WPF makes annual grants to Australian-registered Deductible Grant Recipient non-government organisations concentrating on the Asia Pacific region. Our partners are committed to enabling access to family planning services, to working with local staff in overseas program areas, respecting the local cultures and are open in their planning and reporting.
Programs being funded in 2020-21 are in PNG, Lao PDR and Cambodia. In 2020-21 WPF's grants total $115,000.
Download our Funding guidelines for proposals for WPF Grants 2020
Our current grant recipient partners are:
These impressive organisations are accredited by AusAID, now a part of the Department of Foreign Affairs and Trade. It is hoped that AusAID’s focus on reproductive health will continue in areas where men’s views of ownership of women make continual childbearing a default setting for the woman’s role. Violence in gender relationships, or virility measured by the number of children, create barriers to women’s entry to health clinics where rapid population increase is perpetuating poverty. The proportion of the reproductive health allocation expended on behavioural programs for men as a prelude to reaching women and making contraception possible, means that existing levels of funding may not provide sufficient rural and urban family planning for a sustainable society.
Since inception in 2004, Women’s Plans Foundation has focused on programs that directly bring family planning to women who lack it. Early grants supported a variety of projects to increase awareness and availability of modern methods of contraception.
CARE Australia is a leading international aid agency dedicated to ending poverty, saving lives, and creating a more equal world. CARE puts women and girls at the centre because we know that we cannot overcome poverty until all people have equal rights and education.
Women's Plans is supporting CARE's work in Papua New Guinea (PNG), specifically the Mamayo Project in Lufa District of the Eastern Highlands Province. The goal of the project is to increase the uptake of family planning and improve the reproductive and maternal health and wellbeing of women, their families and communities in rural, disadvantaged areas of PNG by promoting gender equitable relations and decision making.
Women’s Plans Foundation is supporting CARE’s Mamayo Project
Background to project
The Mamayo project commenced in July 2018. The first year of the project involved recruitment of the project staff, a baseline study and setting up for success in the next three years. This report covers the period July 2020 to June 2021.
An ill-equipped health system and remote mountainous landscape means reproductive and maternal health information and resources are out of reach for many women in Papua New Guinea (PNG). Without quality healthcare and community support, women in rural areas have a one in 20 chance of dying in pregnancy or during childbirth. This is further compounded by the fact that for every woman who dies in childbirth or pregnancy, another 30 will suffer lifelong pain or disability from pregnancy-related complications. All this in the country that is Australia’s closest neighbour.
CARE’s Mamayo Project is working with partners, community leaders and families to address gender inequalities in intimate partner relations, families and communities related to harmful cultural and social norms that restrict women’s autonomy and participation in decision-making. Activities are supporting decision-making and family financial goal-setting with the aim of increasing demand for reproductive and maternal health services, especially the use of contraceptives.
Key achievements this reporting period
Intermediate outcome 1 - Trained Community leaders promote women’s rights to healthcare, family planning, gender-equitable decision-making, and violence free relationships.
Increasing access to reproductive & maternal health services
The Community Workshop Series (CWS) Leadership training is aimed at strengthening the ability of community leaders to identify, analyse and take action on Sexual Reproductive Maternal Health (SRMH) issues affecting their communities.The trained community leaders were equipped with essential knowledge and skills that enabled them to role model good SRMH behaviour. By becoming an SRMH role model, community leaders were able to analyse SRMH from a gender and rights based approach and take appropriate action to improve SRMH practises in their communities.
A total of 290 community leaders (192 male, 95 female, 2 male PLWD (person living with a disability), 1 female PLWD) from Lufa District, Unavi LLG in Eastern Highlands Province and Menyamya District, Kome LLG in Morobe Province were registered to undertake the leadership training. Of this, 162 (100 male, 60 female, 2 male PLWD) completed the training. They attended beginners, intermediate and advance level of the leadership raining. A total of 86 (58 male, 27female, 1 female PLWD) attended only two training sessions and 42 (34 male, 8 female) dropped out of the training.
In this reporting period, data reported in the previous report (July – December 2020) needs to be corrected of the actual number of participants that completed the CWS Leadership training. The accurate quantitative counts are; from a total of 77 (male 51, female 26) participants that registered, 38 (male 24, female 13, PWD male 1) completed theCWS leadership training by attending all three training installments.
Immediate outcome 2 - Couples have new knowledge and skills to improve their SRM health and wellbeing.Couples develop action plans, including actions for health and wellbeing
The CWS Family training manual consists of an amalgamation of proven training tools that promote respectful relations that lead to violence free relationships. Family Business Management Training that increase gender equitable decision-making and relations, especially on family budgets and managing household income and Sexual, Reproductive and Maternal Health education that enables participants to analyse SRMH using a gender and rights based approach. The training is facilitated in three series, beginners, intermediate and advance levels or instalments. At the end of the training, each couple is expected to develop Family Action plans that incorporate key learnings and plan actions for improved health and well-being.
In Lufa District, the second instalment of CWS family training was completed in March with a total attendance of 104 (47 males, 55 females, 1 male PLWD, 1 female PLWD) participants.
The third instalment was completed between late May and early June. A total of 92 (43 male, 48 female, 1 male PLWD) participants attended the final CWS Family training. There were various challenges that contributed to the delay in conducting the training including poor attendance whilst project staff were on site to facilitate the training. Continuous bad weather and poor road conditions caused delay to access the project site by air and land. Furthermore, as weather permitted entry, seasonal harvest periods of major cash crop-coffee greatly affected participants’ consistent attendance at the final training. There were numerous absenteeism’s, with only few participants that committed themselves to complete the training.
Four couples experiencing gender-based violence were referred by Unavi Counselling services to attend the family training, with the aim to enable the clients to gather more insight and information on how they, married couple could improve their well-being and practise respectful relationships.
At the end of the second training, all participants, mostly married couples were asked to develop their action plans around equitable decision making and sharing of household and farming work load. Most participants-couples reported that they were sharing household and farming chores, thus improved gender roles in the households. During follow up field visits in August, project staff will check on the gender equitable decision making aspect of their family action plans.
Intermediate Outcome 3 - Reproductive and maternal health knowledge is shared in target areas. VillageHealth Volunteers (VHVs) provide support to women and their families to access SRMH services
The Mamayo Project supported three Integrated Maternal & Child Health (IMCH) patrols into the catchment areas of Kwaplalim Sub health centre in Kome LLG in Menyamya District, Ubagubi Health Sub Center in Unavi LLG Lufa District and Gouno Health Sub Center Mt Michael LLG in Lufa District. The support reached 973 community members. Immunisations were given to children aged <5yrs (477 girls/433 boys). Antenatal care services were attended by 28 females, tetox injections were administered to 31 women; Family planning services provided as follows; Contraceptive injections provided for 2 females; 2 women received implants.
"We use words instead of weapons"
Anastacia, 32, is married to Hermon. Prior to CARE working in their community, the couple were on the verge of divorce. “We had so many problems. I have undergone several court cases with my husband but violence still prevailed at home and so I decided to divorce my husband. I was at the police station to file for divorce when CARE came to our village,” Anastacia says. “Our Village Councillor asked me to register my name to participate in the community workshop training.”
“After every training session, I shared what I learnt with my husband, and he started to have an interest.” Hermon agreed to sign up for training too and the couple soon started to see some changes in their home. “[Now when my husband and I have an argument] I try to keep myself calm and allow him to speak and he does the same. I learnt to control my anger towards my husband. This enabled us to listen to each other and communicate well. We started fighting less. In the past, he would fight using knives when we fought. He stopped. We used words, instead of fists and weapons.”
“My husband is now assisting me with household chores and does not get angry when food is not prepared on time. My dream is to live a peaceful life, free from violence. There have been a lot of changes that have taken place in my home since attending the training and I am very happy,” says Anastacia.
Hermon agrees. “One of the changes included the realisation that as a couple, my wife and I have to understand and trust each other. We respect each other’s belongings and we now have an idea of how to make good family decisions and how to do a family budget. In the past ... I was the only breadwinner. I prioritised my social life hence spent money unnecessarily. Today I am wiser around the use of money. I prioritise my family’s needs and I ensure that they have everything they need before I do any unnecessary spending of money. Our home is now a happy home”.
Health staff shortage
Ubagubi Health Sub Centre in Lufa District is still operating with one male community health worker. The project continued to follow up with EHPHA for additional staff, the same agenda was discussed during the partners and stakeholder meeting in March 2021. A new staff member has now been appointed.
Reduced road access
Reduced road access to project sites at Ubagubi and Maiva-Fututai Community, in Unavi LLG Lufa District Dueto poor weather, rain and unfavourable weather patterns restricted air and road travel to Ubagubi and Maiva. The roll out of the Community WorkshopsFamily/Couples training was subsequently delayed fromFebruary till early March.
Mining activities in the neighbouring community, Ward 3 Kuasa contributed to less attendance at Community Workshop Family Training. As the developer of the Crater Mountains mine site withdrew its operations from the area in September 2020, local villagers from Kuasa and people from neighbouring villages freely accessed the mine site excavating gold deposits for themselves. This event caused a lot of people movement to Kuasa, most fathers left their households and families for weeks and months to dig up their own gold in the mine site. Some of the participants of the Community Workshop Family training were also involved in this activity.
ChildFund Australia is an independent and non-religious international development organisation that works to reduce poverty for children in the developing world. It works in partnership with children and their communities to create lasting change by supporting long-term community development, responding to humanitarian emergencies and promoting children’s rights. We want every child to be able to say:
ChildFund Rights, Respect, Resilience Project in Papua New Guinea
As ChildFund Australia continues to navigate the still unfolding challenges of the COVID-19 pandemic, we are grateful for the steadfast support of the Women’s Plans Foundation. Women’s Plans Foundation’s generosity ensures that our work in Papua New Guinea (PNG) through the ‘Rights, Respect, Resilience’ (RRR) project continues so that girls and young women receive critical education in the areas of sexual and reproductive health (SRH), family planning and contraception.
The COVID-19 pandemic in PNG directly affected project implementation. During the reporting period school closure and restrictions on gatherings and cross-border travel all resulted in output delays that extend into the next financial year. However, there was much good work achieved and stakeholder relationships strengthened in the 2020-2021 Financial Year despite these COVID-19 driven delays. ChildFund Australia is pleased to present to Women’s Plans Foundation this annual feedback report demonstrating our achievements and challenges during the reporting period. Please find below an update on monitoring and evaluation activities and the delivery status of project outputs.
Monitoring & Evaluation
Following the reopening of schools in April, the baseline survey was conducted in May. Focus group discussions and key informant interviews were held with students, teachers and members of School Boards of Management in three target and one control school across National Capital District and Central Province, and with members of the Joyce Bay community. Qualitative tools were developed
to establish an understanding of students’ and out-of-school young people’s knowledge and attitudes towards intimate relationships, issues young people face in their schools and communities including safety and equality that act as barriers to participation, and help-seeking behaviours including awareness of service providers. The baseline documented a concerning level of corporal punishment in schools, which strongly reinforces the need for the RRR project as it provides teachers with alternative strategies for positive behaviour management. This is essential as exposure to violence can harm children’s physical and emotional wellbeing. Several barriers to the project were evident, including teacher attrition; limited community and parental engagement with schools; social norms discouraging female attendance at school; and a significant power imbalance between students and teachers. Within communities, the voice and agency of youth has been suppressed and there is poor communication with community leaders. Youth face serious issues, including crime, substance abuse, relationship problems, unemployment, low literacy, gender-based violence, and water and sanitation access. A positive finding was that community members are eager to be more informed about the RRR topics and service providers that can help them.
Baseline/endline data will be supported with pre/post testing that will be conducted with each cohort of students and young people who receive the school - and community-based
Respectful RelationshipsLearning Resource Material (LRM).
Objective One: Both in-school and out-of-school youth have increased confidence, knowledge and skills to think critically about, address and help-seek around gender, violence and sexual health issues in school.
Having finalised the Memorandum of Understanding between ChildFund PNG and the National Department of Education (NDoE) both parties commenced the update of the school-based LRM in the final quarter of FY2021.
A series of writing workshops were held in June and July involving the ChildFund PNG project team and representatives from NDoE’s Curriculum and Guidance & Counselling divisions to revise the school-based LRM in alignment with the NDoE’s new Character and Social Development (CSD) curriculum that replaces its Personal Development curriculum.
Alongside alignment, these writing workshops reviewed all LRM activities to create two distinct LRMs, one each for younger (Year 9) and older (Year 11) students. These grade-specific LRMs are currently being finalised. Both ChildFund PNG and NDoE staff highly valued their collaboration in the writing workshops – an indication of their strengthening relationship.
Teacher training on the updated school-based LRM will take place in FY2122, followed by rollout in classrooms. Exposure sessions in the 17 target schools to raise awareness and build community support for the project will also be conducted at this time. Service provider visits will be conducted concurrently with LRM teaching.
The joint review and update of the Student Wellbeing: Support for Secondary Schools teacher’s manual will also be completed in the first quarter of FY2122.
Alongside updating the LRM and Student Wellbeing manuals, in the final quarter of FY2021 ChildFund PNG and NDoE consulted on the implementation of School Action Groups (SAGs), with the NDoE offering the support of school representative councils to strengthen student leadership opportunities in the 17 target schools. NDoE has also agreed to support ChildFund PNG to develop a student peer education guide linked to the LRM for use in the project schools.
Out - of - school
The community-based LRM has been translated into Tok Pisin and a local consultant has been hire to design a range of supporting visual materials including posters and flipcharts. These additional resources will support peer educators to present key topic messages to young people in the community, particularly on SRH. Peer educator training, mentoring sessions and LRM rollout in Joyce Bay and Gabi & Eleva communities will commence in the third quarter of FY2122. Service provider visits will be conducted concurrently with peer education sessions. Alongside this, ChildFund PNG is compiling information, education and communication materials to be distributed to parents in the community on child rights, wellbeing, HIV prevention and COVID-safe practices.
Objective Two: Youth implement community level initiatives that respond to issues emerging from the RRR project with the support of community leaders
As indicated in the April 2021 report, outputs under this objective have been postponed to FY2122 due toCOVID-19 related delays. These outputs include the community forum to introduce the project in new settlement areas, exposure sessions with parents and community leaders to form Community Action Groups with youth leaders, joint community-based activities led by peer educators and community leaders, and the annual community learning and reflection forum.
Issues and Challenges
COVID - 19 impact
Covid-19 has had a significant impact on the roll out of the RRR project. Restrictions including a ban on inter-provincial travel, school closures and social distancing have all caused significant delays in implementing parts of the program. Scheduled community and stakeholder meetings and training days have been postponed. This is a rapidly evolving situation and there is significant uncertainty regarding scheduling and timelines. Despite this setback ChildFund PNG can work remotely to complete activities such as the review of the LRM mentioned in this report.
Other issues the team has dealt with include the delay in finalisation of the Memorandum of Understanding (MOU) and the release of the CSD framework. Progress is happening but at a slower pace than anticipated. The Project Team is in continual contact with the PNG authorities and feel confident that the updated LRM will be finalised in early FY 2122.
Availability of experienced and reliable local consultants
Recruitment of a local consultant to lead the review and alignment process of the LRM was a challenge despite the effort put in to comply with the recruitment process to contract local consultants. There were not many suitable applications received for this consultancy. This was due to the lack of local consultants with expertise in this area. Thus, only one applicant was interviewed and selected to lead the LRM review process with the LRM review team put together by the project comprising CurriculumOfficers from the Curriculum Development Division (CDD) and Teacher Trainers (TTD) from NDoE, YWCA and PNG Education Institute representatives. Upon recruitment, the consultant was unfortunately unreliable and delayed the activity, hence the consultant contract was amicably ended.
However, in the absence of a consultant to lead the process, guidance and support were provided by the officers from the CDD. A schedule was drafted to guide the process during the two weeks workshop to complete the LRM review and alignment.
Once more, ChildFund Australia expresses sincere thanks to the Women’s Plans Foundation. We are proud of what the Rights, Respect and Resilience project has achieved in PNG, aided by your generous support these past three years. ChildFund Australia anticipates more promising work promoting awareness, understanding and cultural change concerning gender equality in decision-making, respectful relationships and higher sexual and reproductive health literacy among students and out-of-school youth in PNG. We hope to rely on the firm support of the Women’s PlansFoundation in the years ahead.
Marie Stopes International Cambodia. As one of the leading providers of sexual and reproductive health (SRH) services, Marie Stopes International Cambodia (MSIC) has been supporting women and girls in Cambodia for over twenty years. Since 1998, MSIC has established a network of clinics in the country, with seven clinics in operation.The clinics are situated in Phnom Penh (2), Kandal, Svay Rieng, Kampong Thom, Battambang, and Siem Reap. In addition, the Marie Stopes Ladies network operates in locations where there are no MSIC clinics, bridging the gap of SRH needs. With SRH services such as contraception and reproductive health care information, MSIC focuses on empowering women, girls, and everyone in Cambodia to make their own reproductive choices.
The Covid-19 context and MSIC’s response
Although Cambodia was affected by Covid-19 from March 2020 onwards, the situation worsened towards the end of 2020 with the first official case of Covid-19 community transmission reported in November 2020. Things significantly deteriorated in February 2021 with the first substantial community outbreak which has led to a current daily average of 800-1000 Covid-19 cases.
From February 2021 MSIC operations have had to respond and to adapt to a range of government directives aimed at decreasing the risk of Covid-19. Government restrictions included a highly-policed lockdown in Phnom Penh and Kandal in April 2021, an inter-provincial travel ban, a curfew, and a ban on gatherings. In addition to this, various locations have implemented their own restrictions in response to an increase in Covid-19 cases in their local area. Despite these challenges, all MSIC clinics have remained operational with minimal disruption, in contrast to many other private and public facilities which struggled to operate during these challenging months.
In response to the Covid-19 context, MSIC has implemented a number of initiatives to support staff and clients, including:
* Enhanced infection prevention measures at a service delivery point level. This includes checking client’s temperature and asking if clients have any Covid-19 symptoms before they enter facilities, increasing cleaning protocols, implementing social distancing and ensuring staff wear provided personal protective equipment (PPE). * Transitioning offline community engagement activities to online community engagement. Using social media and online adverts to reach women with messaging on the importance of accessing SRH services during the Covid-19 pandemic. * Implementing support to staff to ensure they feel safe and secure working for MSIC. This includes providing support and equipment for staff to work from home where possible, as well as providing online sessions for staff to support their well-being.
During the implementation of the project from July 2020 – June 2021, funding from Women's PlanFoundation and other donors has supported the MSIC program to achieve the following:
6,412 people reached with comprehensive information on SRH through community activities in Phnom Penh.
1,957,556 people reached and engaged with information on SRH through social media, including ourFacebook page, of whom 39% are youth, and 49% are women (Phnom Penh only).
12,821 clients accessed FP/SRH services in centres located in Phnom Penh, 6,086 services were accessed by young people.
23,626 calls to the contact centre with 8,821 referrals to SRH services being made.
From the total calls, 5,867 were from young people.
4,512 messages received through social media apps, including Facebook, Line, WhatsApp and Google.
Objective 1: Increased understanding of FP/SRH amongst vulnerable youth in Phnom Penh, Cambodia.
Reaching young people through partnerships
During the reporting period, MSIC partnered with three NGOs working with vulnerable youth in Phnom Penh: Happy Chandara (Toutes à l’école Luxembourg), Enfants D’Asie and AusCam Freedom Project. Happy Chandara is a local organization who work with more than 1,300 vulnerable girls by providing free education, food, and medical monitoring. Happy Chandara students are mostly vivacious, eager, and smart women who strive to become future leaders, decision-makers and influencers in their communities. Enfants D’Asie is a French organization, established in Cambodia since 2001, that works to support about 1,000 young people with education, career, and moral support. AusCam Freedom Project engages with 145 young girls as part of their scholarship program.
Through these partnerships, MSIC has reached 195 young people, 74 aged 15-19 years old and 121 aged 20-24 years old with comprehensive SRH information and education through face-to-face discussions. We provided seven information sessions to the students of NGO partners.
The sessions were focused on topics ranging from puberty, menstruation, contraception, and safe sex. Tostimulate a lively discussion, we used games and videos to engage with the students. Face-to-face sessions were stopped at the start of 2021 because of Covid-19 related restrictions.
In November 2020, MSIC was invited to participate in the Introduction to Sexual and Reproductive Health and Rights session organized by Dosslarb. Dosslarb is a multi-media platform founded by young women who want to promote youth wellbeing, especially on SRH. 25 young women from various youth organizations attended the event. Representatives from MSIC gave a speech on the importance of SRH education and access to services among young people. Our centre midwife also provided free consultations for the participants in case they had any concerns or questions about their own SRH.
Before each of our engagement sessions, a pre-session survey is conducted to gauge participants’ current understanding and knowledge of SRH topics. From these results, we can address the gaps and focus on their SRH needs. At the end of the reporting period, MSIC did a post-session survey to compare young people’s understanding of SRH before and after the sessions. A total of 79 participants answered the post-test survey, lower than the pre-test because of the students’ unavailability.
After the training, knowledge about SRH including contraception increased. Their attitudes on access to contraception by young, unmarried women improved compared to before the session and they agreed that a woman should have the right to use contraception even if her partner doesn't want her to. Realizing the importance of understanding SRHR, the respondents showed high commitment to further learn about SRH either by themselves (96%) as well as encourage their close friends and/or family members to do so too(86%).
A total of 276 “Let’s talk about it” Kits were distributed to NGO partners. Packed in a nice pink bag, our kit contains a card game (which is a bundle of questions and answers about SRH, including contraception, which we have used to play Q&A games during group discussions and other marketing activities), a condom, and an emergency contraceptive pill. The objective of the distribution is to normalize conversation about SRH and encouraging young people to talk openly about contraception, whereas the card game is designed as a fun way to test their knowledge about SRH and providing them with accurate information through the answers.
Engaging young people online
Using social media to reach young people with information
In response to Covid-19 and government guidelines on limitations on gatherings and social distancing, MSIC moved many of our community engagement activities online, to ensure that young people still received messaging on SRH and accessed services despite the Covid-19 pandemic. In particular, MSIC used its presence on Facebook (Marie Stopes Cambodia) to reach potential clients with messages. Facebook serves as an important tool to reach young people due to the number of young people using it in Cambodia, especially during Covid-19 as they remain at home and engaged in e-learning. Our Facebook page has more than 94,000 followers, 29% (27,000) of whom are women under 24. During the reporting period, our content achieved an 11,506,102 reach (the number of times people have seen the content) with 346,253 engagements (reactions, comments, and shares).
Our content is designed to raise awareness on SRH topics, empower people to make choices over their body, while remaining as inclusive and sensitive to everyone, ensuring members of marginalized groups feel seen and able to access SRH services. Content topics included consent, teenage pregnancy, menstruation, masturbation, vaginal discharge, SRH services available for LGBTIQ+ people, and Pride Month celebrations.We make sure that our content is representative by including images of same-sex couples, wheelchair users, and people with disabilities. For Women’s Day celebration, we produced a video telling the inspiring story of a blind woman who owns a massage therapy centre. The video has been viewed over 15,000 times.
In June 2021, we arranged an online quiz on Facebook, asking people to share their experience using FP. We received 63 comments from people talking about which FP they’re using along with their personal anecdotes. Many of them said they’re using an IUD or implant, mostly because it’s convenient, effective for along time, and it helps ease their concern over unintended pregnancy.
Below are some examples.
“My contraception experience is "implant" because it's a great method to prevent pregnancy and it's effective for 3-5 years. There are a few side effects, but you feel relieved without worrying about unintended pregnancy.”
“My experience in using contraception is long-term method, IUD because it doesn't have any harmful health effects and it helps regulate my period(There are a few side effects such as light or heavy period.) There are other methods that are good, but you have to consult with a provider before deciding.”
Let's Talk About It Online Sessions
Staring from April, we have started an online series called “Let’s Talk About It”, a monthly webinar live streamed on Facebook featuring a MSIC provider discussing different SRH topics. Three webinars have been conducted covering the topics of menstruation, vaginal discharge and cervical cancer, and modern contraception. They were conducted on Zoom while also live streamed on Facebook. A total of 376participants registered for the webinars through our partner NGOs: Happy Chandara (Toutes à l’école Luxembourg), Enfants D’Asie and AusCam Freedom Project. All three webinars have been viewed 3,758 times on Facebook.
Tes Vechny, clinic Senior Midwife, was the guest speaker for the webinar on modern contraception. During the session, Vechny discussed the different types of contraceptive methods as well as dispelling any misconceptions that people might have, which is one of the biggest barriers to women accessing contraception. 109 people registered for the session. They asked questions such as, “Can you lift heavyweights if you’re using an implant?”, “Which method is the best contraceptive method?”, “Does using a contraceptive method for too long cause infertility?” and “Can breastfeeding women use a contraceptive method?”
We had two rounds of quizzes at the end of the session. The participants had to answer 10 questions and the people with the highest score won a MSIC branded water bottle. In the first attempt, 54 participants joined the quiz, earning a total response accuracy of 67% with one of the questions that stumped them the most being “How long are implants effective for?”. In the second round, 47 participants took part, earning 80% accuracy.
The students and participants from NGO partners were very active and engaged during the webinars, asking many questions about the topics, especially the topics of menstruation and vaginal discharge.
The directors from Enfants d'Asie said the students were very happy with the training and they learned many things, especially during the menstruation session. They outlined that their students had learned how to take care of their body and reproductive health better after the sessions, as well as saying that after Covid-19 is no longer a concern, we should conduct offline sessions at their schools so that the students will be able to learn even more.
For Menstrual Hygiene Day, AusCam Freedom Project invited MSIC as a guest speaker on their virtual discussion, focusing on the topic of menstruation. The discussion was live streamed on Facebook, joined by their students and the public. The live video has been viewed 1,600 times.
The MSIC Contact centre
The MSIC Contact Centre is the central point where people in Cambodia can access non-judgmental and confidential SRH information and advice. The Contact Centre also refers them to access SRH services atMSIC clinics and MS Ladies. From July 2020 to June 2021, the Contact Centre achieved the following:
25,431 total calls handled, of which 10,894 (43%) were calls from Phnom Penh. 5,867 (25% of the total calls) calls were from young people. 4,512 social media messages received. 8,821 referrals were made to MSIC service delivery points (centres and MS Ladies), of which 2,127 were young people.
Objective 2: Improved access to FP/SRH services for vulnerable youth in Phnom Penh, Cambodia.
In addition to raising awareness on SRH, MSIC also ensures young people have access to SRH services through our clinics and MSLs.
In November 2020, MSIC opened a new clinic located in Sen Sok, a district of Phnom Penh. The new clinic focused on reaching young, unmarried Cambodians with SRH services. The centre also aims to support MSIC to achieve financial sustainability across the centre network by enabling MSIC to cover the cost of service provision by generating income. During the reporting period, our two clinics located in Phnom Penh reached: 12,821 clients with SRH services, of which 905 were long-term family planning methods 6,086 services were accessed by young people
As part of the partnerships with NGOs mentioned above, MSIC provided access to quality and affordable SRH services through special discounts for students (young people) and staff associated with our partner NGOs. In addition, we provided mobile services to our partners, to make our services even more accessible. During the reporting period, 100 young women accessed SRH services in our clinics through the service discount initiative and through mobile service provision, where MSIC providers visited NGO facilities / offices to provide services. The services included gynaecological consultations, menstrual hygiene guidance, STI testing and HPV vaccination provision. However, in 2021, mobile service provision was cancelled due to theCovid-19 pandemic and related government restrictions.
Challenges and lessons learned
The most significant challenge during the reporting period was responding to the Covid-19 context and in particular, the lockdowns in Phnom Penh and Kandal. During the lockdown, most people were not allowed to leave their homes, and businesses, aside from essential businesses, had to close. We were fortunate enough to remain open, but many of our clients could not travel to MSIC clinics to access services. Not only did this decrease the number of services we provided, but it also meant more people had to risk unintended pregnancy or delay getting treatment for their SRH problems.
However, our providers were highly committed to continue serving clients as they understood how important it is for women to access SRH services. We have also learned to shift our marketing activities from offline to online, facilitating webinars and different virtual discussions so that the conversation surrounding SRHR continues, despite Covid-19. However, we were not able to conduct other sessions with our partners like VCAT because of their availability. Most partners were occupied with responding to the basic needs of their students and families during Covid-19.Through our partnership with three NGOs, we continued to engage with their students and referred them to our clinics should they need SRH services.
The curriculum for SRH adolescent training has been developed but will need to be further reviewed. This has been delayed but will be finalized by the end of August. Although we implemented limited face-to-face interactions, technology has enabled us to continue engaging with young people via video webinars. With online sessions, we can reach more participants at one time and reach clients anywhere in the country. This allows us to reach more people. It also provides a sense of anonymity for participants if they have any questions, they feel too shy to ask as they can simply turn off their camera and/or write the questions in the chat box.
We are finding ways to adapt to the Covid-19 world, ensuring that our target groups still get comprehensive information about SRH, as well as access to services.
H. C. Rith, implant client from CCA
H. C. Rith is a 22-year-old with two children. She has a small shop at home and her husband works at a publishing house. Before, she was using contraceptive pills, but because she was afraid that she’d forget, she decided to use implants after going to Marie Stopes Clinic Chba Ampov as she heard it would be more convenient. She discussed it with her partner and he didn’t say anything, simply asking if she experienced any pain or discomfort, which she hasn’t. She said, “I think it’s very important that women have access to contraception. Had I not used it, I might get unintended pregnancy”
She heard about Marie Stopes from her in-law. She continued, “The service is good. Before going in, I had to spray alcohol to clean my hands. The waiting time wasn’t too long. The provider explained well and when I had any questions, her response was easy to understand.”
A. Heang, IUD client
A. Heang is a 29-year-old mother with two children. Her husband is a construction worker. She recently got an IUD from a Marie Stopes clinic.
“I decided to use an IUD because I didn’t want to use contraceptive pills. I was afraid I would forget. Plus, I don’t want to become pregnant again. Using an IUD is very convenient, so I opted for that,” she said. “It’s essential for women who don’t want to get pregnant.” “People in my village talk about contraception openly. I learned about Marie Stopes from my sister as she had gone there, too.”
P.K Pisey, implant client
Pisey is a 30-year-old office staff with one child. She went to MSIC clinic in July to get an implant because she didn’t want to have another child yet. She said, “My partner and I are working, and living with my parents, so we’re unable to take care of any more children.” She said she hasn’t experienced any side effects from the implant. Before getting an implant, she told her husband about it, and he agreed.
“It was during Covid and we talked about how difficult it would be. If I had another child, getting into any hospital for a check-up is hard. We’d have to get tested every time,” she said. “I might wait for another year or two.”
“Some pregnant women are infected with Covid-19. That’s incredibly difficult. We can see women getting pregnant this year during Covid-19 and they face many challenges.”
Australian Doctors International (ADI) is an Australian NGO registered with the Australian Charities and Not-for-profits Commission; a member of the Australian Council for International Development (ACFID) and is supported by the Australian Government through the Australian NGO Cooperation Program (ANCP). ADI is governed by a Board and a suite of governance committees (Risk and Compliance, Finance and Audit, Revenue, Program) and people fill these roles on a volunteer basis.
ADI has maintained the delivery of training, clinical services and community education in family planning in rural communities, while also managing and supporting PNG's COVID - 19 responses.
In March 2021, PNG saw a surge in positive COVID-19 cases nationwide, limiting the delivery of some of our activities as originally planned. However, this has also provided opportunities for ADI to direct its focus on investing in PNG’s health workforce further and emphasise the importance of localisation. ADI now has PNG staff dedicated to family planning, maternal health and gender equity in all three provinces where we work – New Ireland, West New Britain and beginning in late 2020, Western Province. With the growing number of staff, ADI has been able to expand our reach in rural areas. ADI remains committed to a multi-pronged approach to improving women’s health and wellbeing, with family planning central across all of our activities.
Currently, ADI is advocating for PNG’s provinces to receive regular and sufficient supplies of COVID-19vaccinations, and will be assisting with the distribution of these vaccines to ensure rural health workers are well-protected and supported, to continue the provision of essential health services in their communities, including in family planning.
Highlights from ADI's family planning work during the 2020 - 21 Financial Year :·
* Family planning services and awareness delivered on 21 outreach health patrols across three provinces, delivering 90 hours of public health education on family planning and sexual reproductive health to 12,000 rural community members.
* In-service training focused on Jadelle implant insertion to rural health workers in New Ireland. * Contributions towards 1680 couple years protection (CYP) through the provision of contraceptive services.
* Expanding family planning work in Western Province - increasing availability of contraceptive counselling and services to rural women in the provinces's North Fly District. ADI will also be delivering training in this province.
* Gender Equity program established in all three provinces.
Outreach health patrols
Providing family planning services and reproductive health education for rural health workers and community members is one of ADI’s core activities. ADI undertakes regular, outreach health patrols in partnership with local health authorities and health providers. During these patrols, activities include providing contraceptive methods alongside counselling, training local health workers, community awareness and distribution of family planning commodities.
During the 20/21 financial year, health professionals and educators providing family planning services and education attended 21 outreach health patrols in all three provinces where ADI is located. In total, patrols visited 60 rural health facilities and 80 communities and villages across three provinces – New Ireland, West New Britain and Western Province.
During these patrols, women and couples received a range of family planning services including contraceptive services and counselling.
In addition, community education sessions to increase awareness and understanding of family planning were also delivered to rural communities. Education sessions are tailored to address key barriers and misunderstandings communities may face, that impact access and acceptance of family planning for rural women. Common issues that are often addressedduringthesecommunityeducationsessionsinclude:
* Understanding birth spacing and its impact on maternal health
* Knowing what contraceptive options are available for rural women in PNG, and dispelling rumours and misunderstandings they may have in regards to contraception (e.g. implants can cause cancer, side effects often misunderstood as sickness caused by contraception, etc.)
* Community wide understanding of reproductive rights, and what it means for women to make their own decisions regarding their health.
In this financial year, approximately 90 hours of education on family planning and sexual and reproductive health were delivered to over 12,000 individuals in rural communities visited on patrol. In addition to this, ADI's Gender Equity Officers also delivered awareness sessions on gender equity. Outreach health patrols also provide opportunities to engage with local health workers, and provide support and training based on their needs and requests. Many rural health workers in PNG work in isolation, with little opportunities for professional development.
A volunteer Doctor, Nursing Officer, Health Extension Officer (HEO) work alongside these local health workers during patrols, offering guidance and support in carrying out family planning services, counselling, implant insertions and removals. This year, 19 rural health workers received clinical, case-based training in family planning during ADI patrols in the health facilities where they worked.
Supporting remote health workers at the place they work is important for consolidation of skills, further training in counselling techniques and practical contraceptive revision. Case-based training reinforces learnings from in-service trainings, and gives health workers the opportunity to practice their history taking and decision-making process, ask questions and get tailored input into their practice. This annual follow-up is an integral part of ADI’s capacity building approach.
In July 2020, ADI also expanded our family planning work in Western Province with the commencement of new staff member, Ruth Biendwore. With over 25 years of clinical experience working for organisations including Catholic Health Services, North Fly Health Services, World Vision, Marie Stopes PNG and Port Moresby General Hospital, Ruth’s input in strengthening ADI’s family planning work has already been invaluable. While ADI has been established in Western Province for more than 20 years, this is the first time ADI has had a permanent, PNG clinician dedicated towards providing family planning and maternal health services to rural women in the province. Ruth has strong leadership skills and has fitted into the team very well. She has a passion for promoting women's rights to have information and choice to determine their contraception options.
Case Study: Family planning, sexual and reproductive health education to youth in rural New Ireland
General knowledge on sexual and reproductive health is in high demand in New Ireland’s rural youth population. Due to traditional and religious beliefs, varying literacy levels and reluctance of some rural health workers in delivering in-depth knowledge about this subject, many do not understand family planning in relation to their sexual and reproductive health. As a result, unintended pregnancies and teenage pregnancies are very common in rural areas that ADI visits.
ADI Health Extension Officer (HEO), Mary Silakau, notes that while young people are curious about the topic, they are reluctant to come forward and seek this knowledge. Mary believes that having young people understand their sexual and reproductive health will lead to better understanding and decisions in family planning. Since making this observation, ADI’s patrol team in New Ireland have made a concerted effort to address this gap in knowledge in the youth population. Mary is now looking for other opportunities to increase the understanding of young people on sexual and reproductive health.
On outreach, ADI’s patrol team in New Ireland work with students at both primary and high school level to delivery public health education. Mary has observed that youths are more engaged, opened up more and asked questions when in groups split by gender, so they could ask questions without being embarrassed or ashamed. ADI is working with its clinical staff to produce educational material and visual aids to assist in the delivery of these sessions on sexual and reproductive health and family planning. In doing so, ADI is assisting many young people in rural New Ireland to make informed decisions regarding their health.
In-service training in Jadelle implant insertion
In March 2021, ADI conducted an in-depth training session to four rural health workers in family planning, and Jadelle implant insertion/removals. Training was delivered at Kimadan Health Centre, a large rural health facility serving over 10,000 people in the Namatanai District. This training was delivered by Nursing Officer, Athaliah Bagoi and co-facilitated by Kimadan HC’s Sister in Charge (SIC), Susan Salot. Having previously attended this training in March 2020 and completed the “training of trainers”workshop held by Family Planning NSW, Susan has been accredited as an ADI family planning trainer. Health workers spent two days on theoretical sessions focused on general revision of family planning contraception and counselling. Three days were then dedicated to supervised practical sessions in implants with both insertions and removals taking place at Kimadan Health Centre and Bol Health Centre. In total, 32 clients participated, of which 29 received implants.
Learning outcomes of this training included:
* Increasing knowledge on all forms of contraceptive options available in their province
* Identifying and knowing how to effectively dispel common myths and misinformation that may influence requests for inappropriate implant removal·
* Conducting effective client consultation and counselling, including post-partum insertion·
* Demonstrating safe and effective Jadelle implant insertion and removal, and managing difficult removals and correctly using aseptic technique.
All participants were supervised by trainers and assessed on their skills in Jadelle implant insertions and removals to determine their competency. Additionally, at the conclusion of training all participants stated that they felt "very confident" in Jadelle insertions, and 90% of participants reported the same for removals. All health workers also reported that after the training, they felt better equipped to counsel women on both the advantages and disadvantages of Jadelle implants.
Another round of this training is currently being planned for later this year to a fourth cohort of health workers in New Ireland and for the first time, in West New Britain. Currently, ADI is also working with PNG staff and health workers to improve training content to ensure it is more culturally relevant and aligns with the needs of rural health workers. This is the second in-service training in family planning ADI has facilitated that has been led entirely by PNG health workers. While COVID-19 has restricted travel from Australia, it has provided an opportunity to acknowledge the value and importance of localisation, and prioritising the PNG health workforce with skills to train their fellow colleagues. ADI has focused on building the competence of trainers to nurture and increase in-country training capability. Future family planning trainings will also be delivered by PNG staff, with Sydney staff closely monitoring and providing support and logistical assistance.
Provision of contraceptives and contribution to Couple Years Protection (CYP)
Couple years protection (CYP) refers to the estimated protection provided by contraceptive methods during a one-year period. In the 20/21 financial year, ADI’s outreach health patrols and in-service training contributed towards 1610 CYP.
ADI’s partnership with UNFPA PNG established in May 2020, has allowed for sufficient supply of family planning commodities during this financial year, that has contributed towards the CYP achieved. When possible, ADI has distributed supplies of implants to rural health facilities where there is a family planning-trained health worker. Due to COVID-19 however, consistent and regular supplies of commodities via UNFPA PNG has not been guaranteed for 2021 due to worldwide delays in shipments, as well as the reallocation of funds by the PNG National Department of Health (NDoH). ADI is closely following this situation, as well as exploring all options for continuity of supply.
Gender Equity Program
Gender Equity Officers continue to participate on all outreach patrols. In this financial year, we have expanded our Gender Equity program with dedicated officers delivering education in this area in all three provinces. Improving gender equity is integral to increasing access to appropriate contraception options for women. In addition to patrols in rural areas, ADI’s Gender Equity Officers have also been approached by schools and organisations in urban areas, to deliver awareness to students.
Over 50 hours of education on gender equity, including discussions on reproductive rights, adolescent pregnancy, PNG laws and referral pathways for survivors of gender-based violence and sexual violence have been delivered this financial year. In addition to gender equity education carried out on patrol, ADI has also concluded its Community MobilisationTraining (CMT) program in New Ireland. The CMT program was aimed towards community leaders and key decision makers to initiate and maintain community-wide change on gender issues, women’s involvement and gender equality during a three-day workshop.
Since the start of the CMT workshops in August 2019, ADI has delivered training to 11 different wards in the Namatanai District, training a total of 302 community leaders. Due to the relocation of the facilitator back to her home province in the Highlands, the CMT program in New Ireland is currently on hold. Meanwhile, ADI has been working with Gender Equity Officers in West New Britain and WesternProvince to also assess the information and support needs of community leaders so they can be part of positive improvements in gender equity and women's health.
Challenges faced in FY20/21 and upcoming activities for FY21/22
Since 2020, the impact of COVID-19 has affected all aspects of ADI’s activities in PNG. While we have been able to adapt certain activities to work within national and provincial restrictions and recommendations to continue the delivery of training and clinical services, we have experienced delays at the request of our in-country partners. In March 2021, as PNG saw a surge in positive COVID-19 cases, family planning training in West New Britain was postponed to assist with the province’s need to reallocate staff and resources.
ADI has also been notified that due to national funds being diverted towards PNG’s national COVID-19response, that supplies of family planning commodities have been delayed for 2021, and there is currently a nationwide shortage of contraceptives in rural areas. ADI continues to advocate for continuity of commodity supplies. As well as this, ADI has also observed that other related commodities such as local anaesthetic (lignocaine) and sterile equipment required for some family planning procedures, is also in short supply. ADI has been able to supplement patrol staff with these items (including the provision of a portable autoclave to sterilise equipment in rural areas which is necessary to offer contraceptive options such as implants and IUDs), however, rural health facilities continue to face difficulties in procuring these items through the national system.
ADI is regularly invited to PNG’s national sub-cluster meetings with other key stakeholders, to discuss family planning issues in the country and will continue to advocate for the inclusion of rural health workers and health facilities in national family planning strategies and plans.
In the coming year, ADI looks forward to continuing our work in family planning with your support. Plans for in-service training to rural health workers in New Ireland and West New Britain, are well underway for November 2021.
The emphasis on community education of family planning, gender equity and reproductive rights will continue in 2020/21 to address the various myths, misconceptions and poor practices in villages. By working with community members at various levels, we plan to inform both men and women of the importance of gender equality, family planning and ensuring women are given access to appropriate information and services regarding their sexual and reproductive health in an environment conducive to that decision making.
The inclusion of a family planning officer and gender equity officer will continue to be a priority on our outreach health patrols as they visit remote and rural communities in both New Ireland and West New Britain. For many isolated women, this is one of the few opportunities available for them to access family planning information and services.