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

Jhpiego has contributed to advocacy for task-shifting to improve access to long-acting family planning methods by contributing to the global evidence in support of lower level health cadres to provide contraceptive implants.   

• As part of the Targeted States High Impact Project (TSHIP) funded by the United States Agency for International Development (USAID), Jhpiego and the State Primary Health Care Development Agency (SPHCDA) implemented a pilot intervention to increase access and utilization of long-acting reversible contraception (LARC) services among rural community members in Nigeria’s Bauchi and Sokoto states. The intervention focused on strengthening the capacity of Community Health Extension Workers (CHEWs) to insert implants and document the services provided through training and supportive supervision. The intervention also sought to improve commodity security and logistics systems, create demand, improve access to quality implant services, and strengthen the referral system. Evaluations of this intervention documented high quality of service provision and statistically significant increases in counselling skills for all methods by trained CHEWs. With proper training and continuous supportive supervision, Jhpiego’s work has demonstrated that CHEWs in Nigeria are able to administer contraceptive implants and provide adequate counseling for various contraceptive methods. A journal article highlighting the findings from this intervention has been accepted in the Global Health: Science and Practice Journal and will be published in an upcoming issue.
• Through the Maternal and Child Health Integrated Program (MCHIP) and Maternal and Child Survival Program (MCSP) funded by USAID, Jhpiego has supported the Ministry of Health of Mali to demonstrate the feasibility of matrones (auxiliary midwives) inserting contraceptive implants at rural community health centers. Evaluated through observation checklists for skills quality, the study demonstrated that matrones can insert implants satisfactorily up to one year after training. This study provides supporting evidence that matrones can be a key link to facilitate access of LARC services, especially for rural populations. The study results have been presented at a national event presenting best practices in maternal, newborn, and child health in 2014.

Jhpiego has continued to support with training matrons or auxiliary midwives to provide implants in these settings.

• As part of the TSHIP program in Nigeria, Jhpiego in partnership with SPHCDA trained 166 CHEWs in Sokoto and Bauchi states from September to December, 2013. Supportive supervision was conducted for nearly all trainees (95%; n=145). At the endline assessment six months later, a total of 3588 implants were inserted at 151 health facilities, and over 10,088 couple years of protection (CYP) were generated through implant insertion over a period of six months. In addition, the average number of family planning visits during the six months prior to the survey increased from 23 (n=157) to 28 (n=147) clients per month.
• In Mali, between August 2012 and February 2014, a total of 173 matrones across 160 sites in Diema, Kita, Sikasso districts were trained to insert implants. Between August 2013 and May 2015, 2362 clients received implants and 5020 clients were counseled and educated about Healthy Timing and Spacing of Pregnancy (HTSP).
• Of note, all of these lower level health workers were trained in implant insertion but not removals. Removals in both of these countries are referred to higher level health cadres.

Jhpiego’s initial commitment of $200,000 at the London Summit on Family Planning in July 2012 has turned into more than $7 million to increase the availability and utilization of postpartum family planning (PPFP) and postpartum intrauterine devices (PPIUDs) in Burkina Faso. In collaboration with Burkina Faso’s Ministry of Health, and after a review of the government’s revised strategy on FP, Jhpiego identified PPIUD services as a key entry point for increasing contraceptive use, along with integrating maternal health care and FP services. Read more about this financial update here.