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 counselling 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 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. For more information, visit the project report: GAC/She Decides Report

The Learning Center Initiative recognizes the outstanding leadership capabilities of member associations in the different focus areas namely access to family planning and contraception, adolescent and youth programming, integration of sexual and reproductive health services and HIV/AIDS including gender rights and sexuality, provision of safe abortion services, logistics management of commodities and good practices in governance. To capitalize on different member associations strengths the Region embarked on this initiative in 2006 with the aim of providing south to south learning between member associations but this evolved and the focus has since changed.  The initial selection included the member associations of: Cameroun for integration of gender, rights and sexuality into their programs; Uganda for increasing access to family planning and contraception; and good practices of governance; Ghana and Mozambique for adolescent and young people programming. The region quickly realized that using this initiative could transform the member associations from providers of services to enablers creating a pull effect in-country especially in the area of service delivery models. This then informed the next selection of countries - Ethiopia, Kenya, Swaziland, Togo and Cote d’Ivoire. 

The Japan Trust Fund for HIV and Reproductive Health is built on the three pillars Maternal, Newborn and Child Health.  i.e. Reduce child mortality and improve maternal health by strengthening health systems through use of EMBRACE approach Infectious Diseases: HIV/AIDS, tuberculosis and malaria: Scale up effective interventions through the Global Fund to fight against HIV/ADIS, tuberculosis and malaria. Public Health Emergencies: Provide support to respond to global public health emergencies and health crises due to natural disasters and conflicts, thereby contributing to peace-building and community stabilization In Africa the fund is granted to programmes in Kenya, Lesotho, Rwanda, Ghana, Swaziland, Zambia and Senegal where we deliver mother to child health services through the EMBRACE model increase access to sexual and reproductive health services to most vulnerable women and girls including post conflict/emergency settings promote innovative service delivery models for SRHR and HIV services (sometimes in partnership with the Japanese multinational companies) JTF allocated funds for M&E and capacity building as one of the priorities of the initiative is to increase capacity of Member Associations on new thematic areas as well as develop innovative service delivery models. The projects are operational for a maximum of two years.   

The Access, Services and Knowledge (ASK): what young people want, what young people need’ programme targets young people (10-24 years) including underserved groups, with a specific focus on uptake of sexual and reproductive health (SRH) services. The 3 year programme targets African young people in Kenya, Uganda, Ethiopia, Ghana and Senegal. ASK aims to ensure that young people not only receive direct information on sexual and reproductive health and rights so that they can make independent informed decisions. The ASK programme is a joint effort by 7 organisations: IPPF Rutgers WPF, Simavi, Amref Flying Doctors, Choice, dance4life and Stop Aids Now! Child Helpline International is engaged in the programme as a technical partner.

Expanding access to safe abortion is a key priority for IPPF and our Member Associations. A programme at IPPF since 2008 and now in its fifth phase, the Global Comprehensive Abortion Care Initiative (GCACI) is our flagship project entirely dedicated to this mission.   GCACI currently supports 15 IPPF Member Associations across 3 regions to provide quality comprehensive abortion care, increase the uptake of post-abortion contraception, increase access to contraceptive services through service provision and implement a client-based clinic management information system in all participating Member Association clinics. From 2019 to 2020 (phase V), 213,875 women received comprehensive abortion care in 16 countries across three regions. Out of this total, 90% adopted contraception with 25% choosing long-acting methods. In addition, about 1.6 million women were provided with a modern method of contraception. During the COVID-19 pandemic, Member Associations have continued to provide abortion care to women, adapting and implementing innovative service delivery models to respond to the unique challenges to access and service provision the pandemic brought. From self-care approaches, telemedicine and home-based delivery of safe abortion, women and girls have benefitted from alternative and highly effective mechanisms to access safe abortion in the face of COVID restrictions. In 2021, GCACI Member Associations will prioritise the expansion and strengthening of these innovative models of service delivery, as well as continuing to ensure that in-clinic care remains quality, accessible, and affordable. Strategies will focus on increasing access to abortion care for poor, marginalised and vulnerable communities, including reaching young people through youth-centred services.

Cervical cancer is the third most common cancer in women worldwide with approximately 500,000 new cases and about 250,000 deaths each year (about 85% of these deaths occur in low and middle income countries). This translates to around one woman dying of cervical cancer every two minutes around the world.  In response to this huge disease burden among women, IPPF Member Associations in the Africa Region are providing Cervical Cancer Screening and Treatment as part of the SRH package of services offered to their clients, with a focus on the poor and marginalized.  With the support of the Bill and Melinda Gates Foundation, IPPF has a focused initiative on Cervical Cancer Screening and Preventive Therapy through Reproductive Health Networks being implemented in four Member Associations in Kenya, Nigeria, Tanzania and Uganda. This programme focuses on the integration of cervical cancer screening and treatment of pre-cancerous lesions through Visual Inspection with Acetic acid (VIA) and Cryotherapy. This is an approach that has shown great effectiveness in low resource settings whereby middle level health workers using inexpensive and affordable technology are able save the lives of hundreds and thousands of women by identifying pre-cancerous lesions early and providing early treatment. The initiative supports the training of service providers, procurement of equipment and supplies, community mobilization/outreach and IEC, strengthening data systems and conduct of operations research around cervical cancer screening and preventive therapy programme implementation. For just over one year of implementation in the four countries, there are now over 190 static and outreach screening sites and 25 Cryotherapy sites. During this period, the four Member Associations have been able to reach over 80,000 women with cervical cancer screening services and provided Cryotherapy to those found eligible.  IPPF envisages scaling up the cervical programme implemented in these four countries and other across the region to further expand cervical cancer screening and treatment so as to reach more women with these lifesaving services through an integrated approach.