The International Planned Parenthood Federation (IPPF) and its network of Member Organizations/partners constitute the world’s largest provider of sexual and reproductive health (SRH) services and share a long history of being at the forefront of promoting and defending sexual and reproductive health and rights. Working toward a vision in which “all people are free to make choices about their sexuality and well-being, in a world free of discrimination,” IPPF emphasizes the intersectionality of good health and well-being with poverty, gender, race, ethnicity, addressing these through the provision of integrated, rights- based, and gender-inclusive health services for all.
From 2018 to 2020, funding from Global Affairs Canada (GAC), through the She Decides project, supported IPPF and its local partners in five priority countries – Colombia, the Dominican Republic, Guatemala, Malawi, and Mali – to expand their reach and impact in advancing sexual and reproductive health and rights (SRHR), particularly for those who are most marginalized.
During the project period, partners provided close to 17 million SRH services at their service delivery points, such as STI screenings, HIV testing, safe abortion, and counseling and access to modern contraceptives such as long-term injectables, surpassing the initial target by 770,000. The vast majority of clients receiving these services (76.5%) are those living below the poverty line, frequently at great distances from existing health services/facilities, who may be internally displaced as a result of humanitarian crises, and are often further marginalized on the basis of their sexual orientation and/or gender identity.
Funding through GAC/She Decides enabled partners to develop and implement innovative strategies for reaching these populations and the most hard-to-reach regions that had some of the worst SRHR indicators. For example, In Malawi, our Member Association - Family Planning Association of Malawi (FPAM) - expanded its service delivery to rural, under-served communities in four districts (Dedza, Dowa, Mzuzu and Lilongwe) through outreach services, and strengthened provision of a comprehensive package of integrated SRH services through static clinics in 12 districts. Over the course of implementation, FPAM reached approximately 555,186 (over 25 years) women and 659,382 (<25 years) girls with integrated SHR services. A particular focus of the project has been to increase the access of hard-to-reach youth to SRHR information and services, through Youth Life Centers, youth outreach clinics, and intensive involvement of youth in outreach activities and awareness-raising campaigns.
In Mali, IPPF Member Association - Association Malienne pour la Promotion et la Protection de la Famille (AMPPF) - used multiple service delivery strategies to expand access to SRH services in some of the most under-served regions of the country, some of them affected by ongoing security risks. It includes the regions of Kayes, Koulikoro, Sikasso, Ségou, Mopti, Gao, and Bamako District. Over the course of the project, AMPPF provided 1,524,825 integrated SRH services to over 556,228 women and girls. AMPPF organized 857 community engagement activities, including outreach at highly attended community festivals, reaching an estimated 41,423 people with positive messages about SRHR.
In addition to directly supporting services and community mobilization to reach specific vulnerable populations in each country, She Decides has helped boost partners’ advocacy efforts to champion sexual and reproductive health and rights (SRHR), in particular for a more enabling environment in which governments and other key decision-makers are committed to upholding and fulfilling SRHR. Through this project, partners completed 2,005 specific advocacy engagements. Partners contributed to 31 advocacy wins that engender greater respect and protection of SRHR and have long-term implications for the health and wellbeing of women and girls in project countries.
Key high-level advocacy initiatives included: incorporation of SRHR in municipal development plans in project regions (Colombia); approval of the National Plan to Reduce Teen Pregnancy (Dominican Republic); increasing contraceptive security and transparency around SRH financing (Guatemala); advancing abortion law reform (Malawi); and advocating for the integration of SRH into the COVID-19 response (Mali).
Underpinning these interventions was a deliberate effort to build partners’ overall sustainability through data and financial systems strengthening and sustainability efforts to improve their resilience to future shocks, whether from a sudden loss of donor funding or a crisis. The COVID-19 pandemic, which erupted in the last quarter of the project, tested this capacity as partners pivoted quickly to provide continuity of services and to advocate for the inclusion of SRHR as part of the emergency response.