Moving from Policy to Implementation MSI experience in

Moving from Policy to Implementation MSI experience in Uganda, Malawi and Zambia

This Presentation • MSI brief overview • Policy to Implementation – Malawi: Partnership with Government – Uganda: Taking action on Supplies – Zambia: Facilitating access to Safe Abortion

MSI’s Strategic Focus MSI’s Mission – Children By Choice Not Chance We aim to contribute to: • eliminating unplanned pregnancy and unsafe abortion, especially among the underserved • revolutionising sexual and reproductive health service delivery • reducing the barriers to SHR services and supplies • strengthening health systems

Geographic Focus • MSI’s 6500 staff, in 43 offices and country platforms • Over 6 million clients and 17. 8 million Couple Years of Protection in 2009

MALAWI

Malawi: Health SWAp • Malawi Government Health SWAp objectives includes Marie Stopes International (BLM in Malawi) • Banja La Mtsogolo (BLM) is a major player: • 31 static clinics (5% of overall health system infrastructure) • Outreach sites for un-served or underserved populations • 35% of all modern family planning methods delivered by BLM

Why include BLM in national health priorities? • Go. M lack resources to fully implement RH care, BLM logical partner • BLM has expertise and competencies to deliver on Malawi health SWAp, RH Policy, HIV/AIDS action Framework • Joint Financing Agreement (or “mini-SWAp”) for RH services between DFID, Norway, Mo. H, and BLM 20062010. Will continue to 2015

Successes and Challenges × Funding and supplies from GOM inadequate/slow. No supplies first 5 months-BLM kicked in own resources, MSI had to supply and Norway had to add funds. ü Aligned strategy and policy with Government, BLM part of strategy and policy setting ü Go. M recognises the comparative advantage of private sector service delivery – reaches where Go. M cannot reach

UGANDA

Supplies in Uganda a major Challenge Ø The Problem: Service Providers (public and private) do not have enough supplies to meet need of FP Ø Government of Uganda might decide that National Medical Store can no longer supply to private providers (ie. NGOs) Ø Supplying to NGOs is not the main cause of the current shortages in all health facilities

Ø Potential Consequences if this policy is implemented: Ø Split between Mo. H and Private Providers Ø Immediate vs long-term needs – solution a parallel system? Ø For example MSI: Ø providing 16% of modern contraceptive methods Ø working in post conflict area and other hard to reach places where government services do not reach

Partnership for Impact Ø Coalition of NGOs and Donors are getting together to respond: ØEnsure access to key supplies by beneficiaries: now! ØFill current gaps in financing and procurement of Mo. H system ØAdvocate to Mo. H + other donors about urgent need for supplies

ZAMBIA

Abortion in Zambia • The problem of unsafe abortion is large: – Causes 1/3 of Maternal Mortality – 80% of deaths of unsafe abortion < 19 yrs • However, abortion Law is reasonably liberal, since 1972 • But…. providers nor women know the law

• MSI relatively new in Zambia, provides 1. 2% of all safe abortions • MSI on government task force to create guidelines for CAC and PAC • Working with others to catalyse change in safe abortion services

Increasing Access • • • Distribution of guidelines to health facilities Training of service providers Educating the public about their right In motion for only 6 months MSI figures for save abortion services are increasing – will have to wait for wider results

Lessons • Work together • Educate • Advocate • Capitalize

Women like Rachel have been waiting for change, and the right to control the size and spacing of their family