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From Pilot to Nationwide Scale Up : Increasing Access to FP and PAC in Djibouti

Learn how CARE's SAFPAC project has successfully increased access to family planning (FP) and post-abortion care (PAC) in Djibouti through clinical training, community engagement, and logistics management. Discover the evolution of the partnership with the government and the ingredients that make this scale-up possible. Explore future plans for sustainability and policy support.

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From Pilot to Nationwide Scale Up : Increasing Access to FP and PAC in Djibouti

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  1. From Pilot to Nationwide Scale Up: Increasing Access to FP and PAC in Djibouti Jimmy Nzau, MD (CARE) Amadou Traore, MD (MoH Djibouti) Heidi Schroffel, MPH (CARE)

  2. Djibouti Sources: World Bank, WHO (2013-2015)

  3. CARE’s SAFPAC Project • SAFPAC: Supporting Access to FP & PAC • Since 2011 in 5 countries: Chad, DRC, Mali, Pakistan & Djibouti • Quality FP & PAC services through: • Clinical Training • Engagement with community and partners • M&E system • Logistics & Supply Chain Management (including provision of supplies)

  4. CARE in Djibouti: The Timeline… • SAFPAC EXPANSION • 10 health facilities (2 camps & 8 MoH facilities) • 173 new FP users/month • SCALE UP • CARE supports MoH • 22 govt. health facilities nationwide • >900 new FP users/month CARE HEALTH PROGRAM • 2 refugee camps • 2 health facilities • 21new FP clients/month • SAFPAC PILOT • 2 refugee camps • 2 health facilities • 37 new FP clients/month • Started introducing LARC/PAC CARE Office Closes

  5. Evolution of a Partnership I

  6. Evolution of a Partnership II

  7. The Ingredients in this Special Sauce… Technical Support PARTNERSHIP & SCALE UP

  8. The Equation • CARE • Trusted brand • Capacity building • M&E systems • Technical assistance • Advocacy/Influence • Outcomes • Increased coverage • Better access • Decreased costs • Accountability • Sustainability • Greater impact • Government • Stability • Security • Reach • Buy-in from the MOH • Ownership 8

  9. What Do our Partners Think? 9

  10. # of New FP and LARC Users by Month 2013 2014 2015 Commodity stock-outs due to unexpected high demand # FP Users # LARC Users 10

  11. What Makes it Possible? • Strong results convinced MoH of the value of the intervention. • Trust and accountability leveraged our partnership to go to scale. • Scale-Up and transition requires a stable, motivated government. • An NGO that can innovate and is willing to take risk. 11

  12. What’s Next? • Sustainability: reliance on commodities purchased by CARE > exploring other options • New initiative funded by FP 2020 for $90,000: • Support the MoH to revise national FP policies and guidelines • Support the MoH and local stakeholders to adapt the national RH Law • Support the MoH to establish capacity building (TOT/Training Manuals)

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