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Networking and Partnership among Relevant Stakeholders on Access to SRHR services

Eshet Children and Youth Development Organization is a local civil society organization based in Addis Ababa, Ethiopia. The organization is primarily dedicated to contributing to the development and well-being of children, youth, women, and other disadvantaged groups of people including people with disability. The organization implements various developmental projects by focusing on the social problems of the grass root community in Ethiopia. In addition, ECYDO works on preventing the spread of HIV/AIDS and other sexually transmitted diseases by creating awareness in the communities. Moreover, the organization works on Sexual and Reproductive Health Rights of women and girls, Family Planning as well as dissemination of women and girls’ rights information, and awareness on related issues. Because the organization is contributing to fighting against harmful traditional practices including female genital mutilation, abduction, and unsafe abortion practices, the condition of the sexual and reproductive health of women and girls in the region is improving. 

As usual, Eshet Children and Youth Development Organization has launched a sexual and reproductive health project in collaboration with MAMA Network in Arsi Zone, Ethiopia. The project activities involve stakeholders’ workshops, SRH Doulas and medical professionals training, and community outreach. The project plan was sketched out and the activities were undertaken in a good manner.

Activities:

  1. Stakeholders’ Workshops 

After undertaking the community research and designing the project, Eshet Children and Youth Development Organization signed the project agreement with MAMA Network for strong collaboration, good partnership, and joint support and implement the project. As per our project plan, the first activity that is the workshop of relevant stakeholders was undertaken. In our plan, 2 stakeholders’ workshops were undergone in Tiyo District and Digeluna Tijo District of Arsi Zone, Ethiopia. The members of SRH doulas candidates, the leaders of the health office of the districts, directors/heads of 5 health centers, pharmacists, the leaders of the women, children, and youth affairs office, and administrative authorities participated in the workshop. 

Events carried out in the workshop include launching and familiarization of the project, advocacy, strengthening networking and collaboration, discussion on the better strategies of increasing access to SRHr services , and engaging the government partners in the project for better success.

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  1. Selection of the SRH Doulas

The community Sexual and Reproductive Health Doulas are the main pillars of this project. Accordingly, about 50 sexual and reproductive health doulas were selected from two districts jointly by the district’s offices of women, children, and youth affairs and Eshet Children and Youth Development Organization. These are Tiyo District with 21 kebeles (villages) and Digelunna Tijo District which has 28 kebeles (villages). In each of the two districts, 25 sexual and reproductive health doulas have been selected. Out of the 50 SRH doulas, 15 of them are delalas (mediators) i.e. those who push women and girls towards harmful traditional practices. The selection criteria include that the candidate:

  1. Must be a female
  2. Must complete at least 10th grade
  3. Has a little bit hint about sexual and reproductive health or family planning 
  4. An active speaker and good at communication
  5. Sociable 
  1. Training of the SRH doulas 

We use professional trainers from Arsi University. After selecting and registering 50 community sexual and reproductive health doulas (non-medical professional doulas) from 2 districts, we have given them comprehensive training for 3 days by our trainers. The training was conducted in 2 groups. The first group comprising 25 sexual and reproductive health doulas attended the training at Asella Town Administration whereas the second group comprising the same number received the training at Sagure Town Administration with the aim of capacity building. 

The Community Sexual and Reproductive Health Doulas training was given on important topics including signs of pregnancy, unwanted/unplanned pregnancy, medical abortion, contraceptives, procedures, and post-abortion family planning by the professional from Arsi University named Solomon Tejineh (Assistant Prof.). The key points of the training include the types and ways of taking the pills (misoprostol and mifepristone), doses, procedures, symptoms, contraindications, etc. It also includes a self-managed abortion. 

The assessment of the trainees was conducted by pretest and post-test. The results indicate that their knowledge about medical abortion increased by more than 50%. The sexual and reproductive health doulas will assist and link the women and girls to the health centers to facilitate access to medical abortion and related services. And at the end of the training, they were given the reporting format for their community-based services. The reports will be collected from the SRH doulas every 1 or 2 months.

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  1. Information leaflet and community outreach 

The information leaflets were prepared in English, Amharic, and Oromiffa. The leaflets explain the harmful traditional practices, the danger (risk) of unsafe abortion, the safety of accessing medical abortion, and related issues. In addition, 4 community outreach programs were carried out. The outreach involves edutainment including teaching dramas, short plays, poems, and music. During the outreach program, the information leaflets were distributed to the participants in the languages they needed. About 500 brochures and leaflets were distributed to the participants. Through the community outreach programs we have reached more than 1,400 people out of which 13 are commercial sex workers, 19 are survivors of violence, 5 are internally displaced people, 10 are people living with HIV/AIDS, 7 are persons with disability, and about 22 are single moms out of which the majorities are younger. 

  1. Selection of Health Professionals for training 

Out of the 9 health centers found in the 2 districts, 5 health centers were selected jointly by the head of Arsi Zone and the heads of the districts health offices and Eshet Children and Youth Development Organization. The selected health centers are: 

  1. Gonde Health Center (in Tiyo District)
  2. Golja Health Center (in Tiyo District)
  3. Tijo Health Center (in Digeluna Tijo District)
  4. Sagure Health Center (in Digeluna Tijo District)
  5. Digelu Health Center (in Digeluna Tijo District)

Each of the health centers is required to present 3 relevant health professionals for the training.

  1. The Health Professionals’ training

According to the plan of our project, 15 health professionals are selected from 5 health centers and receive the training which makes about 15 professionals. However, through communication and discussion with the heads of the districts’ health offices, we have participated in 17 professionals with the same budget and time. We have included 2 more health staff in the training from 2 health centers namely Arrabbi Health Center and Hofi Health Center. And about 17 health professionals received comprehensive training on medical abortion including contraceptives, the service procedures, counseling, treatment for severe contraindication, family planning, and related issues. The training was delivered by an expert woman from Arsi University called Mamit Mamo under the supervision of ECYDO. 

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Achievements:

Throughout the project, there are good achievements. These include:

  1. A strong network and collaboration on access to SRHR services including medical abortion were created among the relevant stakeholders including the government offices. 
  2. People’s outlook and awareness of medical abortion were improved through community outreaches and information leaflets
  3. Government and community parts start to engage in enhancing access to medical abortion
  4.  Advocacy on strategy improvement on access to medical abortion 
  5. 40 stakeholders took part in the sessions and pledged to enhance access to medical abortion as opposed to unsafe abortion. 
  6. 50 Sexual and reproductive health doulas received a good quality capacity development training
  7. 17 health professionals have improved their skills specifically in medical abortion 
  8. The percentage of people having lower awareness decreased from 70% to 30% in a random end-line survey. 
  9. Access to medical abortion is increased from 20% to 35%
  10.  The needy women and girls started to receive the necessary services (the medical abortion information, access, and assistance including referral for safe abortion)
  11. The health centers start to give more focus on enhancing access to medical abortion 
  12. High impact on the communities’ traditional beliefs and level of understanding of the safety of medical abortion
  13. Women and girls start to be linked to the health centers for information and medical abortion services through the community sexual and reproductive health doulas 

Challenges:

Challenges during the implementation of the project include shortage of the budget, short duration of the training, absence of office or center of organizing activities for the SRH doulas, absence of transportation service, the higher influence of the traditional beliefs towards women and girls, Covid-19 and long lasted Harmful Traditional Practices(HTP) .

Opportunities:

The opportunities include the willingness of the government stakeholders and officers, baseline data collection for measuring the changes, the secured environment in our project area as compared to other parts of Ethiopia, etc. 

You can learn more about ECYDO work on their website: ECYDO | Home

Call for action

The Trust and Support Foundation Join voice with 150 women advocates in Lagos State Nigeria to demand the immediate lift of suspension on safe legal abortion guideline we believe that the state government is being blackmailed by religious, cultural, and political sentiments, and women have a right to their bodily integrity and take a decision on their reproductive health.  what the guild lines is pushing for us to save women from a good preventable death. The suspension of the Guideline on safe Termination of pregnancy for Legal indication should immediately be lifted. 

Restrictive laws have not prevented women with unplanned pregnancies from resorting to abortion anywhere, it only makes the procedure dangerous and unsafe. Women should be allowed to make informed decisions on their body autonomy and self-manage their abortion in a safe way

Trust And support Foundation (TSF) is a non-governmental and non-profitable organisation establish in 2018 formerly known as Trust And care initiative.The organisation is rooted to support women and girls in rural communities with passion to reduced morbidity and mortality rate among young women of reproductive ages through adequate knowledge on SRHR, equity, gender-based violence and HIV. we sustain a common front to enable women and girls make inform decision about their general well-being through information, income generation activities. You can learn more about the organization here: THE TRUST AND SUPPORT FOUNDATION

Centre for Social Concern and Development (CESOCODE) called on the Government and Pharmacists to improve women’s access to health using Technologies in Malawi.

Cross section of participants who attended the May 28 meeting.

May 28th is the International Day of Action for Women’s Health. Women’s rights advocates and allies in the sexual and reproductive health and rights (SRHR) movement worldwide have commemorated in diverse ways. MAMA Member selected this year’s theme as “Using technology to improve women’s access to health”

CESOCODE commemorated the day by organizing an offline meeting to call the government through the Ministry of health and the Pharmacists to facilitate access to telemedicine and to Work together with feminist organizations and hotlines to provide the correct information to those seeking abortion, free of judgment and stigma.

For the part of the government, we discussed that the government has a role to make sure that the sharing of information about Abortion and Self-Managed Abortions has been decriminalized, it facilitating access to abortion pills and allowing pregnant people, who wish to abort on the first trimester abortions to be able to access Self-Managed Abortion outside Health facilities.

During the meeting we also discussed that, to maximizing the potential for medical abortion to improve access to safe abortion and reduce use of unsafe methods, the pharmacies need to be supported to ensure that high quality products are available, and women have access to client-cantered information about how to use these products safely. Feminist organizations can support pharmacies to increase access and improve quality through:

  • Training pharmacy workers to deliver accurate information and support
  • Ensuring contact details are included on the packaging for follow-up care, in case unexpected side effects arise
  • Providing 24 hour hotlines to share tailored information about MA self-management and follow-up care
  • Including pictorial instructions in product packaging, for clients with language and literacy barriers.

We discussed that feminist organizations have a role to ensure that women are accessing safe abortion information without relying on pharmacy staff only. For example, safe abortion hotlines are commonly used to ensure that individuals can access counselling and information about self-management of medical abortion. Hotlines can offer confidential and personalized counselling, and including an advice online on the packaging of medical abortion products can help facilitate access to those who need it. Hotlines also offer information about how to use the pills in a freely accessible way. This means that using technology to improve women’s access to health is important. 

Vision in Action Cameroon( VIAC) is debunking myths around SRHR

With support from the MAMA network, VIAC is able to organize a good number of community interventions and research on access to SRHR information specifically on safe abortion and self-managed abortions in Cameroon. Using various techniques and strategies in community interventions, we are able to design and organize age-appropriate programs targeting different age groups within our program scope.   As a means to talk about self managed and safe abortion with pills in our setting (restrictive) we have organize seventeen (17) community outreach, held six (06) safe spaces with adolescent girls and young women, four (04) sessions with persons with disabilities and seven (07) sessions with internally displaced persons (women) in the past five months.

Our entry points have always been sexual health education, menstrual hygiene management, contraceptives including male and female condoms, and access to safe abortion information. These outreaches involved parents, whereby Vision in Action (VIAC) advocated for access to sexual reproductive health for adolescents. 

In our safe space discussion with adolescent girls and young women, we reached out to 88 AGYW in our safe space initiative. Through our sessions, we are able to create an enabling environment for them to share their stories and find empathy within the group thereby reducing abortion stigma, increasing confidence and self-esteem, and clarifying myths about self-managed abortion while sharing information on the hotline. 

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(Pic decription: A cross section of safe space discussion) 

An attained milestone for the organization is our work with girls and women with disabilities; we organize four sessions reaching out to 52 girls and women with disabilities in the region. It was amazing to see and know the needs for women with disabilities, how different the needs are and to say the least, how impactful was our session. Ranging from talking about contraceptives and menstrual health.

It’s worth highlighting that, the outcome of these activities in rural and urban areas varied as people in the rural areas had so many myths about contraceptives and sex education, highlighting stigmatization and fear of promiscuity as one of the reasons for the lack of sex education for adolescents.  In urban areas, there were a lot of misconceptions about contraceptive use. Many people attributed the usage of contraceptives (except condoms) to infertility. 

At the end of these community outreaches, a positive impact was created as they stop believing myths associated to sexual reproductive health, thus their interest grew over time as an overwhelming number of people contacted the hotline to get more information on their sexual reproductive health. Because parents of adolescents gained knowledge on the importance of sexual reproductive health, after the session, parents talked about sex education with their children. Moreover, we were called back by the parents of some communities as they gave us the opportunity to talk about contraceptives, safe abortions and sex education with adolescents. This created a free atmosphere for these children to discuss issues of their sexuality without being reproached. 

ACCOMPAGNER LES JEUNES FILLES, FEMMES ET GARÇONS SUR LA NÉCESSITÉ DE L’AVORTEMENT SÉCURISÉ.

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Les facilitateurs ont mis les points rappelant que l’entrée dans la vie sexuelle active des adolescents et jeunes représente une étape importante mais aussi très difficile pour la plupart des jeunes et adolescents. Car il faut concilier d’une part les aspects positifs et prometteurs de la sexualité «découverte, amour, partage», d’autres part les aspects négatifs «crainte d’une grossesse précoce, des maladies sexuellement transmissibles comme les IST et du VIH/SIDA». D’où la nécessité du programme sur la santé sexuelle et reproductive des adolescents et jeunes (SSRAJ). L’adolescence est caractérisée par une augmentation de contact avec le sexe opposé. Ainsi à l’éveil sexuel de la puberté s’ajoute les dimensions sexuelles amoureuses, pour certains c’est le début de relation allo sexuelle. Les conditions d’entrée dans la vie sexuelle diffèrent d’une région à une autre. Les facteurs influençant cette entrée sont notamment; les normes sociales, la foi et la spiritualité, la tradition, les médias, le prolongement généralisé des études mais aussi et surtout les avancées enregistrées dans le domaine de la contraception et pour certains pays la légalisation de l’avortement. Des nombreuses études se sont penchées sur le concept de fécondité des adolescentes et ont noté un accroissement de l’activité sexuelle des célibataires  et donc des grossesses avant le mariage. Actuellement, la socialisation sexuelle des femmes reste toujours plus contrôlée que celle des hommes, et leurs premiers rapports sont à la fois plus souvent tardifs et parfois encore mal vécus. En Afrique subsaharienne, la sexualité préconjugale est intense, précoce, instable, multipartenaire, diversement justifiée, dépendant des caractéristiques socio-économiques, sociodémographiques et socio- culturelles des jeunes et des membres de leurs ménages. 

Dans presque tous les pays, la loi permet l’avortement pour sauver la vie de la mère, et dans la majorité des pays, l’avortement est autorisé pour préserver sa santé physique et/ou mentale. Par conséquent, il faut que des services d’avortement sécurisé, tels que prévus par la loi, soient disponibles et applicable. C’est la lutte que l’ organization membre mene auprès des autorités ou les décideurs.

L’avortement non sécurisé, ainsi que la morbidité et la mortalité associées chez les femmes, sont évitables. Des services d’avortement sécurisé devraient donc être disponibles et accessibles pour toutes les femmes, dans le plein respect de la loi.

l’accès à l’avortement légal reste très limité  en partie à cause de: 

• La compréhension et l’application incohérente de la loi par  les institutions juridiques et les personnes chargées de faire appliquer les lois.

 • L’intégration lente du langage du Protocole de Maputo  dans les lois nationales. 

• Les stigmas graves contre les femmes qui cherchent ou qui  ont eu un avortement.

Ceci occasionne des avortements clandestins, non sécurisés et souvent y a perte de vies

Centre for Social Concern and Development (CESOCODE) engages Adolescent girls and young women in access to Sexual Reproductive Health services.

 

Cross-section of adolescent girls who attended the meeting  

As one way of improving access to Sexual Reproductive Health among adolescent girls and young women in Chiradzulu and Zomba districts in Malawi, the Centre for Social Concern and Development (CESOCODE) conducted Adolescent girls and young women SRH friendly meetings. The meetings were aimed at discussing different SRH issues affecting adolescent girls and young women about Youth Friendly Health Services, finding possible solutions to the challenges and strategizing on how they can deal with those challenges, and identifying and engaging possible stakeholders like pharmacists and community-based health workers who could help solve the challenges. The meetings were also aimed at strengthening and raising the capacity of adolescent girls and young women accessing SRH services at Chiradzulu and Zomba Health Centres.
 During the meetings, girls and young women shared with the gathering the different activities they are undertaking to help fellow adolescent girls and young women understand Sexual Reproductive Health issues in their communities. Some girls and young women reported using drama, forum theatre, songs, poems, and sports as strategies for disseminating information to their peers.
 Pharmacists and Community Based Health workers have a role and a responsibility to play to promote Youth Friendly Health Services and make sure that adolescent girls and young women have access to the right knowledge and services in terms of  Sexual Reproductive Health; There is a need to intensify activities aimed at educating adolescent girls and young women in Zomba and Chiradzulu districts with information on SRH issues, and adolescent girls Young women from different groups should encourage their peers to go to the health facilities every time they have Sexual Reproductive health issues but also to access Youth Friendly Health Services.

CESOCODE is conducting a six-month project in Chiradzulu and Zomba districts with financial support from MAMA Network to promote access to SRH services among adolescent girls and young women.   

Introducing the MAMA Sophia App

Sex, pregnancy, love, and health are complicated enough as it is, whether you are a young woman studying and building a career, or a parent managing a family. Matters of family planning and birth control or sexual and reproductive health, in general, are complex. 

Everyone can benefit from more trusted, reliable support! 

The MAMA Network has created a mobile phone app that will make it all simpler. The Mama Sophia app is designed to give you the confidence and convenience you need to live your best life. Mama Sophia is a free mobile app that will help you manage your period, choose effective contraception, deal with an unplanned pregnancy, and connect you with a network of qualified and empathetic experts!

Mama Sophia offers the full range of solutions for young people and women who want to not just take care, but take control of their sexual and reproductive lives, starting with a customized period tracker. Answer a few questions to establish your cycle and Mama Sophia will provide a reliable calendar with the days of your menstruation, the days you may be ovulating, and support if you miss a period. You can also reach out to Mama Sophia’s network of experts for a chat or call if you have questions. 

What about pregnancy? The Mama Sophia app can track pregnancy as well, and tell you how far along you may be. If you decide you don’t want to continue with a pregnancy, there are confidential hotlines to offer information on safe abortion and someone to talk to if you need support. Mama Sophia also has a feature for women who want to know which contraceptive method may be best for them. Just go through a quick and easy quiz that will lead you to options that suit your lifestyle and preferences.

The Mama Sophia app is a free, lightweight app from the MAMA Network and is available now in the App Store and the Google Play store. For more information on the Mama Sophia app, like and follow us on Facebook, Twitter, and Instagram. For any inquiries write to us at coordinator@mamanetwork.org or info@womenhelp.org

MAMA Network is looking for a video animator!

Mobilizing Activists around Medical Abortion – MAMA – Network is a collaboration of grassroots activists and feminist groups based in Sub-Saharan Africa. The MAMA Network represents a regional movement of activists working to share evidence-based and stigma-free information about self-managed medical abortion and sexual and reproductive health and rights directly with women on community level.

As part of its work on information sharing, MAMA has developed its own E-learning platform, accessible only to its members, with videos, quizzes and live Q&A sessions on different subjects relevant to its goals.

Looking into improving the materials provided, MAMA is now hiring a video animator.

Scope of work:

  •  Developing illustrations for MAMA’s animated videos
  •  Animating 5 videos of around 8 minutes each according to the script provided.

Qualifications and experience:

  •  Ability to communicate in English (French is an asset)
  •  Proven experience in developing animated videos

Interested applicants should submit their proposals stating their experience in a similar position, including 1 or 2 samples of work they have done and a budget to coordinator@mamanetwork.org on or before March 18th. We regret that only shortlist applicants will be contacted.

If you have any questions or concerns regarding the scope of work, please don’t hesitate to reach out on the email above.

Pharmacists training to promote access to safemedical abortion services in Malawi

The cross section of the participants who attended pharmacists training 

Pharmacists need refresher training to conduct their duties effectively and against this background Centre for Social Concern and Development (CESOCODE) a MAMA member based in Malawi with funding from MAMA on granting conducted training for 20 pharmacists to equip them with accurate information on how to administer safe medical abortion in their pharmacies. Pharmacists need such refresher training sessions to sustain their knowledge and work effectively to administer safe medical abortion to clients in the community.

The training also provided accurate information and approaches that successfully improve pharmacists’ ability and willingness to administer safe medical abortions as well as referrals to other healthcare providers which will help women benefit from safe and effective medical abortions. Although pharmacists’ knowledge about medical abortion is limited, many are willing to provide medicine to help women with unwanted pregnancies. Women already seek medicines from pharmacists to end an unwanted pregnancy. 

After the training pharmacy workers showed more willingness to offer safe medical abortion services which will help to reduce cases of unsafe abortion among women and girls.

MAMA member’s meeting in Nigeria

In 2021, GIWYN, one of MAMA Network’s Coordinators, has held an in person meeting with members based in Nigeria.

The meeting was part of MAMA’s project for Visibility, Security and Continuous Innovation which is an Amplify Change supported program, and had as its goal to strengthen the work of West-African members and discuss experiences and strategies by linking and learning from each other’s work.

 

MAMA members in the meeting in 2021
MAMA members in the meeting in 2021