DSW has engaged in the following activities in support of its commitment to FP2020.
- Advocacy: In Eastern Africa, our advocacy for both greater availability of contraceptives and removal of barriers to access is closely linked to our advocacy on budget allocation and service provision. For more information on these activities, please access DSW’s review of national and district policies and budgets for Kenya, Rwanda, Tanzaniaand Uganda.
- Advocacy: DSW is a member of the Reproductive Health Supplies Coalition and actively contributes to different working groups and work streams within the coalition, especially the advocacy and accountability working group.
- Engaging youth: DSW’s Youth-to-Youth Initiative (Y2Y) is a cross-sectoral, integrated and holistic approach that takes into account the interrelations between sexual and reproductive health and rights (SRHR) and sustainable development in Eastern Africa (Kenya, Ethiopia, Tanzania and Uganda). It addresses the multi-faceted needs of adolescents and youth aged 10 to 24 to equip them with knowledge and skills that help them make informed decisions. Its overall goal is to empower young people in areas of SRHR as well as socioeconomic development to live a self-determined life. Y2Y is operated through a network of approx. 400 youth clubs which engage in youth-driven and needs-oriented local advocacy, sensitisation, and community work. As part of Y2Y, 20 advocacy and dialogue forums were conducted at local and national levels in 2014. Local administration, young people, youth leaders, political leaders, opinion leaders, health workers, village elders, parents, community leaders and development partners attended the forums which discuss various issues affecting youth like provision of youth-friendly reproductive health services, youth in leadership, youth unemployment and inclusion.
- Prioritizing sexual and reproductive health and rights, family planning, and gender policies and programs: DSW promotes the integration of maternal and adolescent health, child health, HIV&AIDS and SRHR in health and development plans, policies and programmes. Examples of this work are a series of reviews of national and district policies and budgets for family planning. With the reports, DSW aims to establish trends in the allocation and disbursement of resources at donor, national and subnational levels in Kenya, Rwanda, Tanzania, and Uganda. This analysis will inform advocacy engagement with decision-makers in these countries by improving civil society organisation’s (CSO) understanding of existing family planning policies and budgets. The research will enable CSOs to track the progress of government decision-making on responsive family planning policies, budgets and their implementation, and will support progress towards international and national family planning commitments. The in-depth analysis has involved a review of national and sub-national (selected districts or counties) family planning policies and budgets, in addition to focus group discussions with local communities. The outcomes of these debates will be used to determine whether the policies and budgets in place are effectively addressing the concerns of these local communities. Through these studies, DSW aims to strengthen communities and CSO capacity to engage in decision-making on policy and budget cycles. This ensures that they are equipped to contribute meaningfully to the processes.
Increasing access: DSW is supporting health service providers in East Africa. In 2014, for example, DSW contributed to 357,876 instances of SRHR service provision. The most common services were HIV/AIDS prevention (123,628 services), followed by family planning services (96,402). DSW also contributed to services related to sexually transmittable infections (prevention: 28,304 and treatment: 20,857).
- In Uganda, DSW works with 15 health facilities. In each facility, DSW has set up youth corners which are supervised by facility managers. DSW has trained health workers in most facilities. In Ethiopia, DSW mainly refers cases to nearby health facilities. The provision of SRHR services is very different by geography: While DSW Kenya focuses very strongly on family planning and HIV/AIDS services, DSW Uganda is represented across all service categories. DSW Ethiopia records many services related to prevention of STIs. Finally, DSW Tanzania has supported services related to HIV/AIDS prevention, family planning, and treatment of STIs as well as counselling of victims of GBV.
- DSW data show that roughly one third of SRHR clients were aged 20 to 24 years, one third 15 to 19 years and one third was 10 to 14 years old. This is evidence for DSW’s expertise in improving access to SRHR for young people. In addition, 10 per cent of clients were aged 25 to 30 years and the rest was above 30 years. The age distribution is very different by country. DSW Uganda is entirely focused on the age group of 10 to 24 years, with a very big amount of 10 to 14 years. DSW Kenya focuses more on older age groups, starting from 15 years, but with a clear focus on 20 to 35. DSW Ethiopia’s focus lies on the younger age groups and interestingly many clients above 35 years. Finally, Tanzania’s focus is on the 15 to 30 years old.
- Another measure of DSW’s contribution to health systems is the number of referrals made through youth clubs at community level. In 2014, a total of 60,050 referrals were tracked. A majority of young people were referred for family planning cases (30,680 referrals). Second come referrals for preventing HIV/AIDS (11,527 referrals). A third important category of referrals relate to maternal health; 7,198 young women were referred for ante-natal care, 1,907 for skilled birth attendance and 2,033 for pre-natal care. In addition, 2910 young people were referred to STI prevention services, 1433 referrals regarding preventing gender based violence, plus other referrals 2,362. Most referrals were made in Ethiopia with 83% of all DSW referrals, followed by Uganda (10%), Tanzania (4.5%) and Kenya (2.5%). An analysis of referrals by age groups confirms that DSW is well focused on its target group of young people. 44% of referred clients, were aged 20 to 24 years, followed by the 15 to 19 years (31%) and 25 to 30 years (20%). Very few young adolescents (10-14) were referred (mainly in Uganda) and few cases above 30 years.
- In 2014, DSW distributed 1,590,045 sexual and reproductive health commodities. The main commodities distributed were 1,563,740 male condoms. Through partnerships with Ministries of Health, DSW distributed 720,383 male condoms in Ethiopia, 619,200 condoms in Uganda, 153,925 condoms in Tanzania and 72,615 in Kenya. In addition, DSW also provided access to injectable (9,273), implants (7,810), mainly in Ethiopia, as well as 7,489 oral contraceptives (in Ethiopia and Kenya). Other contraceptives included female condoms and IUD – 10 years.
DSW has engaged in the following activities in support of its commitment to FP2020.
Europe
- DSW is continuously tracking government expenditure for family planning. For Germany and the European Commission this was done collaboratively with the Countdown 2015 Europe Network. Please see here for the results of the tracking which is being used to hold governments and the European Commission to account.
- Until 2013, DSW in a consortium with other European partners published “Euromapping”, tracking the commitments and disbursements of donors in the field of family planning and reproductive health. DSW has used these figures and presented them a way that is easily accessible for decision-makers and advocates. “Euromapping” served as an advocacy tool for civil society organizations to convince donors to spend more of their budgets on family planning and reproductive health.
- At EU level, DSW together with partner organisations has successfully advocated for stronger language on family planning in the programme of the main development cooperation instrument and protected the budget related to family planning against proposed cuts.
Africa
- In Africa, DSW successfully worked together with multiple partner organisations for increased funding for family planning. Budget changes included increases in reproductive health allocations in four state budgets and seven district budgets. The budget changes at district levels encompass activity budgets to improve sexual and reproductive health and rights service uptake; the improvements of health centres to increase greater privacy; family planning demand creation; and waiving user fees.
- DSW and its partners have developed analyses of the budget on family planning for Kenya, Rwanda, Tanzania and Uganda, not only at national level but also at local level; indeed with the devolution process, most of the decisions made on budget allocation s and policy affected FP commodities and barriers to FP are made at district or county level.
DSW has engaged in the following activities in support of its commitment to FP2020.
Europe
- Germany: DSW’s serves as secretariat for the German All Party Parliamentary Group on Population and Development (APPG), which was very strong during the legislative period from 2009 to 2013, when it consisted of 34 members. After the 2013 election, 14 members lost their mandate, including long-standing champions. In order to be able to continue the APPG’s work on sexual and reproductive health and rights and family planning, DSW worked to rebuild the APPG. Until June 2015, DSW was able to recruit new members from different parliamentary groups and committees since the election. Thus, the APPG currently consists of 29 members and is very productive. A number of meetings on SRHR issues took place since 2014. In addition, APPG members were the main initiators of a parliamentary motion in summer 2014 that included a strong focus on family planning.
- DSW maintains longstanding relationships with the Federal Ministry for Economic Cooperation and Development (BMZ) on the working level and has been able to gain the interest of the BMZ leadership for sexual and reproductive health and rights and family planning. DSW advocated strongly and successfully for the integration of SRHR in BMZ’s new strategy on gender equality which is binding for all actors of the official German development cooperation.
- European Union: 2014 was a transition year for the EU leadership with European elections in May 2014 and the nomination of a new College of Commissioners who took office in November. Since then, DSW has reinforced the working relationship with previous champions and built contacts with new Members of the EP who have already shown their support to sexual and reproductive health and rights and family planning in several EP reports. DSW has moreover maintained and strengthened working relationships with members of the cabinet of the European Commissioners as well as around 10 permanent representations of Member States to the EU to strengthen support for SRHR in the EU Council. Through the collaborative efforts of partner organisations in Brussels, the European Parliament positions on post 2015 include strong calls for universal access to family planning and unprecedentedly progressive Council Conclusions on Gender in Development were adopted in May 2015.
Eastern Africa
- In Eastern Africa, DSW has continuously increased its work with members of parliament and government officials at national, district, county and community level. This has been essential for the results outlined in the following answers.
International
- In April 2015, DSW together with the APPG and EPF hosted the international G7/G20 parliamentarians conference “She Matters – Empowering women and girls to lead self-determined, healthy, and productive lives,” which brought together more than 90 MPs representing 50 parliaments from all world regions. In a very ambitious appeal, the parliamentarians called on the G7 and the G20 to step up their commitment to SRHR, gender equality, women’s and girls’ human rights and their empowerment to create the conditions for them to lead self-determined, healthy, and productive lives. The appeal was handed over to the German G7 Sherpa, Mr. Roeller at the end of the conference. Please visit www.she-matters.org for further information.
