The Ouagadougou Partnership (OP) is a regional initiative aimed at accelerating family planning progress in francophone West Africa. Since its inception in 2011, the Partnership has contributed to significant reductions in maternal deaths, unsafe abortions, and unwanted pregnancies. The current objective is to reach 13 million modern contraceptive users by 2030. Despite this progress, there is limited documentation on the status of High Impact Practices (HIPs) implementation across the nine member countries and the coordination mechanisms involved.

Description

With funding from the Bill & Melinda Gates Foundation, EVIHDAF, in partnership with FHI 360, conducted the SMART-HIPs project in the Ouagadougou Partnership countries. This formative evaluation aimed to help countries identify opportunities to enhance collaboration and learning around the implementation of High Impact Practices (HIPs) in the region. The HIPs included in the study are Community Health Workers (CHWs), Immediate Postpartum Family Planning (IPPFP), Pharmacies and Drug Shops (PDS), Postabortion Family Planning (PAFP), and Mass Media (MM).

Study aim and objectives

The OP HIP formative assessment generated information on the status of HIP implementation to promote enhanced regional coordination around HIP implementation and scale-up. Specific objectives were to:

1. Produce a high-level analysis of HIP implementation efforts in the nine OP countries, including scope and patterns of HIP implementation and scale-up, strategies and practices to advance HIP implementation, as well as potential challenges, including questions of reach and equity.
2. Explore opportunities for knowledge sharing and collaboration to strengthen HIP implementation and scale-up across those countries.

Approach

This assessment was conducted in the nine Ouagadougou Partnership (OP) countries: Benin, Burkina Faso, Guinea, Côte d’Ivoire, Mali, Mauritania, Niger, Senegal, and Togo. The region was selected because the OP provides a robust coordination platform, and all nine member countries have endorsed the use of High Impact Practices (HIPs) to achieve both regional and national family planning goals. This created an ideal environment for collecting and analyzing data on the implementation of HIPs to accelerate progress in family planning.

The HIPs covered in this study are the five practices being assessed under the R4S and SMART-HIPs initiatives. According to the respective HIP briefs (https://www.fphighimpactpractices.org/briefs/), the HIPs are defined as follows:

• Community Health Workers (CHWs – proven): Integrate trained, equipped, and supported community health workers (CHWs) into the health system.
• Immediate Postpartum Family Planning (IPPFP – proven): Offer contraceptive counseling and services as part of facility-based childbirth care prior to discharge from the health facility.
• Mass media (MM – proven): Use mass media channels to support healthy reproductive behaviors.
• Pharmacies and Drug Shops (PDS – promising): Train and support pharmacies and drug shops to provide family planning information and a broad range of quality contraceptive methods.
• Postabortion Family Planning (PAFP – proven): Proactively offer voluntary contraceptive counseling and services at the same time and location where women receive facility-based postabortion care.

During this study, we used a mixed-methods approach involving a desk review and key informant interviews in each country.

Findings

At the OP level, a dissemination of findings from the landscape analysis to OP Coordination Unit and countries was held on June 20, 2024, and a global webinar organized online on July 24, 2024.