20 February 2019

Jhpiego

2018

Commitment Progress

Jhpiego believes that women deserve more than just to survive—they deserve to thrive. To have their family planning (FP) needs met, on their terms – meaning greater method choice, quality, and for their rights to be at the center. Jhpiego is dedicated to meeting women’s and girls’ desire for FP, especially at times when their need is often underestimated-during adolescence, after birth or after loss of pregnancy. Jhpiego has delivered on its promise and internally-funded specific investments in Ghana, Uganda, and West Africa.

In Ghana, to better understand adolescents’ unique needs, Jhpiego conducted a co-creation event using human-centered design principles with pregnant adolescents, first-time mothers, health workers and influencers. Using the event’s insights , Jhpiego partnered with the Ghana Health Service to build 51 health providers’ capacity to respond to adolescent needs, engaged key influencers to create supportive environments for adolescents, and established mother support groups to provide social support to 85 pregnant adolescents and new adolescent mothers. Jhpiego partnered with the National Board of Small Scale Industries to provide employment training for 73 adolescents, in trades like soap making or jewelry crafting. Jhpiego reached 506 adolescents and increased uptake of FP among adolescent mothers in project-supported facilities from 32% to 56%(2017-2018). In the mothers’ groups, 85% of the cohort received FP counseling, attended at least four antenatal care visits, and delivered in a facility. 93% accepted an FP method after birth to delay their next pregnancy, demonstrating the high effectiveness of the mothers’ group program.

From 2016-2018 in Uganda, Jhpiego-capacitated adolescent mother peer guides reached 4504 adolescents through home visits, resulting in 1060 completed referrals for antenatal care, delivery, postnatal care, and FP services. Peer guides held community groups, reaching 3526 adolescents, and dialogue meetings with influencers, reaching 351 community members, to provide information on available health services and confront stigma associated with adolescent pregnancy. Jhpiego built the capacity of providers in postpartum and postabortion FP and prepared staff to deliver adolescent-friendly services through facility-wide orientations. After the intervention, 658 postpartum and postabortion adolescents from these facilities were counseled and initiated a FP method of their choice. Uptake of FP immediately after delivery among adolescents increased from 15% to 51% in maternity, from 26% to 69% at postnatal care, and from 29% to 78% for adolescent postabortion care clients(June 2017-May 2018).

To support francophone West Africa, Jhpiego convened key stakeholders from MOHs and partners at the 2018 International Conference on FP to advocate for approaches to improve facility-based team performance in postpartum and postabortion FP and include relevant indicators to inform programming. Jhpiego leverages strategic regional meetings to advocate for best practices and leverages sponsored programs, such as the “Accelerating uptake DMPA-SC” project to scale-up life-saving FP services for women in the region.

Globally, Jhpiego developed an impact modeling tool for postpartum FP using data on interventions throughout the maternal continuum of care. Once finalized, this tool will be publicly available to support governments and partners in goal-setting and strategic decision-making for their context.

2017—London Family Planning Summit

Over the next three years, Jhpiego will provide US $500,000 to implement and advocate for programs and policies that increase access to family planning for adolescents and first-time parents, expand uptake of PPFP, and prepare frontline health workers to deliver quality family planning services. This commitment in support of FP2020 and Every Woman Every Child, will be implemented globally, with targeted activities in Ouagadougou Partnership Countries, Uganda and Ghana.

In Uganda and Ghana, we will introduce interventions to empower first-time parents to ensure healthy timing and spacing of future births and provide lifesaving information on breastfeeding and newborn care. Furthermore, Jhpiego commits to supporting West African governments in achieving their FP2020 commitments.

Commitment Progress

Jhpiego remains dedicated to meeting women’s and girls’ desire for family planning (FP), especially at times when their need is often underestimated–during adolescence, after childbirth, or after loss of pregnancy. Since updating our commitment in 2017, Jhpiego has implemented and advocated for programs and policies that increase access to FP in many African and Asian countries. Jhpiego has delivered on its promise and internally-funded specific investments in Ghana, Uganda, and West Africa.

At the recommendation of the Ministry of Health (MOH) in Ghana, Jhpiego is implementing a FP program sensitive to adolescents’ unique needs. This program includes provider capacity building for adolescent-friendly services and empowering adolescents with information on positive self-esteem, postpartum FP, and newborn care. In January 2018, Jhpiego conducted a co-creation event using human-centered design principles with pregnant adolescents, first-time mothers, health workers and influencers to better understand barriers adolescent girls face to receive FP information, services and supplies. Future programs in Ghana will integrate insights generated from this event to develop relevant and meaningful services for adolescents.

In Uganda, Jhpiego-trained adolescent mother peer guides reached 1,161 adolescents through home visits, resulting in 461 completed referrals for antenatal care, delivery, postnatal care, and FP services. Peer guides held community meetings, reaching 1,392 adolescents, to discuss adolescent health, confront stigma associated with adolescent pregnancy, and provide information on available health services. In collaboration with the MOH, Jhpiego built the capacity of providers in adolescent-friendly services and postpartum and postabortion FP across Tororo and Bukedea districts. As of December 2017, 134 postpartum or postabortion adolescents from these facilities were counseled and initiated a FP method of their choice.

In West Africa, Jhpiego supports Ouagadougou Partnership (OP) countries to achieve their FP2020 goals through the promotion of high impact practices such as postpartum and postabortion FP. At the request of OP country governments, Jhpiego invested our resources to conduct a situational assessment in OP countries–Benin, Burkina Faso, Cote d’Ivoire, Guinea, Mali, Mauritania, Nigeria, Senegal, and Togo–to determine the extent of current implementation of postpartum and postabortion FP, identify opportunities to accelerate these practices, and explore strategies for rapid scale-up. Key findings included:
• Challenges include lack of political commitment and budget, minimal coordination of FP actors, lack of commodities, lack of trained and willing providers, lack of community-based FP distribution, and weak male engagement.
• Women have relatively frequent contacts with the health system during pregnancy and childbirth; this may represent untapped opportunities to expand PPFP services.
• Mali offers long acting reversible contraception in the immediate postpartum period, but women in other countries have minimal access to these postpartum methods.
• Integrating FP competencies into pre-service midwifery and OB-GYN education is a promising opportunity to scale up postpartum FP nationally

Jhpiego presented the assessment results at the 2017 OP Annual Meeting, shared with FP2020 to support the Francophone Focal Point Meeting, and continues to engage the MOH in these countries to use these results to inform their programs and in turn, improve access to life-saving FP services for women in the region.

2012—London Family Planning Summit

Jhpiego commits to providing new, incremental funds in the amount of US $200,000 to support innovations in the provision of implant/injectable services at the community-level, using front-line health workers. Jhpiego also commits to advocating for task-shifting to improve access to long-acting family planning methods in underserved settings and training matrons or auxiliary midwives to provide implants in underserved settings.