PROGRESS Newsletter #3

Linking Family Planning with Child Immunization: Intervention Suggests Flexible Model Needed, Global Projects Documented on Interactive Map

To address the high unmet need for family planning (FP) among women during the extended postpartum period, FHI worked with the Ministries of Health and local partners in Ghana and Zambia to determine if integrating FP messages and referrals into early child immunization visits could increase contraceptive use among this group of women.

The intervention did not lead to a statistically significant contraceptive uptake. However, providers in both countries were positive about this approach in stakeholder meetings and in-depth interviews. More work is needed to understand the most effective messages to give to women (and potentially men) during immunization contacts and elsewhere during the postpartum period about both the risk of pregnancy and the benefits of FP. The intervention suggests that a flexible intervention approach is needed that is sensitive to the realities in particular service locations.

One of the immunization clinics in Ghana where the study was conducted. Photo by Gwyneth Vance, FHI.

FHI/PROGRESS, working in collaboration with the Maternal and Child Health Integrated Program (MCHIP), has documented recent programmatic and research experiences with integrating family planning and immunization. You can view this material in an online map or in a table format (PDF, 210 KB).

Expanding Contraceptive Use in Rwanda

To understand factors constraining contraceptive use in Rwanda, the Ministry of Health collaborated with FHI to examine barriers to modern contraception use and explore psychosocial factors influencing modern contraceptive use. The findings suggest that women would benefit from more accurate messages about risk of pregnancy, particularly in the postpartum period, and that information about IUDs and sterilization could be improved. Also, information supporting the use of family planning needs to reach men, who play a key role in a woman's decision to use contraception.

An interviewer in the non-use study at work in Rwanda. Photo by Jennifer Wesson, FHI.

Kenya Holds First National Population Conference in 20 Years

In November, the Kenya National Coordinating Agency for Population and Development (NCAPD) and others hosted the National Population Leaders Conference "Managing Population to Achieve Vision 2030." The first national population conference in Kenya since 1989, it sought to develop recommendations to meet the Millennium Development Goals and the Kenya Vision 2030 plan. The NCAPD called on FHI/Kenya to provide technical support.

With USAID/Kenya field support through PROGRESS, FHI staff worked with the NCAPD to conceptualize the overall event, develop the scientific committees for guidance of the meeting, help prepare and review the key papers presented, coordinate the rapporteur process, and develop the meeting report. The NCAPD is now working with technical assistance from FHI/Kenya to develop a final plan of action to be presented to Parliament to help guide the future population policy in the country. More information about the national population conference is available here.

 Number 3 • January 2011

National Vasectomy Training Plan Launched in Rwanda

FHI is supporting the Rwandan Ministry of Health (MOH) to increase access to quality vasectomy services in Rwanda by training physicians across the country to use a method of no-scalpel vasectomy known as cautery with fascial interposition and by building local capacity to use monitoring and evaluation for continuous quality improvement. In September 2010, representatives from the MOH and the Family Planning Technical Working Group developed a national scale-up plan. In 2010, 12 physicians and 18 nurses were trained in the Northern Province, and trainings will continue throughout the rest of the country in 2011. Data from post-training evaluations, routine supervision visits, client follow-up, and interviews with providers will help guide the scale-up of this service and provide information relevant to global audiences.

Ethiopia Team Visits Kenya to Help Revitalize IUCD Efforts

In December 2010, a 14-member delegation from the Ethiopia Federal Ministry of Health (FMOH), USAID, and cooperative agencies traveled to Kenya to learn about Kenya's intrauterine contraceptive device (IUCD) revitalization efforts. The Ethiopian FMOH is currently rolling out an IUCD revitalization effort. Information from the learning tour will be used to guide the Ethiopian effort. The tour included visits to sites where IUCDs are being inserted. At the request of USAID and Ethiopia, FHI/PROGRESS supported the planning and implementation of the trip.

Family Planning Training Resource Package Beta Site Launched

At USAID's request, PROGRESS developed and launched a "beta" website for the Family Planning Training Resource Package, a project led by USAID and WHO, with input from EngenderHealth, the Institute for Reproductive Health, IntraHealth, Jhpiego, Management Sciences for Health, Pathfinder, and others. FHI serves as the secretariat, coordinating the development and review of training resource modules on contraceptive methods and core family planning skills for both clinicians and community health workers, as well as other key components of this resource. The website is designed to serve as a complement to the WHO cornerstones for family planning, particularly the Global Handbook for Providers. The final site, to be developed with the Knowledge for Health project, will be available in stages, beginning in March 2011 at http://www.fptraining.org/.

FHI Supports Rwanda MOH in Scaling Up Community-Based Family Planning

FHI has provided technical assistance to the Rwanda Ministry of Health (MOH) to roll out an ambitious plan to scale up community-based family planning. FHI has helped the MOH in designing a phased approach, developing materials used so far to train more than 3,000 community health workers (CHWs) in the three Phase I districts, and developing a low-cost monitoring and evaluation plan for Phase I to inform the national scale-up process. In the first month of service provision at the end of 2010, more than 3,600 clients received a contraceptive method in the three districts: 41% got injectables, 32% condoms, 25% oral contraceptive pills, and 2% the Standard Days Method.

PROGRESS (Program Research for Strengthening Services) is a five-year project awarded to FHI 360 by the U.S. Agency for International Development (USAID) in June 2008. The project seeks to improve access to family planning among underserved populations by providing global technical leadership and working in selected countries. PROGRESS currently works in eight countries in sub-Saharan Africa and in India.