Young Advocates, Political Will Drive Progress on Family Planning in Francophone West Africa

Newlywed couple in Ouagadougou.

Young newlyweds in Ouagadougou, Burkina Faso, which is one of the nine countries that make up the Ouagadougou Partnership. Photo by Trevor Snapp for IntraHealth International.

Countries throughout francophone West Africa are celebrating progress in family planning this week at the Ouagadougou Partnership (OP) annual meeting in Cotonou, Benin, where the theme is We Demand More: Youth and Social Behavior Change.

In 2015, the nine OP countries—Benin, Burkina Faso, Côte d’Ivoire, Guinea, Mali, Mauritania, Niger, Senegal, and Togo—exceeded their initial goal of reaching one million additional individuals with modern contraception and then committed to reaching 2.2 million additional users by the end of 2020. So far, OP leaders announced Tuesday, the countries have achieved 87% of this goal.

In the past year alone, OP countries have added 450,000 users of modern contraception, surpassing their projected figure of 443,000. They estimate that this has prevented 162,000 unwanted pregnancies, 58,000 unsafe abortions, and 560 maternal deaths. The countries have achieved these results in part through social and behavior change approaches that have increased demand for family planning services in the region.

"We are finally seeing sustained momentum in this region."

The OP countries have among the highest maternal, neonatal, and child mortality rates in the world. They also have some of the highest fertility rates. Niger tops the list with an average of seven children per woman.

But since the partnership began in 2011, the OP countries have reached 3.4 million additional women and girls with modern contraception. Key factors in their success this year, leaders said this week, include high levels of political engagement, a dynamic civil society, a growing network of champions, and greater donor interest and investment in the francophone West Africa region.

IntraHealth International, which hosts the Ouagadougou Partnership Coordination Unit, is working throughout the region to boost access to family planning and connect more young people—especially women and girls—to health services that can lead to longer, healthier lives.

"We are finally seeing sustained momentum in this region,” says Pape Gaye, IntraHealth’s president and CEO. “And it’s not just due to one approach or one influx of resources. We’re partnering with multiple donors, young people, community leaders, health workers, government agencies, schools, the private sector—frankly, whoever we can—to help the OP countries maximize returns on family planning investments and develop holistic approaches to make faster, sustained progress in the region.”

Local leadership, local resources

IntraHealth works with mayors and local officials in ten cities—home to 11.7 million people, including 3.1 million women of reproductive age—throughout francophone West Africa through the Challenge Initiative (TCI). These local leaders have committed to boosting family planning and reproductive health services for their populations, including increasing demand for these services, notably among young people—and they’re investing community resources to make it happen.

By the end of its third year, TCI Francophone West Africa Hub had mobilized $423,095 in local contributions.

Also read: President of UCOZ, Benin, Says His Community is Benefitting from the TCI Platform

By the end of its third year (June 2019), TCI Francophone West Africa Hub had mobilized $423,095 in local contributions (both cash and in-kind) and provided messaging to increase awareness of and use of family planning services to 484,000 women of reproductive age. In the past year, 345,000 women have benefited from family planning services in TCI-supported municipalities in Burkina Faso, Benin, Cote d’Ivoire, and Niger. The result: 59,417 new contraceptive users.

Also read: In Six Francophone West African Cities, Mayors Are Serious about Investing in Family Planning

Sex ed & youth advocacy

We’re working to reduce bias in health care, make services friendlier to young people, and get comprehensive information about reproductive health to young people who need it.

We do this in part by developing civil society coalitions—including with local youth ambassadors, religious leaders, women’s groups, and more—through our Strengthening Civil Society Engagement for Family Planning (CS4FP) project. For example, we’re integrating comprehensive sexual education into the high school curricula in Cote d’Ivoire, Guinea, Mauritania, and Niger through a participatory approach, ensuring religious leaders, parents, and students themselves are driving the process.

Community health workers we’ve trained have visited 8,717 young clients in their homes this year.

And because so many of our young colleagues are demanding more comprehensive information and solid advice, they’re not stopping there. A few examples:

  • In Mali, the coalition’s targeted advocacy messages—including those of youth ambassadors—have helped lead to a new presidential decree establishing free access to family planning services in 2019.
  • The Niger coalition’s advocacy during a donor group visit in 2019 helped lead to the newly created Family Planning Directorate in Niger, an important step in making funding for family planning a priority in the country. (Also read: Niger Faces Five Key Family Planning Challenges)
  • In Mauritania, the coalition successfully advocated to include comprehensive sexual education in the national costed implementation plan to reach more youth and adolescents with family planning and reproductive health information.
  • This summer in Côte d'Ivoire, CS4FP youth ambassadors organized a summer camp in Miandzin, where more than 200 young people ages 15–24 gathered to talk about comprehensive sex ed, reproductive health, and using social media to spread the word.

Also read: This Nigerien Med Student Has a Plan to Tackle Family Planning Taboo

Health worker training for youth-friendly services

This year we’ve trained 60 master trainers and 211 health workers to provide youth-friendly services in Cote d’Ivoire, Guinea, Mauritania, and Niger through CS4FP.

And through our work with TCI, we’ve trained 213 health workers in 137 facilities to provide youth-friendlier services. Community health workers we’ve trained have visited 8,717 adolescents and young people in their homes to provide family planning counseling and referrals.

Now, through INSPiRE, we work in all nine OP countries to help integrate postpartum family planning with nutrition and maternal, neonatal, and child health services. We’ve worked with health facilities in three flagship countries that have become models of excellence for integrating these services. These will serve as training sites for other countries.

INSPiRE has also identified and is working with a local organization, INSP (National Institute of Public Health) in Burkina Faso, to build a foundation for the future of locally driven knowledge-sharing, advocacy, and technical assistance in the region. INSP will serve as a regional hub through the life of the project and beyond.

Also read: New Study Explores Solutions to Postabortion Care Barriers for Young People in Togo

IntraHealth International hosts the Ouagadougou Partnership Coordination Unit, primarily funded by the William and Flora Hewlett Foundation and the Bill & Melinda Gates Foundation. The Challenge Initiative and INSPiRE are funded by the Bill & Melinda Gates Foundation. CS4FP is funded by the William and Flora Hewlett Foundation and the Dutch Embassy.