Issakha Diallo: Harnessing the Power of Civil Society for Family Planning in West Africa

Issakha Diallo. {Photo credit: MSH.}Photo credit: MSH.

The USAID Action for West Africa Region project (AWARE II) is expanding the use of regional best practices in family planning and reproductive health, HIV & AIDS, and maternal, neonatal and child health through creating positive policy environments, training regional institutions, and leveraging funding. The project also supports local civil society organizations in implementing best practices for repositioning family planning.

MSH spoke with USAID AWARE II Project Director Issakha Diallo about the role of civil society organizations in expanding access to family planning.

How do civil society organizations (CSOs) help expand access to family planning?

CSOs are generally small, flexible, and willing to serve as change agents for innovative actions. And they are well rooted in the communities where they operate. The Association Togolaise pour le Bien-Etre Familiale (ATBEF), for example, has been selected by AWARE II to provide injectable contraception in remote areas of Togo. Providing injectable contraception through a CSO has not been tried anywhere in the country or even the region, but ATBEF is eager to step up to the challenge. ATBEF is also using a mobile clinic and community health workers to reach 250 villages and remote areas, bringing family planning and reproductive health services to people who otherwise would have to go without. Injectable contraception is particularly popular because it is discrete, easy to use, and lasts three months. ATBEF, a local non-governmental organization affiliated with the International Planned Parenthood Foundation, is able to carry out this work with a small grant from USAID through AWARE II.
With small grants from USAID, the 12 local nongovernmental organizations that AWARE II has engaged in the region are all showing excellent results in reaching their communities with family planning services as well as services for HIV & AIDS.

What challenges do CSOs face in this work?

Family planning services provided by CSOs depend on community health workers. These workers are highly effective because people in their communities trust them. But some health professionals believe that community health workers cannot safely provide some family planning services like injectable contraception. It will take time to convince everyone that the workers are well trained and well supported enough to provide high-quality care. Task-shifting from health professionals to community health workers is an important part of expanding access to health care.

How do CSOs empower local people through this work?

CSOs and community health workers live in the communities they serve. They understand their communities and are accepted by them. They know how to engage their communities in supporting family planning efforts, which is necessary for real long-lasting success. In this way, community health workers and their families, friends, and neighbors own the family planning projects and can adapt the projects to fit their needs.

In addition, the services that the CSOs provide can empower traditionally disadvantaged communities. Force en Action pour le Mieux être de la Mère et de l'Enfant, for example, has trained nearly 450 female sex worker peer educators on condom use in the past year and in three months has provided more than 1,000 sex workers with voluntary counseling and testing for HIV.

How do CSOs strengthen entire health systems?

CSOs are proving to be the best way to extend and scale-up health system services. They provide a link between communities and other levels of the health system and they are able to mobilize resources. They are also able to independently find new ways to implement and support best practices. AWARE II recently convened more than 120 delegates from 80 CSOs in the region to share best practices and review draft action plans. At the conference, Engaging Civil Society for Repositioning Family Planning in Francophone West Africa, participants worked together to revise each country's work plan to reflect CSO concerns about implementation. They also chose a representative from each country delegation to serve as a focal point for monitoring and coordinating the implementation of the action plans with their government counterparts and donor representatives.

For more on the project, visit: AWARE II.