Transform/PHARE at the Francophone SBC Summit in Abidjan

Posted mars 11, 2019
Impact Area Adolescents & Youth, Sexual & Reproductive Health

by Jessica Vandermark, Director, Camber Collective

The post below originally appeared on Medium.

At the close of the Transform/PHARE project, the work goes on! This week, over 450 stakeholders gathered for the first Francophone Summit on Social and Behavior Change in Abidjan, Côte d’Ivoire. The halls resounded with the sounds of ideas being exchanged, connections being made, and networks being expanded, pushing forward progress made by Ministries, civil society actors, and their partners, including transformative lessons learned over the five years of Transform/PHARE.

Family planning is essential to achieving the objectives of human development, both at the individual and population level. Access to family planning — including knowledge and acceptance of modern family planning methods — gives women autonomy over their bodies and provides tools for families to provide the most loving and favorable environment for their children, according to their own needs and desires.

Family planning is a major priority in West Africa, home to countries with some of the world’s highest fertility rates, in large part due to social norms favoring large family size. In Niger, for example, the average woman has 7.6 children — yet both men and women desire more children than they have, according to DHS surveys.

A 5-year project funded by USAID, Transform/PHARE focused on innovations in approaches to social and behavior change to increase acceptance and use of family planning in Francophone West Africa. Social and behavior change (SBC) interventions aim to improve the quality and coverage of health products and services. Successful SBC requires understanding how individuals’ behaviors are shaped by communities and societies, including the social norms that condition access to essential health services and the ability to engage in health behaviors. SBC is therefore critical to ensuring that those most in need are included in interventions.

A few examples of Transform / PHARE project work, for more information on other project activities, visit the site here.

Jessica Vandermark from Camber Collective, presenting Transform / PHARE project results at the Francophone Summit in Abidjan, February 2019

At the Francophone SBC Summit on February 25–28th, 2019 in Abidjan, SBC funders, decision makers, and technical experts convened to discuss the exciting work that has taken place in the West Africa region, and align on a common agenda for elevating the importance of SBC. A number of lessons learned from Transform/PHARE were shared with participants, including sessions on FP demand analysis among men in Niger and youths in Côte d’Ivoire, operational obstacles among FP service providers in Côte d’Ivoire, and a health coaching project for girls not in school in Benin.

Over the 5 years of its duration, Transform/PHARE made great strides in developing innovative strategies to reduce barriers to use of modern contraceptive methods in West Africa. It is perhaps fitting that the Francophone Summit took place for the first time in the region at a time when the Transform/PHARE project is coming to a close. One project may end, but the SBC community is growing, learning from one another, and strengthening our coordination.

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Digitalizing contraceptive counseling to reach rural women and girls in Ethiopia

By: Fana Abay, Marketing and Communications Director, PSI Ethiopia

In rural Ethiopia, women and girls often face significant barriers in accessing healthcare facilities, which can be located hours away. Moreover, there is a prevailing stigma surrounding the use of contraception, with concerns about potential infertility or the perception of promiscuity. To address these challenges, the Smart Start initiative has emerged, linking financial well-being with family planning through clear and relatable messaging that addresses the immediate needs of young couples—planning for the lives and families they envision. Smart Start takes a community-based approach, utilizing a network of dedicated Navigators who engage with women in their localities. These Navigators provide counseling and refer interested clients to Health Extension Workers or healthcare providers within Marie Stopes International-operated clinics for comprehensive contraceptive counseling and services.

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For example, in Mali, access to formal health services remains challenging, with four in ten people living several miles from the nearest health center, all without reliable transportation or access. In 2009, the Ministry of Health adopted a community health strategy to reach this population. The U.S. President’s Malaria Initiative (PMI) Impact Malaria project, funded by USAID and led by PSI, supports the Ministry with CHW training and supervision to localize health services.

In 2022, 328 thousand malaria cases were recorded by CHWs); 6.5 thousand severe malaria cases were referred to health centers, according to the national health information system.

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Supervisors directly observed how CHWs performed malaria rapid diagnostic tests (RDTs) and administered artemisinin-based combination therapy (ACT). They recorded CHW performance using the digitized checklist, interviewed community members, reviewed records, and provided on-the-spot coaching. They also interviewed the CHWs and tried to resolve challenges they expressed, including with resupply of commodities or equipment immediately or soon afterwards.

Beyond the observed interactions with patients, supervisors heard from community members that they were pleased that CHWs were able to provide essential malaria services in the community. And the data shows the impact.

In IM-supported areas of Mali, 36% of CHWs in the first round were competent in performing the RDT, which rose to 53% in the second. 24% of CHWs in the first round compared to 38% in the second were competent in the treatment of fever cases and pre-referral counseling. Between both rounds, availability of ACT increased from 80 percent to 90 percent.

Supportive supervision with interviews and observations at sites improved the basic competencies of CHWs between the first and second rounds, and additional rounds will help to understand the longer-term programmatic benefits.

Taking a market-based approach to scale sanitation in Ethiopia

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“Rather than relying on traditional aid models that often distribute free or heavily subsidized sanitation products, market-based sanitation creates sustainable and affordable solutions, integrating market forces and supporting businesses to grow.”

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Kassai’s analytics system to follow learners’ success rate and to adjust the course content to learners’ performance and needs. Kassai analytics are integrated with DHIS2 – the Health Management Information System (HMIS) of Angolan MOH, to be able to link learners’ knowledge and performance with the health outcomes in the health facilities. The analytics track learners’ performance by course and gives visibility by health provider, health facility, municipality, and province. Each course has pre-and post-evaluation tests to track progress of learning, too.

By the end of 2022, there were 6,600 unique users on the Kassai platform and 31,000 course enrollments. PSI Angola’s partnership with UNITEL, the largest telecommunication provider in Angola, allows for free internet access to learn on the Kassai for all public health providers in Angola. Building on its success for malaria training, Kassai now also provides courses in family planning, COVID-19, and maternal and child health. This reduces training silos and provides cross-cutting benefits beyond a single disease.

Implementing the SLPM digital ecosystem brings numerous benefits to health systems. It allows for more strategic and efficient workforce training and performance management, enabling ministries of health to track changes in health workers’ knowledge, quality of care, service utilization, and health outcomes in real time. The ecosystem also supports better stewardship of mixed health systems by facilitating engagement with the private sector, aligning training programs and standards of care, and integrating private sector data into national HMIS. Furthermore, it enables the integration of community health workers into the broader health system, maximizing their impact and contribution to improving health outcomes and strengthening primary healthcare.

Transform/PHARE at the Francophone SBC Summit in Abidjan

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The Consumer as CEO

Digitalizing contraceptive counseling to reach rural women and girls in Ethiopia

Building community health worker capacity to deliver malaria care

Taking a market-based approach to scale sanitation in Ethiopia

Promoting self-managed care like Self-testing and Self-Sampling

Using peer coaches to counter HIV stigma in South Africa

simplifying consumers’ journey to care in Vietnam

Engaging the private sector for disease surveillance in Myanmar

Training health workers in Angola

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