Women’s Integrated Sexual Health (WISH)

WISH is the UK government’s flagship programme on sexual and reproductive health rights (SRHR) that was initially implemented 27 countries (24 in Africa and 3 in Asia). The number of countries for the extension phases was reduced to 17 countries. WISH is divided into two ‘Lots’. Lot 1 was implemented in West and Central Africa by a consortium of eight organisations led by MSI Reproductive Choices and Lot 2 was implemented in Eastern and Southern Africa and South Asia by a consortium of seven organisations led by IPPF. Programme oversight, verification of reports, evidence generation, learning and dissemination was done by a Third-Party Monitor (TPM).

Donor: Foreign, Commonwealth and Development Office (FCDO)

Budget: Total budget of £ 272 million. Lot 2 budget £164.8M

Duration: August 2018 to May 2024

Consortium Partners: The IPPF led Lot2 WISH programme also called WISH2ACTION (W2A) implemented by a consortium comprised of MSI Reproductive Choices, International Rescue Committee (IRC), Development Media International (DMI), Options, Ipas, Humanity and Inclusion (HI) and 10 IPPF Member Associations in Burundi, Ethiopia, Malawi, Mozambique, Pakistan, South Sudan, Sudan, Tanzania, Uganda and Zambia.

WISH adopted the “Leave No-One Behind” (LNOB) approach specifically aiming to increase access for those below 20 years, the poorest, persons with disabilities and vulnerable communities such as IDPs and refugees.  

Some results and impacts figures of Lot2 W2A over the life of the project

• Number of couple years of protection (CYPs) generated by W2A family planning services: 29,510,107
• Estimated additional users of modern methods of contraception: 3,571,683
• Estimated number of total family planning users: 8,405,222
• Estimated maternal deaths averted: 21,579
• Estimated unsafe abortions averted: 4,309,553
• Estimated unintended pregnancies averted: 13,256,301
• Estimated additional disability adjusted life years (DALYs): 19,224,382

And highlights in each of the four output areas:

Output 1 - Community/Individual choice: Poor and marginalised women and men, and adolescent girls and boys are accessing high quality family planning services and have the knowledge and community support to make informed SRHR decisions.

An estimated 76 million people in seven countries in East and Southern Africa were reached with mass media campaigns including 100 master radio spots, translated into 29 African languages and broadcast on 136 radio stations. 402 audio-visual recordings were produced and distributed reaching an approximate 49.5 million people.

Alternative broadcasting channels were also explored e.g., in Ethiopia where audio spots were broadcast in Hawassa Industrial Park, targeting young people; 33 spots in Amharic and Sidama languages reaching about 35,000 young people, and linked to an increase in FP service delivery between 2019 and 2021. Sudan and South Sudan benefited from remote technical assistance by consortium partner DMI, adapting existing radio and audio-visual material for electronic and alternative broadcast. The W2A mass media campaign was shared with the MoH, other consortium partners and FP/SRHR implementing partners, distributing over 22,600 flash disks and SD cards for further use within their networks.

Output 2 - National Ownership: Sustainable national engagement in changing and/or implementing policies, government financing, commodity security and public sector SRHR capacity

Between 2019 and 2023, W2A through Options has contributed to an increased annual budget allocation of US$ 9,280,451 million for family planning, through targeted and evidence informed advocacy and accountability across Malawi, Madagascar, Tanzania, Uganda, and Zambia.

Throughout the programme, government stewardship of quality improvement for SRH/FP has improved with assessments in Pakistan, Zambia, Uganda and Madagascar, showing increased scores in key domains including quality improvement systems and processes and actions and improvements.

Since 2019, W2A through Options has strengthened government stewardship by supporting the development or implementation of 13 policies, strategies, guidelines or plans in Madagascar, Tanzania, South Sudan, and Uganda.

Between 2019 and 2023, W2A through Options has strengthened the capacity of 74 local CSOs in Bangladesh, Madagascar, Malawi, Tanzania, Uganda, and Zambia to conduct evidence-based advocacy for SRH/FP.

Output 3 – Access to Service: Access to quality, voluntary FP and other SRHR services, eliminating barriers for young and marginalised women

Activities under this output focussed on the provision of quality and voluntary FP/SRHR services. Throughout the W2A programme, FP/SRHR service delivery was implemented across three channels - static facilities, outreach, and community-based distributors (CBDs). As a health system strengthening mechanism, capacity building of service providers was an integral component of the programme including values clarification and attitudes transformation (VCAT), training on provision of youth friendly services, integrated FP/SRHR service delivery (contraception, safe abortion, HIV/STIs, cervical cancer screening, GBV, counselling), commodity planning, safeguarding, QOC, adverse events reporting, infection prevention and control (IPC), disability inclusivity, data management and MISP. These trainings have reached approximately 9,000 health care workers across the W2A programme countries.

Across the life of the W2A programme, the average youth reach was 16.93% against a target 17%, an increase from the original target of 15%.

The W2A programme continued to learn and adapt programming with the aim of reaching clients living in extreme poverty with FP/SRHR services adopting innovations  to improve poverty reach including the use of targeted demand creation strategies, use of poverty heat maps and prioritization of outreach services and cluster/service delivery points (SDPs).

The W2A programme continued to work on disability inclusive FP/SRHR service delivery through various demand and supply approaches including working closely with Organizations of Persons with Disabilities (OPDs), disability inclusive targeted outreaches, disability inclusive training, and accessibility audits. Disability reach for the programme ranged from 7-10%.

Output 4: Global goods: Evidence-based innovations and practice shared globally to increase women’s choice and access to SRHR services

The project has achieved and surpassed targets for global goods development with 17 knowledge products including learning syntheses, peer-reviewed manuscripts, as well as knowledge management products (WISH resource portal and WISH data sharing portal). In addition, W2A contributed to 11 discrete studies led by the TPM. W2A has also utilised both internal and external platforms to share and disseminate learnings form the programme. These include regional and international conferences (ICFP, SBCC Summit), as well as several webinars and learning events.

The W2A Programme was also regularly and systematically monitoring other aspects of the programme such as risk, value for money and safeguarding making necessary adaptations based on lessons learnt. The WISH Programme made outstanding achievements in several areas and had an overall score of A. IPPF feels extremely privileged to have been involved in WISH.