PROGRESS Newsletter #8

New Film Highlights Benefits of Family Planning to Microfinance Clients in India

A new film produced by FHI 360's PROGRESS project in partnership with the Network of Entrepreneurship and Economic Development (NEED) demonstrates how a collaborative project is working to improve women's access to family planning in India. The 12-minute film — A Healthy Investment: Linking Family Planning and Microfinance — shows how a microfinance organization's village health guides have been trained by FHI 360 and the Institute for Reproductive Health to deliver basic family planning information to community groups in 70 villages of Uttar Pradesh that receive NEED's microfinance services. "What we hope to leave behind are village health guides who have good quality family planning information available to them, who know how to communicate these simple messages to the people they come in contact with, and who can serve as a resource and a link to the government family planning services that are already in place," says Rick Homan, a health economist at FHI 360 who worked on the project. As shown in the film, the village health guides have already become a vital community link to family planning services, suggesting that access to family planning can be enhanced by organizations outside of the health sector. The film, which is narrated in English, is available here on YouTube. Additional information on the project, for which final results are expected in 2013, is available here.

Study Assesses Capacity in Ethiopia to Expand Access to Long-Acting Methods

	© 2005 Virginia Lamprecht, Courtesy of Photoshare.

Ethiopia's Federal Ministry of Health, with technical assistance from PROGRESS, recently assessed the readiness of Ethiopia's health system to expand the delivery of family planning services — especially long-acting methods — in selected sites. This situational analysis found that most health facilities have the capacity to provide short-acting methods and have the basic infrastructure to provide intrauterine devices (IUDs) and implants. Provider interest in these long-acting methods also exists, although training on the methods will be necessary to expand coverage. Clients reported that services are close by and that operating hours are convenient, so government efforts to improve access to family planning seem to be working. However, the analysis also identified possible barriers to the uptake of long-acting methods, including low awareness (especially of IUDs) and provider restrictions related to age, parity, marital status, menstruation, and the need for a husband's consent to use contraception. This suggests that Ethiopia's family planning guidelines, which do not address these possible restrictions, should be reviewed and possibly updated. Results of the situational analysis are available in brief format (PDF, 490 KB) and as a full report (PDF, 859 KB). More information on PROGRESS work in Ethiopia is available here.

Results from Zambia Suggest Benefits of Free Pregnancy Testing

PROGRESS-supported research from
Zambia suggests that free pregnancy tests should be made available in developing countries where denial of contraceptives services to non-menstruating clients remains a problem. Highly sensitive pregnancy test strips cost very little and fill an obvious gap when a client's history fails to exclude pregnancy. In the randomized study, 10 governmental family planning clinics in both Zambia and Ghana received a supply of free pregnancy tests and training on how to rule out pregnancy among non-menstruating clients. Ten control clinics received no such tests or information. In Zambia, the rate of denial of contraceptive services remained high in the control clinics (at 17 percent) but decreased from 15 percent to 4 percent in the intervention clinics. Because of the low cost of the pregnancy tests, the estimated cost of "averting a denial of services" was only U.S. $0.57. In Ghana, adding pregnancy testing did not significantly increase the number of women receiving contraceptive services. For more details about the study and its results, see this new research brief (PDF, 241 KB).

 Number 8 • December 2012

Kenya Changes Policy: Community Health Workers Can Provide Injectable Contraceptives

Conducted by the Kenya Ministries of Health and FHI 360 with funding from USAID, a demonstration project has led to a policy change announced in November 2012 (PDF, 1.2 MB). The new policy allows trained community health workers to provide the injectable contraceptive depot medroxyprogesterone acetate (DMPA) in areas of the country where access to contraceptives is limited. The ministries' announcement said the change was "based on the findings of the successful demonstration project and subsequent consultations with key stakeholders." The demonstration project was done in collaboration with Jhpiego (a nonprofit organization affiliated with Johns Hopkins University) through USAID/Kenya's bilateral project known as AIDS, Population and Health Integrated Assistance (APHIA). PROGRESS has worked closely with the ministries and others (including Jhpiego and the Advance Family Planning project) in recent years to achieve this policy change. More information is available in the FHI 360 announcement here.

PROGRESS Supports National Family Planning Conferences

In November 2012, PROGRESS supported sessions and participants in major family planning conferences held in both Nigeria and Ethiopia. At the 2nd Nigeria National Family Planning Conference in Abuja, called "Population and National Development," PROGRESS supported a plenary session on expanding access to family planning in hard-to-reach communities, with an emphasis on Nigeria's new national policy to allow community health extension workers to provide injectable contraceptives in communities. Presentations covered the successful pilot on this service, World Health Organization (WHO) guidance on task shifting, commodity security issues, community mobilization, and scale-up lessons from Uganda. Monica Kerrigan of the Bill & Melinda Gates Foundation co-chaired the session. In Ethiopia, the meeting entitled "Family Planning: A Drive to Achieving Socio-Economic Development" discussed recent achievements in family planning and how they can influence other development sectors.

Regional Mobile Technology Meeting Held in Tanzania

At the request of USAID's Africa Bureau and USAID/Tanzania, PROGRESS provided logistical and technical support for the regional meeting "Using Mobile Technology to Improve Family Planning and Health," held in Dar es Salaam, Tanzania, on November 12-16, 2012. More than 150 people from Ministries of Health and partner organizations attended the meeting, which was organized primarily through 15 African country teams. The meeting was a week-long dialogue on how to use mobile technology to improve family planning and health, with the goal of helping programs use resources more efficiently, develop innovative programming ideas, expand engagement with the private sector, and work more closely with donors on this topic.

Consultation in India Seeks to Expand Contraceptive Choices

With technical assistance provided by
FHI 360/PROGRESS and Marie Stopes India, Advocating Reproductive Choices (ARC) organized a stakeholder consultation entitled "Expanding Contraceptive Choices in India: Focus on New and Underutilized Methods." Held on September 6, 2012, in New Delhi, the consultation attracted approximately 85 participants from the government, donor community, academic and technical organizations, and implementing partners. The objectives of the meeting, a meeting summary, and technical presentations from the meeting are available here.

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 13 countries in sub-Saharan Africa and in India.