African Christian Health Associations Role in Family Planning services.

Presenter: Karen Sichinga Executive Director: Churches Health Association of Zambia

Board Chairperson: Africa Christian Health Association Platform

INTERNATIONAL CONFERENCE ON FAMILY PLANNING (ICFP) FAITH PRE-CONFERENCE: THE ROLE OF FAITH COMMUNITIES IN FAMILY

PLANNING ADVOCACY AND SERVICES TOWARDS ACHIEVING THE SUSTAINABLE DEVELOPMENT GOALS

JANUARY 25TH 2016, NUSA DUA, INDONESIA.

Outline of the Presentation • Background and main features of Christian Health Associations

(CHAs)

• Highlights on African Christian Health Association Platform (ACHAP)

– Mission, objectives

– FP Advocacy Role

• ACHAP members’ Roles in FP

• The case of Uganda (UCMB & UPMB)

• The case of the Churches Health Association of Zambia (CHAZ)

• Lessons Learnt.

• Challenges ACHAP face in the implementation of FP

• Recommendations & Conclusion

Background and main features Christian Health Associations (CHAs)

CHAs: The majority of CHAs were established in the 1960s

and in early 70s Catholic or protestant or combined Not homogenous. Vary in size, age and capacity Work within the their respective national health policy

frameworks, and within the WHO six building blocks (Leadership & Governance ,HRH, Service Delivery,, Infrastructure, Health

information, Finance), therefore contributes to National Health Systems

Major partners of governments in health service delivery and provide between 20 and 50 percent of total health care in Sub-Sahara African countries -.

Background and main features- 2 CHAs:

• Contribute to the development of national human resources for health through their schools of Nursing, medical schools, and bio-medical science schools

• Provide comprehensive health packages including family planning services that are scientifically sound and guided by their church doctrine.

• Are autonomous in nature but are organized at a regional level ( Sub-Sahara Africa) through ACHAP to pursue a common goal.

• Have developed strong sub-granting mechanisms- Principal Recipients for Global Funds ,PEPFAR and other global funding mechanisms.

ACHAP The Africa Christian

Health Associations Platform (ACHAP) is a networking forum for 26 Christian Health Associations (CHAs)

and Networks representing 23

countries in Sub-Sahara Africa.

The Secretariat is Nairobi, Kenya and housed at CHAK

Vision Health and Healing for all in Africa

Mission Committed to supporting Church related health Associations and organizations to work and advocate for health for all in Africa, guided by equity, justice and human dignity

ACHAP Objectives.

Networking and communication.

Joint advocacy.

Capacity development.

Establish and maintain partnerships.

ACHAP FP Advocacy Role

Overall Focus : Advocate for favourable policy and practice environment in order to meet health objectives.

FP Focus: adequate investments and equity in family planning.

Strategy and Philosophy

Use spaces and methods that yield results without compromising the necessity for continued engagement.

ACHAP members’ Roles in FP

Two major roles

Advocacy and service delivery: • All CHAs provide FP services that are scientifically sound

and guided by their church doctrine.

• Some members only cater for Natural Family Planning while others provide all family planning options

• No member provides abortion services.

The case of Uganda (UCMB & UPMB) Impact of FP training

Interventions Outcomes

increased communication between couples

increased male involvement in family planning

provided couples with a FP method that supports

their faith.

Over 7,600 new users were recruited

Health provider training

Community sensitisation

Clergy training Implementers. Uganda Catholic Medical Bureau and the Ugandan Protestant Medical Bureau

The case of CHAZ: Background

CHAZ Profile • Formed in 1970.

• Interdenominational(Catholic and

Protestant) umbrella organisation

for 152 CHIs.

• The second largest provider of

health services in Zambia.

• One of the two Principal Recipients

for the Global Fund Mechanism in

Zambia for HIV/AIDS (including

ART), Malaria & TB GF inception

in 2002.

• CHAZ has successfully managed a

grant value of over $160 million in

the last 8 years. None of it for

FP!!!

• Lead NGO/SCO in health

Family planning is an integral component of both the Health Programs and Advocacy units.

FP is implemented in all the church health facilities and integrated into the District health management teams

Protestant health facilities

promote and offer both Natural and modern methods

Catholic heath facilities promote the natural Family Planning method. However,

“If Clients request for Modern FP Methods, we provide Comprehensive FP Counseling, and refer them to government Health Facilities or Community Based Distributors (CBDs) for the services” Beatrice Mulenga, Chilonga Catholic Mission Hospital (20140)

None offers Abortion as option

CHAZ FP overall Objectives

FP Advocacy Specific Strategies Collaborate with government and work within Zambia’s FP

2020 Commitment Integration of facility level activities into the District health

management teams (DHMT) for sustainability Partnerships Consideration and respect of each of the 16 denomination’s

doctrine/policy (Catholic and Protestant) Demand Creation-

– Use of a combination of Communication Channels: Interpersonal & Mass Media Channels and community, regional( district) and central levels.

•

1. Increase Access to Quality FP Services 2. Strengthen the Integration of FP into MCH and STI/ PMTCT/HIV

and AIDS programs

CHAZ FP Advocacy activities

Central level activities • Training of Church Leaders in

FP

• Established dialogue between church leaders and Government on FP.

• Participation in FP national TWG

• Engaged in Policy meetings to represent the church and other SCO working in health

• Budget tracking at central and district level

Outcomes

• Joint Advocacy Goals developed

• Clergy FP Champions identified and engaged.

• FP Budget now established in national budget (2015, 2016)

Lessons Learnt While family planning has suffered from inadequate investments in ACHAP member countries, the church health system has been most affected because the development partners have assumed that Churches: are “anti-Family Planning”, have one stand on Family Planning do not have the technical knowhow to effectively

contribute to improving Family Planning outcomes.

Because of this perception the church has been left out in the allocation of family planning resources and in the decision making space- a missed opportunity

ACHAP FP Challenges Demand:

• Poor Behavior

due to misconception

• Low Education

• Poverty

• Forgotten

Clients: -Adolescents

-Couples

Service Delivery & Access

Services Access: -Limited Points of

Service -Poor Integration of

Services

-Poor Rural Access +++

Availability Limited by:

-HR Crisis -Limited Methods

Procurement & Supply Chain

-Poor Funding Domestic and reliable

FP funding is

inadequate in ACHAP countries. -FP Commodities

not always guaranteed

“He sent them to preach the Kingdom of God and heal the sick” Luke 9:2

Teenage Pregnancies- the result of “the forgotten client”

Challenges cont.;

The CHAs advocacy is effective but is publicity shy therefore their work go unnoticed but claimed by others who may not have been involved in the real advocacy struggle.

Recommendations.

• Development partners should embrace and support the Faith Community’s contribution in FP.

• The church should document its work and

communicate its position in Family Planning.

• Sub-Sahara African governments will need to increase their annual allocation to FP in the era of Sustainable Development Goals and fully engage their “all-weather partner”, the Christian Health Association in their respective countries.

Conclusion • Church health systems have been involved in the

implementation of Family planning services at both national and community levels for decades, working and collaborating with governments in the promotion of a variety of FP methods while respecting their own church FP policies .

• ACHAP and its members, the Christian Health Associations stand ready individually and collectively to make unique contribution to improving Family Planning health outcomes as countries implement the SDGs, provided that stakeholders respect the Church individual policies on FP.

Conclusion -2 • The Natural Family Planning method is still an option

for women who choose to use it, women and couples must be supported by all concerned . The Church is uniquely qualified to support the Scientific Natural Family Planning which require more effort to ensure adoption, compliance and sustained use.

• ACHAP and member Christian health Associations are together an important “resource “in the promotion of FP uptake in Africa. However, this reliable pool of resource would need its capacity strengthened in order to effectively play its role in Advocacy for Family planning.

Acknowledgements

• Respective governments in Sub-Sahara Africa

• Christian Connections for International Health(CCIH)

• Faith in Action.

• Bill and Melinda Gates Foundation

• CRS, EPN, IMA,

• ACHAP Secretariat and CHAK

• ..and the Committee and sponsors that worked so hard to organize this meeting and to bring all of us here, ………many others .Thank you

Thank you for your attention…… ….God bless

References

• ACHAP Report ( unpublished)

• UCMB Report (Unpublished)

– The Natural Plan Project on Faith Based Communities in Africa: an Integral Part of Improving Family Planning and Reproductive Health.

• CHAZ Activity Report( unpublished)