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Time to Deliver on Maternal Health and Family Planning Best Practices: White Ribbon Alliances in Asia and the Middle East Make It Happen

White Ribbon Alliances (WRAs) across Asia and the Middle East have become strong advocates for evidence-based strategies to reduce maternal mortality. The USAID | Health Policy Initiative, Task Order 1, has helped to form alliances and support their efforts to scale up family planning (FP) and maternal, neonatal, and child health (MNCH) best practices in the region. This brief highlights the achievements of alliances from Bangladesh, India (Orissa), Indonesia, Pakistan, and Yemen.
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Moving From Policy to Action: End of Project Symposium
Moving From Policy to Action: End of Project Symposium (10:44)
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Where We Work

India

The USAID | Health Policy Initiative completed its work in India on September 29, 2010.

Task Order 1 of the USAID | Health Policy Initiative (HPI) in India fostered an enabling policy environment for family planning/reproductive health (FP/RH) and HIV programs. Major activities focused on the northern states of Jharkhand, Uttar Pradesh, and Uttarakhand, with support for national activities as well.

Specifically, in Jharkhand, HPI facilitated a multisectoral, evidence-based process to improve access to FP services among the urban and rural poor. Jharkhand has one of the highest levels of poverty in the country. For the poor, lack of access to family planning and continued high fertility can mean fewer resources (e.g., money, time, attention) for each child, leading to poor nutrition, ill health, and limited educational opportunities—ultimately trapping this group in a poverty cycle. HPI's work informed the development and operationalization of FP/RH strategies for the poor to be undertaken by the state.

In Uttarakhand, project activities focused on updating and putting into practice the state Health and Population Policy into practice. In 2002, under the POLICY Project (predecessor to HPI), our team assisted the state government to organize a participatory process to formulate the policy. In 2008, HPI gathered feedback from more than 400 stakeholders, including policymakers, program managers, community-level workers, and clients, to identify barriers to the policy's full implementation. Based on findings from the assessment, newly available data, and lessons learned from innovative pilot projects in the state, HPI helped the government amend the policy and design a program implementation plan. The new policy will help the state to better meet the needs of underserved groups, such as the poor, and foster effective implementation and scale-up of new service delivery models, including public-private partnerships. 

In Uttar Pradesh, there is high-level commitment for RH/HIV integration, but limited practical experience rolling it out and attaining desired results. In 2008, HPI facilitated the formulation of district HIV action plans in Uttar Pradesh's five highest prevalence districts. As a next step, HPI documented and shared best practices for RH/HIV integration from India's high prevalence states. The project worked with stakeholders in Uttar Pradesh to adapt and test relevant approaches for the state context, which experiences relatively low HIV prevalence but high fertility and the presence of risk factors that could make the state vulnerable to further spread of HIV.

KEY ACHIEVEMENTS

Mapping Exercise Informs Programming for the Most At-risk Populations (MARPs). India's National AIDS Control Program III aims to prevent HIV infection among MARPs. In 2008, the government organized a country-wide mapping exercise to estimate and validate the size and location of these groups. These data are needed to scale up interventions and achieve high program coverage. Family Health International (FHI) carried out the mapping process in 25 districts in Uttar Pradesh, while HPI analyzed secondary data to help fill knowledge gaps, provided monitoring and supervision support, and analyzed the results of the mapping. The mapping exercise and additional analyses revealed that the number of MARPs was higher than expected. As a result, the Uttar Pradesh State AIDS Control Society (UPSACS) revised its 2009-10 targets for program coverage. In short, the mapping data contributed to improved planning and resource allocation to better reach out to and meet the needs of MARPs.

Model Helps Companies Promote Family Friendly Workplaces. HPI in India has worked to improve access to family planning in the private sector. The project successfully developed and pilot tested the Family Friendly Workplace Model, a tool that helps communicate to businesses the financial benefits of implementing family-friendly workplace policies, which can increase women's access to FP and basic healthcare. 

Last Updated 11/24/10