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July 10, 2019

Ana Aguilera is a life-long advocate for the sexual and reproductive health and rights of young individuals all over the place. She’s helped to advertise their schooling, entrepreneurship, health and well-being, and most lately, their sexual and reproductive health and rights. As EngenderHealth’s Deputy Director of Adolescent and Youth Sexual and Reproductive Well being and Rights, Ana shares some ideas on strengthening well being methods, growing access to contraceptive providers, and why youth matter.


(Photograph credit score: Jon Thorpe / EngenderHealth)

EngenderHealth has an extended historical past of working to strengthen health methods around the globe. Why does EngenderHealth concentrate on systemic health techniques modifications in creating nations?

EngenderHealth believes that strengthening health methods is crucial to any sustainable international well being effort, especially any reproductive health initiative. While each country is totally different, we now have discovered by way of many years of expertise that weak well being techniques severely limit nation governments’ talents to succeed in weak populations with quality healthcare. To succeed in unserved and underserved groups—similar to adolescents, rural populations, and other people with disabilities—we can’t rely on one-off initiatives and approaches to revamp well being methods.

The supply of contraceptives and reproductive well being providers is essentially depending on the performance of a health system. Sustainable service supply approaches are needed to succeed in adolescents, youth, ladies, and couples. Solely once we construct well being techniques to answer the various needs of their populations can we create long-term change.

Are you able to inform us about a number of of EngenderHealth’s accomplishments in this area?

We now have many years of experience building the capability of national, regional, and district-level well being methods to assist ladies and women entry reproductive well being providers. Last yr alone, we educated greater than 17,000 healthcare suppliers to ship high quality reproductive well being providers.

We are notably pleased with the great instruments and methods that we share with the healthcare group and native governments. For instance, our COPE® (client-oriented, supplier environment friendly) method is an easy and low-cost method to consider and improve service supply to fulfill shopper wants. COPE® has been launched and scaled up in 50 nations, together with Nigeria, where it has been built-in into the health system’s high quality improvement protocols.

Our REDI framework is an identical example of our efforts to enhance quality of care. As a client-centered counseling framework, REDI presents a comprehensive strategy and training curriculum to strengthen contraception counseling by empowering well being providers to raised acknowledge and respond to shoppers’ wants. The REDI counseling framework has been adopted into the Ethiopian and Ugandan health techniques as the national family planning counseling framework.

Our Actuality Verify™ software helps district and nationwide health methods monitor important info to help advocacy and planning efforts to succeed in national household planning objectives. Actuality Examine™ was used in the course of the improvement of Malawi’s first Family Planning Costed Implementation Plan and continues to be used by local governments in Uganda for contraceptive prevalence price projections.

Globally, more than 200 million women and girls should not have entry to trendy contraceptives and family planning strategies. On the similar time, greater than 800 ladies die from problems in childbirth day by day. How is EngenderHealth serving to to deal with these points?

First, we have now seen the importance of being intentional when designing packages. We search to completely perceive the precise context of a woman or lady who needs to access household planning providers. We’ve discovered that we must keep away from cookie-cutter approaches, which fail to think about the precise context that affects if, how, and when ladies can entry reproductive health providers. We also make it some extent to succeed in women, ladies, and couples who are thought-about “never users” as they make up more than half of the inhabitants needing family planning providers.

We additionally work to extend full, free, and informed selection. Women, ladies, and couples should have the correct and applicable info to make one of the best selections concerning the number, timing, and spacing of pregnancies for themselves and their households.

With these approaches, we see success every year. For example, up to now yr, we helped more than 17,428 healthcare providers attain over 6.2 million shoppers with contraceptive providers and prevented over 50,813 baby deaths and 5,457 maternal deaths.

How have your colleagues improved the standard of well being providers?

Quality of providers is at the core of a healthy inhabitants. Poor high quality care is now a larger barrier than lack of access to health providers. In my work, I see how underserved teams, like adolescent women, typically have access to a well being middle however fail to receive the quality reproductive health providers that they deserve as a result of these providers are poor high quality and never youth-friendly.

Our quality-centric strategy to working with health techniques is grounded in rules of gender fairness and emphasizes sustainability and self-reliance. It places the adolescent woman or lady on the middle and understands and addresses all of the obstacles that get in the best way of her receiving high-quality reproductive or maternal health providers.

Our international quality enchancment group of professional clinicians and technical specialists, based mostly in our regional and country workplaces, work globally to strengthen well being delivery techniques and enhance the quality of care. This consists of monitoring providers and strengthening high quality enchancment methods; mobilizing communities to carry their local health system accountable for delivering high-quality care that responds to their needs; and medical monitoring and training utilizing a whole-site coaching strategy that ensures expertise standardization and strengthens all the quality of care ecosystem.

You’ve a robust background in serving youth. Why do you assume concentrating on youth is so necessary?

The apparent answer is that right now there are 1.eight billion younger individuals between the ages of 10 and 24 years on the earth, together with 1.2 billion between the ages of 15 and 24 years. That is the most important population of young individuals the world has ever seen!

Maybe extra importantly, we have now 1.8 billion adolescents and youth with hopes, goals, and aspirations. Along with these aspirations, come specific challenges they face to succeed in their full potential. One of many major challenges they face is restricted access to reproductive and maternal healthcare info and providers. Adolescent women and younger ladies in many societies aren’t capable of make selections about their own our bodies, and consequently, have limited company and power over their lives. The current and future potential of younger individuals is limitless, if we will more effectively attain these younger individuals with correct, applicable info and providers that respect, shield, and fulfill their human rights.

Given this reality, it is not acceptable to determine whether or not you’ll reach adolescents and youth in reproductive health packages. This can be a must and we have to shift the dialog to talk about how we’ll do this, not whether or not or not we’ll do it.

You additionally help lead EngenderHealth’s efforts to extend access to adolescents and youth sexual and reproductive health info and providers. Can you inform us extra about how EngenderHealth hopes to perform this?

At EngenderHealth, we firmly consider that we should work to respect, shield, and fulfill the sexual and reproductive well being and rights of adolescents and youth by means of two complementary objectives:

First, we should improve entry to high-quality, gender-equitable sexual and reproductive well being and rights info and providers for adolescents and youth. Once we speak about quality, we aren’t just referring to international medical tips and standards—although those are essential. Once we think of quality, we’re wanting on the whole shopper expertise—from the second they determine to entry reproductive well being or household planning info and providers to the follow-up care they obtain later. For adolescents and youth particularly, we emphasize that high-quality means evidence-based, respectful, and applicable care, recognizing the various further limitations that they face in accessing family planning and reproductive as compared to different individuals of their communities.

On a current trip to Tanzania, I had the pleasure of meeting Rehema, a youth-friendly public sector health supplier in Arusha. Rehema is a compassionate, nonjudgmental provider who takes the time to get to know each adolescent woman and younger lady that seeks well being providers from her. She makes a world of a distinction and exemplifies the significance of working inside well being techniques to vary provider attitudes, biases, and norms in an effort to absolutely help younger individuals’s well being and rights.

Second, we should improve the gender-equitable and socially inclusive participation and management of adolescents and youth. You is perhaps questioning why we qualify this participation. The most important cause is that we don’t need to reinforce the dangerous gender and social norms that have traditionally prevented women and other marginalized youth groups from collaborating equally within the household planning or reproductive well being initiatives concentrating on younger individuals. We would like our packages to advertise gender- and youth-transformative approaches that take a look at all younger individuals as belongings and specialists in their very own sexual and reproductive health and rights. For example, in Ethiopia, we’ve got developed a significant youth participation technique for all phases and end result areas of challenge implementation. Youth participation and management is just not limited to a single activity or intervention, it is a vital cross-cutting and efficient strategy for all our work. Our strategy consists of incorporating actions which are designed by young individuals for young individuals—notably actions related to growing access to sexual and reproductive well being and rights info, assessing youth-friendly health providers at public amenities, and fostering an enabling setting the place adolescents and youth can exercise their rights.

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