• 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.

• Le gouvernement du Madagascar s’est engagé à augmenter chaque année d’au moins 5% le budget de l'État alloué à la planification familiale y compris l'achat des contraceptifs et l'acheminement :
  • Prochainement, on va insérer cette augmentation dans le budget de la Direction Administrative et Financière du Ministère de la Santé afin d’être voté dans la loi de finance.
• Mais le problème c’est qu’il y a peu d’engagement qu’on peut effectuer même pour le budget de fonctionnement en général au niveau du pays.

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

• The Government of Cameroon introduced Implanon NXT and Sayana Press in 2015. The Family Health Department is currently developing a pilot project for community-based distribution with Sayana Press in two health districts.
• The [Family Health Directorate] is organizing a family planning caravan that will offer free family planning services and raise awareness amongst the population. The caravan will visit two regions for the first phase. This caravan is expected to start in the coming weeks. 
• 690 providers were trained in family planning in 2015.
• The Logistics Management and Information System (LMIS) was developed and launched to improve the management and availability of contraceptives and other medicines. Data was collected monthly on contraceptives at the central and regional levels.
• The “SMS for Life” campaign for the telephone collection of data on the stock levels of contraceptives and family planning services among 22 districts in 6 regions of the country was launch.

• A joint effort by the Government of Cameroon’s Department of Family Health/Ministry of Public Health, UNFPA, and the Clinton Health Access Initiative, Inc., has resulted in implant distribution in public health facilities increasing 3.7 times between 2013 and 2015.
• Specifically, Cameroon’s central warehouse distributed 33,708 implants to public health facilities in 2015 compared to 9,063 implants two years before.
• Various factors contributed to this increase: stronger forecasting; the procurement of sufficient buffer stock to gauge true consumption; an investment in targeted healthcare worker training; and strategic planning by the government, which enabled thousands more women to access contraceptive implants, helped reduce high levels of unmet need, and advanced progress toward Cameroon’s FP2020 commitments.
• Historically, Cameroon’s chronic stock-outs of contraceptives, particularly implants, have contributed to a low CPR (16.1%) and high maternal mortality (720 deaths/100,000 live births).

Implant Distribution in Cameroon, 2013-2015

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

• The Government of Ethiopia is strengthening youth reproductive health services for family planning in universities by giving training on comprehensive family planning for health professionals and by equipping universities’ clinics with family planning commodities. In addition, the government has implemented demand-creation activities.
• Furthermore, the Ministry of Health has developed a national strategy with a minimum service package for scaling up of adolescent and youth reproductive health services by recognizing the vulnerability of these groups to unwanted pregnancy and pregnancy related complications, STD/HIV/AIDS, accidents and gender-based violence.
• In addition, a multisectoral task force for youth was established and led by the Ministry of Health to expand and strengthen adolescent and youth reproductive health activities. Members of the task force include representatives from different government ministries, CSOs, and partners.

The federal Ministry of Health has engaged in several activities to strengthen Ethiopia’s family planning program and to increase the number of family planning contraceptive users, with a particular focus on pastoralist communities.

• Raising awareness within communities at large is one of these activities. The government has conducted a series of advocacy workshops in pastoralist areas by using religious leaders to address religious, cultural and other related barriers to using family planning. Beside this, the ministry is producing radio and TV messages on family planning and translating these messages into local languages. To increase access for family planning services, different capacity building for health professionals has been provided. In addition, facilities have also been better equipped with family planning commodities and supplies.
• The Reproductive Maternal and Neonatal Health Innovation Fund (RIF) has supported interventions in four regions where fertility is high, use of reproductive maternal and neonatal health services is low and where communities lack access to services, such as pastoralist women. The program is being implemented in Somali, Afar and pastoralist districts of Southern Nations Nationalities and Peoples Region (SNNPR) and Oromiya. The implementation of innovative activities aimed at reducing barriers and increasing demand for reproductive maternal and neonatal health (RMNH) services is designed to complement on-going efforts to increase access to services for pastoralist communities in Ethiopia.

To ensure commodities security and monitor the availability of contraceptives, the Ministry of Health’s Pharmaceuticals Logistics Management Unit (PLMU) and the Pharmaceuticals Fund Supply Agency (PFSA), with technical support from the USAID | DELIVER PROJECT, engaged in activities to generate timely forecasts and quantifications to support advocacy and resource mobilization efforts.

• PLMU and PFSA conducted supportive supervision and evaluation to monitor stock-outs at service delivery points. In addition, this issue was also addressed in PMA2020’s Round 3 survey.
• The government’s recently revised Reproductive Health Strategy and costed-implementation plan documents contained detailed activities focused on ensuring commodities security and monitoring the availability of contraceptives.

The Government of Ethiopia is driven to meet its FP2020 commitments, which prioritize expanding access to Long Acting Reversible Contraceptives (LARCs). The following are major initiatives that support this commitment.

•  Implanon Scale-Up Initiative: More than 22,000 Health Extension Workers (HEWs) were trained in different regions of the country. About 1.8 million Implanon insertions have been made nationwide by HEWs since the beginning of the scale‐up program.
• IUCD Scale-Up Initiative: Taking into account the early success of the Implanon Scale-Up Initiative and the increasing demand for LARCs in Ethiopia, the Federal Ministry of Health launched and implemented an IUCD scale‐up project in 2011 and, based on the results of the first round of the project, the second round has been extended till 2017. To date, IUCD service has been expanded to 300 woredas (districts) through choice-based interventions.
• The Federal Ministry of Health has implemented activities to increase awareness of long term family planning methods through community mobilization efforts, behavioral change and communication using different media and conducted sensitization workshops focusing on IUCD for regional health office head, program coordinator, and region political leaders and religious, clan and community leaders, youth and women organization. Also, the ministry has ensured continuous supply of long acting family planning commodities to health institutions.
• The revised reproductive health strategy incorporates new strategies for long-acting reversible methods.

In July 2016, the Government of Ethiopia 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:

• To help meet the needs of married and unmarried adolescents and youth, the government has undertaken the following activities in 2015-2016:
  • Training on comprehensive family planning was given for university clinic personnel and health professionals to make family planning services available for youths and adolescents in collaboration with partners and Ministry of Education.
  • The government are working to strengthen youth reproductive health services in youth centers by providing training and IEC/BCC materials and franchising private clinics to address both in- and out-of-school adolescents and youths.
  • The Ministry of health has developed a 2015-2020 adolescent youth health strategy and made adolescent and youth reproductive health as one of the components.
  • The government is conducting research on the “factors affecting utilization of family planning among adolescents” and developing a policy brief focused on examining the risk-taking behaviors of adolescents and youth in the country.
  • Taskforce Update Nationally as a country Ministry of Youth and sport established and working specifically on adolescent and youth.
  • The Ministry of Health is a member of a taskforce on adolescents and youth, which has been formed by the Ministry of Youth and Sport.

• The Government of Ethiopia has engaged in the following activities to improve access to family planning for isolated pastoralist communities:
  • In 2015-2016, the ministry continued conducting advocacy activities to promote family planning by engaging religious and community and clan leaders.
  • The government has also started conducting fully-funded research on the barriers for utilization of family planning among pastoralist communities to design evidence-based interventions.
  • In addition, Ethiopia has developed the Health Sector Transformation Plan to 2015-2020, which states equity as one of the transformation agenda focus areas; based on this agenda, the ministry is expanding access for quality family planning services for these communities.

• The government of Ethiopia has engaged in the following activities in 2015-2016 to strengthen commodities security and to monitoring the availability of contraceptives:
  • The Pharmaceuticals Fund Supply Agency (PFSA) has established a family planning logistics technical working group to coordinate all stakeholders for the efficient management of the logistics system; the technical working group meets monthly.
  • A three-year forecasting and quantification analysis has been developed under the leadership of the Ministry of Health’s Pharmaceuticals Logistics Management Unit (PLMU) and Pharmaceuticals Fund Supply Agency (PFSA), and with technical support from the USAID | DELIVER PROJECT for advocacy and resource mobilization.
  • Regarding the availability of contraceptives, supportive supervision and evaluation has been undertaken to monitor stock-outs at service delivery points. UNFPA has also conducted a stock status survey.
  • The government has continued to fulfil commodities needs based on gaps and requests made by health facilities.

• The government of Ethiopia has engaged in the following activities to increase the uptake of long-acting reversible methods:
  • Both the Implanon Scale-Up and IUCD Scale-Up initiatives continue to be implemented, with more than 3000 health extension workers being trained on Implanon and 2401 health care providers being oriented to the new Implanon NXT.
  • In addition to this, the ministry is piloting IUCD provision by level 4 health extension workers in selected woredas and zones with high population pressure and low family planning use. The government has trained level 4 health extension workers from selected zones and equipped them.
  • To address high unmet need, the government is expanding post-partum family planning services in hospitals and health centers with high delivery caseloads.

• Following the London Summit on Family Planning, UNFPA has continued to invest significantly in Family Planning to fulfill the commitments made at the Summit.

• An analysis of expenses conducted by UNFPA in 2012 demonstrated that, in 2012, UNFPA spent a bit over 40% of its overall resources on Family Planning.

• UNFPA is currently reviewing its 2013 expenses and will be soon able to provide an update on 2013 expenses

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

In the case of UNFPA, tracking how much went specifically into family planning is not easy to do due to the cross-cutting nature of family planning programming vis-à-vis the other areas covered by UNFPA’s mandate. We estimate that the UNFPA expense on family planning was as follows:

• 2013: $310 million
• 2014: $334 million

Note: For additional information, please access UNFPA's Transparency Portal. 

Merck for Mothers has made significant progress on a number of fronts:

Scaling up a new supply chain model to expand access to family planning – a powerful tool to prevent maternal and newborn deaths

• Merck for Mothers and the Bill & Melinda Gates Foundation have formed an eight-year, $50 million collaboration to expand access to family planning. As part of this commitment, we have launched our first project in partnership with IntraHealth International and the Senegalese Ministry of Health and Social Action to support the expansion of an innovative distribution model which uses incentives to ensure the availability of contraceptive supplies at public health facilities across the country. This three-year partnership is strengthening the supply chain for family planning products and supporting the government’s family planning goals to increase the contraceptive prevalence rate from 12.3% to 27%. 
• The project is a phased national expansion of a novel supply chain model designed to ensure a reliable supply of family planning products at government-operated health facilities in Senegal.  A pilot of this model  conducted in two Senegalese districts (with 40 health facilities) in 2012 succeeded in reducing stock out rates to less than 2% of facilities and increasing utilization by 38%. Eight of 14 regions and 1,000 health facilities are currently participating in the expansion.   In addition to providing financial support for the project, Merck’s experts in health economics and supply chain are analyzing the cost-effectiveness of this novel and providing technical assistance on supply chain integration for other products (e.g., malaria and tuberculosis medicines) into the model to support the Government of Senegal’s capacity building efforts and ensure program sustainability.

Supporting 7 additional projects that are responsive to local maternal health and family planning needs.

Merck for Mothers is integrating postpartum family planning services into its maternal health programs to help women space their pregnancies.

• In Uttar Pradesh and Jharkhand, India, MSD for Mothers and Jhpiego are developing training curricula to strengthen the capacity of private providers to integrate postpartum family planning into their maternal care
• In Uttar Pradesh, India, MSD for Mothers has partnered with Pathfinder and World Health Partners to integrate family planning services through telemedicine across the Sky Network of social franchise clinics
• In Rajasthan, India, MSD for Mothers has partnered with Hindustan Latex and Family Planning Promotion Trust to train franchised providers to provide comprehensive maternal health and family planning services
• In Uganda, MSD for Mothers has provided an independent grant to PACE – the local Population Services International affiliate – to train ProFam franchise network providers to deliver postpartum family planning alongside maternal health services

Merck for Mothers is focused on broadening the range of service delivery points that offer a mix of family planning options and quality, client-centered care.

• In Rajasthan, India, MSD for Mothers and Hindustan Latex and Family Planning Promotion Trust are growing a network of community health workers to help increase access to maternal health services and family planning products for low-income women in urban and rural areas.

The Merck for Mothers Global Giving Program was designed to amplify the reach of the Merck for Mothers initiative and engage MSD offices around the world by supporting local projects to improve maternal health and access to family planning.

• In Indonesia - educating women who work in factories about family planning and maternal health and linking them to external health services
• In South Africa - accelerating access to high impact interventions through capacity-building of national and provincial governments and PHC outreach teams to integrate family planning services

In August 2015, Merck for Mothers shared an update on progress in achieving its commitments to FP2020.

• Since last reported, the Informed Push Model in Senegal has been scaled nationally to over 1,300 health facilities in all 14 regions of the country, ensuring reliable access to modern contraceptives for over 32 million women.
• To date, Merck for Mothers has expanded reliable access to modern contraceptives to nearly 280,000 women across three states: Jharkhand, Rajasthan, and Uttar Pradesh.
• Merck for Mothers is also partnering with the Population Council in Kenya to develop a mobile phone-based platform for women to select a family planning method of their choice, refer her to a nearby facility that offers her selection and follows up with her to rate the quality of care she received.
• The Merck for Mothers Global Giving Program was designed to amplify the reach of the Merck for Mothers initiative and engage MSD offices around the world by supporting local projects to improve maternal health and access to family planning. In Indonesia. Merck for Mothers has partnered with Project Hope across four factories to reach nearly 8,000 women about family planning and maternal health, connect them to workplace-based health services, and link them to external health services.

• IPPF Member Association saw 50 advocacy ‘wins’ in 2013 related to increasing access to SRHR, contraception or its funding and education and services for young people.

• In 2014, IPPF has helped empower civil society advocacy and accountability for reproductive health and family planning on the Every Newborn Action Plan, BRICS summit, CSW, Commission on Population and Development (CPD), World Bank, MNCH summit in Canada, WHO campaign for SRH, Open Working Groups and PMNCH Partner’s Forum, among other events. 

The following are international and regional highlights of IPPF progress towards mobilizing civil society and governments to improve the legislative, policy and regulatory and financial environment:

International highlights

• 110 IPPF Member Associations and partners from around the world including 27 from FP2020 Focus Countries and 60 on government delegations mobilized to advocate for SRHR including family planning at CPD in 2014.  

• Through mobilizing at the regional level, IPPF coordinated and led civil society to influence the regional reviews of the International Conference on Population and Development (ICPD) in 2013, resulting in five regional declarations which advanced the ICPD Program of Action. 

• IPPF has continued to monitor UN processes in New York and Geneva to identify and share opportunities for civil society to hold their governments to account. 

• Through IPPFs role as co-chair of the Reproductive Health Supplies Coalition (RHSC) Advocacy and Accountability working group IPPF has mobilized CSOs to position family planning and access to reproductive health supplies as key to post 2015 messaging. 

• IPPF works with Advanced Family Planning and the African Women’s Development Fund supporting the African Women Leaders Network for Reproductive Health and Family Planning (AWLN). AWLN helped ensure the outcome of the 6^th Africa Conference on Sexual Health and Rights included repositioning family planning as a priority health goal in the post-2015 agenda. 

• Advocacy by IPPF Member Associations and civil society globally (including the RHSC) contributed to a strong focus on family planning and reproductive health commodity security on the regional ICPD outcome documents, the CPD 47 Resolution and FP being reinstated into the final report of Open Working Group 13, after initial omission under the health goal in the zero draft. 

Regional highlights

• IPPF partners with leading European NGOs are working to increase European donor support in Official Development Assistance (ODA) for reproductive health and family planning in the Countdown 2015 Europe Consortium. Countdown 2015 Europe holds donors to account for their policy and funding commitments to achieve universal access to reproductive health and address the unmet need for family planning. 

• IPPF have partnered with the Campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA) to ensure progress at national and regional levels to reduce maternal mortality by increasing access to life saving family planning.

 National highlights in some priority countries

Democratic Republic of Congo

• IPPF Member Association The Association de Bien-Etre Familial – Naissances Désirables (ABEF-ND) engaged the support of other national organizations and networks to jointly persuade the government to make a commitment to procuring contraceptives and persuade them to take responsibility for the country’s contraceptive security. Their advocacy efforts resulted in the first ever budget allocation ($1 million) as well as the passing in early 2014 of the new law on family planning. Previously, contraceptive procurement depended solely on donor support.

 Ghana

• IPPF Member Association The Planned Parenthood Association of Ghana (PPAG) played a very active role in making contraception free in the public sector. The Association participated in the Contraceptive Security Committee, which plays a leading role in finding solutions to challenges to contraceptive availability. In 2013, the government added contraception to the list of free services provided to women as part of maternal health care.

 Malawi

• One of the Malawi government’s financial commitments was to add a line for contraceptives in the national budget. Following advocacy by the IPPF Member Association Family Planning Association of Malawi (FPAM), the government delivered on this promise and allocated a part of the national budget for the procurement of contraceptives. 

• FPAM worked with parliamentarians, traditional and religious leaders, and other non-governmental organizations to build their understanding of the effects of rapid population growth and the need for contraceptive security in the country. 

• Previously, there was no official government commitment to ensuring contraceptive security in the country, and procurement of supplies was possible primarily through donor funds. 

Nigeria

• The Nigerian government pledged a significant increase in the national budget for contraceptive procurement. The Planned Parenthood Federation of Nigeria (PPFN), an IPPF Member Association, worked with Ministry of Health technical staff and policy makers to convince them of the importance of realizing this commitment. As a result, the government allocated an additional US$8.4 million to purchase contraceptives in 2013.

 Uganda 

• Advocacy by Reproductive Health Uganda, an IPPF Member Association, helped to achieve the pledged budget allocation of $5 million from the government for contraceptive supplies. This work was in partnership with Advanced Family Planning. 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. 

Pakistan

• IPPF Member Association Rahnuma-FPAP advocacy has seen elements of Pakistan’s FP2020 commitments incorporated in the national vision 2025. 

The Philippines

• The Reproductive Health Advocacy Network advocated hard for the new Reproductive Health law, which was signed by the President in December 2012. The law was contested in the Supreme Court and largely upheld in a 2014 decision. The Family Planning Organization of the Philippines, an IPPF Member Association, are engaged in Track20 project.

 The Solomon Islands

• After advocacy by IPPF’s Member Association - Solomon Islands Planned Parenthood Association (SIPPA), the Solomon Islands government are developing a national plan for sexual and reproductive health and rights.

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

IPPF is a global leader in family planning service delivery and advocacy, and has been at the vanguard of delivering comprehensive voluntary family planning services for over 60 years. IPPF is the global and regional convener and mobilizer of civil society organizations that advocate for public, political and financial commitments to voluntary family planning. In 2014, IPPF continued to unite a global movement to improve the health status of poor and young people, in particular women and girls, through an enabling family planning policy environment and access to a range of cost-effective, high-impact health services. Particularly, the Federation succeeded in securing:

• National legislative change for access to contraception: 81 successful policy initiatives and or positive legislative changes in support or defense of sexual and reproductive health and rights (SRHR) to which Member Associations’ advocacy contributed. This included 27 increased national budget allocations for contraception, access to contraception and SRHR of vulnerable people;

• Global and regional norm setting for rights-based family planning: 18 successful regional and global policy initiatives and/or positive legislative changes in support or defense of SRHR to which IPPF’s advocacy contribute. IPPF implemented its largest-ever international advocacy program to prioritize sexual and reproductive health and rights—including rights-based family planning--within the new Sustainable Development Goals;

• Reproductive rights are human rights: 54% of Member Associations monitor obligations made by government in the international human rights treaties that they have ratified. IPPF Member Associations continue to use the United Nations Periodic Review process to raise concerns and make recommendations about sexual rights in their countries – including access to contraception.

The IPPF Member Association, Rahnuma-Family Planning Association of Pakistan (Rahnuma-FPAP) stands as an example of country impact. Rahnuma-FPAP is part of Pakistan’s national FP2020 Champions Group. Rahnuma-FPAP has agreements with national and provincial ministries, including the Ministry of National Health Services, the Population Welfare Department in Punjab, and the National Institute of Population Studies, and implements maternal and newborn child health programs in the provinces of Balochistan, Punjab and Sindh. These programs support service delivery and family planning in line with the national government’s commitment to FP2020. Rahnuma-FPAP, working with other civil society organizations, advocated for more family planning services with the provincial governments of Khyber Pakhtunkhwa, Punjab and Sindh. Together, these three provinces account for more than 85 per cent of the total population of Pakistan.  As a result, the provincial governments have incorporated commitments on family planning into their draft population policies and other influential policy documents; increased budgetary lines for contraception in both 2013–14 and 2014–15; allocated resources to procure contraceptives; established and reconfigured health delivery points to strengthen service reach; and increased their targets for contraceptive prevalence rates.

• Injectables have been included in the methods that can be provided by community health workers.

• The MoH has doubled the number of youth centers from 25 to 50 since 2010. At the centers, youth can organize activities, hold discussions, and access information on reproductive issues and family planning.

• Mobile clinic services were created, however cost remains a problem. The MoH is hoping to continue its work with donor partners regarding this issue.

• The Ecole Des Maris (School for Men) are considered very successful and are now nationally scaled (from 11 in 2007 to 610 at the end of 2013; these will continue to expand). The MoH asserts that certain regions, where the schools are present, have seen an increase in family planning coverage rates.

• Family planning information has been integrated into the school health curriculum in Niger’s capital, but contraceptive methods being offered at schools has not started.

• The MoH constructed a survey tracking 41 indicators, including contraceptive coverage rate and other RMNCH indicators, defined as being important for achieving national strategies. All regions must provide information on all of the indicators during yearly evaluations at a national level.

• Software has been implemented in the 42 districts that allows the MoH to monitor commodities and identify bottlenecks and stock outs.

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

The Government of Niger has engaged in several activities to expand access to family planning:

• Mobile clinics: The government reports that 16 districts have mobile clinics to reach rural and nomadic populations and 7 districts with very dense populations organize monthly mobile trips.
• More than 1,228 new community-based distribution sites for contraceptives have been created since 2013, while maintaining old sites.
• Sayana Press (depo subQ) is available at health centers;
• A pilot project offering injectables at community level is underway;
• An initiative for teenage girls in Niger—Knowledge for dignity–aims to reach, between 2014 and 2018, nearly 250,000 adolescents between 10 and 19 years of age, to encourage the adoption of positive health behavior and effect a change in social norms.
• Écoles des Maris [(Schools for Husbands] have been opened across the country: all regions are covered. There are more than 1,000 schools with an average of 12 model husbands per school.
• A partnership has been developed with the Association of Traditional Chiefs of Niger with UNFPA assistance. A partnership that engages traditional chiefs (players who are greatly listened to) in local awareness raising about FP, assisted deliveries, the fight against child marriage;
• Sexuality and family planning are part of the curricula in secondary schools;
• The Government of Niger, with the help of UNFPA, is implementing a program to empower young girls who do not attend school.

An annual survey of RHCS indicators is conducted in November each year on the availability of contraceptive products and vital life-saving medicines.

• Evaluation of the contraceptive coverage is in progress (survey combined with that of the PDES indicators). The results will be available in September 2015.

Since 2012, two joint MSP-Partner monitoring missions are performed each year for monitoring the implementation of the family planning program activities.

• Its missions cover 44 districts, 8 regions, 3 ONPPC (Office National des Produits Pharmaceutiques et Chimiques du Niger [National office of Pharmaceutical and Chemical Products of Niger]) regional depots and the ONPPC’s central stock.
• In 2015, a review of the first half year took place in May/June and allowed the MSP and partner teams to discuss the progress made by each aspect of service delivery.
• Niger is one of the few countries in West and Central Africa to have adopted the strategy of widespread use of Channel software as an inventory management tool and information management tool. Therefore, Channel is used by the ONPPC (central and regional depots), 8 regional divisions and 44 districts.

• Plus de 22 centres de santé intégrés organisent une sortie de clinique mobile de 10 jours par mois.
• Le contraceptif injectable est distribué au niveau de 1231 cases de santé sur 2500 que compte le Niger. 2380 utilisatrices auprès des agents DBC au niveau de 2 districts sanitaires et plus de 24614 utilisatrices au niveau des 1231 cases de santé. Le Niger a décidé en 2015 de porter à l’échelle des 2500 cases de santé l’utilisation de ce contraceptif.
• Le plan PF est en cours de révision pour prendre en compte des stratégies innovantes pour couvrir les besoins de jeunes. Et un plan stratégique spécifiquement sur la santé des adolescents et jeunes est en cours d’élaboration.
• En fin 2015 le Niger compte 1241 écoles des maris avec plus de 14800 maris modèles qui sensibilisent leurs pairs et la population entière à l’utilisation des services de santé notamment la planification familiale et les accouchements au niveau des services de santé.
• La planification familiale est intégrée dans le cursus de l’enseignement secondaire. Les enseignants sont formés.
• Le Niger n’a pas encore conduit d’enquête triennal sur la prévalence contraceptive. La prochaine enquête est prévue pour 2017.
• L’enquête annuelle RHCS sur les indicateurs de la sécurité contraceptive a été conduite chaque année et cela depuis 2012. Les résultats indiquent :
  • 100% des points de prestations de services offrent 5 méthodes de contraception moderne
  • 5% des points de prestation de services n’ont pas connu de rupture de stock au cours des 6 derniers mois.
• Le suivi semestriel du niveau central au niveau des 44 districts et 8 régions se sont poursuivis en 2015 et 2016. Chaque Direction Régionale de la Santé organise un suivi trimestriel vers les districts sanitaires relevant de sa région. Chaque district sanitaire effectue une mission de suivi trimestriel vers les centres de santé intégrés de son district.
• Channel est utilisé au niveau de toute la chaine d’approvisionnement jusqu’au niveau district. Ainsi l’ONPPC (central et zonal), les 8 DRSP et les 44 districts utilisent Channel pour la gestion logistique et pour collecter les informations de gestions en vue de décisions rationnelles d’approvisionnement. Le Niger vient de former le personnel à l’utilisation du Channel 2 (version améliorée de Channel).