ECSACON, a program of the East Central and South Africa- Health Community organized a one day meeting on family planning updates for senior nurse/midwives from ECSA. This is in line with ECSACON mission to improve the quality of health of the communities in the ECSA region through strengthening of the contribution of frontline health workers (nurses and midwives towards delivery of quality health care services. The workshop was organized in collaboration with ECSA and to coincide with the Best Practices Forum. Malawi, Swaziland, Ethiopia, Kenya, Lesotho, Tanzania, Zambia and Zimbabwe were represented at the meeting. Engender Health, Pathfinder International, Family Health International 360 and USAID/EA provided technical updates and countries represented shared their experiences in each technical update areas presented. The meeting focused on High Impact Interventions/Practices in family Planning; Evidence Based Tools for Family Planning; Healthy Timing and Spacing of Pregnancy; Post-Partum Family Planning; Long Acting and Permanent Family Planning Methods; Community Based Family Planning Services; and Integrated Services Provision.
Issues arising from country presentation were discussed and recommendations were made to ECSCON and their respective countries programs.
Major issues discussed were:
Task shifting pilot studies in provision of DPMA to community health workers to reach the underserved showed that CHW can learn how to inject in as few as 3 weeks training ; they perform well on the job and clients would refer their friends to them for injections. The question of accountability in case of malpractice was also raised. The practice has generated regulatory challenges that are holding up rollout in some countries.
Many missed opportunities for family planning service and education still exist especially in integrated services, management of fistula, postpartum care continuum and PAC services.
Priority Recommendations are:
1. Nursing Education and Service Leadership promote and monitor implementation of all classified High Impact Interventions in family planning. The ECSACON Member countries must ensure that:
- At service delivery family planning is a key component of immediate post-partum and post abortion care
- Pre-service education programs must address and intensify skills acquisition in Integration of services in a variety of services and delivery of all family planning services. (Graduates are currently described as being theoretical.)
- Regular reviews of curricula to address the high impact practices as they are identified in order to facilitate scaling up.
- Promote documentation and sharing of what works well.
2. ECSA Countries establish local mechanisms for regulating performance of technical skills like provision of injections where task has been shifted to CHW and evidence exists from pilot programs to show that the practice works, is safe, sustainable and helps expand the reach of underserved populations.