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This week, our staff took part in the 2021 @TzHealthSummit including keynote speaker @MasakoPrudence, presenters Dr. Moke Magoma & Deus Ngerangera & Youth Capacity Building facilitator @RehemaGeorge7. Congratulations team! #THS2021 #Tanzania

Meet the 2021 3rd @TzHealthSummit Youth Capacity Building Program facilitators: @RehemaGeorge7 and @MasakoPrudence (@EngenderHealth); @Theddylp (@HealiTZambia), and yours truly (@Jhpiego). Pls show some ❤️ to these selfless #leaders I was blessed to work alongside🙏🏽

Honored to have facilitated the 3rd @TzHealthSummit youth capacity building program alongside @Theddylp @charleswanga. Proud to have been part of nurturing other youth leaders to take up space in the world and cement themselves #THS2021 @EngenderHealth @YouthDeliver

J'ai eu l'honneur d'aborder la thématique des violences domestiques en #CIV225 avec @Sylvia_Apata sur les ondes de Radio Yopougon et notamment le projet de lois relatif à la protection des victimes de violences domestiques.
#ProjetLoiVBG
#TousUnis

@EngenderHealth @CACi225

"This has become an ideological issue. As countries become more partisan, as countries become more ideological on each side, women's bodies are used as a pawn in this war between two parties or three parties."
#SRHR #ReproductiveRights

http://ow.ly/es7Q50Gr5Wr

"...[CSE programs]reinforce our human rights to autonomy, teach youth that sexual violence is not ok & provide young people with information about how to recognize and respond to sexual violence if it were to happen in the future." 💯 🙌 👏
http://ow.ly/Qlsh50Gqptk

Today, 400,000 Nigerian women—representing 40% of obstetric #fistula cases worldwide—wait for corrective surgery. In #Nigeria, MOMENTUM Safe Surgery is partnering w/ gov't, institutions, and local organizations to confront this preventable problem. @USAIDNigeria @PaulineKTallen

Salma advocates to end stigma & discrimination against people living w/ HIV in #Tanzania. She uses skills learned through the Boresha Afya project funded by @USAIDTanzania & administered by @EGPAF in partnership with EngenderHealth & the Tanzania Ministry of Health. #DayoftheGirl

In response to #Pandemics we need Public Private partnerships in cofinancing the health sector so that no one is left behind.

Dr. @MasakoPrudence from @EngenderHealth
#THS2021

Today in the US is #IndigenousPeoplesDay, which celebrates the contributions, diverse cultures, and resiliency of Indigenous people. Learn more about the holiday & what it means to 5 Indigenous women and two-spirit people.

http://ow.ly/Skan50GoTxb

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May 8, 2017

Multidimensional Approaches to Enhance Access to Reproductive Health in Ethiopia

Over the last 15 years, Ethiopia has expanded access to family planning (FP) services, and the contraceptive prevalence rate (CPR) has quadrupled, from 8% in 2000 to 36% in 2016 (CSA & ORC Macro, 2001; CSA & ICF, 2016). (The CPR is the percentage of women of reproductive age who are using a contraceptive method at a particular point in time.) However, unmet need for FP in Ethiopia hovers around 22% (CSA & ICF, 2016), with contraceptive prevalence still relatively low. Ethiopia’s maternal mortality ratio (MMR) has fallen dramatically, from 676 per 100,000 live births in the period since the last Demographic and Health Survey (DHS) in 2011, to 412 deaths in the 2016 DHS, but it is still high (CSA & ICF, 2016). While the share of abortions performed within health facilities in Ethiopia (assumed to be the safest option) increased between 2008 and 2014, the number of women seeking treatment for abortion-related complications still almost doubled over the same time period (Ipas & Guttmacher Institute, 2017), indicating a need for high-quality safe abortion services and postabortion care. EngenderHealth’s Access to Reproductive Health Initiative (ABRI) seeks to reduce maternal mortality and morbidity in Ethiopia by expanding access to and use of quality comprehensive contraception and abortion care services. (Maternal morbidity is any medical complication caused by pregnancy, labor, or delivery that has a negative impact on the woman’s well-being.) Generously funded by an anonymous donor, ABRI has been operating in Ethiopia in successive phases since mid-2008.[1]

During ABRI’s eight years of implementation, FP service utilization dramatically increased across ABRI-supported sites through enhanced services which include additional method options for clients—namely, the most effective long-acting and reversible contraceptives (LARCs) and permanent methods (PMs), and broader FP service availability (both in terms of number of health units offering FP services and extended hours). Eight years ago, only 58 project-supported facilities offered FP services, and 21 offered comprehensive abortion care (CAC) services; today both FP and CAC services are available in 424 sites. ABRI has also integrated FP with maternal health, child health, HIV care, and other services. The project attributes its success in expanding access to quality, voluntary FP and CAC in part to “holistic, multidimensional, and interrelated interventions” across various levels of the health system. At the national level, ABRI and the Federal Ministry of Health have worked together closely on a number of key guidelines, training and strategy documents designed to improve services, such as an update to the National Reproductive Health Strategy to include integration of RMNCH services, the development of a postpartum family planning training package, and training of trainers.

ABRI developed a structured on-the-job training package based on the national FP training package for comprehensive in-service FP training. The project provided individualized provider follow-up and support to trained providers to explore and address challenges in institutionalizing quality service delivery. Beyond training and ongoing mentorship, the project equipped facilities with needed supplies, instruments, equipment, and commodities, improved infrastructure through renovations to ensure service readiness and secure client privacy, and strengthened systems for effective internal referral. ABRI is also doing important work at the community level in support of the Ethiopian government’s health extension program. The project has designed and implemented community engagement strategies that include conducting focused community dialogues and household sessions, often involving couples, supported by confirmed community-facility referral linkages.

By the close of ABRI III, the project was supporting services in 220 districts across five regions and two city administrations. Since the start of ABRI, up to 5 million women received FP services at project-supported sites, with 1.4 million opting for a LARC or PM, and the percentage of postabortion clients adopting a FP method increased from 33% to 86%. FP service options and availability were  expanded as capacity was built to deliver—and maintain—high-quality services. High quality is defined by readiness to provide a wider range of contraceptive options, (particularly for underserved groups, such as postpartum and postabortion women)  to make methods available within a range of service units, as well as adhering to up-to-date processes of care, including sound counseling and infection prevention practices. Project strategies were geared toward reliably meeting needs for effective, quality contraception and CAC services and thereby contributing to the ultimate goal of reduced maternal mortality and morbidity in Ethiopia.

References

Central Statistical Authority (CSA) [Ethiopia] and ORC Macro. 2001. Ethiopia Demographic and Health Survey 2000. Addis Ababa, Ethiopia and Calverton, MD, USA.

Central Statistical Agency (CSA) [Ethiopia] and ICF. 2016. Ethiopia Demographic and Health Survey 2016: Key indicators report. Addis Ababa, Ethiopia, and Rockville, MD, USA.

Ipas and Guttmacher Institute. 2017. Induced abortion and postabortion care in Ethiopia. New York. Accessed at: www.ipas.org/en/Resources/Ipas%20Publications/Induced-Abortion-and-Postabortion-Care-in-Ethiopia.aspx.


Indicators Report. Addis Ababa, Ethiopia, and Rockville, Maryland, USA. CSA and ICF.[1]ABRI Phase I: April 2008–May 2011; ABRI Phase II: June 2011–May 2013; ABRI Phase III: June 2013–May 2016 (with a no-cost extension through Sept. 2016)

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