Integrated RMNCH + PPFP Scale-Up in Ethiopia
In Ethiopia, 86% of postpartum women express a desire for family planning—yet only 36% access it. This discrepancy is largely due to gaps in healthcare provider training, service integration, and community awareness.
To contribute to reductions in maternal and newborn morbidity and mortality, EngenderHealth and partners are supporting the expansion of post-partum family planning (PPFP) and selected RMNCH services across 300 high- and 600 low-caseload health facilities in the regions of Oromia, Amhara, Sidama, Southern Ethiopia, Central Ethiopia, and Addis Ababa.
EngenderHealth leads this initiative in partnership with the Ethiopian Pediatrics Society, the Ethiopian Midwives Association, the Ethiopian Society of Obstetricians and Gynecologists, and St. Paul’s Hospital Millennium Medical College. We collaborate with health system actors, including the Ethiopian Ministry of Health, Regional Health Bureaus, and teams at public health facilities, to support the adoption of evidence-based practices for integrated service delivery in public health facilities.
The project provides tailored technical assistance to improve the quality and voluntary uptake of RMNCH and PPFP services. This includes integrating PPFP with RMNCH services, introducing the hormonal intrauterine device (HIUD) to expand method choice, training healthcare providers, implementing integrated catchment-based mentorship, and incorporating gender, youth, and social inclusion considerations across interventions.
The project supports selected high-caseload facilities to become Centers of Excellence for the integration of RMNCH and PPFP by adapting the SMART model—a catchment-based approach that accelerates Service provision, Mentorship, clinical quality Audit, Referral linkage, and Trainings aligned with the three-tier Ethiopian healthcare delivery system. The project then facilitates the cascading of practices and skills to other facilities nearby.
Examples of facility-level activities include:
- Whole-Site Training: A structured, on-the-job and blended training approach for staff in a variety of roles across a health facility to support the changes needed to enable women to learn about and access PPFP and post-abortion family planning services.
- Low-Dose, High-Frequency Training: A progressive skill-building model for providers in smaller facilities, featuring ongoing mentorship, performance monitoring, and professional development through repeated on-the-job training sessions.
The project team closely collaborates with the Ministry of Health and other related projects to ensure alignment. For example, community-level projects complement the work done at healthcare facilities by raising awareness of the PPFP options available at these facilities.
Expected results:
- More than 1.6 million clients, including more than 600,000 in the immediate postpartum period, will access family planning services.
- HIUD will be introduced as a new long-acting, reversible contraceptive option offering characteristics distinct from existing method options.
- More than 1.7 million women will benefit from the bundle of postpartum hemorrhage interventions called E-MOTIVE.
- Kangaroo Mother Care for preterm and low-birthweight infants will increase by approximately 10%.
- Indicators of respectful maternity care will improve by 25%.
- Quality of maternal healthcare will be enhanced through a model of 8 contacts of antenatal care, intrapartum and postpartum care, neonatal care, immunization, and nutrition services.
