Partenariat transformateur: Offrir l'accès à la planification familiale dans les régions éloignées de la République démocratique du Congo (RDC)

Transcription

1 Partenariat transformateur: Offrir l'accès à la planification familiale dans les régions éloignées de la République démocratique du Congo (RDC)

2 Mon histoire: Dr. Didier Mazongo, WWF-DRC

3 République démocratique du Congo: Le défi pour un système de santé en péril

4 Partenariat avec la mission de l'usaid en RDC: Le transport des contraceptifs vers les sites distants de WWF et del'institut Jane Goodall

5 WWF Site du projet dans la province de l Equateur Jane Goodall Institute Site du projet dans la province de Nord Kivu

6 Nous livrons des contraceptifs par les mêmes stratégies de projet PSE

7 Augmentation de la «prévalence contraceptive» de 0% à 5% et 14%

8 Objectifs du Partenariat pour la santé: 1 bénéficier de réseaux de transport de conservation 2 surmonter les défis de sécurité 3 atteindre les populations d accès difficile

9 Objectifs du Partenariat pour la conservation: 1 répondre aux besoins de santé 2 générer des stocks pour la conservation 3 assurer l autonomisation des femmes

10 2 dollar graphic 80% of the population earn less than $2 a day

11 Nous tenons à souligner l'appui de Population Reference Bureau et Johnson & Johnson. Les contenus de cette présentation ont également été rendue possible par le soutien généreux du peuple américain à travers l'agence Américaine pour le Développement International (USAID). Le contenu est la responsabilité de leurs auteurs et ne reflètent pas nécessairement les vues de l'usaid ou du Gouvernement des Etats-Unis.

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13 Population-Health-Environment-Livelihood Integration A Cradle for Effective Rural Family Planning/RH Ethio Wetlands and Natural Resources Association By Tilahun Semu and Shewaye Deribe Paper presented at 2011 International Conference on Family Planning Dakar /Senegal Nov 29 Dec 2/2011

14 Presentation Outline EWNRA profile Areas of intervention Major components of integration Key Results Implications

15 Established in 2001 Transformed from research project to an NGO Works in three regions of Ethiopia Implements integrated and participatory projects EWNRA s Profile

16 Areas of intervention Capacity building & community empowerment Natural resources management Livelihood and nutrition diversification Provision of safe water Introducing safe rural energy Health, gender and RH/FP

17 Different faces of EWNRA s Intervention area Fast Changes (population growth, poverty, management problems, climate change, ecosystem degradation)

18 Selected components of the Population, Health, and Environment (PHE) integration

19 Livelihood and Nutrition diversification Vegetable and Fruit production (MCH) Beekeeping/honey production (MCH) Micro credit services for women's groups (MCH) Fattening of mammals for market (MCH) Multipurpose agro forestry promotion (MCH) Maternal and child health

20 Installation of safe water Establishing WASH committees Training on health education Encouraging preparation and use of local bylaws Establishing water maintenance fund 84 hand pumps and 5 springs developed Benefited more than 4000 house holds (21000 people) Women and girls are safe from harassment Reduce infant sickness and mortality

21 Integrated Actions Livelihood diversification (MCH) Fuel saving and clean energy (MCH) Safe water (MCH)

22 Family Planning Service Provision Supported by the BALANCED Project Started in 36 watersheds of Metu in 2009 Inhabited by more than 20,000 people Using community volunteers as peer educators and PHE-providers (CBD outlets) Capacity building (women, men, youth, decision makers)

23 Family Planning (contd.) Adult & youth peer educators trained 4 PHE youth clubs established 36 PHE providers trained to distribute contraceptives and PHE information PHE information disseminated by posters and drama Decision makers, technical staff and health post workers trained on PHE integration 11

24 Key Results Peer Educators increased knowledge on the value of PHE integration Village PHE providers increased ease of access to FP for women, men and youth to prevent unwanted pregnancies reduced walking distance for FP from 90 minutes to 10 minutes in rural villages Local support from different stakeholders increased 12

25 Why integrate conservation and health activities? Reduces environmental degradation Improves human health and wellbeing Contributes to climate change adaptation and mitigation Strengthens partnership among actors in the community Greater sustainable community development at large

26 Thank you for listening

27 The BALANCED Project Integrated PHE for Resilient Coastal Communities: Tanzania Case Presentation to the 2011 International Conference on Family Planning Dakar; Senegal Presenter Baraka Kalangahe Tanzania Coastal Management Partnership Coastal Resources Center PATH Foundation Philippines, Inc.

28 The BALANCED PROJECT Duration: 5-year PHE initiative ( ) Supported by: USAID/OPRH Focus Areas: Africa and Asia

29 GOAL Promote wider adoption and use of effective PHE approaches globally IR1 - Build PHE capacity IR2 - PHE knowledge management IR3 - Scale up PHE implementation

30 Saadani National Park

31 Rukia in Mkalamo Rukia lives close to Saadani National Park Most of the arable land is in the Park. Population pressure, destructive farming and fishing practices and drought threaten food security Growth rate range from 4 to 6% Nearest health care clinic is 5 to 10 kilometers away.

32 WHAT ARE WE DOING? Family Planning information and services HIV prevention and gender mainstreaming Environmental Conservation fuel-efficient stoves, appropriate fishing gears, sea turtles conservation, elephant tracking, climate change adaptation Livelihood activities - SACCO, seaweed farming, bee keeping, baking, eco-tourism

33 WHAT ARE WE DOING? Capacity-building through peer-to-peer mentoring Developing integrated PHE IEC materials Community sensitization on PHE by using TFD, advocacy meetings, etc. Scaling up PHE approach to Bagamoyo

34 Integration Key Not only adding FP Develop conceptual framework to show linkages Develop goals and objectives which articulate the integration Develop integrated IEC messages Advocate for integrating PHE within local government Integration makes sense and cents!

35 WHAT HAVE WE ACHIEVED 50 CBDs, 184 Peer Educators and 55 kiosk owners/condom sellers trained 3,407 individuals counseled 545 individuals referred to CBDs/dispensaries 1, 281 new Family Planning acceptors 2,481 cycles of pills distributed

36 WHAT HAVE WE ACHIEVED Over 20,000 male condoms distributed Over 1,500 IEC materials distributed Increased number of people using fuelefficient stoves (Mkwaja 180, Mkalamo 38) MOU with Pangani district for PHE youth program

37 Mahija peer educator in Mkwaja Peer educator Entrepreneur Showcasing fuel efficient technologies

38 Salim in Sakura village Beekeeper Chair of Savings and Credit Association Owner of accredited drug outlet Peer educator

39 Women s SACCO in Mkange

40 Challenges Reinforcing the linkages between PHE takes time and education PHE needs frequent technical backstopping Advocacy is needed to overcome cultural and institutional barriers

41 WHAT HAVE WE LEARNED? PHE approach enables access to communities typically not reached Partnering with environmental organizations provides easy reach to remote communities Integrating PHE addresses the root causes of problems in the community

42 For more information he/ 16

43 FROM MARINE CONSERVATION TO PHE How to reach the hardly reached Dr Vik Mohan Project Director

44 What is PHE? A cross sector and integrated approach to meeting the interrelated challenges of achieving conservation and health goals A way of reaching communities in remote/rural/high biodiversity areas Taking an integrated approach creates synergies, enhancing effectiveness and reducing costs

45 Madagascar World s 4 th largest island home to 5% of global biodiversity 80% of its flora and fauna is endemic Ranks as a Least Developed Country GDP per capita $438

46 Reproductive health Population of 19.6 million 1, 45% aged 15 or under 2 One of the fastest growing populations in the world, projected to reach 29 million by High maternal mortality rates 469 per 100,000 births 3 Only 1 in 4 women in union is using contraception 4 Sources: 1 World Bank 2 INSTAT 3 PRB 4 UNFPA

47 Where we work Remote, coastal fishing communities, poor access to health care/education 70,000 people relying exclusively on marine resources Started as a social enterprise running marine conservation and research expeditions.

48 Andavadoaka

49 Velondriake To live with the sea Covers an area of 640 km 2, encompassing 24 villages First and largest locally managed marine area in Western Indian Ocean Complemented by a range of other programmes to support sustainable resource use

50 Uncovering an unmet need Higher fertility rates than the national average, 6-7 live births per woman; limited access to sexual and reproductive health services (SRHS), and health education Closest SRHS facility 50km walk through spiny forest Population growing so fast, demand for resources outstripping supply

51 Impact of population pressure on fisheries In one region, number of fishers has risen from 235 to 1510 in 20 years In 1991 fish caught were predominantly carnivorous; in 2011 fishery dominated by herbivorous species In 2011, 60% of fish caught are juveniles Of concern to communities and conservation practitioners

52 Meeting the need August 2007, first regional family planning clinic opened by Blue Ventures In 2011, multisite service covering 40 villages Clinics and Community Based Distribution Reaching the hardly reached

53 Community education Peer led education programmes Focus group discussions Educational films Community theatre, radio Community events, such as sporting and cultural events Branding of our service, and promotional merchandising

54 Results

55 Results

56 Lessons learnt We are meeting an unmet health care need Good relationships with the community have enabled effective, culturally sensitive introduction and rapid uptake, at low initial cost Integrating this work into an existing programme has created synergies, and has enabled us to reach this isolated population

57 Political coup, 2009 Isolation, lack of infrastructure Lack of basic health and education services, lack of reliable data Identification of appropriate funding opportunities Balancing safe provision of services vs ensuring good access

58 Integration Sharing resources and opportunities Staff/community members trained in multiple disciplines Integrated messages, reaching broader audiences Greater cooperation from communities

59 The next steps Thematic and geographic expansion Develop best practice PHE template Replicate in other parts of Madagascar, and beyond Advocate for and identify opportunities for integrated programming Answer key questions to inform policy

60 Thanks to...