SCIENTIFIC PANEL

INNOVATIONS IN FAMILY PLANNING ADVOCACY DURING COVID-19

Advocates look forward: What will ensure family planning continuity in the year ahead?

This panel brings together four concrete examples from across the globe of how advocates are responding to the challenges of continuing family planning services during COVID-19. The panel highlights innovative advocacy responses and adaptations to ensure family planning continuity during the pandemic. It will also offer lessons learned from these interventions that can be replicated and scaled up in the immediate future and beyond.

Presentation 1: Using technology platforms to promote youth-led accountability: Mapping contraceptive methods and service availability in Kampala, Uganda

Bridget Kezaabu

Access to contraceptive services among youth was already a challenge in Uganda and Covid-19 worsened the situation. As a result, youth leaders have been at the forefront of advocacy and accountability efforts during the pandemic. International Youth Alliance for Family Planning (IYAFP) members in Kampala have updated and leveraged the Contraceptive Availability in Kawempe Division Google Map during the pandemic – helping to ensure that when youth leave their homes for contraceptive services, they know which clinics are open, what methods they carry, and, ultimately, are able to access the care they need.

The Contraceptive Availability in Kawempe Division Google Map effort began in 2018 when focus groups and interviews conducted by Population Reference Bureau (PRB) and IYAFP in Kampala, Mayuge, and Kabale Districts revealed that despite strong policies dedicated to expanding youth-friendly contraceptive services in Uganda, these services are not readily available.

IYAFP youth leaders worked with PRB to design several products that share key data and policy commitments related to youth reproductive health. A resulting advocacy video describes a unique opportunity to map contraceptive methods and service availability with a Google Map to help ensure that young people can access these services at nearby locations when needed. The Google Map provides those who use it with real-time availability of contraceptive methods and services at seven facilities in Kampala’s Kawempe Division.

During the pandemic, the team has diligently updated the Google Map and organized virtual workshops providing young people with a safe space to share their challenges with contraceptive services. They ensured the Google Map was updated bi-monthly with any shifts in each clinic’s working hours, emergency phone numbers, services offered, methods available – critical information for youth to be able to access services as many experienced restricted mobilities, reduced access to resources, and a continued need for family planning.

The advocates also met with facility staff to advocate for increased method mix —  advocacy and accountability efforts have resulted in some health facilities stocking a greater variety and quantity of contraceptive methods since more clients were coming in because of the Google Map, and creating youth-friendly corners. Next steps include working with collected health facility data together with the ministry of health, pharmacy department to influence supply of contraceptives to match the demand at each of the health facilities. This advocacy will address the continued challenge of stock-outs and could be a model to be replicated in other countries.

Presentation 2: Ask, Listen, Act: Elevating women and their demands in FP budget and policy advocacy in Sindh Province, Pakistan

Rafia Rauf 

Decision-makers are ultimately accountable to women, girls, and beneficiaries with FP budgets and policies. Yet, there are few opportunities for women and girls to systematically inform these processes. Understanding women’s needs and calls for FP takes on greater urgency during COVID-19, when many governments are redirecting resources away from FP/RH. In Sindh Province Pakistan, White Ribbon Alliance (WRA) and partner organizations pioneered novel advocacy approaches in the time of COVID to link women and their FP demands with decision-makers, which helped spur a five percent increase in the 2020-2021 FP budget and a commitment from the Sindh government to formalize women’s engagement in shaping FP policies. Approaches included bringing thousands of women’s “What Women Want” campaign requests for FP information, personnel, services, and supplies to bear on budget negotiations. It also included organizing “Listening Sessions,” in accordance with COVID-19 safety protocols, to convene WWW constituents and decision-makers and give women a direct platform to voice their detailed FP demands. This presentation will examine citizen’s/women’s demands as a critical lever for FP budget advocacy and accountability and will explore how mechanisms to connect FP users with decision-makers can be replicated and scaled up now and beyond COVID-19.

Presentation 3: The right issue at the right time: Advancing self-care in Senegal amidst COVID-19 

Ida Ndione

COVID-19 has highlighted the importance of enabling women to manage their own reproductive health—especially in a crisis when health systems are at their weakest—through self-care approaches. As the first cases of COVID-19 were being reported in Senegal, PATH was beginning to work with the Ministry of Health (MOH) to increase awareness around self-care and identify ways to advance self-care for sexual and reproductive health and rights (SRHR) through policy action and partner coordination. These efforts, coupled with Senegal’s leadership in scaling up contraceptive self-injection, built support for self-care at a critical time—key stakeholders agreed that self-care was an important component of the pandemic response, recognizing that people were quickly adopting new behaviors and that health services must adapt to physical distancing measures. With the Department of Maternal and Child Health, PATH brought together donors, advocates, and implementing partners from the SRHR, digital health, and noncommunicable diseases spaces to develop a joint self-care advocacy agenda. Together, they virtually launched a Self-Care Pioneers Group to drive forward national guidelines, as well as host consultations with civil society organizations and health providers to ensure self-care policies and programs are user-centered. During this panel, PATH will share early learnings from a year of self-care advocacy and offer lessons for other countries interested in advancing self-care to meet the needs of women, both during and after the pandemic.

Presentation 4: Partnerships in research and advocacy to advance access to contraception and abortion during (and after) COVID-19

Sarah E. Baum

Over the past year, COVID-19 has erected myriad new barriers to contraception and abortion around the globe, while at the same time shining a spotlight on existing inequities in access. Advocates who had been working to improve safe, high-quality family planning services before the pandemic have had to adapt to the changing landscape and ensure that their interventions aligned with the needs of their communities. Partnerships between research and advocacy organizations has allowed for the expansion of evidence-based advocacy efforts during COVID-19 and beyond. This presentation will include advocacy efforts that evolved during the COVID-19 pandemic, and will explore the ways that research informed and documented these changes. First, we will discuss an intervention to support people that self-manage abortions outside of formal health systems in legally restrictive settings. Second, we will discuss a campaign in the United States to allow access to over-the-counter oral contraception. Both interventions were nimble in their responses to the challenges presented by COVID-19; for example, they adjusted protocols to account for privacy concerns, adapted campaign messaging to reflect the additional barriers imposed by social distancing policies, centered the needs of those most impacted by the pandemic, and reorganized key events and study recruitment to be held virtually. In addition, exploratory research studies with a range of stakeholders elucidated the needs, preferences, and experiences of those seeking care. Changes that occurred during the pandemic have shed light on the new, more urgent role of each of these interventions, as well as contributing evidence for their sustainability and expansion in the future.

Host: Sivananthi Thanenthiran