Announcing the 2017 Winners of 120 Under 40

The Bill & Melinda Gates Institute for Population and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health announces the 2017 winners of 120 Under 40: The New Generation of Family Planning Leaders today.

120 Under 40 recognizes and highlights the achievements of the next generation of family planning leaders worldwide; it is led by the Gates Institute with support from Bayer. Over the course of this multi-year project, 120 young family planning champions will be chosen, 40 in each of the three project years.

This year’s 40 winners are advocates, researchers, service providers, epidemiologists, medical doctors, program officers, communications/media professionals, and founders of NGOs and nonprofits. They work all over the world—in clinics and universities, in offices, and in the field—to advance family planning and reproductive health. Some examples:

  • In Madagascar, Maia Freudenberger leads Projet Jeune Leader, a comprehensive sexual and reproductive health program running in 12 rural and urban middle schools, which she co-founded at the age of 21.
  • In Bangladesh, Abu Sayed Hasan of UNFPA has introduced and implemented a national family planning campaign targeted toward adolescents and youth in the lowest-performing districts, and played a major role in reactivating the FP2020 Bangladesh Country Engagement Working Group.
  • In Uganda, Allen Kabagenyi serves on the family planning working group of the Uganda Ministry of Health and is a researcher, statistician, trainer and lecturer at Makerere University.
  • In New York, Thoai Ngo directs Population Council’s Poverty, Gender, and Youth Program and its new GIRL (Girl Innovation, Research and Learning) Center, which translates and generates high-quality evidence to transform adolescent girls’ lives.

FP Voices Profiles Three TCI Hub Leaders

Family Planning Voices recently profiled three of the Initiative’s hub leaders: 

  • Therese Maye Diouf BA, Director, The Challenge Initiative (TCI), West Africa Francophone Hub, IntraHealth International
  • Sanjay Pandey, Senior Director of Programs, Acting Chief of Party, The Challenge Initiative for Healthy Cities, PSI India
  • Mukesh Sharma, Director of Programs, The Challenge Initiative for Healthy Cities, PSI India

TCI Toolkit to Provide Access to Proven Best Practices for Family Planning Interventions






TCI Toolkit to Provide Access to Proven Best Practices for Family Planning Interventions | The Challenge Initiative











Mobilizing funds from multiple sources, the Initiative aims to build on the successes of the Urban Reproductive Health Initiative (URHI) and increase the number of cities replicating and adapting URHI interventions on a demand-driven (self-selection) and cost-efficient basis. It will also test an effective and sustainable scale up model that strengthens health systems and builds on existing resources with original URHI partners functioning as its regional hubs.

Each of the original URHI projects has developed – and under the Initiative is now refining – a toolkit to provide guidance to health managers and other decision-makers on how to strengthen urban family planning services. The toolkits are based on the experience of the URHI projects in Kenya, Nigeria, Senegal and India, which produced critical lessons on how to increase access to and utilization of quality contraceptive services in disadvantaged urban settings. These lessons and experiences are packaged in the form of tools to support key program areas, including Service Delivery, Commodity Security, Demand Creation and Advocacy, and can be adapted to new public and private sector settings.

India – The Challenge Initiative Update

Population Services International (PSI) is a leading global health organization which began its operations in India in 1988. Since then, PSI has expanded comprehensive programs targeting reproductive health, child survival, tuberculosis, sanitation, HIV/AIDS, gender-based violence, non-communicable diseases, and urban health to 17 states of the country. As TCI’s Accelerator Hub in India, PSI is uniquely positioned to ensure rapid start-up of this program due to its longstanding presence in Uttar Pradesh and strong relationship with the Uttar Pradesh, Madhya Pradesh and Odisha governments.

Urbanization in India has been increasing at a rapid pace, presenting an opportunity to work towards improving health of the urban poor in India. PSI is engaging with both USAID and The Challenge Initiative in joint programming named, The Challenge Initiative for Healthy Cities in India (TCIHC), to unlock public and private resources and to implement proven health solutions for urban poor. This joint program will aid urban local governments in building its capacities to manage, implement, and monitor response to reproductive health issues, especially family planning (FP). The Initiative emerges to guide and accelerate public and private sector investments in contraceptive services to ensure healthy and productive lives.

PSI is implementing a jointly funded program for greater scale and impact. In its first three years of a five-year horizon, PSI’s work as an Accelerator Hub will help urban health systems consolidate gains made by the Urban Health Initiative (UHI) in Uttar Pradesh and scale proven and innovative interventions in multiple states to increase access to quality care with the goal of increasing the contraceptive prevalence rate among women in reproductive age group in approximately 31 cities.

East Africa – Building on the Success of Tupange

Jhpiego is the Initiative’s implementing partner for the East Africa Accelerator Hub. Since 2010, with funding from the Bill & Melinda Gates Foundation, the Jhpiego-led Tupange Urban Reproductive Health Initiative (URHI) Project has been addressing urban family planning supply and demand side interventions as well as advocacy in five urban cities of Kenya, including Nairobi, Kisumu, Mombasa, Machakos and Kakamega. These efforts have contributed to unprecedented improvements in the contraceptive prevalence rate (CPR) of these cities from 45% to 58% over the project implementation period (MLE, Tupange, 2014).

The Initiative will assist Kenya, Uganda, Tanzania and potentially more countries in East Africa, to scale up family planning in order to reach additional women and girls with voluntary FP services over the next three to five years. The East Africa (EA) Hub’s strategy is to amplify the momentum achieved by Tupange’s success by translating URHI best practices in family planning programming to provide geographies throughout East Africa with the necessary tools, knowledge, skills and financial commitment necessary to achieve scale in coverage of high-quality, sustainable family planning services.

The Initiative is envisioned as a ground-breaking new demand-driven model of ensuring that quality reproductive health services will be expanded to more women and girls by scaling up successfully tested URHI innovations and related best practices.

Nigeria – Building on the Success of NURHI

The Challenge Initiative is positioned to promote sustainability, local ownership and demonstrate the feasibility of long term investment in Reproductive Health. TCI offers Nigeria the chance to accelerate and scale up the positive changes in reproductive health delivered through the Nigerian Urban Reproductive Health Initiative (NURHI) since 2009.  Managed by The Johns Hopkins Center for Communication Programs (CCP) with funding from the Bill and Melinda Gates Institute, TCI will accelerate the scale-up of NURHI approaches and provide guidance to self-selected states, Local Government Areas (LGAs) and partners willing to invest in family planning (FP) programming.

TCI Nigeria will catalyze a true FP movement in Nigeria where new states, cities, and partners ask for technical and financial coaching and mentoring to implement successful FP programming to match their own investments. TCI seeks to help states and cities replicate innovative FP models for improved maternal health in Nigeria.

Over the life of the project, TCI Nigeria will encourage at least 10 states in Nigeria to invest their own resources to replicate the NURHI model and increase the number of FP users in urban areas.

Francophone West Africa – Building on the Success of ISSU

IntraHealth International’s office is located in Dakar, Senegal, and acts as the Francophone West Africa Accelerator Hub for The Challenge Initiative. For more than a decade, IntraHealth International collaborated with the government, health workers, and other local stakeholders to strengthen Senegal’s health systems and bring high-quality health care services to more communities. After years of investment, Senegal greatly reduced child mortality and malaria-related mortality, increased access to family planning (FP), and stabilized a low incidence of HIV.

In 2014 alone, IntraHealth’s Senegal Urban Reproductive Health Initiative (ISSU) delivered FP services to over 30,000 women and provided more than 67,000 couples years of protection via community-based interventions in poor urban areas.

As an Accelerator Hub, IntraHealth International is responsible for advocating for The Challenge Initiative to city government officials, helping applicants develop reproductive health proposals and providing technical coaching and mentoring for project implementation.

Providing family planning services to women in Africa

Access to contraceptives in Africa has not increased at the same pace as elsewhere in the world. Some African nations are investing in family planning services to reduce fertility rates, improve economic development and their population’s health. Tatum Anderson reports.

 

Berhane Assefa, national family-planning coordinator in Africa’s second most populous country, Ethiopia, recalls that only 20 years ago many women in her country gave birth to more than eight babies.

By 2016, however, the average fertility rate had fallen to 4.6 live births per woman, according to Ethiopian Demographic Health Survey (DHS), and in Addis Ababa, the capital of this country of some 99 million people, women have fewer than two babies on average, Berhane says, citing the Ethiopian DHS 2011.

“Every five years the contraceptive prevalence (proportion of women using contraceptives) is doubling, so I am happy with the programme because more women can manage the size of their families,” she says.

Ethiopia’s family-planning revolution started about 10 years ago when hundreds of primary care centres were built, contraceptive stocks increased and the health extension workers based in these centres were trained to advise families on contraceptive methods.

These community health workers started to distribute male and female condoms, provide medroxyprogesterone acetate injections and, more recently, they have been trained to insert and remove implants and intrauterine devices.

Awareness-raising and education have been key to helping women and their husbands decide how large their families should be, when to stop having children, and the options available to achieve this.

The results are impressive. Between 2000 and 2016, the proportion of married women using contraceptives increased from 8% to 36%, according to the Ethiopian DHS 2016.

Ethiopia has become part of a family-planning revolution that has seen the use of contraceptives taking hold across the globe since the 1960s.

Family planning the world over has long been fraught with political, cultural and religious controversy, ever since the first pioneers began to promote the benefits of birth spacing in the early 20th century.

In spite of these controversies, huge progress has been made.

Between 1950 and 1975, average global fertility rates remained steady at five live births per woman. But as contraceptives and sex education became increasingly available – along with economic development, more women in the workplace, changes in social mores and increasing child survival – that figure halved to an average of 2.5 births by 2015, according to United Nations data.

The unmet need for contraceptives among married women aged 15–49 years in WHO’s Africa Region is estimated at 24% and lags considerably behind the rest of the world, according to the Atlas of African health statistics 2016.

Religious opposition to family planning has been at the heart of many restrictions, notes Dr Nafis Sadik, executive director of the United Nations Population Fund (UNFPA) from 1987 to 2000.

In the 1960s, Sadik implemented one of the world’s first national family-planning programmes in a developing country, in Pakistan. As Secretary-General of the landmark 1994 Cairo International Conference on Population and Development, she guided the conference preparations and proceedings.

She recalls meeting the late Pope John Paul II to discuss the Vatican’s opposition to all contraception a few months before the conference in 1994. “Somehow, I thought I could change his view,” she says.

“The only thing that he accepted to prevent pregnancy was abstinence, but that was not always possible for women … and there was immense social pressure on most marriages to have children.”

The debate became so divisive that even the UN Millennium Development Goals initially omitted family planning in 2000, although it was included, as an indicator to monitor progress in 2007, when the benefits for development and women’s rights were recognised.

Today, the efforts of public health advocates like Sadik have paid off and family planning is no longer widely seen as a tool of population control, but rather an essential component of development and a means to promote and protect basic human rights.

“Family planning started as a population control idea, but then it changed,” says Sadik, adding that the 1994 conference helped to establish the idea that family planning addresses primarily concerns about health and rights.

For Ian Askew, Director of the Department of Reproductive Health and Research at WHO, the most dramatic transformation in family planning over the last 30 years has been the rapid change in the norms around family size and attitudes to contraceptive methods.

“Most people don’t want four or more children any more, today they want one or two, or sometimes three children,” he says.

“People realise that smaller families are generally healthier, more prosperous and have better educated children and – in most countries – people no longer feel social or cultural pressures to have so many, because women are less likely to die in childbirth and child survival is much greater,” he says.

Education, especially of women and girls, is key. High literacy rates in Zimbabwe, for example, mean that family planning is widely appreciated and used.

With one of the highest contraceptive prevalences in sub-Saharan Africa – 67% of married women aged 15 to 49 years, according to the 2015 Zimbabwe DHS – the country exceeds the global average, according to Dr Munyaradzi Murwira, Executive Director of Zimbabwe National Family Planning Council.

“Today women are able to get an education and have a career. This results in smaller families in Zimbabwe,” he says.

In the United Republic of Tanzania, women who have just given birth are offered counselling and contraceptives while they are still in hospital to promote child spacing, says Halima Shariff, Director of Advance Family Planning.

She adds that the Ministry of Health and its partners have played a key role in running campaigns to educate the public about family planning and its many benefits.

“Outreach programmes to deliver services have done a great deal in terms of changing the landscape and communicating the benefits of family planning,” Shariff says.

“As in many countries in sub-Sahara Africa, religious and cultural practices may militate against the smooth provision of these services, but this resistance is gradually subsiding,” Shariff says, adding that her country is striving to attain a national contraceptive prevalence target of 45% by 2020. Prevalence currently stands at about 32%, according to the country’s DHS 2015–2016.

These commitments announced at the Family Planning Summit in July in London, underscore the Tanzanian government’s and its partners’ determination to prioritize family planning in the country’s development planning process, she says.

For the advocates and implementers of family planning, it remains unclear how a recent policy change by the United States government to stop funding family planning services that provide safe abortion services will affect programmes across Africa.

To plug the resulting funding gaps, an initiative called “She Decides”, launched by the Netherlands government, sprung up to reinforce women’s rights to decide freely whether to have children, when and how many to have.

Potential funding gaps are nothing new, as funding for family planning was diverted to HIV programmes across the developing world during the 1990s.

“Funding for our family planning programme has been limited over the last 10 to 15 years,” said Murwira. “That is the biggest challenge we have faced.”

Despite religious, cultural and political opposition to family planning, contraceptive use has increased across Latin America, where Catholicism predominates, in the largely Muslim nations of the Eastern Mediterranean, and in Asia and southern Africa, showing that the desire to plan pregnancies is often stronger than belief systems.

Barriers to meeting the full demand for contraceptives abound. Stockouts limit access to contraception; some countries limit contraceptives on non-medical grounds, for example, to unmarried women and adolescents; and some women need their husbands’ consent to use contraception or must pay for it.

For James Kiarie, Coordinator of the human reproduction unit at WHO headquarters, the high unmet need is not surprising. Most governments could invest more in family planning services or use mass media more effectively to challenge myths claiming that contraceptives make wives more promiscuous, cause cancer or are against the will of God.

“Such myths can circulate if unchallenged,” Kiarie says.

The Family Planning 2020 partnership, launched in 2012 by the United Kingdom of Great Britain and Northern Ireland, UNFPA, the Bill & Melinda Gates Foundation and many others, aims to increase investment in the 69 poorest countries so that 120 million additional women can meet their contraceptive needs by 2020.

Bulletin of the World Health Organization 2017;95:614-615. doi: http://dx.doi.org/10.2471/BLT.17.020917

9 Experts to Watch on Family Planning

As part of our ‘Experts to Watch’ series, we highlight nine experts who are advancing research, policy and interventions for women and girls’ sexual and reproductive health and rights.

 

ACCESS TO FAMILY PLANNING – the ability to choose whether to have children, when and how many – has an impact on a multitude of issues, including poverty, education and maternal mortality. When women can space out their children, they are less likely to die in childbirth, and their families have more opportunities to make a living and send their children to school. But there are currently 225 million women without access to reliable family planning services, most of them in developing countries.

As part of our “Experts to Watch” series, we highlight nine people – from veterans to youth leaders – who are working to help bring family planning services to the women who need them, using research, policy and interventions to advance the sexual and reproductive health and rights (SRHR) of women and girls worldwide.

Robin Gorna

Robin Gorna is a co-lead of the She Decides movement that launched after President Donald Trump’s reinstatement of the Global Gag Rule, which blocks U.S. funding to any foreign organization that offers abortion services or advice. Her advocacy work focuses on SRHR, particularly in regard to women, children and adolescents. Previously, she was head of the Partnership for Maternal, Newborn & Child Health, and before that she established the Global AIDS Policy Team for the U.K. government’s Department for International Development. She then served as that department’s senior health and AIDS adviser in Southern Africa. She is on Twitter @RobinGorna.

Mojisola Odeku

Dr. Mojisola Odeku is portfolio director of the Nigerian Urban Reproductive Health Initiative 2 (NURHI 2), which aims to eliminate supply and demand barriers to contraceptive use and promote family planning in Nigeria. A veteran public health physician with about 30 years of experience, she was previously head of the reproductive health program in the Federal Ministry of Health, where she focused on safe motherhood; family planning, including contraceptive logistic management; adolescent reproductive health; and gender issues. She was also director of NURHI 1, the success of which led to NURHI 2 with the goal of scaling up the interventions.

Beth Schlachter

Beth Schlachter is executive director of Family Planning 2020, where she monitors and reports on global and country progress in meeting the movement’s goals to enable an additional 120 million women and girls to access contraceptive information, services and supplies by 2020. Prior to joining FP2020, she worked for over 15 years as a career foreign affairs officer for the U.S. government. Most recently, she was senior population policy adviser in the Bureau of Population, Refugees and Migration at the U.S. Department of State, during which time she coordinated the U.S.government’s participation in a global 20-year review of the International Conference on Population and Development. She is on Twitter @BethFP2020.

Tara Sullivan

Dr. Tara Sullivan is project director for the K4Health Project, a knowledge-sharing project that aims to connect health program managers and service providers around the world to improve family planning and reproductive health services in low- and middle-income countries. She is also director of Knowledge Management Programs at Johns Hopkins Center for Communication Programs, and assistant scientist in the Department of Health, Behavior and Society at the Johns Hopkins School of Public Health. Her research examines knowledge needs in health systems worldwide and factors that influence the provision of quality of care in international family planning and reproductive health programs. She is on Twitter @taramsullivan40.

Georgia Arnold

Georgia Arnold is the senior vice president of social responsibility for MTVNetworks International, as well as executive director and founder of the MTV Staying Alive Foundation, which provides funding and training to youth-led HIV prevention projects. To date, it has donated more than $6 million to more than 200 HIV-focused organizations in over 70 countries worldwide. She is also executive producer of MTV Shuga, a TV series that focuses on the lives of young African millennials. MTV recently announced it will bring two new localized versions of the show to India and Egypt, with a heavy emphasis on family planning and contraception, as well as two new seasons in Nigeria, where it will look at issues concerning sexual health education and gender-based violence. She is on Twitter @georgiaarnold.

Jessica Kakesa

Dr. Jessica Kakesa is a reproductive health coordinator at the International Rescue Committee focusing on the Democratic Republic of the Congo. Having witnessed first-hand the suffering of displaced women and children, as well as losing members of her own family due to health reasons she says stemmed from not being allowed to choose a family planning method, she now works to expand free access to comprehensive family planning across the eastern region of DRC, parts of which suffer from the highest rates of maternal mortality in the country. After several free clinics were set up in Tanganyika Province last year, 400 new clients were reached in June alone. You can follow IRC and the work of its reproductive health workers on Twitter @IRC.

Sandra Krause

Sandra Krause is director of the Reproductive Health Program at the Women’s Refugee Commission. She has worked on international health and advocacy research for over 20 years in countries such as Thailand, Haiti, Colombia and Croatia, as well as numerous countries in sub-Saharan Africa. As an expert on family planning in humanitarian settings, she has established health programs for refugees and internally displaced persons in Somalia, Sudan and Malawi, where she was a WRC country director. She is also a registered nurse with a master’s degree in public health administration. You can find her on Twitter @SandraWRC.

Martha Brady

Martha Brady is head of PATH’s Reproductive Health Program, where she focuses on both family planning and reproductive rights issues. Previously, she was director of the Expanding Contraceptive Choice Program at the Population Council, where she worked on facilitating access to contraceptive products in public- and private-sector markets, and providing access to prevention technologies, which deliver a combination of HIV or STD-prevention and contraception. She also has extensive experience on adolescent health and development and holds a master’s degree in nutrition and public health from Columbia University. Follow her work at PATH on Twitter @PATHTweets.

Génesis Luigi

Génesis Luigi is a Women Deliver Young Leader and coordinator of the Youth Network at International Planned Parenthood Federation, Western Hemisphere Region. While a student at the Central University of Venezuela, she conducted research on sexuality and intellectual disability. She began volunteering at PLAFAM after her own negative experience with sex education that she felt presented sex as shameful, and began a video blog called “La Pastilla” – The Pill – that focused on gender and sexuality issues. She currently works to connect youth from throughout the Americas and the Caribbean to share best practices among youth advocates and to highlight the work they are doing for SRHR in their communities. She is on Twitter @Gene_Luigi. For more young leaders in family planning, explore the annual 120 Under 40 nominees list.

Government of India is Congratulated for the Launch of New Contraceptives

Mr. Nadda is Congratulated for the Launch of New Contraceptives.

September 5,  Dhaka: The Ministry of Health and Family Welfare of the Government of India has launched two new contraceptives, injectable contraceptive Medroxyprogesterone acetate (MPA)  named as ‘Antara’ and  a contraceptive pill, ‘Chhaya’,   in the public health system to expand the basket of contraceptive choices to address the unmet contraceptive needs of couples.

Dr Joe Thomas, the executive Director of Partners in Population and Development, an intergovernmental organization of 26 countries committed to promote, family planning and reproductive health issues among developing countries commented on government of India’s initiative to address unmet contraceptive needs.   “Honorable Nadda must be congratulated for his efforts in expanding the basket of contraceptive choices to address the unmet contraceptive needs” said Dr. Thomas.   India may also take efforts to provide contraceptives as part of its bi lateral assistance to other developing countries, added Dr Thomas.   HE JP Nadda, the Minister for Health and Family Welfare of the Government of India is the Vice Chair of PPD board of directors.

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