Moving from Policy to ImplementationMoving from Policy to Implementation

MSI experience in Uganda, Malawi and ZambiaMSI 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 FocusMSI’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 SWApMalawi: 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?

• GoM 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, MoH, and BLM 2006-2010. Will continue to 2015

Successes and ChallengesSuccesses 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.

Aligned strategy and policy with Government, BLM part of strategy and policy setting

GoM recognises the comparative advantage of private sector service delivery – reaches where GoM cannot reach

UGANDA

Supplies in Uganda a major Supplies in Uganda a major ChallengeChallenge

The Problem: Service Providers (public and private) do not have enough supplies to meet need of FP

Government of Uganda might decide that National Medical Store can no longer supply to private providers (ie. NGOs)

Supplying to NGOs is not the main cause of the current shortages in all health facilities

Potential Consequences if this policy is implemented:

Split between MoH and Private Providers Immediate vs long-term needs – solution a parallel

system?For example MSI:

providing 16% of modern contraceptive methods working in post conflict area and other hard to reach places

where government services do not reach

Partnership for Impact

Coalition of NGOs and Donors are getting together to respond:Ensure access to key supplies by

beneficiaries: now!Fill current gaps in financing and procurement

of MoH systemAdvocate to MoH + 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 < 19yrs

• 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