In September 2015, the Government of Zambia shared an update on progress in achieving its policy, financial and program and service delivery commitments to FP2020.

• National Family Planning Coordinating Board (ZNFPC) made strides in advocating for the increase in the family planning budget allocation. Advocacy meetings with parliamentarians are ongoing. However, but the crippled economic situation and limited resources being allocated for health programs and family planning programs held back the progress in this area.

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 financial commitment:

• Due to the economic crisis in the country, the government is facing challenges in fulfilling its financial commitment of increasing the national budget allocation of FP from 1.7% to 3%. In the meantime, the government is providing salaries of FP service providers both for Zimbabwe National Family Planning Council (ZNFPC) and the Ministry of Health and Child Care (MOHCC) only. All family planning commodities are being provided by development partners. The budgetary allocation to FP services by the government remain low.

In September 2015, the Government of Zambia shared an update on progress in achieving its policy, financial and program and service delivery commitments to FP2020.

The Government of Zimbabwe has engaged in the following activities to increase access to a comprehensive range of family planning methods:

• Training health service providers in both private and public sectors.
• Awareness campaigns in both electronic and print media are under implementation.
• Integration of sexual and reproductive health services at all levels are being encouraged.
• Operational studies on determining factors associated with uptake of LARCs are underway; however, the efforts are being drawn back by negative media publicity which are playing down the use of LARCs.

The Government of Zimbabwe has engaged in the following activities to develop innovative service delivery models to meet the needs and rights of adolescent girls:

• Community, facility, and school-based approaches to reach the adolescents in line with the National ASRH Strategy are being implemented.
• Efforts to mainstream ASRH issues in other ministries have been made. For example, the Ministry of Primary and Secondary Education launched the Life skills, Sexuality and HIV and AIDS Strategy in 2013.
• Operational studies around issues affecting the youths and national ASRH program evaluations are being conducted to inform future programming; these include the Determinants of Teenage Pregnancy, ASRH County Programme Evaluation, and ASRH Interventions Review.
• Policy inconsistences in the country which hinder the full implementation of some of the recommendations from study findings and program evaluations are being addressed.
• Limited resources to expand the coverage of ASRH service provision to youths is a major challenge.

The Government of Zimbabwe has engaged in the following activities to increasing knowledge on all family planning methods:

• Targeted IEC material for SRH and family planning are being printed and distributed nationally.
• Awareness campaigns through road shows about importance of family planning are currently underway.
• Social media is also being used as a channel to disseminate and educate the public on the importance of family planning.
• However, due to financial constraints essential activities, such as awareness campaigns and advocacy and social mobilization campaigns are not being conducted as per national expectations.

The Government of Zimbabwe engaged in the following activities to improved gender-sensitive family planning services:

• Providing men with relevant family planning information.
• Training service providers in ASRH so that they are able to provide quality services.
• Involving young people in ASRH issues e.g ASRH forum at national level.
• Training service providers in family planning services, including at youth centers.
• Development of brail material to enhance access to family planning information for the blind.

The government has engaged in strengthening the integration of family planning with reproductive health, HIV and maternal health services:

• Training service providers in the provision of quality integrated services, so providers can offer a comprehensive package of SRHR; trainings include voluntary medical male circumcision, cervical cancer screening, HIV testing and counseling, PMTCT, Syndromic STI management.
• Piloting the Electronic Patient Monitoring System, which now awaits rolling out nationally in both private and public sectors.
• The Government of Zimbabwe also improved on family planning method mix by introducing Implanon and Revoke 72 (emergency contraception).

The Government of Zimbabwe has engaged in the following activities to promoting dual protection for the prevention of unwanted pregnancy and STI/HIV&AIDS by increasing the availability of male and female condoms for sexually active persons:

• The family planning commodity delivery system being used in the country ensures that commodities including male and female condoms are always available and accessible at all Service Delivery Points (SDPs). The national commodity stock out for all commodities has been below 5% for the past 5 years.
• There has been efforts to promote the use of the female condom through engaging external funders such as the Female Health Company (FHC) so as to promote dual protection.
• Awareness campaigns and production of IEC materials specifically for the use of condoms for dual protection have been carried out although the funds are not adequate.
• All public sector brand condoms are issued for free.

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.

In September 2015, the Government of Zimbabwe shared an update on progress in achieving its policy, financial and program and service delivery commitments to FP2020.

• The Government of Zimbabwe is meeting with relevant authorities to map the way forward on how the administrative costs associated with storage and distribution of commodities can be covered. It is these costs which are being transferred to clients as user fees at a minimal cost.
• In collaboration with NGOs and other partners in the reproductive health sector, the government has strengthened the community involvement in all family planning and reproductive health program. The National Family Planning Coordination Forum and ASRH Coordination Forum were established in 2014 as a platform to reinforce public-private partnerships. These forums have also been cascaded to provincial levels in an effort to improve on service delivery.

The Government of Zimbabwe has engaged in the following activities to developing a research agenda on family planning and to strengthening overall monitoring and evaluation efforts:

• There are plans to prioritize family planning research areas at national level so as to inform the national response to family planning challenges, including teenage pregnancies.
• Quarterly National FP and ASRH Coordination Forums have been conducted since 2014. This platform involves all players providing FP services and other stakeholders in sexual and reproductive health services sharing experiences, best practices as well as coming up with possible recommendations to improve the FP program and SRH. However, there are limited resources to fund research and M&E activities.

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 policy and political commitment:

• The government of Zimbabwe reports significant improvement toward its commitment in removing the user fees for family planning services. In most of the health facilities only a consultation fee is being charged and the services being provided free of charge. This has contributed to the reduction in cost of accessing FP services in the country. In few health facilities a minimal charge on FP commodities is being charged to cover operational costs. Advocacy meetings and campaigns with decision makers were conducted during the year, specifically targeting parliamentarians, and family planning champions were used to reinforce the message to the intended audience. These activities have contributed toward the reduction of costs associated with accessing FP services.
• The government remains committed to providing services that meet the needs of teenagers in the country. One of the key activities carried out this year was the Teenage Pregnancy Study to determine factors contributing to teenage pregnancies and service availability .The study is now in its final stage and the results are expected soon. The government also renovated Youth Centers and has started offering clinical services to the adolescents’ youths of the country.
• To ensure that the needs of adolescents are addressed at policy and strategy formulation levels, an adolescent youth has been appointed as board member on the Zimbabwe National Family Planning Council. During 2015-2016, the government targeted youths in tertiary institutions and provided them with information and ASRH services, tended to help young people make informed decisions about their health. Furthermore, ASRH committees were formed at district levels to coordinate activities and ensuring that the adolescents have been targeted in all programs.
• As a way of increasing knowledge on FP service among disadvantaged women, the government rolled out a massive sensitization campaigns targeting key informants and community leadership. Advocacy meetings were held with traditional leadership to spearhead and promote the use of FP service in the countries. Such meetings were conducted with traditional chiefs in selected provinces to encourage disadvantaged women access available services .The parliamentarians were also targeted as they have access and influence on the marginalized communities. An advocacy meeting with parliamentarians was held on Dec. 16, 2015. The purpose of the advocacy meeting was to generate awareness and educate policy makers and opinion leaders on FP/RH issues.
• The government of Zimbabwe also carried out different activities to promote awareness and use of FP services in the country. The activities included printing information, education, and communication materials on FP and reproductive health (posters, pamphlets and fliers) under the Marvelon 28 pill mass media campaign, FC2 Female Condom Education and Promotion program, ASRH/IPPF, Global Female Condom Day, and World Contraceptive day celebrations were also used for promoting awareness. Short videos on family planning were screened on national television with the aim of promoting the use of FP services for all women in the country.
• During the development of the country’s costed implementation plan and FP strategy it was emphasized that developmental partners play a critical role in complementing government efforts in providing quality FP services for the country. Stakeholders, such as NGOs, are part of the National Family Planning Forum and have participated in different technical working groups, including the M&E, Marketing and Communications, and Demand Creation groups. Strengthening public-private partnerships, including civil society organizations in the provision of community-based and outreach services, were also seen in the CIP development process as civic organizations actively participated during the entire process in shaping the strategic direction of the country. The government has also renewed Memorandum of Understandings (MOUs) with national and community-based NGOs and has given civic organizations an increased mandate to offer FP services in the country with the aim of targeting community levels.

The Government of Zimbabwe has engaged in the following activities to developing a research agenda on family planning and to strengthening overall monitoring and evaluation efforts, including operations research in family planning:

• During 2015-2016, the country has developed the CIP on Family planning. One of the activities in the CIP is the strengthening of the M&E unit of the ZNFPC and having a harmonized FP M&E system. Activities towards the development of a national research agenda on FP were put in place and subsequently costed. This was a major step in promoting operations research and the use of evidence in decision making in the country. A research agenda will be finalized by the end of 2016 after all the inputs from stakeholders. Plans were made to strengthen the M&E technical working group and improvements on the data collection tools with the development of the national FP register being piloted in some provinces. Key activities conducted to strengthen the M&E of FP in the country were:
  • Finalization of the ASRH M&E framework with a set of core indictors to track;
  • Development of the national family planning register; and
  • Strengthening of the M&E technical working group to effectively monitor FP activities.
• The recruitment of Track20 M&E officer seconded to the Ministry of Health and Child Care to track country progress of 17 FP2020 Core Indicators and identify possible areas of improvements and indicator projections for 2020.
• The first family planning Consensus Building workshop for the country was conducted with the support from Track20 to discuss country progress towards FP2020 commitments.
• Other studies conducted throughout the year included the one titled “The Role of Family Planning: Addressing the Determinants of Unmet Need in HIV-Positive Women in Matabeleland South and Mashonaland Central Provinces” with support from UNICEF. This was aimed at determining the factors contributing to the high unmet need of FP services among the HIV positive women within the reproductive health age group. During the year, the Government conducted an IUCD qualitative study. This was aimed at assessing the determinants of the low uptake of IUCD in Zimbabwe paying particular attention to both the supply and demand sides of service delivery. The finalization and dissemination of the study results are expected by end of 2016. There was also representation in the planning and implementation of the National Adolescent Fertility Study. During the 2015-2016 time period, Zimbabwe was privileged to host the International Conference on STIs and AIDS in Africa (ICASA) and an abstract on the Role of FP in PMTCT was accepted for poster presentation. On another note, out of the 3 abstracts which were submitted to International Conference on Family Planning (ICFP) 2 were accepted for presentation in Indonesia.