Join FP2020 by Making a Commitment

• The German government has increased its bilateral commitments for RMNCH. Disbursements will increase accordingly, but there is a time lag due the project cycle.

• Data is not yet available for 2013; the German government will be able to report on 2013 funding flows only when OECD DAC data is released in December 2014.

• The tables below show how Germany’s commitments and disbursements towards RMNCH have developed in 2011 and 2012:

Note: The funding that Germany committed at the London Family Planning Summit is not additional to funding committed as part of Germany’s Muskoka commitment. It is a specification of part of the Muskoka commitment by earmarking 25% for interventions targeting family planning.

G8 Muskoka- Initiative (disbursements), in Mio. €

G8 Muskoka- Initiative (commitments), in Mio. €

• No major changes in how the Government of Germany allocates resources to health/RMNCH are foreseen for the near future.

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.

• Le gouvernement du Madagascar s’est engagé à institutionnaliser la campagne nationale annuelle en planification familiale :
  • La campagne PF est déjà célébrée chaque année depuis 2012, le problème est surtout le manque de financement pour sa réalisation.
  • L’institutionnalisation n’a pas encore été effectuée.
• Le gouvernement du Madagascar s’est engagé à renforcer la mobilisation et la distribution à base communautaire en priorisant les zones non accessibles :
  • On est entrain de redynamiser la fourniture des injectables au niveau communautaire avec développement d’un guide de redynamisation pour baliser les services à base au niveau communautaire.
  • On va faire une évaluation de l’offre des injectables (dépoprovéra et sayana press) au niveau communautaire.
  • On va aussi réactualiser le curriculum de formation sur les injectables au niveau communautaire pour allouer plus de temps au stage pratique jusqu’à la maitrise de la compétence.
• Le gouvernement s’est engagé à assurer la sécurisation et la disponibilité des produits contraceptifs incluant les produits pour la contraception d'urgence jusqu’au niveau des bénéficiaires :
  • Pour Madagascar tous les besoins en produits contraceptifs sont honorés, mais c’est l’acheminement du district vers les formations sanitaires qui pose problème.
  • Pour ce 3ème trimestre un PTF (UNFPA) a alloué un certain montant pour l’acheminement des produits en Santé de la Reproduction y compris les contraceptifs du niveau district vers les formations sanitaires.
• Le gouvernement du Madagascar s’est engagé à renforcer les plateaux techniques des formations sanitaires en PF notamment pour les méthodes de longue durée et permanentes, en mettant en exergue la PF post-abortum/post-partum :
  • Cette activité a commencé en 2015 et se poursuit actuellement. La situation est qu’on a déjà fait 5 régions depuis et en 2017 on va faire 7 régions.

L’activité consiste au renforcement de compétence des prestataires ensuite dotation en matériels /équipements.

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

• The government of Uganda has undertaken the following to improve midwifery profession:
  • Skills training: In 2015, Uganda finalized the review of the midwifery curriculum to make it competency based. The curriculum emphasizes more practical time than theory and includes a module on family planning. 160 midwifery tutors and clinical Instructors were given skills in mentoring and coaching of students to improve the quality of training for midwives. The aim is to produce competent midwives to offer quality maternal and child health services including family planning. Four clinical instructors in charge of midwifery skills labs were trained on how to use the equipment that had been supplied by UNFPA. Forty newly recruited midwives have been oriented on maternal health and family planning services. Ninety midwives have been recruited to serve in the hard-to-reach areas.
  • Involvement in Policy Dialogue: More than 200 midwives met the First Lady of Uganda and discussed the challenges they face in delivering midwifery services. More advocacy meetings for improving the midwifery program to be spearheaded by the First Lady have been planned for 2016.Through national and regional symposia, midwives have been supported to establish a Midwives Association that will spearhead the policy dialogues. A constitution for the association is being drafted and will be disseminated to stakeholders in September 2016. Forty Young Midwives Leaders have been equipped with skills in leadership and advocacy for improved maternal health and family planning services. A scheme of services for midwives and nurses, and nursing and midwifery policy were developed and presented to the senior management of the Ministry of Health for approval.
  • Midwifery career promotion: Midwifery career promotions in secondary schools in four hard-to-reach districts were conducted. Midwifery career promotional materials have been developed to be used across the country.
• Uganda is implementing a self-injection pilot using Sayana Press in some communities with good result. Now with support from UNFPA, the government is scaling up the distribution of Sayana Press through community health workers in selected districts. Ninety midwives have been recruited to support the service delivery.
• UNFPA through the RMNCH Trust Fund has supported the government to renovate some health facilities and to purchase hospital equipment; the Association of Obstetricians and Gynecologists of Uganda (AOGU) is now helping to build capacity for use.
• With support from UNFPA, the Ministry of Health, through JHPIEGO, has helped build the capacity of 941 service providers in the provision of family planning, especially postpartum family planning and long acting reversible contraception. In addition, equipment (PPIUDs kits, Mama Natalie, and Mama U models) were given to 160 health facilities and 18 midwifery schools so that health workers have the required tools and skills for service provision and continuous practice following the training.
• Medical Eligibility Criteria Wheel: Trainer-of-trainers training was carried out with selected participants from districts, referral hospitals, and partners supporting family planning to input the development of a localized Medical Eligibility Criteria (MEC) wheel for Uganda, based on the 5th edition of World Health Organization MEC wheel. A final draft was developed and its undergoing validation from various stakeholders. A cascade training of the wheel has also been done in selected districts, and we hope to scale up the training to the rest of the country.
• Uganda has also embarked on improving the quality of services provided by community health workers (CHEWs) by developing a CHEW strategy to be able to increase family planning services at community level. The strategy has been endorsed by the top management of Ministry of Health and is now due for presentation to the cabinet.
• In 2015, UNFPA supported 7 (out of 112) core districts to provide youth-friendly (YFS) services according to national standards in 100 percent and 86 percent of the hospitals and Health Centre IVs, respectively. Furthermore, 15 health centres were supported to establish YFS in targeted districts through faith-based organizations. UNFPA supported the government of Uganda to increase YFS in humanitarian setting with 90 percent of the Health Centres in four refugee settlements by establishing 20 youth spaces reaching out to 59,100 young people with SRH information and services.
• The Ministry of Health, with support from UNFPA, conducted a national assessment on the knowledge, briefs, practices, needs of young people (10-24 years), and on access, appropriateness, and effectiveness of sexual and reproductive services.
• A scorecard has been developed to link results with resources at different levels of service delivery and aligned in the district league table. It is currently being piloted in some districts with capacity building of service providers. This will be disseminated and rolled out in 2016-2017.
• The Uganda RMNCAH assembly was held in December 2015 and stakeholders made commitments in various areas. Most importantly they committed to strengthen accountability and coordination for RMNCAH at the national, district, and community levels in order to streamline RMNCAH implementation. The government plans to hold annual RMNCAH assemblies.
• Uganda has conducted the Annual Household Panel Survey and has completed wave four (series 4) and now is in the process of data collection for wave 5. Through the Joint Assessment Framework (JAF)— a local DP platform—Uganda is able to track the annual CPR using information from panel survey and assess household behavior on family planning uptake.

RHU also helped achieve a task shifting policy that enables clinical staff to undertake sterilization (previously not allowed) and the establishment of the national Population Council, through the passing of the Population Council Bill in 2013 and its signing by the President in 2014.

The Government of Myanmar provided new information on its progress in April 2017.  Read the revised update here.

In July 2016, the Government of Myanmar 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:

• In an effort to implementing a monitoring system to strengthen quality of care, the government of Myanmar agreed to—during the discussion for nationwide Implant training—the Lead FP Working Committee agreed to use a post training assessment form and quality control checklist with technical support from JHPIEGO and PSI as part of monitoring effectiveness. An assessment study on implant removal will also be conducted by MOHS and JHPIEGO to highlight the quality of care in service provision.
• Myanmar is working continuously on strengthening its logistics management information system to ensure reproductive health commodity security. Since 2014, RH Commodity Logistic System was being implemented in 12 townships. In 2016, with technical support from JSI and financial support from UNFPA, 55 townships under Shan (South) and Mandalay regions are having the LMIS expanded. To cover all other State/ Region, The funding gap to cover all other states and regions still exists and is under the negotiation of the MOHS with 3MDG fund.
• Nationwide Implant Training will be provided to health care providers in public in 2016 through a public-private partnership approach. The Total Market Approach for FP is being conducted by PATH in collaboration with MOHS and UNFPA. Introduction of Sayana Press in Myanmar is still going on in collaboration with UNFPA and other private partners. UNFPA will be supplying 0.8 million doses of Sayana Press in 2016 and, with the MOH’s lead to get pre-registration waiver, Sayana Press initiation program begin in the second quarter of 2016. This will increase additional users of modern method of contraception.
• To improve the monitoring system of family planning, the capacity building of M&E officers was carried out with the support of the Track 20 team and Consensus Building Workshops were conducted since last year to get consensus among stakeholders and discuss data utilization, data monitoring, private sector involvement, and other monitoring issues.

The Government of Myanmar provided new information on its progress in April 2017.  Read the revised update here.

In July 2016, the Government of Myanmar 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 policy and political commitment:

• In 2016, Myanmar has made some progress in the policy environment for providing clinical contraceptive methods by trained and skilled nurses and volunteered, such as the commitment for task shifting to Auxiliary Midwives (AMW) in FP services; some methods of family planning like OC pills and condom can be provided by AMW. Long-term methods of family planning (particularly, implant) training is scheduled to start in July 2016 for the public sector, with a nationwide roll out planned for 2016-2017 with the support of UNFPA, PSI, Jhpiego and ObGy Society/ MMA. There will be trainings of health care providers to give services targeted to peri-urban poor in the Yangon region (reaching 34 townships), in the Mandalay region (23 townships), and in the Magway region (25 townships), where maternal mortality is high and unmet need is high.
• Myanmar has developed a five-year strategic plan for reproductive health and developed a Costed Implementation Plan (CIP) in 2014 to meet the commitment on Family Planning 2020. All implementing partners are providing FP services according to the strategies and guidance of that plan, but the government plans on revisiting the CIP this year 2016 to explore the gaps in family planning.
• Lead Working Group on Family Planning and Lead Working Group on RH are being conducted quarterly in alignment with the Reproductive Health Technical Working Committee meetings and any recommendations are discussed at the Maternal Newborn and Child Health Technical Strategic Group. In addition, the FP commodity meeting and coordination meetings of the nationwide training effort are also occasionally conducted occasionally.

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.