Social accountability: What are the lessons for improving family planning and reproductive health programs?

The concept of accountability is increasingly important in the family planning (FP) and reproductive health (RH) field. While much recent discussion has focused on developing global or national-level mechanisms for accountability, less emphasis has been placed on understanding the relevance of “social accountability” approaches for ensuring access to, and quality of, FP/RH services. Social accountability refers to the efforts of citizens and civil society to scrutinize and hold duty bearers (politicians, government officials, and service providers) to account for providing promised services, actions most often at the subnational or community level. In the FP/RH field, this concept builds on a rich history of community involvement and civil society participation. This working paper draws on the debates and emerging lessons of the social accountability field to better understand its potential for improving FP/RH programs. It synthesizes the literature across a variety of sectors including the health sector, and on broad review papers as well as individual studies related to FP/RH programs

PEPFAR special initiative on sexual and gender-based violence: Baseline report

The PEPFAR Special Initiative on Sexual and Gender-Based Violence aims to strengthen services for survivors of sexual violence (SV) though the implementation of a comprehensive model of care in participating PEPFAR partner facilities. This baseline report examines project sites in Uganda and Rwanda and suggests strengthening health services involving training, community and provider awareness and attitudes

Executive summary: A step-by-step guide to strengthening sexual violence services in public health facilities

This document contains an executive summary of “A step-by-step guide to strengthening sexual violence services in public health facilities: Lessons and tools from sexual violence services in Africa.” Sexual violence (SV) is a serious health and human rights problem across Africa that disproportionately affects women and girls. Survivors require comprehensive and sensitive care to mitigate the negative health consequences of SV, minimize psychological trauma, and promote long-term reintegration and recovery. Despite high levels of sexual violence and a growing recognition of the need to improve the management of rape and sexual assault, many public health facilities in Africa do not currently have capacity to provide comprehensive, patient-centered SV care to adult and child survivors. The guide provides practical guidance on the steps necessary to establish and strengthen SV services within existing public health facilities, improve linkages to other sectors, and engage local communities around issues of sexual violence. The eight steps included in the guide are summarized in this document

Mainstreaming emergency contraception pills in Kenya

To improve access to emergency contraception (ECP) and ensure that adequate information is provided to all users, the Kenyan Ministry of Public Health and Sanitation, the Population Council, and Population Services International-Kenya undertook a three-year effort to mainstream ECP in Kenya. This brief presents the results of this initiative and discusses strategies for further strengthening ECP provision. Kenya has emerged as a leader in ECP programming in the region and has demonstrated that it is possible to strengthen ECP services in both the public and private sectors while at the same time increasing public awareness, knowledge, and use of the method. The Kenyan experience can serve as a model for other countries on the continent interested in mainstreaming ECP services

Strengthening the evidence base on social accountability for improving family planning and reproductive health programs

The concept of accountability is important in the family planning (FP) and reproductive health (RH) sector, building on a rich history of community involvement and civil society participation. There are three categories of FP/RH accountability initiatives: tracking donor and government financial commitments, tracking national-level program implementation, and tracking service-delivery outcomes. The third category, often referred to as “social accountability,” includes the efforts of citizens and civil society to scrutinize and hold duty bearers to account for providing promised services, most often at the subnational or community levels. Social accountability is premised on the assumption that increased and targeted citizen and civil society engagement and action will force public officials to act on their commitments. The Evidence Project convened an expert consultation, “Strengthening the Evidence Base on Social Accountability for Improving Family Planning and Reproductive Health Programs” in July 2014 hosted by the International Planned Parenthood Federation, an Evidence Project partner, in London. This meeting report notes that the aim was to develop an understanding of social accountability for improving FP/RH programs and to identify gaps in the evidence base that can be addressed by the Evidence Project

Mainstreaming emergency contraception in Kenya: Final project report

For more than a decade, advocates have sought to improve access to emergency contraception (EC) around the world. These efforts have been highly successful in Europe and North America, have generated much debate in Latin America, and are beginning to take hold in Asia. In Africa, however, the success of EC programs remains limited. Even in countries where the regulatory environment is favorable, resource constraints within the public sector limit the ability to provide consistent and quality EC services at low cost. In a growing number of African countries, the private sector has emerged to fill these gaps, increasing access primarily among young, affluent urbanites. Low knowledge levels among the general population ultimately undermine the impact of such provision strategies. The initiative described in this report includes activities aimed at improving overall awareness of EC across Kenya and strengthening the quality of EC services in the public and private sectors. It was intended to serve as a model for other countries interested in improving access to EC, and to generate in-depth knowledge on EC program strategies and utilization characteristics in sub-Saharan Africa. This final project report details the outcomes of this initiative

Comprehensive responses to gender-based violence in low-resource settings: Lessons learned from implementation

The Population Council undertook a program of technical assistance and research to strengthen the evidence base on sexual and gender-based violence (SGBV) programming in sub-Saharan Africa. This project created an active network of implementers and researchers across sub-Saharan Africa, all of whom were charged with developing, implementing, and evaluating core elements of a comprehensive, multisectoral model for strengthening responses for survivors of SGBV, especially survivors of sexual violence. Based on the experiences of these partners, this document reviews the findings, lessons learned, and promising practices in the provision of comprehensive SGBV services in sub-Saharan Africa. The findings are intended to serve as a resource for programmers and policymakers throughout the region, and contribute to the emerging evidence base on such program strategies

Mainstreaming EC in Africa: The EC facilitative re-granting program—Final narrative report

Since 2006, ECafrique has been working to build the capacity of African nongovernmental organizations to design, implement, and evaluate successful emergency contraception (EC) mainstreaming projects. Through a process of “facilitative regranting,” ECafrique annually awarded nine grants ranging from $25,000 to$30,000 to organizations from across Anglophone and Francophone Africa. The program’s objectives were to increase access to EC across Africa by supporting projects intended to introduce, scale up, or mainstream the method, and build the capacity of African NGOs to design, implement, and evaluate successful EC mainstreaming projects. Each grantee participated in an international proposal development workshop and received individualized technical support throughout the life of their project. The nine projects supported under this program took place in Burkina Faso, Cameroon, Cote d’Ivoire, Ghana, Kenya, Nigeria, Senegal, and Uganda (two). This final narrative report details the accomplishments of each grantee, and highlights lessons learned regarding this approach to grant making