Our Programs

Family Planning Integration in Ethiopia’s Primary Healthcare System

| 2021-2023
This program, funded by the Bill & Melinda Gates Foundation, informs how family planning (FP) services can be integrated into reproductive, maternal, child health, and nutrition services as part of the broader primary healthcare system in Ethiopia.

According to FP2030, Ethiopia has one of the highest fertility rates in Africa, with 45 percent of its population under the age of 15, and a modern contraceptive prevalence rate for married women of 40.5%. The government of Ethiopia considers FP key to meeting UN Sustainable Development Goal 3 to avert maternal and child mortality and morbidity and is striving to improve access to FP as part of its Health Sector Transformation Plan II by ensuring it is fully integrated into the primary healthcare system.

EngenderHealth is collaborating with the Ethiopian Ministry of Health (MOH) to improve and strengthen the integration of FP services across Ethiopia’s PHC service delivery. Through this program, we are supporting the government’s efforts by undertaking a comprehensive national FP integration assessment and carrying out implementation research to generate learning on how to effectively integrate postpartum family planning (PPFP) and postabortion family planning (PAFP) into existing health services.

Through the comprehensive national assessment, EngenderHealth is exploring the feasibility of FP integration within the current primary healthcare system, including into community health services. The assessment will incorporate findings from a desk review of existing data at the national and global levels, a survey of primary healthcare facilities, and interviews with key stakeholders. As part of the assessment, EngenderHealth is also working to identify current FP service integration challenges and gaps, successes, and opportunities.

EngenderHealth’s implementation research focuses on evaluating high-impact interventions to facilitate FP integration. We are conducting this research in collaboration with MOH and partnership with three Ethiopian universities—Addis Ababa University, Jigjiga University, and Wolaita Soddo University—in agrarian rural and pastoral regions of the country with low rates of modern contraceptive prevalence.

EngenderHealth employed the socioecological model to design and implement FP integration interventions that aim to identify and address community, sociocultural, and age- and gender-related barriers to PPFP and PAFP. These interventions include providing training and support to address health facility needs and gaps in delivering PPFP and PAFP services and conducting community outreach and engagement to improve knowledge of and access to FP services. EngenderHealth, MOH, and the university partners are analyzing and evaluating the impact of these interventions to inform guidance on nationwide FP integration.

EngenderHealth will apply the results of the assessment and research to develop an FP Integration Intervention Package designed to complement the Ethiopian government’s existing FP Integration National Implementation Guidelines. The package aims to support the full integration of FP into the primary healthcare system by providing key recommendations, guidance, and tools with a focus on addressing sociocultural barriers to FP care and integration.