nombre de cliniques mobiles et les services franchisés. Ceci permet d’atteindre les populations les plus éloignées qui sont en général les plus vulnérables. Le programme cherche aussi à acquérir des kits d’insertions retraits pour les méthodes de longues durée afin d’éviter les prescription faites aux femmes.
• Le Sayana Press est offert sur l’ensemble du territoire national. Le programme insiste beaucoup sur les services de PF offerts aux jeunes notamment la communication sur les méthodes disponibles, la contraception d’urgence et surtout la nécessité de leur donner les connaissances nécessaires afin de les préparer à leur futur statut.
• L’offre de service à base communautaire est généralisée pour les pilules, les injectables en IM et en sous cutanée. L’intégration de la PF aux services de vaccination n’est pas encore généralisée mais est commune et est considérée comme une pratique prometteuse. Il est encore tôt d’évaluer son intégration avec le VIH.

In August 2015, Bloomberg Philanthropies shared an update on progress in achieving its commitments to FP2020.

• Bloomberg Philanthropies has engaged CDC Tanzania to conduct an impact evaluation of the Philanthropies’ work in Tanzania and found that on average, at least 100 maternal deaths and 2,000 injuries are being prevented annually because of interventions. Their evaluation also found that interventions increased access to emergency obstetric care within 2 hours from 68% to 72%
• CDC also conducted a household survey of 4,000 women of reproductive age in Kigoma, and findings from that survey were used to shape Philanthropies’ reinvestment strategy for the region.