Making SRH Services Work for next generation

Summary

Innovation for Promotion of SRH and for Quality SRH Services

Evidence has shown that access to better Sexual and Reproductive Health (SRH) care and family planning can provide tremendous health gains. If all women who want to avoid unintended pregnancy were to use modern contraceptives, the number of unintended pregnancies in developing countries would decrease by 71%, from 75 million to 22 million annually.

Goals

  • Inform youngsters in Burundi, Rwanda and DRC/South Kivu so they make healthier choices on sexuality
  • Increase access to safe commodities for sexual and reproductive health in Burundi, Rwanda and DRC
  • Improvement and increase of sexual and reproductive health services in Burundi, Rwanda and DRC

Background

In the focus countries of this program, the challenges surrounding SRH are enormous. For instance, the modern contraceptive rate of South-Kivu is 10% and teenage pregnancy rate among 15-19 years old is 34%. In Burundi use of modern contraceptives is higher but there is still an unmet family planning need of over 30%. Rwanda has made gains over the years, and can function in some ways as an “example country”, but the adolescent birth rate stayed stable and violence against women is high; 57% of sexual and gender based violence in 2010 was committed on girls between 5-18 years .
Lack of access to sexual reproductive health information and services and obstacles to make free choices have a negative impact on the health and wellbeing of women and youth. Moreover this lack of access does negatively contribute to the overall social economic development and stability of this region where overpopulation and scarcity of land have been sources of tension and conflict for decades.

Initial situation

The project starts in January 2013 and will run until 31 December 2015. The project takes place in Burundi and South Kivu and Rwanda, where Cordaid has programs in the field of healthcare and Performance Based Financing for a longer period and in the case of Rwanda had programs in the past. Cordaid is building on this experience.

Goals

We aim to improve the sexual and reproductive health for women and youth in Burundi, Rwanda and DR Congo (South Kivu). The program will directly contribute to three of the four outcomes of the Ministry of Foreign Affairs namely:
– Young people are better informed and are thus able to make healthier choices regarding their sexuality
– A growing number of people have access to contraceptives and other commodities required for good sexual and reproductive health
– Public and private clinics provide better sexual and reproductive healthcare services, which more and more people are using

Goals

  • Inform youngsters in Burundi, Rwanda and DRC/South Kivu so they make healthier choices on sexuality
  • Increase access to safe commodities for sexual and reproductive health in Burundi, Rwanda and DRC
  • Improvement and increase of sexual and reproductive health services in Burundi, Rwanda and DRC

Target group

The target groups are:
1. Young people (men and women) in Burundi, Rwanda and DR Congo / South Kivu are better informed and are thus able to make healthier choices regarding their sexuality
2. A growing number of people have access to contraceptives and other commodities required for good sexual and reproductive health
3. Public and private clinics provide better sexual and reproductive healthcare services, which more and more people are using

Project plan

The main activities include:
– To improve quality sex education for young people, the program aims at establishing performance contracts with secondary schools in the country, to keep young girls in school and to integrate quality sex education in school curriculum (indicators for each girl year in school, bonus for additional year at school, for management and for quality sex education delivered). The program also stimulates peer education by youth organizations for youth in and out of school.
– Health services in the three countries will become more youth friendly through establishing special youth centers (with special attention for gender based violence) in under-served areas. Health staff will be trained in youth friendly services, and in their capacities to give proper SRH information to young people. The program will also include quality indicators for youth friendly services in Performance Based Financing contracts, and include youth in community verification/ client satisfaction surveys.
– The program aims at improving supply of commodities in the three countries by training and on-the -job monitoring for Health procurement departments to better procure, plan, quantify, forecast and distribute SRH related medicines and supplies. The program also plans activities to make commodities geographical accessible, by establishing side kiosks/subcontracting in areas where religious facilities do not provide them, and by introducing pharmacy in the box, an entrepreneurial way of better supply chain management.
– The program addresses socio-cultural barriers, preventing women deciding on SRH and family planning, by training male peer educators, who will discuss the issues with other men, by organizing reflection sessions with Civil Society Organizations, government and media, by creating incentives for couples that come for SRH services, by using mass media and tablets / smart phones, and by training health workers, traditional and religious leaders, Traditional Birth Attendants and traditional healers.
– Lastly, the program will ensure that SRH and family planning will be integrated in other health services, through premiums in the Performance Based Financing system and training of all actors involved, and that contraceptive commodities will become more affordable, through a voucher system targeting vulnerable groups. And faith based organizations will be supported through Informed Decision Making to improved their service delivery.

Based on the above each country will develop an annual work plan that specifies the activities per country.

Through the above described interventions the program’s main targets are women and youth in the program areas. An estimated 1,5 million women will have access to family planning and 1,3 million young will be reached by services targeting youth. Other groups that will benefit from the program are men, family and community members, health service providers and schools in the areas will benefit of the program.

Sustainability

The program will ensure that SRH and family planning will be integrated in other health services, through premiums in the Performance Based Financing system and training of all actors involved, and that contraceptive commodities will become more affordable, through a voucher system targeting vulnerable groups. And faith based organizations will be supported through Informed Decision Making to improved their service delivery.

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