L'Organisation mondiale de la Sant (OMS) recommande le partage des tches comme stratgie importante pour amliorer l'accs aux services de sant sexuelle et reproductive en sattaquant la pnurie des prestataires de soins de sant. Moreover, WHO Regional Office for Africa conducted an intensive advocacy which yielded a special resolution relating to task sharing for family planning endorsed by governments of the Economic Community of West African States (ECOWAS) region. The report by FP2030 and the Kaiser Family Foundation, said UK overseas aid cuts were the main driver of the Burkina Faso is a West African country struggling with severe health workforce shortages [26]. When autocomplete results are available use up and down arrows to review and enter to select. 2019;4(Suppl 9):e001115. 2019. Family planning is the information, means and methods that allow individuals to decide if and when to have children. Adeniyi OV, et al. Among nine study settings, the proportion of users relying on implants ranged from 12.4 percent in Lagos, Nigeria to 50.3 percent in Burkina Faso. All authors read and approved the final manuscript. AM validated the content and edited the manuscript before submission. Moreover, they share common priorities: advocacy, capacity building, and financial pledge for impact sustainability. Choices and Challenges: Dynamics of Contraceptive Use, Interactive. Key challenges included lack of awareness and misconceptions regarding some contraception methods such as long-acting family planning (LAFP) methods among the target population, shortages of medical equipment and logistics, poor infrastructure (electricity, water, and roads), and poor mentorship and supporting supervision. Cette tude explore l'tat des lieux, les russites, les dfis et les impacts de la mise en uvre du partage des tches pour la planification familiale dans cinq pays d'Afrique subsaharienne. 2017;12(3):e0174631. Towards achieving the family planning targets in the African Prevents pregnancy by avoiding unprotected vaginal sex during fertile days, Reliable effectiveness rates are not available. High rate of unplanned pregnancy in the context of integrated family planning and HIV care services in South Africa. Consequently, the number of women using a modern contraceptive method increased from 663 million to 851 million and the contraceptive prevalence rate increased from 47.7 to 49.0 per cent. The method allows a rapid and progressive learning with conscious exploration and flexible use of methods without following a blueprint programme [25]. Particular attention must be paid to promoting their reproductive rights, access to family planning, and other sexual and reproductive health services. WebDepartment of Health Care Services. Instead, CHWs increased uptake of IUCD utilisation in Rwanda [41] and in Ethiopia [42]. The platform FP2020 has built is resilient, inclusive, and effective. While UN A country cannot move forward if it leaves half of its population behind and family planning is that tool that brings women together to be able to choose, insists Dr Dube. Yet women and girls around the world face serious barriers to using contraceptives. What are some of the barriers? One of the barriers in West Africa for young people is that family planning services cost money and usually young people dont have enough money to pay for those services. But weve been working with transformational leaders who advocate for free access to family planning services. Methods This study used the nineteen demographic and health surveys (DHS) conducted between 2015 and 2020 in sub-Saharan Africa. Family planning is central to gender equality and womens empowerment, and it is a key factor Both numbers exceed the 1.4 percent benchmark set at the 2012 London Summit on Family Planning. Community health worker promotions increase uptake of long-acting reversible contraception in Rwanda. 2018;7(4.34):1237. WebFP2020 is a global partnership to empower women and girls by investing in rights-based family planning. Some barriers to successful implementation of task sharing include poor retention of lower cadre providers, inadequate documentation, and poor data systems. The authors note that one possible explanation for these high rates of growth for modern contraceptive prevalence rates include the introduction of contraceptive implants in the sub-Saharan region. Trends in contraceptive prevalence rates in sub-Saharan Africa since the 2012 London Summit on Family Planning: results from repeated cross-sectional surveys was written by Saifuddin Ahmed, Yoonjoung Choi, Jose G Rimon, Souleymane Alzouma, Peter Gichangi, Georges Guiella, Patrick Kayembe, Simon P Kibira, Fredrick Makumbi, Funmilola OlaOlorun, Elizabeth Omoluabi, Easmon Otupiri, Sani Oumarou, Assefa Seme, Solomon Shiferaw, Philip Anglewicz, Scott Radloff and AmyTsui. One of the tools to deal with unsustainable urbanisation is family planning. Role of birth spacing, family planning services, safe abortion services and post-abortion care in reducing maternal mortality. A total weighted sample of 175, 820 women of reproductive age who were married during the survey was used for Sharma N, et al. A couple of notable challenges concerned funding gaps and the uneven distribution of CHNs in task sharing. Section 6 proposes future directions for family planning decisionmakers to prioritize during the next decade. Furthermore, in addition to an effective supply chain of services, mechanisms for quality control were put in place. UNFPA never promotes abortion as a form of family planning. Bull World Health Organ. Data was collected in two steps. Furthermore, there is a robust financial pledge and advocacy from political and administrative authorities, technical and financial partners and non-governmental associations working in the field of family planning. Another lever was the ability of majority of CHEWs to fast-learn and absorb training materials. These regional hubs established across Africa will not only bring us closer to the problem but will enable us to establish proven solutions to the many issues women are facing all over the continent, Dr Dube says. Google Scholar. Other family planning indicators are presented in Table 1. Health, M.o., COSTED IMPLEMENTATION PLAN FOR FAMILY PLANNING IN ETHIOPIA 2015/162020. In recent years, well-paid and college-educated Americans have shed major cities like New York, San Francisco and Washington for places like Philadelphia or Results were disseminated through regional and sub-regional meetings in Burkina Faso, Ghana, Kenya, and Cote dIvoire. The Family Planning model in Spectrum was used to project the impact of modern contraception on pregnancies, abortions and births in South Africa (2015-2030). The contraceptive prevalence rate (CPR) was increased annually by 0.68 percentage points. Family planning is central to gender equality and womens empowerment, and it is a key factor in reducing poverty. Cela impliquait la revue documentaire des documents de politique nationale de partage des tches, des plans de mise en uvre et des directives, des rapports annuels sur les programmes de sant sexuelle et reproductive, des rapports des runions rgionales de l'OMS sur le partage des tches pour la planification familiale; et des informations provenant des informateurs cls sur le contexte du pays, les programmes d'intervention, l'impact, les catalyseurs, les dfis et les voies suivre pour le partage des tches pour la planification familiale. Another explanation for the high growth rates is that countries are now committing more resources to familyplanning. In December 2019, a second regional advocacy meeting was held to expand the task sharing policies to an additional 11 English-speaking countries. 2020;15(8):e0236352. [5] United Nations Department of Economic and Social Affairs, Population Division (2020). Geneva, Switzerland: WHO; 2018. Population Estimates And Projections. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF; 2019. Part of Having frequent monitoring surveys establishes trends with directly measured rates and avoids having to compare, and possibly reconcile, estimates across other surveys conducted around the same time, adds Radloff. World Fertility and Family Planning 2020. Methods are classified by their effectiveness as commonly used into: Very effective (00.9 pregnancies per 100 women); Effective (1-9 pregnancies per 100 women); Moderately effective (10-19 pregnancies per 100 women); Less effective (20 or more pregnancies per 100 women), Mechanisms of action and effectiveness of contraceptive methods[6], [1] Kantorov V, Wheldon MC, Ueffing P, Dasgupta ANZ (2020) Estimating progress towards meeting womens contraceptive needs in 185 countries: A Bayesian hierarchical modelling study. A RPR focuses on synthesizing information regarding a programme (task sharing programme for family planning in this case) through desk-review of programme documents, reports and key stakeholder information. 2020;17:110. volume18, Articlenumber:22 (2021) Task sharing was also piloted at health facility level where midwives were trained to perform long acting reversible contraception (LARC) proceduresthe intrauterine contraceptive device (IUCD) and implants. Family Planning, Maternal and Reproductive Health. Division of Sustainable Development Goals. Furthermore, training and monitoring of lay- and auxiliary-level cadres remains a dire necessity. Furthermore, the collection of electronic information rather than verbal could have limited the depth of information provided. P.O. In low-resource settings such as Zambia, obstetric fistula (OF) is a visible indicator of gaps in maternal health care resulting in failure to provide adequate, The findings indicate mainly the involvement of community health workers, midwives and nurses in the task sharing programmes with training in provision of contraceptive pills and long-acting reversible contraceptives (LARC). To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Twenty-seven delegates from Burundi, Ethiopia, Kenya, Rwanda, South Sudan, Tanzania and Uganda attended the annual coordination meeting. Nigeria has an estimated population of 200 million with 45 million women of reproductive age [36]. This rapid review set out to identify lessons learnt from the task sharing for family planning pilot programmes in four African countries with an aim to assist WHO Regional Office for Africa in identifying areas and strategies to strengthen advocacy for policy expansion region-wide. For all countries studied, CHWs, midwives, and nurses were trained on the provision of contraceptive pills and LARC namely, Implants and IUCD. TN validated the content and edited the manuscript before submission. Burkina Faso vowed to build on successes to strengthen task sharing programmes through the recruitment and training of lay- and auxiliary-level healthcare providers by the Ministry of Health. After the Jadelle programme, nurses and midwives from across Ghana started receiving tailored training on Implant provision nationally in 2013. From 2014, nurses, midwives, and CHEWs became responsible for the provision of the entire family planning arsenal except tubal ligation and vasectomy (Box 1). Unfortunately, we did not obtain data on adverse effects that could have resulted from CHWs and midwives inserting and removing IUCD. Notable challenges included data reporting, as routine paper-based reporting system was solely used, and financial constraints. Hum Resour Health. Postpartum & Post-Abortion Family Planning, Performance Monitoring and Evidence Working Group, Postpartum & Post-abortion Family Planning, Protect Adolescent Health in Pandemic Response, FP2030 affirms the right to reproductive autonomy in light of the Dobbs ruling, Meaningful Adolescent and Youth Engagement Consensus Statement, FP2020 Joins the Thriving Together Campaign, Statement on the Future of Family Planning, Global Call to Action for the Provision of Rights-Based, Client-Centered SRH During and After COVID-19, Performance Monitoring & Evidence Working Group. New UNFPA report debunks 8 myths about a world of 8 billion, Six UNFPA programmes around the world ensuring health for all in a world of 8 billion, Child brides fight back against gender-based violence in Bangladesh, Ending unmet need for family planning in a world of 8 billion: The innovations enabling access for all, Strengthening supply chains so that contraceptives reach those who need them, Ensuring that family planning services and supplies have sustained funding support, Improving the quality of care in family planning service. Most importantly, in this region, the rate of unmet needs for family planning is about 21% among married women or those living in union [12]. New York: Guttmacher Institute; 2016. The effect of payment and incentives on motivation and focus of community health workers: five case studies from low-and middle-income countries. On the one hand, while reaffirming that human resources is at the core of each health care system around the world, the health workforce remains inequitably distributed in most sub-Saharan African countries, with rural areas suffering chronic and severe shortages of competent health care providers [15, 16]. While task sharing guidelines have been developed and disseminated in many SSA countries, limited evidence exists on their adoption, implementation and outcomes to promote scale-up. Obstetric Anesthesia Digest. Ouagadougou Partnership for Family Planning Coordination Unit, Economic Community of West African States. The review triangulated data from secondary sources with information from key informants in four countries which have already piloted the task sharing programmes for family planning. Task sharing in family planning. Ces donnes factuelles visent promouvoir la mise en uvre et l'extension des programmes de partage des tches dans les pays d'Afrique sub-saharienne par l'OMS. Certain groups including adolescents, unmarried people, the urban poor, rural populations, sex workers and people living with HIV also face additional barriers to family planning. We explore the existing evidence to gain a better understanding of the progress thats been made and the challenges that will influence family planning and inclusive development in sub-Saharan Africa over the next decade. 2020. https://www.un.org/en/development/desa/population/publications/pdf/family/Ten_key_messages%20for%20WFFP2020_highlights.pdf. Alkema L, et al. In this country, task sharing programmes for family planning started in 2008 when 33 Community Health Nurses (CHNs) from 6 regions received training in Jadelle insertion and removal. Contraception prevalence rate among married women increased from 18.6% in 2008 to 19.8% in 2014 among rural residents and from 15.1% in 2008 to 24.6% in 2014 among urban women. A new task sharing programme that sought to promote LARC in remote areas was able to achieve 38,662 new users within a period of 5years [43]. This report examines the status of family planning programs in 22 countries in sub-Saharan Africa since the 2016 release ofFostering Economic Growth, Equity, and Resilience in Sub-Saharan Africa: The Role of Family Planning. Community health workers involvement in preventative care in primary healthcare: a systematic scoping review. Owing to the limited number of data-points (often only two data-points), a trend line was only possible for Ghana and Nigeria. Reprod Health. 2020. https://www.unfpa.org/data/world-population-dashboard. Correct and consistent use of contraceptives has been shown to reduce pregnancy and childbirth related maternal deaths and generally improve reproductive health. Phase Two, which started in 2011, was the IUCD task sharing programme which was piloted in one region where the device was inserted and removed by midwives and nurses rather than physicians. Provided by the Springer Nature SharedIt content-sharing initiative. The eight countries include Burkina Faso, the Democratic Republic of Congo, Ethiopia, Ghana, Kenya, Niger, Nigeria andUganda. The study team used data from Performance Monitoring for Action (PMA) surveys, formerly Performance and Accountability 2020 (PMA2020), all undertaken since 2012, which involved women ages 15 49. 2020. https://www.who.int/workforcealliance/countries/bfa/en/. Africa Press Release. Step Two consisted of a trend analysis of key family planning indicators. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Miseda MH, et al. From having to give up ownership of their basic rights to being in control over their bodies and even careers, women all over the world are changing the narrative. In Burkina Faso, LARC uptake increased by greater than three times within a period of six months with 232.9% new implant users and 163.0% new IUCD users. 2 Although family planning Most Published: 23 January 2021 Towards achieving the family planning targets in the African region: a rapid review of task sharing policies Leopold Ouedraogo, Desire The study applied the Rapid Programme Review (RPR) methodology to generate evidence on what WHO Regional Office for Africa and member countries can do to build on successes and tackle challenges with an aim to scale-up task sharing programmes for family planning region-wide. For instance, within a period of six months (February to September 2017) during the implementation of task sharing for family planning by trained CHWs and midwives, a total 1225 implantsof which 857 were new userswere administered. We use cookies and other identifiers to help improve your online experience. 2016;36:14555. By Stephanie Desmon. These benefits were recognized in the Programme of Action of the International Conference on Population and Development (ICPD), which called for the right of men and women to be informed and to have access to safe, effective, affordable and acceptable methods of family planning of their choice. This agreement lays the foundation for much of UNFPAs work. Implant users increased from 11 users per provider in 2013 to 18 users per provider as of 2018 (DHIMS2). Ganatra B, Faundes A. The World Health Organization (WHO) recommends task sharing as an important strategy to improve access to sexual and reproductive healthcare services by addressing shortage of healthcare providers. Nairobi, Kenya, PACE: Policy, Advocacy, and Communication Enhanced for Population and Reproductive Health, U.S. Census and the American Community Survey, Adaptive Learning and Knowledge Management, Distilling Research for Non-Technical Audiences, Policy and Advocacy Communications Training, Our Commitment to Diversity, Equity, and Inclusion, Report. Data was collected, analysed, and presented according to five subdomains: country background, task sharing intervention packages, impact, enablers and challenges, and ways forward. The unmet need for family planning among currently married women is high in urban Nigeria, at 20%. Meeting the family planning needs of the urban population can help to achieve population growth rates that make cities to be good places to live. But family planning remains a neglected subject in urban development programmes in Nigeria. The Nigerian government has created a multiplier effect in years to come with this investment. Singh D, et al. Data and materials used for this review are available either online (policies and country reports) or from the corresponding author (meeting presentations, information from key informant interviews). Ormel H, et al. The study looked at all women, cohabitating women and married women. May 31, 2023 1:20 AM PT. Step one consisted of compiling information from the country background, the task sharing intervention packages, the system-level enablers and challenges, and the ways forward. 2015;13(1):112. 2019;97(11):783. In Ghana and Nigeria, there has been an increase in the number of new users with a significant uptake of Implants and IUCDs. 2017;127:1324. Therefore, from 2019, Nigeria embarked on rolling out the pilot project at country level. 2019;19(1):261. Population growth and economic development in developing and developed countries. Similar results have been found in many other African contexts. Provision of Implanon was shifted from healthcare facility level to community level. De la Croix D, Gobbi PE. Kamarudin MKA, et al. 2018 World Health Organization and Johns Hopkins Bloomberg School of Public Health. So while working with the Population Council, we hope not only to leverage on their existing network but also to provide a robust platform for collaboration and learning.. We still have challenges with the maternal mortality rate in Africa and women's rights. Over the years, women's choices have slowly metamorphosed. Evaluation of the pilot programme yielded promising results, leading to the validation and nationwide rollout of the task sharing programme in November 2017. Although this remains true, SSA continues to register higher proportions of unmet contraception expectations to date [10, 11]. One of the key barriers to accessing family planning in SSA is the shortage of healthcare providers. For instance, the Democratic Republic of Congo (DRC) is one of the countries that have suffered the most from human resource shortages in the whole world. The trend in Implants (Jadelle and Implanon) utilisation is depicted in Fig. In addition, geographical reach and the type of tasks and healthcare professionals involved were documented. Fulgence Kayishema, one of the last fugitives sought over the 1994 Rwanda genocide, appeared before a court in the South African city of Cape Town on Friday, two days after being arrested following 22 years on the run.He allegedly took part in one of the genocide's bloodiest episodes, when thousands of men, women and children who had 2018). Specifically, sexual and reproductive health. A list of full family planning indicators for Burkina Faso before (2010) and after (2019) implementation of the task sharing for family planning programme is shown in Table 1. This can lead to higher rates of unintended pregnancy, increased risk of HIV and other STIs, limited choice of contraceptive methods, and higher levels of unmet need for family planning. This is way lesser than the WHO doctor-population ratio of 1:1000. Webbeing from Africa. While this may seem insignificant to some, experts like Dr Dube think differently. Ghana: GSS, GHS, and ICF; 2017. WebThis second edition of Family Planning Methods and Practice: Africa is the product of collaboration between African and American colleagues, the Centers for Disease We employed a rapid programme review (RPR) methodology to generate evidence on task sharing for family planning programmes from five SSA countries namely, Burkina Faso, Cote dIvoire, Ethiopia, Ghana, and Nigeria. WebFamily planning in Africa can be a challenge as there are lots of misconceptions surrounding them. It is also essential for improving maternal and newborn health: around the world, complications from pregnancy and childbirth arethe leading killer of adolescent girls (ages 15-19). World Family Planning 2020 Highlights: Accelerating action to ensure universal access to family planning (ST/ESA/SER.A/450). Teklu AM. There were also adequate post-training follow-up and monitoring of the health workers. This study examined post-London Summit trends of modern contraceptive prevalence rates in nine settings in eight sub-Saharan African countries, which together represent almost 73 percent of the population of the 18 initial FP2020 countries in the region. PLoS ONE. Where has modern contraceptive use increased? In the bid to assuage human resource shortages, many countries have started to train less experienced health workers perform tasks that should otherwise be performed by qualified doctors or other highly-trained healthcare workers [18]. We also documented system-level levers and challenges that played an important role in the successful/unsuccessful implementation of task sharing programmes. 1992. Access to safe, voluntary family planning is a human right. Family planning is central to gender equality and womens empowerment, and it is a key factor in reducing poverty. The small sample size of key informants who provided information to the RPR could be considered a limitation to the study. Johns Hopkins Researchers Identify Two Distinct Perspectives on Power Imbalances in the Field of Global Health, Game Changers: 5 Global Vaccine Innovations on the Horizon, Inclusion, Diversity, Anti-Racism, and Equity (IDARE).