Marie Stopes International and EngenderHealth lead endeavor to expand contraceptive choice

by Sara Malakoff, Senior Program Associate, EngenderHealth

Female sterilization is the world’s most popular contraceptive method with more than 220 million users. Sterilization is convenient for women who desire to limit childbearing, as it requires no further visits to a health care provider. In addition, it does not have the side effects that contribute to the discontinuation of user dependent methods, such as hormonal contraception. However, access to both male and female sterilization varies significantly geographically, is limited in many parts of the world (particularly in rural areas), and has not increased at a pace comparable to that of the unmet need to limit childbearing.

In an attempt to address issues of full contraceptive choice and to ensure the availability of and access to a wide range of contraceptives, including permanent methods, Marie Stopes International (MSI) and EngenderHealth under the auspices of the Support for International Family Planning Organizations (SIFPO) project funded by USAID, convened a two-day technical symposium in Nairobi in March 2014 entitled Provision of Permanent Methods of Contraception in Low-Resource Settings. A dynamic group of over 40 participants from 27 organizations and 13 countries attended the event.

Continue reading

Health in hand: New contraceptive option expands access to family planning

Guest post by Sara Tifft, Project Director, PATH Sayana® Press Pilot Introduction project

Worldwide, women choose injectable contraceptives because they are safe, reliable, and discreet. In many rural or remote areas, however, travelling to a clinic to receive an injection is costly and burdensome. PATH, an international nonprofit health organization, is collaborating with global partners to address this challenge. We began with a basic question: What would it take to deliver more injectable options to women, particularly outside the clinic setting?

One answer is Sayana® Press: a small, easy-to-use injectable contraceptive that has the potential to increase access and choice for millions of women worldwide.

PATH is training community health workers in the Mubende district of Uganda to expand access to family planning, including the Sayana Press injectable contraceptive shown here. Photo credit: PATH/Will Boase

PATH is training community health workers in the Mubende district of Uganda to expand access to family planning, including the Sayana Press injectable contraceptive shown here. Photo credit: PATH/Will Boase

Continue reading

Uganda Prioritizes Voluntary Family Planning and Charts Course for a Rights-Based Approach

Blog post by Jan Kumar, EngenderHealth/RESPOND Project

The planets have aligned in Uganda over the past few weeks for a significant shift in the country’s national family planning (FP) program that sets it on a new and ground-breaking course. From July 28-30, 2014, the Ugandan Ministry of Health (MOH)—with support from the United Nations Population Fund (UNFPA)—hosted an event titled “Accelerating social and economic transformation through universal access to voluntary family planning.” President Museveni used this opportunity to accelerate the government’s commitment to FP2020 and to voice his endorsement for FP as a means to improve maternal health, reduce poverty, and support social and economic development. The meeting paved the way for the promotion of equitable access to a wide range of quality FP services that ensure full, free, and informed choice, as well as the protection and fulfillment of human rights for all Ugandan women and couples who wish to space or limit their childbearing.

DSC_1557

Continue reading

Can 223 million women be wrong? A reflection on the status of voluntary sterilization programs

Guest post by Lynn Bakamjian

Tanzanian couple receiving family planning counselling (Photo credit: Sala Lewis)

Tanzanian couple receiving family planning counselling (Photo credit: Sala Lewis)

Today, as family planning (FP) programs are receiving renewed attention and resources as a result of FP2020, several important issues have risen to the top of the investment agenda. These include increasing access to quality long-acting reversible contraceptive (LARC) methods; task-shifting FP information and services to lower level health workers to address provider shortages; and scaling- up approaches that extend services, such as postpartum FP , mobile services, and increased engagement of the private sector. As programs strive to make more contraceptive choices available to reach more than 200 million women with an unmet need for FP, there is one topic that receives little attention—how to expand access, availability, acceptability and quality of permanent methods (PMs) (voluntary female sterilization and vasectomy). Continue reading

Getting Real on Rights: Experience from Two Country Consultations on Applying a Rights-Based Approach to Family Planning Programming

Guest post by Shannon Harris

Given the many challenges that countries face in providing family planning (FP) services, how can a client-centered, rights-based approach to programming help governments meet their obligations to respect, protect, and fulfill clients’ rights to meet their reproductive needs and desires? This question framed two recent country consultations in India and Kenya to explore the feasibility and desirability of applying the voluntary, rights-based FP (VRBFP) conceptual framework. Were country-level FP stakeholders—program managers, policymakers, and providers—even interested in such an approach?

With funding from the Bill & Melinda Gates Foundation, the Futures Group and EngenderHealth partnered with the Population Foundation of India and the National Council for Population and Development in Kenya to host national and regional stakeholder consultations, as well as conduct FP site visits to explore these questions. Despite diverse cultural, policy and program environments, stakeholders in both countries expressed tremendous interest in using a rights-based approach. Stakeholders found the program vision described in the VRBFP framework appealing and relevant to their programs because of its emphasis on the individuals and communities served by the FP program, while simultaneously acknowledging the importance of the policy environment and supply-side factors.

Photo by H. Connor/EngenderHealth

Members of the Futures Group/EngenderHealth rights framework team visit a community motivator in India’s Bihar State to identify the realities and challenges related to protecting and fulfilling human rights in FP at the community level—specifically to identify the conditions and practices that either uphold or violate human rights. (Photo by H. Connor/EngenderHealth)

Continue reading

Family Planning for All: The Importance of Contraceptive Access and Choice following Fistula Repair

Guest Post by Carrie Ngongo (Project Manager, Fistula Care Plus)

People often assume that women who’ve undergone an obstetric fistula repair are not interested in using family planning (FP). After all, most lost a baby during the obstructed labor that led to their injury. However, recent studies (see here and here) indicate that fistula clients are often interested in using FP if they learn about available methods and services during their post-repair recovery period. When fistula surgeons and counselors make assumptions about women’s desires, they miss the opportunity to provide needed services and to offer reproductive choices to women who may have been disadvantaged and marginalized as a result of their injury.

Photo by R. Raj Kumar/EngenderHealth

Photo by R. Raj Kumar/EngenderHealth

Continue reading

Walking Together: Strengthening Health Facility and Community Links to Improve Access and Choice

Guest post by Molly Tumusiime, Program Associate (Community Engagement), EngenderHealth/Uganda

The Right to Health asserts that people are entitled to access reproductive health services, including family planning (FP), that are acceptable to them and of the highest possible quality. However, there are many barriers to individuals’ realizing this right at many levels. While policy change and provider training can support increased FP access and use and better ensure contraceptive choice, interventions at the policy and service delivery levels alone are insufficient. Community-level barriers also impede service utilization and should be addressed in participatory and cooperative ways.

In 2010, EngenderHealth began piloting site walk-throughs (SWTs) in Bangladesh, Ethiopia, Ghana, Tanzania, and Uganda. This promising approach—rooted in the core human rights principles of participation, empowerment, and accountability—catalyzes community participation in health and strengthens the accountability of service providers to communities. In addition, SWTs foster linkages and collaborative partnerships between health providers and community members in addressing barriers to informed choice and service access and in improving the quality and acceptability of services.

Photos by E. Brazier/EngenderHealth

Photos by E. Brazier/EngenderHealth

Continue reading

Hot Topic: Rights and Choice at the International Conference on Family Planning

From November 12–15, an estimated 4,000 government officials, policymakers, program managers, researchers, academics, and youth advocates will gather in Addis Ababa, Ethiopia for the 3rd Annual International Conference on Family Planning (ICFP).

The theme of this year’s conference—cohosted by The Bill and Melinda Gates Institute for Population and Reproductive Health and Ethiopia’s Ministry of Health—is “Full Access, Full Choice,” echoing the Family Planning 2020 (FP2020) initiative’s call to ensure that rights and contraceptive choice are central to meeting the commitment made at the London Summit on Family Planning to reach an additional 120 million women with access to contraception by 2020.

Continue reading

Developing Country Leaders and Advocates Urge Improved Commodity Security to Ensure Rights

Ms. Anuradha Gupta, Additional Secretary of India’s Ministry of Health and Family Welfare and Mission Director of the National Rural Health Mission (NRHM)

Ms. Anuradha Gupta, Additional Secretary of India’s Ministry of Health and Family Welfare and Mission Director of the National Rural Health Mission (NRHM) / Photo credit: RHSC

Last week, the Reproductive Health Supplies Coalition (RHSC) held their 14th annual meeting in Delhi, India. The meeting, cohosted by India’s Ministry of Health and Family Welfare, convened more than 200 participants from civil society, the private sector, and governments to work collaboratively toward strengthening the core principles of commodity security—method choice, quality, and equity—to increase access to affordable, high-quality family planning (FP). Continue reading

World Contraception Day and the UN General Assembly Millennium Development Goal Review

Celebrating World Contraception Day

Today, the international community celebrates World Contraception Day. This global campaign strives to increase awareness of contraception and encourage its use to enable people to make informed decisions about their sexual and reproductive health and to prevent unplanned pregnancy and sexually transmitted infection. This year’s motto, “Your Future, Your Choice, Your Contraception,” targets young people.

Bwaila Hospital, Lilongwe, Malawi (Photo by Holly Connor/EngenderHealth

A woman enjoys her new granddaughter at Bwaila Hospital in Lilongwe, Malawi. She is there in support of her daughter, who has requested counseling from a family planning nurse on obtaining a female sterilization. (Photo by Holly Connor/EngenderHealth)

Continue reading