Reproductive health services for girls

Summary

Access to Family Planning with a focus on youth

Banja La Mtsogolo (BLM) operates a national program that provides reproductive health services through a network comprised of clinics, outreach teams, community health workers, and partnerships in the private sector. The underlying program seeks to address the unmet need for Family Planning (FP) in Nkhotakota District and to expand access to FP among adolescent girls.

Goals

  • A transition to a lower-cost, higher-efficiency outreach model covering all service delivery
  • Train health workers in Family Planning service delivery
  • Integration of capacity building through on-the-job training

Background

Malawi has one of the highest rates of maternal mortality in sub-Saharan Africa with 675 deaths per 100.000 live births and remains off-track to achieving Millennium Development Goal 5 by 2015. A major underlying cause is the unmet need for contraception of 26.1%, leading to avoidable pregnancy-related morbidity and mortality associated to unplanned births and unsafe abortion. This situation is both unacceptable and preventable.

Initial situation

BLM was established by Marie Stopes International (MSI) in 1987 and is now a senior partner of the MSI Global Partnership. The organization’s mission is to bring private sector excellence to bear in the delivery of reproductive health services to improve quality and equity. In 2009 BLM began its second program of work (POW) 2009-2015. The goal of this POW is to reduce maternal mortality and rapid population growth, and combat HIV/AIDS in Malawi and has joint support from different organizations.

Goals

The key objectives of the proposed Cordaid program include:
– Increasing access to high quality Family Planning (FP) services including long-acting and permanent methods through direct service provision thereby reducing unmet need for FP, reducing unwanted pregnancies, and reducing maternal mortality and morbidity for 50.000 FP clients.
– Increased awareness and knowledge of FP and Sexual and Reproductive Health services at the individual, household and community levels
– Strengthen both public and private healthcare service providers to ensure long-term availability of FP.

Goals

  • A transition to a lower-cost, higher-efficiency outreach model covering all service delivery
  • Train health workers in Family Planning service delivery
  • Integration of capacity building through on-the-job training

Target group

The target group is 50.000 family planning clients.

Project plan

The main activities are:
Activity 1. Provide Family Planning (FP) and other Sexual and Reproductive Health (SRH) services through BLM’s outreach program.
– A full range of FP services are provided, with an emphasis on where short-term methods are already available. These include: LAPM (Long Acting and Permanent Methods)

Activity 2. A health markets approach to increase private sector delivery of FP through BLM clinics, BlueStar Healthcare Network and product social marketing.
– In addition to the franchised network, we will continue to work with healthcare product wholesalers and retailers to increase access to male condoms, pregnancy test kits and emergency contraception through BLM’s social marketing program.

Activity 3. Ensure access to FP and SRH services and referrals through BLM’s network of community-based Reproductive Health Assistants.
– Training and deploying three Youth Reproductive Health Assistants.
– Increase the total number of Reproductive Health Assistants trained in FP counseling, referral and service delivery.

Activity 4. Increasing youth access to FP service delivery through all service channels.
– This will include training in the national Youth Friendly Health Services curriculum as well as supportive supervision visits by BLM’s youth team to encourage use of youth friendly techniques.
– This will also involve coordination with the National Youth Council of Malawi to support accreditation of these facilities as youth friendly delivery points.

Activity 5. Support the further development and implementation of an evidence-based Behavior Change Communication strategy.
– Additional resources through the Cordaid program will enable BLM to undertake ambitious communications activities to diversify the method mix in Malawi, with a focus on increasing uptake of LAPMs and increasing access to FP for youth.
– We will support low-cost national level mass communications via radio and with the production of leaflets and information, education and communications materials.

Activity 6. Training and mentoring of healthcare workers in the delivery of FP services with particular focus on LAPMs (in line with national standards).
– BLM will undertake in-service training in FP, general FP training, LAPM, for Ministry of Health mentorship sites, BlueStar Healthcare Network providers, for community level distributors, and for staff employed in direct service delivery in BLM clinics and outreach teams.
– Over the course of program implementation, BLM will provide in-service training to over 65 healthcare workers with over 15 trained on LAPMs in Nkhotakota District.

Sustainability

BLM seeks to address unmet need for family planning in Nkhotakota District and to expand access to contraception among adolescent girls. Cordaid investment in the BLM program will help support a total market intervention that leverages all of BLM’s service channels for the first time in this district to provide service access for the next two years and build a sustainable platform for long-term access to essential reproductive health services.

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