Integrating family planning to build resilience - models from the Sahel to the Lake Victoria Basin

Background: Pathfinder International is an international organization working across about 25 countries whose mission is to ensure that sexual and reproductive health and rights (SRHR) are available to all people, particularly the most vulnerable. Since 2014, Pathfinder has been growing our PHE portfolio, in an effort to reach rural populations who lack access to family planning, face dire consequences due to their direct dependence on natural resources, and have not yet been reached by more established practice models. PHE enables Pathfinder to collaborate beyond the health sector to address root causes and build resilience, and serves as an advocacy platform for FP on the SDG agenda. Our PHE approaches build on cross sectoral experiences, and Pathfinder’s 60 years of promoting SRHR through programs and advocacy. We have now gathered extensive evidence on the power of comprehensive SRHR-based PHE approaches in the Lake Victoria Basin, and are piloting adapted PHE approaches in the Sahel. Methods: Across the five countries where Pathfinder implements PHE programs, PHE program attributes include: community-based family planning and basic maternal and child health care service delivery, and referrals; outreach clinics; integrated PHE messaging; livelihood activities; and family planning sensitization that particularly targets men and youth. Comprehensive PHE projects such as the Health of People and the Environment in the Lake Victoria Basin (HoPE- LVB) Project (2011-2019), also include elements such as PHE model households, multi-scale, multi-sectoral advocacy, and health systems strengthening. In Niger’s Zinder Province, Pathfinder has incorporated basic PHE components into a resilience-focused project, including training agricultural extension and community health workers to deliver integrated PHE messages, and sensitizing conservation farmers on PHE topics.    Results: In the LVB region, a concentration of PHE investment and stakeholder engagement, prompted by trained PHE champions and HoPE-LVB’s comprehensive advocacy efforts, contributed to the adoption of an East African Community (EAC) PHE strategic plan, the development of national PHE policies in EAC countries, and more than 60 local ordinances, many of which support family planning. Key PHE components are also incorporated into PHE strategies that are being rolled out across the region. In the Sahel, although community-based PHE activities are still nascent, resiliency development actors are beginning to reach out to the family planning sector to explore integration. PHE is one approach that offers a platform on which to build these dialogues. As such, Pathfinder-Niger is building on the results of PHE programs such as HoPE-LVB, while incorporating nutrition and food security. Donor interest in the results is growing. Conclusions: PHE has begun to demonstrate its power of influence in both advancing family planning access and ensuring that family planning remains on the SDG agenda.