The Integrated Family Health Program (IFHP) is a five-year USAID-funded program to promote an integrated model for strengthening maternal and child health, family planning (FP), and reproductive health services for rural and underserved populations in Ethiopia. Led by Pathfinder International and John Snow, Inc. in partnership with the Consortium of Reproductive Health Associations, IFHP has pursued scale-up of community-based provision of Implanon since 2009.

This publication describes the experience of the USAID-funded Integrated Family Health Program, a partnership between Pathfinder International and John Snow, Inc., to train Health Extension Workers in Implanon Insertions as one of four pilot programs under the Ethiopia Federal Ministry of Health's Health Extension Program in order to improve availability of long acting family planning.

Between 1998 and 2003 more than 600 nurses in Ghana received training to provide Norplant implants. Now more than 88,000 women have used or are using implants. Training nurses, as well as some doctors, was crucial to increasing access to implants and reducing waiting times for clients. The large number of providers trained to provide Norplant will make it easier for Ghana to start providing the new implants. The Ghana Health Service collaborated with EngenderHealth, a technical assistance organization, to carry out the training. The U.S.

In 2008, Marie Stopes Sierra Leone and BlueStar Sierra Leone, working in conjunction with the Ministry of Health Services, began a national expansion programme to provide contraceptive access to women in every chiefdom in the country. Central to the expansion plan was being able to offer all women an increased range of contraceptives to choose from when they desire to prevent or delay a pregnancy.

PROFAMILIA had been routinely providing Norplant for 30 years when it successfully switched to Jadelle in 2002. Counseling clients about the comparative advantages of the new implants is necessary, especially where Norplant is well-known and liked. This counseling led some women to choose Jadelle. Others, however, still preferred Norplant, while it was available. Once PROFAMILIA stopped offering Norplant, counseling was very effective in helping Norplant-seeking clients accept Jadelle.

Marie Stopies International/Zambia (MSIZ) is supplementing the government’s efforts in the provision of family planning services in rural areas of Zambia. Both Rural Centres in Chiyawa and Sichili have not been offering long-acting methods because of lack of family planning training, supplies and instruments. MSIZ is the first organization to introduce long-acting family planning methods in both areas. MSIZ donated family planning instruments and supplies to the clinics and trained the health workers to provide long-acting methods.

Over the last two decades, MSI has pioneered innovative approaches to reaching men and women with high quality contraceptive services. A promising model which reaches areas where traditional health services cannot reach is the use of mobile outreach health teams. The MSI outreach model generally consists of a team of nurses, healthcare assistants, counselors and a driver visiting rural, hard-to-reach areas and providing a range of high quality contraceptive services. In 2009, MSI provided services to over 1,200,000 men and women through its outreach services.

Save the Children USA’s Maya Salud project worked carefully to bring high-quality sexual and reproductive health (SRH) services to the doorsteps of families in the Ixil Triangle in western Guatemala by fostering partnerships between community members and service providers. Using a methodology that Save the Children calls Partnership Defined Quality or PDQ, representatives of 88 communities and of the health system jointly examined and improved SRH services in a manner that met the aspirations of service users.

For the past 32 years, Marie Stopes International (MSI) has been working to close the gap between the need and availablility of long-acting and permanent methods (LA/PMs) by delivering these methods to communities with limited access to family planning services. In 2008, MSI delivered over 1.1 million LA/PMs through clinics, mobile outreach, and the BlueStar social franchise network of private health providers.

This presentation provides information about Population Services International's approach in Cambodia to expand access and demand for long-acting family planning methods through mobile services. Mobile service delivery of IUDs and implants provided the opportunity to give on-the-job training to providers while also increasing access to clients. The presentation also provides results of the initiative and lessons learned.

This presentation gives an overview of Population Services International's intervention in Kenya to increase uptake of IUDs and implants. The intervention involved developing a private-sector network of private providers, who were identified with a common logo. They agreed to promote long-acting methods, especially IUDs and implants and to adhere to quality service provision. In return, they were provided with training and other resources. The presentation presents the initiative's results, as well as successes and challenges of the model.

This presentation gives an overview of Population Services International's intervention in Zambia of seconding highly skilled, dedicated long-acting method providers to selected high-volume government facilities to improve access to and uptake of long-acting methods. In the first 12 months, the initiative served over 26,000 women with long-acting methods. The presentation provides advantages, challenges, and lessons learned about this particular model.

This brief provides information about Population Services International's approach in Mali to raise awareness among women of family planning methods, with a special emphasis on IUDs and implants. The women were reached at clinic immunization days for children under one year. The initiative provided the women with information about the methods and provided them with family planning services. The brief discusses challenges and lessons learned. 

In 2004, Pathfinder launched a new model of service delivery-based training in long-acting family planning methods. The project provides basic theory as well as practical supervised clinical practice to large numbers of practitioner-trainees, while simultaneously providing services to hundreds of clients. The new approach represents a major paradigm shift in providing reproductive health/ family planning training in Ethiopia: it is the first comprehensive family planning clinical training project that prepares all facility staff to respond to client needs.

Hormonal implants are proving to be increasingly popular among Tanzanian women, according to national-level service statistics at public-sector health facilities. The reasons for this popularity include the hormonal implant’s convenience, ease of insertion, and long-lasting effectiveness. Another factor contributing to the implant’s success is that the method is being provided in Tanzania primarily by nurses (in addition to doctors), which means that it can be offered at health centers and dispensaries.