Our Approach

A small meeting in Afghanistan. Photo by Douglas Huber
Repositioning and Integrating Family Planning: Back to Basics
The recent focus on HIV & AIDS, tuberculosis, and other killers has drawn funding and attention away from family planning and reproductive health (FP/RH). MSH is helping countries get "back to basics," by repositioning family planning (FP) as a core health intervention and integrating service delivery with other health services. Our current work in this area is being carried out through worldwide programs-including AWARE, ESD, and BASICS - and national initiatives such as those in Afghanistan, Haiti, Malawi, Mali, and the Philippines. These efforts build on expertise gained in previous projects, notably Advance Africa.

In support of repositioning FP, we provide assistance in:
  • advocating for FP/RH programs: Working with decision-makers at all levels, we raise awareness about the socioeconomic benefits of FP/RH, especially healthy timing and spacing of pregnancy. We encourage governments and NGOs to reshape their priorities and policies and allocate resources to support FP/RH programs. In 2004, for example, all 46 health ministers of WHO/AFRO member states endorsed FP as a critical health and development intervention and a top priority through 2014;
     
  • strengthening service delivery: Through a well-proven participatory rapid assessment process and tools, we identify gaps and weaknesses that undermine effective delivery of FP/RH services. In turn, we assist governments, health officials, and NGOs in prioritizing their investments and carrying out their plans to improve management tools and systems, strengthen health information systems, and develop and disseminate best practices;
     
  • building capacity: Countering a trend among health professionals to migrate from FP/RH to other well-funded areas, MSH helps government and NGO partners rebuild a cadre of motivated leaders, managers, and providers to deliver quality FP/RH services;
     
  • improving supply chain management: To ensure that providers and clients have access to a reliable supply of contraceptives and FP/RH commodities, we help strengthen procurement and distribution systems, including integrating contraceptives into existing pharmaceutical management systems;
     
  • engaging the community to create demand: We rebuild trust in FP/RH services and facilities and encourage wider use of those services by working through community health workers, volunteers, leaders, local media, and other channels. In the postconflict rural community of Huambo, Angola, where FP had been neglected for years, a repositioning initiative contributed to significant growth in the number of contraceptive users. The number of new users grew from roughly 3,500 in 2003 to nearly 28,000 in 2005, and the number of returning users increased from 10,246 to 62,760 in the same period.

Integrating FP/RH services: Evolving toward a "fully functional health system"
Central to MSH's involvement in repositioning family planning is a commitment to integrate and align FP/RH with other essential health services such as primary care, child survival, and HIV & AIDS services. Drawing on our extensive experience in this area, we help governments, NGOs, and other organizations evolve toward a "fully functional health system" by transforming redundant and incompatible policies, systems, standards, tools, and methods into a shared set of information, resources, and processes.

Maximizing impact through a holistic approach to care
Integration helps organizations maximize the impact of their health investments while also allowing people, information, and funding to flow more easily among collaborating groups. Equally important, integration enables providers to treat the health needs of individuals and families more efficiently, regardless of the initial reason a patient seeks care.

  • In Zimbabwe, the integration of family planning with HIV & AIDS voluntary counseling and testing motivated 35 percent of HIV-positive clients to become new FP users and 27 percent to use dual contraceptive methods to protect their partners.
     
  • In the Democratic Republic of Congo, integration of FP/RH into primary health care, coupled with a focus on healthy timing and spacing of pregnancy, dramatically increased contraceptive use. In less than two years, 14 percent of eligible women became new users of FP.