4 Ways MOMENTUM Is Realizing the Importance of World Contraception Day

Published on September 17, 2021

Adrienne Surprenant/IMA World Health

While everyone has the right to make their own decision about whether to use contraceptives, not everyone is able to exercise that right. Today, an estimated 923 million women in low- and middle-income countries want to avoid pregnancy, yet an estimated 218 million of these women are not using a method of modern contraception.1 Unmet family planning needs are associated with higher risk of maternal deaths and more unintended pregnancies and related complications,2,3 all of which have devastating consequences for women and their families.

Family planning is a crucial component of MOMENTUM’s efforts to improve the overall health and well-being of mothers, children, families, and communities. Integrating family planning into broader maternal and child health care helps ensure that people’s varying health care needs and preferences are met and maximizes their access to information and services at each point of contact with the health system. It is a cost-effective approach that reduces the number of unplanned or undesired pregnancies and improves health outcomes.

On World Contraception Day—a global campaign dedicated to improving awareness about contraception and enabling young people to make informed choices about their sexual and reproductive health—we’re reminded that many health-related barriers such as high costs, low-quality services, hard-to-reach facilities, limited knowledge of family planning, and social norms that perpetuate stigma stand in the way of people who want to take charge of their sexual and reproductive health.

In recognition of World Contraception Day, we are sharing four ways MOMENTUM is positioned to address these barriers.

Every day, over 800 women die from preventable causes related to pregnancy and childbirth.4 Estimates indicate that supporting men and women who want to avoid pregnancy by using contraception could reduce maternal deaths by nearly 30 percent.5

1. Supporting local solutions to address persistent barriers

MOMENTUM will engage with local community partners, governments, and professional associations to prioritize and design project activities that help overcome barriers to contraceptive access.

In Sierra Leone, for example, USAID’s MOMENTUM Country and Global Leadership, in collaboration with the Ministry of Health and Sanitation (MOHS) is identifying and engaging with local partners, such as the Sierra Leone Midwifery Association (SLMA), Health Alerts Sierra Leone and Focus1000, to reduce barriers to quality family planning services by improving health care providers’ knowledge and skills around long-acting reversible contraceptives (LARCs).

In June, MOMENTUM organized two 3-day workshops for existing family planning trainers from four districts, Western Urban, Western Rural, Pujehun, and Kailahun, to standardize their counseling and clinical skills for LARC services, preparing them as “master trainers” to further train other health providers.

“Engaging with local organizations and tapping into their potential goes a long way in finding local solutions to increase access to family planning,” says Dr. Neeta Bhatnagar, Senior Technical Advisor, Family Planning, MOMENTUM Country and Global Leadership. “Providing just minimal support helps organizations identify innovative ideas to support the people in their communities—this is a leap towards self-reliance and sustainable development.”

SLMA will continue to work with MOHS to roll out future training for health facilities.

Photo Coutesy of Neeta Bhatnagar, MOMENTUM Country and Global Leadership

Nearly 1 in 10 women aged 15-49 worldwide want to avoid or postpone pregnancy but are not using any form of contraception.6

2. Helping providers be more responsive to client needs

Even when people are aware of available family planning options, they may have difficulty obtaining the contraceptive method of their choice. Health care providers may limit what options they offer their clients based on biases related to a client’s age, the number of children they have, or whether they are married.

Through training, ongoing mentoring, and supervision, MOMENTUM will help health providers explore their own implicit biases and address their behaviors to ensure they provide their clients with a full range of family planning options.

Mubeen Siddiqui/MCSP

3. Ensuring family planning is part of comprehensive maternal care

Studies show that most women do not want to get pregnant again within a year of giving birth,7 but many are not aware that family planning options exist for them and are not counseled on how they can plan and space out future pregnancies.

MOMENTUM will train private clinicians and community health workers to counsel pregnant women during prenatal care and home visits, and through community activities. We also plan to help health providers support women who have given birth, along with their partners, to ensure they are informed of the methods they can choose before they leave the facility.

As part of USAID’s New Partnerships Initiative, MOMENTUM Private Healthcare Delivery will provide tailored training and support to 40 Ugandan Private Midwives Association (UPMA) facilities to expand access to high-quality postpartum family planning services. For 18 months, MOMENTUM will support UPMA by identifying and responding to barriers to postpartum family planning services at facilities in Kampala, Wakiso, and Mukono districts.

With MOMENTUM support, trainers will mentor and coach UPMA facility providers on topics including family planning methods and referrals for permanent methods, high-quality family planning counseling during postnatal care visits, and youth-friendly services for younger mothers. UPMA will then scale the training to an additional 536 sites across the country. This will include training sessions on ways to integrate postpartum family planning services during outreach events, such as immunization days, and supporting community health workers to mobilize, meet demand, and provide family planning-related follow-up with mothers. Such efforts will help put new and expecting mothers in the health care system so they can better navigate access to services.

Kate Holt/MCSP

4. Ensuring adolescents can access contraception

Each year an estimated 16 million women 15-19 years give birth8 and 2 million girls under 15 become pregnant,9 an age when risks of maternal death and complications in pregnancy and birth are highest.10,11 Adolescent pregnancy is often not the result of a deliberate choice, but rather the absence of choices – the consequences of little to no access to schooling, information, and health care.12

MOMENTUM will work with health providers and facilities to offer youth-friendly services where providers are trained to understand adolescent needs, ensure confidentiality, and be respectful to young people. Given that 60 percent of Africa’s population is under 25 years old,13 meeting the needs of this age group has the potential to positively impact their health and well-being for years to come.

In Benin, MOMENTUM Private Healthcare Delivery recently led family planning sessions with pharmacy managers to communicate the value of including contraceptive options among their pharmacy’s products. Moreover, to ensure family planning activities and interventions are meeting the needs of local youth, MOMENTUM will work with several local youth- and women-focused organizations to build their capacity as local advocates.

“Through MOMENTUM Private Healthcare Delivery, we’re working with and for young people to design solutions that break down societal and legal barriers that stand between young people and their family planning and reproductive health access,” said Ando Tiana Raobelison, Deputy Director, Association Béninoise pour le Marketing Social et la Communication pour la Santé, a lead implementer of MOMENTUM activities in Benin. “Moreover, we’ll be working to involve, build capacity, and improve networks among youth organizations.”

PSI

An opportunity to make a difference

Ensuring individuals have access to information, counseling, and a full range of contraceptive methods supports MOMENTUM’s broader goal of reducing maternal and child deaths while also providing women and children the opportunity to reach their full potential.

Building on decades of USAID learning and investment, MOMENTUM is well-positioned to build capacity, sustainability, and resilience to achieve universal access to sexual and reproductive health care and reproductive rights, as highlighted in one of the goals in the 2030 Agenda for Sustainable Development.

Interested in learning more about our work in family planning and reproductive health? Visit our webpage to learn more.

About the MOMENTUM Projects that Contributed to this Blog

MOMENTUM Safe Surgery in Family Planning and Obstetrics supports countries to strengthen surgical safety within maternal health and voluntary family planning. With an overall focus on building awareness and improving equitable access to high-quality surgical care, the project covers four key technical areas: cesarean delivery, hysterectomy performed during or shortly after delivery; fistula prevention and repair; and long-acting reversible contraception and permanent family planning methods.

MOMENTUM Country and Global Leadership works in tandem with country governments and local nongovernmental organizations to provide targeted technical and capacity development assistance and contribute to the global technical leadership and policy dialogue on improving measurable outcomes for maternal, newborn, and child health; voluntary family planning; and reproductive health care.

MOMENTUM Private Healthcare Delivery harnesses the private sector’s potential to expand access to and use of high-quality, evidence-based health care. The project collaborates with governments, local organizations, communities, and private providers in all forms, to generate solutions that drive scale in health service delivery and long-term sustainability of health coverage and outcomes.

References

  1. Sully EA et al. Adding It Up: Investing in Sexual and Reproductive Health 2019, New York: Guttmacher Institute, 2020.
  2. United Nations Department of Economic and Social Affairs, Population Division (2020). World Family Planning 2020 Highlights: Accelerating action to ensure universal access to family planning (ST/ESA/SER.A/450).
  3. Tsui AO, McDonald-Mosley R, Burke AE. Family planning and the burden of unintended pregnancies. Epidemiol Rev. 2010;32(1):152-174. doi:10.1093/epirev/mxq012
  4. Trends in maternal mortality: 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Geneva: World Health Organization; 2019. https://www.who.int/en/news-room/fact-sheets/detail/maternal-mortality
  5. Ahmed, S., Li, Q., Liu, L., and Tsui, A. O. 2012. Maternal deaths averted by contraceptive use: An analysis of 172 countries. The Lancet, 380(9837), 111-125. https://doi.org/10.1016/S0140-6736(12)60478-4
  6. United Nations Department of Economic and Social Affairs, Population Division. 2020. World Family Planning 2020 Highlights: Accelerating action to ensure universal access to family planning (ST/ESA/SER.A/450).
  7. Rossier C, Bradley SE, Ross J, Winfrey W. Reassessing unmet need for family planning in the post-partum period. Stud Fam Plan. 2015;46(4):355–67.
  8. United Nations Statistics Division. 2015. Demographic Yearbook 2013. New York, NY: United Nations. http://unstats.un.org/unsd/demographic/products/dyb/dyb2013/Table10.pdf [07/08/2015].
  9. United Nations Population Fund (UNFPA). 2015. Girlhood, not Motherhood. Preventing Adolescent Pregnancy. https://www.unfpa.org/sites/default/files/pub-pdf/Girlhood_not_motherhood_final_web.pdf [08/02/2019]
  10. Ganchimeg T, Ota E, Morisaki N, et al. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. BJOG 2014;121 Suppl 1:40–8.
  11. Althabe F, Moore JL, Gibbons L, et al. Adverse maternal and perinatal outcomes in adolescent pregnancies: The Global Network’s Maternal Newborn Health Registry study. Reprod Health 2015;12 Suppl 2:S8.
  12. ECPAT. 2015. Thematic Report: Unrecognised Sexual Abuse and Exploitation of Children in Child, Early and Forced Marriage. https://www.ecpat.org/wp-content/uploads/2016/04/Child%20Marriage_ENG.pdf [08/02/2019]
  13. United Nations Population Fund (UNFPA). 2017. The Demographic Dividend Atlas for Africa. New York: UNFPA.

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