• Martha Carlough

    IntraHealth International | Safe Motherhood and Newborn Care Senior Clinical Advisor

    Roy Jacobstein

    IntraHealth International | Senior Medical Advisor
    FP provider with couple in Nigeria

    A couple, Mr. Olatunji Yusuf and Mrs. Nimota Yusuf, attend a family planning counseling session with a service provider at a Centre-Igboro health facility in Ilorin, Kwara state, Nigeria. © 2012 Akintunde Akinleye/NURHI, Courtesy of Photoshare

    Unmet need for family planning has decreased only moderately in recent decades, and the demand for family planning is on the rise due to population growth, longer life expectancies, and the increasing desire for smaller families. We must address this gap if we hope to increase the health, social, and economic well-being of women and their families around the world.

    Integration of family planning into maternal, newborn, and child health (MNCH) helps connect more women with the family planning methods they need to protect their health and plan their futures. Addressing provider bias with evidence-based, supportive, and health systems-based solutions is critical to success, yet often ignored.

  • Anna Zatonow

    WINGS Guatemala | Communications Coordinator
    18-year-old Isabela and her son, Andy, at a WINGS clinic.

    18-year-old Isabela and her son, Andy, at a WINGS clinic. After giving birth to Andy as a single mother, Isabela decided on a contraceptive implant.

    Meet Isabela, an 18-year-old who came to a WINGS clinic in Santo Tomás Milpas Altas, a small town about a 20-minute drive from Antigua, Guatemala. Accompanied by her older sister, Isabela carried her eight-month-old son, Andy, in her arms. She is young but, unlike many of her peers, she is aware of her reproductive rights and contraceptive options thanks to WINGS’ volunteer promoters. She visited our clinic for the first time over a year ago. She had a boyfriend at the time and, since they had started having sexual relations, she wanted to get a Jadelle implant. However, when she took the routine pregnancy test we give to each patient before providing a long-acting method, the result was positive. Isabela was devastated at the time, bursting into tears. She is now raising Andy as a single mother, luckily with a lot of support from her family. She loves her son very much, but admits that being a mother at such young age is very hard and she wishes she waited for a few years. She's one of six siblings, four of them girls. "We now all have implants," she says. "Even my 15-year-old sister, she has one too. I want her to be safe, study, go to university, and not go through the difficulties I had to face." Isabela looks at little Andy with a big loving smile. "It's not easy. But I'm very happy now that I know I'm protected for the next five years."

  • Adrienne Allison

    World Vision | Senior Technical Advisor, Family Planning & Reproductive Health
    Community Conversation Isiolo County

    Community Conversation Isiolo County. Photo credit: Adrienne Allison, World Vision. 

    While World Vision was preparing to integrate Healthy Timing and Spacing of Pregnancies and Family Planning (HTSP/FP) within a community-based maternal, newborn, and child health (MNCH) program in Isiolo County, we found that only 8% of women with a child younger than two used contraception even though 77% knew where to get counseling and services. Moreover, 32% had five or more children, and 80% wanted another child within 24 months of their previous birth. This pronatalist society valued large families, as well as large herds of goats and camels, as buffers against adversity in their harsh, semi-arid climate. Furthermore, they distrusted “family planning”—a foreign concept.

    As we identified these barriers, we recognized that men were the gatekeepers to their communities: imams influenced men, and men made family fertility decisions about whether and when their many wives would conceive.

    Our initial focus was on engaging men by introducing them to a new concept: the health benefits of timing and spacing pregnancies. We trained 71 male and 36 female Community Health Workers (CHWs), 5 Community Health Extension Workers, and several facility-based Ministry of Health (MOH) staff to provide both men and women with friendly, positive counseling on HTSP and the contraceptives that would help them begin to time and space pregnancies to improve the health of women and their children.

  • Elizabeth Futrell

    CCP | Content Development Lead/Program Officer II
    © 2014 Arturo Sanabria, Courtesy of Photoshare

    A mother breastfeeds her infant at Rapale Health Center, Rapale, Nampula, Mozambique.© 2014 Arturo Sanabria, Courtesy of Photoshare

    “I’m still breastfeeding my daughter, and she isn’t even a year old. I didn’t think there was any chance I could get pregnant!” A friend recently shared this as she explained that she was pregnant again—with twins.

    Her situation isn’t unique among my 30-something-year old peers. Several of my friends and acquaintances have unexpectedly gotten pregnant within a year of giving birth—mainly because they didn’t realize they were at risk of pregnancy. Why aren’t more providers helping their patients connect the dots between breastfeeding, birth spacing, and contraception?

    Closely spaced pregnancies might test the patience and finances of American mothers, but for mothers in low- and middle-income countries, they often pose grave health risks. Many of these mothers—and their babies—are at greater risk of nutritional deficiencies and other complications, and have more limited access, if any, to skilled antenatal, delivery, postpartum, and child health care than my friends in the U.S.

  • Adriana Zinn

    Georgetown University | Student

    The well-being of men and women around the world is closely related to gender norms and the ways in which those norms influence health behaviors, including family planning. Engaging men, especially in gender equity efforts, is critical to establishing good health for both men and women, and family planning programs can be a key opening for these efforts.

    Population Reference Bureau created an infographic exploring the constructive engagement of men as clients, men as partners, and men as agents of change. The graphic spotlights key statistics and noteworthy programs from around the world, and emphasizes the importance of engaging men in family planning.  For example:

    1. Male condoms account for only 8% of contraceptive use globally.
    2. The worldwide prevalence of vasectomies is 3%, compared to the prevalence of female sterilization, which is 18%.
    3. A study in Brazil found that young men with inequitable gender norms are less likely to use contraception.
    4. 1/3 of 20-24 year old women in the least developed countries give birth by 18.
    5. Educated husbands feel that decisions about family size should be made with their partner.

    These data underscore the importance of continuing to engage men in family planning and women’s health. Since studies show that careful and constructive male engagement can have positive effects for both men and women, more efforts should be made to include men, especially in family planning. These efforts will, hopefully, create changes surrounding family planning practices and promote better health for men and women worldwide. 

  • K4Health Highlights

    Amanda Puckett

    IntraHealth International | Technical Advisor, HRH and Knowledge Management
    Mothers with their children in Nepal.

    Mothers with their children in Nepal. © 2013 Valerie Caldas/ Johns Hopkins University Center for Communication Programs, Courtesy of Photoshare

    This spring, between Mother’s Day and Father’s Day, K4Health will be shining a spotlight on the integration of family planning with maternal, newborn, and child health services. On our new page on this topic and via our blog, we’ll highlight diverse perspectives and ideas, innovative models for integration, practical tools for implementation, the latest evidence on what works, and much more.

    Let’s be honest—integration of family planning into maternal, neonatal and child health (MNCH) services is a very broad topic. There are so many points at which clients seeking MNCH services intersect with health care providers who could also discuss family planning. These opportunities include antenatal care, labor and delivery, postpartum care, immunization visits, other infant and child wellness visits, and adolescent care. 

    Yes, Adolescent Care. 

    Even though there is no “A” in MNCH, acknowledging the need for adolescents to have access to youth-friendly sexual and reproductive health information and services is crucial. The World Health Organization (WHO) cites that about 16 million girls ages 15 to 19, and some 1 million girls younger than 15, give birth every year. Most adolescent pregnancies occur in low- and middle-income countries.

  • Mamadou Mbaye

    ADEMAS | BCC Advisor
    Senegal Male Engagement Poster

    Qui est Moussa ? Il est un homme sénégalais âgé de 35 ans. Moussa et sa charmante épouse Amy habitent en zone périurbaine de Dakar. Il assume difficilement les charges familiales avec ses revenus modestes. Moussa est  soucieux du bien-être de sa famille mais son attachement aux valeurs traditionnelles et religieuses fait qu’il n’encourage pas son épouse à recourir à la PF. Moussa est un archétype—il ne représente pas un individu, mais de nombreux hommes au Sénégal qui découragent et même bloquer leurs partenaires d'utiliser la planification familiale (PF). L'agence  sénégalaise pour le développement du marketing social (ADEMAS) a créé des archétypes pour Moussa et Amy sur la base de la recherche de marketing.

    À partir de 2013, le Ministère de la Santé du Sénégal et une coalition de partenaires techniques dirigée par ADEMAS, UNFPA et IntraHealth, ont développé, mis en œuvre et évalué la toute première campagne de communication de PF au Sénégal ciblant les hommes et les femmes au niveau national et  à travers de multiples canaux. Utilisant le slogan moytou  nef ("éviter les naissances rapprochées" en wolof, la principale langue locale du Sénégal), la campagne visait à favoriser un environnement propice à l'utilisation de la PF moderne. À mi-parcours, des données d'évaluation ont été recueillies dans 8 des 14 régions du Sénégal à travers des méthodologies de recherche quantitatives et qualitatives, comportant 50 entrevues d’informateurs clés avec le personnel médical et les parties prenantes, 27 discussions de groupes avec les cibles primaires (hommes)  et secondaires (femmes) et une enquête quantitative de 1848 hommes et 896 femmes.

  • Mamadou Mbaye

    ADEMAS | BCC Advisor
    Senegal Male Engagement Poster

    Who is Moussa? He is a Senegalese man, age 35. Moussa and his lovely wife Amy live in the outskirts of Dakar. It’s tough for him to cover his family’s expenses with his modest income. Moussa is concerned about the well-being of his family, but due to his attachment to traditional and religious values, ​​he does not encourage his wife to use modern contraception. Moussa is an archetype—he represents not one individual, but many men in Senegal who discourage and even prevent their partners from using family planning. The Senegalese social marketing association ADEMAS created archetypes for Moussa and Amy based on marketing research.

    Starting in 2013, the Ministry of Health of Senegal and a coalition of technical partners, led by ADEMAS, UNFPA, and IntraHealth, developed, implemented, and evaluated the first-ever family planning communication campaign in Senegal to address men as well as women at national scale through multiple channels. Using the slogan moytou nef (“avoid closely spaced births” in Wolof, the major local language of Senegal), the campaign aimed to foster an enabling environment for modern contraceptive use. Mid-course evaluation data was collected in 8 of Senegal’s 14 regions through qualitative and quantitative research methodologies including 50 key informant interviews with medical personnel and implementing partners, 27 focus group discussions with the primary and secondary audiences, and a quantitative survey of 1,848 men and 896 women.

  • John Stanback, PhD

    FHI 360 | Senior Scientist, Health Services Division

    Dominick Shattuck, PhD

    FHI 360 | Technical Director
    Photo Credit: Dominick Shattuck

    Over the last 30 years, the focus of most family planning interventions has been on the female user rather than the couple. In the mid-1990s, however, family planning programmers began to recognize the need to address household power dynamics and roles, which often limit women’s agency over their reproductive health. And more recently, a wave of interventions focusing on men’s role in contraceptive decision-making have been developed, tested, modified, and re-administered in new areas of the world.

    We define the goals of male involvement interventions as:

    • Couples’ shared contraceptive decision-making, as a result of men’s increased knowledge of and discussion about contraception with their partners; and
    • Men’s support for the acquisition of contraceptive methods through emotional support or allocation of resources (time, money, transportation), and increases willingness to use male-contraceptive methods when available.
  • K4Health Highlights

    Sara Mazursky

    CCP | Deputy Director
    How to Share Fair Cover Image

    Think back over the last few months. Have you had a day where you only communicated via technology?

    A few months ago, I had a highly productive day and worked on several projects— but didn't actually speak a single word. All of my communication was through email, Skype message, Google doc, and text messages. While I crossed a lot off my to-do list that day, I felt really disconnected.

    I had spent the day talking at people, not with people.

    This point is highlighted in an Atlantic interview with Sherry Turkle, renowned author of the 2011 book Alone Together. Both the article and the book focus on the idea that in this age of data overload, the art of conversation and real engagement is becoming lost.

    In the field of KM, we talk about the importance of capturing tacit knowledge. That is to say, the information that is in people’s heads, not written down on paper. Usually this information is shared informally and often in a face-to-face setting. Simply put, we need to talk with each other, not at each other.

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