Background
On average, a Guinean woman will have 5.2 children in her lifetime and has a 5 percent chance of dying from maternal causes (PRB 2011). Only 9 percent of women use a method of family planning (FP), with only 6 percent using modern contraceptives, according to the 2005 DHS survey. Guinea is also experiencing rapid growth of its youth population, with 43% of its citizens under the age of 15. Such a quickly expanding group will have great need for access to reproductive health care and FP services.
PAC-FP Assessment
E2A assessed the implementation and scale-up of Postabortion care (PAC) programs in four Francophone West African countries, including Guinea. The assessment focused on the FP component of PAC. Each of the four countries applied a Virtual Fostering Change methodology for the scale-up of PAC programs, beginning in 2008.
The provision of FP within PAC services – a key component of the widely accepted PAC model – has been identified as a high-impact practice which contributes to the use of FP by women who need FP services. While the impact of this practice is known, more evidence is needed about successful approaches to its implementation and sustainable scale-up. The purpose of the assessment conducted by E2A was to identify the core activities undertaken by the four countries to strengthen PAC-FP services at the point of treatment and factors that contributed to – or hindered – success. In addition, the assessment looked at the role the Virtual Fostering Change methodology played in introducing and sustaining FP within PAC services. Virtual Fostering Change was introduced following a regional meeting in 2008 that focused on strengthening the quality and scale-up of PAC services in West Africa. The meeting was sponsored by the US Agency for International Development (USAID) and the World Health Organization, with support and participation from the Implementing Best Practices Initiative, governments, national and international organizations.
Between September 2012 and March 2013, E2A, working with guidance from key government partners in the region, USAID, and participants of the 2008 PAC meeting, collected data from health facilities, including conducting interviews with service providers, reviewing service delivery statistics, and leading focus group discussions. Key government counterparts were interviewed, as were projects that provided technical assistance to the initiative, and E2A conducted a desk review of PAC programs as a complementary feature of the work.
E2A's assessment report of the PAC program in Guinea is referenced below.
Results of the assessments were presented at a regional workshop, held last October in Saly, Senegal. Based on the assessment results, representatives from the four countries, along with others in Francophone West Africa, have made plans to strengthen certain aspects of PAC service delivery over the next year. The assessment provides a useful contribution to understanding what works and does not work in PAC program implementation. E2A is committed to strengthening FP within PAC services and will seek opportunities to apply these programmatic lessons widely.
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