One Size Doesn't Fit All_Outterson_5.1.12
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The document summarizes discussions from a CORE meeting about integrating family planning into youth programs supported by sponsorship funding. It outlines plans to expand a family planning integration model piloted in Malawi to Bangladesh, Nepal, and Mozambique between 2010-2011. This included situational analyses, program design, monitoring, and technical assistance. Challenges addressed were lack of FP expertise and competing priorities. The meeting looked back on progress and plans to introduce the model globally through a 2011 workshop involving 15 countries.
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One Size Doesn't Fit All_Outterson_5.1.12
- 1. CORE Meeting May 2012 Integrating Family Planning Into Youth Programs Beth Outterson, Brad Kerner, Health Advisors Shahana Nazneen, Bangladesh Adolescent Development Manager Luisa Fumo, Mozambique Adolescent Development Manager Madan Gotame, Nepal Adolescent Development Manager
- 3. Supporting Long Term Development Programs Through Sponsorship Impact Area Sponsor Non-sponsored children Sponsored Children & ALL CHILDREN HAVE ACCESS TO SPONSORHIP FUNDED PROGRAMS
- 4. Sponsorship Supports Programs in 16 Countries Countries receiving more than $1 million USD annually Latin America and the Caribbean Asia Africa Middle East Bolivia Afghanistan El Salvador Egypt Bangladesh Guatemala Ethiopia Haiti Malawi Bhutan Honduras Mali Nepal Mozambique Philippines Zambia
- 5. Sponsorship Core Programs Birth 6 Years 12 Years 18 Years Early Childhood Care Basic Education and Development School Health & Nutrition IP Adolescent Development
- 6. The Program Cycle Situational Analysis Lessons Learned Program Plan Design 5-year Evaluation cycle M&E Plan Design Implementation and Baseline Monitoring
- 7. Our Family Planning Integration Plan Starting in 2006 • Buy-in from Sponsorship Steering Committee Organizational Level • Development of tools and program framework • Testing FP model development Program • Staff capacity building Level • Ongoing Technical Assistance
- 8. Challenges Our Plan Sought to Address Organizational Level • Save the Children is not an FP agency • FP needs of youth and young mothers perceived as too sensitive to address Program Level •Lack FP program implementation knowledge and skills •Competing priorities: - Costly interventions (i.e. WASH, teacher trainings) - Global recognition for Early Childhood Care & Development
- 9. Where have we come from? Where are we going? Catalyst Future Phase II Expand Use Global of FP Model: Introduction of Phase I Mozambique, B Family Planning angladesh, Nep al (October 2011) Develop FP Model: (2010 – 2011) Malawi (2006)
- 10. Phase I: Develop FP Model: Malawi (2006 – 2008)
- 11. Phase II: Expand Use of FP Model: Bangladesh, Nepal, Mozambique (2010 - 2011) Monitoring Situational Program Technical and Data Analysis Design Assistance Collection
- 12. Phase II: Expand Use of FP Model: Mozambique (2010 - 2011) Enabling Access Quality Demand Environment Integrate FP into: Training of -Peer education Local Radio sessions health -Parent Programs Strengthen providers education referral and -Student-led Community events Community systems Campaigns Health Teen Mother Workers on Clubs FP for Youth Male Motivators
- 13. Catalyst for Expansion Global Workshop October 2011 20 people from 15 countries (13 sponsorship countries) 2012: Technical Assistance to Haiti & Malawi
Editor's Notes
- This is a picture of adolescent mothers in Malawi, taken by SC’s newborn health team while visiting a maternity ward. These are mothers of premature babies using a method called Kangaroo Mother care. The newborn team was so happy to see them using this approach. BUT these girls were barely 18 years old and their adolescences were being cut short. Although these girls look happy, that sad truth is that the future for these girls who start having children early and often, is always bleak. This demonstrates our often vertical systems of working, only looking at one issue (in this case newborn health) without seeing the full picture…that in fact ADOLESCENT GIRLS are empirically more likely to die in childbirth and their children are less likely to survive to their first birthday. So I looked at these girls, it reconfirmed that there is so much more that needs to be done to ensure that young girls are delaying marriage and delaying motherhood and we, as global organizations, are integrating a focus on family planning that is adolescent inclusive.
- You can see why we wanted to integrate family planning into these programs so that reaching adolescents in need of FP is routine and integral to the impact we are trying to achieve in our long term sponsorship programs. But this was also a strategic decision after a program audit of our global adolescent development programs found that were not reaching young married girls and interventions typically hovered around general HIV peer education and awareness raising. We designed a plan to integrate Family planning into this well oiled sponsorship machine both at the organizational level and at the programmatic level. We knew organizationally, we would need to do our advocacy and get buy-in for FP as being key to the goals were trying to achieve and we would have to put in the leg work to develop the tools and framework needed for country programs to effectively program FP interventions. At the program level, we knew we would have to test out our developed model, develop program managers’ capacity on FP and provide them ongoing coaching.
- We knew our plan would be met with some challenges: We are not an FP agencybut we value the contribution of FP to improving MNC survival and seek to ensure that quality FP information and services are available to the communities that we serve. But programming family planning is not always a no brainer for us. (2) (for field and for donors). We knew it would not be featured on the sponsorship page of our website, but wanted to get senior staff and sponsorship operations staff comfortable with what we mean when we actually say “Family Planning” (3) Lack knowledge and skills for FP program implementation among staff implementing long-term development programs and these staff are not always health providers. In many cases they are nurses, but not universally true.(4) Competing priorities for the use of the sponsorship funds.
- With our plan in hand and a good analysis of the challenges we would face, we set off to integrate FP into our global sponsorship programs knowing this integration would not happen over night. Along the journey, we brought a healthy dose of patience, perseverance and a desire to learn. I’ll tell you about these phases in more detail so you can see our journey, where we came from and where we want to go.
- In the first phase of this effort, we started out in Malawi, where we had a very strong adolescent development program, with a large scale peer mobilization effort on ASRH, but where they were truly lacking in meeting the needs of younger married girls. Here, we were able to test out a variety of potential interventions that we could help inform a global FP program framework in the context of our sponsorship programs. These interventions included training youth as community based distributors, starting teen mothers clubs and reaching out to older men married to adolescent girls. By the end of this 27- month phase, we had this FP model documented and we were ready to share it globally with all sponsorship program offices.
- During Phase II, we were able to intensely work with three more countries (Bangladesh, Nepal and Mozambique) to analyze their current adolescent programs through a targeted FP situational analysis, conduct a program “re –design” that included FP as a way to achieve their goals they have set for the program, but also to include new indicators and monitoring forms so they could articulate their family planning successes. And we provided technical assistance to these three countries to guide this integration. We also developed an FP TA Tool which is really a detailed checklist that can be used by us at the global level as well program managers, to make sure adolescent and youth FP needs are addressed within our AD projects. This tool will be continually used even now after funding from Flexfund ended in December of 2011.
- As an example, I'd like to highlight the FP interventions that the Mozambique Adolescent Development program integrated into their ongoing program that was already working with peer educators in schools and youth clubs. Since Mozambique is a best practice country in terms of Youth Friendly health services, this did not need to be an intense focus on our work, except that we recognized the need to improve the referral systems between their ongoing work and available health service. We also recognized an opportunity to work with community health workers who were already begin supported by Save the Children to understand the approaches to work with adolescents to lessen their unmet need for FP. In term of building demand for FP, this was an easy win for the program as they just had to add components and dialogues on FP into their peer education sessions, their parent education session and larger student-led community events. But due to the high rates of early marriage, they also chose to start up a totally new intervention to reach husbands married to adolescent girls.In Bangladesh we used PDQ for Youth methodology with married girlsIn Nepal they used PDQ through child clubs.
- Finally, to culminate this 2-year phase, In October we conducted a global meeting with all of our sponsorship country office to introduce the FP model and build confidence in our other country office managers that they too can start to integrate a focus on FP into their programs and learn from our emerging FP leaders. Our two most concrete next steps this year in 2012 are to work more intensely to integrate FP into sponsorship programs in Haiti and our new impact area in Malawi. If you would like more specifics about our approaches in each of the three countries, you can see our FP integration brief, you will see more specific results for each of our programs, including increases in CYP among adolescent girls.