Integrating Family Planning_Borwankar

Food and Nutrition Technical Assistance III Project (FANTA) FHI 360 1825 Connecticut Ave., NW Washington, DC 20009 Tel: 202-884-8000 Fax: 202-884-8432 Email: [email protected] Website: www.fantaproject.org

How are Programs Integrating Family Planning with Nutrition and Food Security?

Reena Borwankar CORE Group Spring Conference April 14, 2015

FANTA Desk Review

• Synthesis of programmatic experiences, lessons learned and promising practices o Models of integration o Entry points o Facilitators and barriers o Case studies

• Grey and published literature

• Primarily USAID-funded development programs (2003-2013)

Overview

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Operational Definitions

Family planning interventions: Could include education, counseling, provision of contraceptive commodities, or referral. Food security and/or nutrition program: Measures at least one food security and/or nutrition outcome as part of program monitoring and evaluation activities. Integrated program: Both interventions delivered either (a) at the same contact/entry point or (b) by the same provider.

Overview

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Methods

Multiple Sources

USAID Targeted Funding Streams

Call for Programs/ Survey Monkey

Electronic Database Searches (Popline and Global Health)

Total Number of Programs

Considered 518

Total Programs Included

102

Program Document Examples Annual Reports, DIPs, Evaluation Reports,

Technical Briefs

Overview

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Case Studies 3

Integration Occurs in Both Health Sector and Multisectoral Programs

Types of Programs

• Child survival

• Maternal and child health

• Bilateral

• Globally funded

• Development food assistance

• Population, health and environment

• Feed the Future

• Agriculture

45% 55%

Multisectoral Health Sector

Family planning and nutrition/ food security integration

Family planning and nutrition integration

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Geographic Focus Location of Programs

49%

24%

21%

4% 2%

Africa Asia LAC Middle East Europe/Eurasia

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Child Survival Program in Kyrgyzstan

30%

25%10%

10%

10%

10%5%

Maternal and Newborn Care Diarrhea Pneumonia STD Immunization

NutritionChild Spacing

Integrated Programs are

Complex

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Development Food Assistance Program in Haiti

Integrated Programs are

Complex

Goal: Reduce food insecurity and increased resiliency of vulnerable and extremely vulnerable rural households

SO1: Improved Nutritional and Health Status of Targeted Vulnerable Groups

• IR1.1: Improved nutritional and health practices of targeted vulnerable populations

• IR1.2: Improved quality of and access to health services

• IR1.3: Decreased risks of communicable diseases among targeted communities

SO2: Improved Productive and Profitable Livelihoods

• IR2.1: Increased food production and household assets

• IR2.2: Enhanced market-based livelihoods

• IR2.3: Rehabilitated natural resources resiliency and local response capacity

• IR2.4: Enhanced program flexibility and community response capacity to acute needs.

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Integrated Service Delivery Range of Platforms

Lifecycle Contact Points Platforms Providers

Antenatal

Birth

Postnatal

Childhood

Source: World Vision/Haiti

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Model 1: Family Planning Education

Model 2: Family Planning Education and Counseling

Model 3: Family Planning Education, Counseling and Commodity Provision

63.7%

17.7%

18.6%

* All Models Could Include Referrals

Level of FP Services Varies

Integration Models

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Source: Pathfinder International and John Snow, Inc. 2013, pp. 1, 16

Nutrition Family Planning Malaria

Integration in Action

Integrated Family Health Bilateral Program in Ethiopia

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Integration in Action

Sak Plen REP Development Food Assistance Program in Haiti

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Limitations

• Weak documentation on integration process

• Information on referral process is limited

• Significant variation in measurement

• Evidence gap on effectiveness of integration models

• Reporting on monitoring compliance with USAID family planning requirements can be strengthened

Gaps in Program Documentation

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Promising Practices

• Building on existing platforms

• Targeting the first 1,000 days

• Including home visits

• Ensuring consistent messaging at multiple contacts

• Engaging men and empowering women

• Responding to community needs

Promising Practices for Programming

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• Define success for integration: o Family planning and nutrition o Family planning and food security

• Agree on a limited set of harmonized indicators

• Harmonize reporting requirements

Recommendations Moving Forward…

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• Conduct research focused on effectiveness of integration models

• Provide guidance and technical assistance

• Promote dialogue and cross-learning across sectors

Moving Forward (2)

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Recommendations

This presentation is made possible by the generous support of the American people through the support of the Office of Health, Infectious Diseases and Nutrition, and the Office of Population and Reproductive Health, Bureau for Global Health, U.S. Agency for International Development (USAID), under terms of Cooperative Agreement No. AID-OAA-A-12-00005, through the Food and Nutrition Technical Assistance III Project (FANTA), managed by FHI 360. The contents are the responsibility of FHI 360 and do not necessarily reflect the views of USAID or the United States Government.

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