The critical burden of the Covid19 pandemic on the health sector has as an immediate consequence, a decrease in the attention paid and the means available to address other diseases. Sexual and Reproductive Health is no exception to this situation. 

How do countries manage to position, promote, and keep Family Planning, and Sexual and Reproductive Health on the health policy agenda in a context where multiple priorities are continuously competing? The implementation of various strategies before and during the crisis by reproductive health actors, including the SRHR Initiative's field teams, is the answer.  

Benin relies on advocacy and communication actions to promote Sexual and Reproductive Health

In Benin, through various advocacy actions with the national health authorities, Sexual and Reproductive Health experts have worked to include Family Planning as a priority in all policy and strategy documents. They participated in developing the budgeted national action plan for Family Planning for 2019-2023 and obtained national commitment through several treaties such as the Ouagadougou Partnership.

In addition, various actions have been carried out in the areas of Information, Education, and Communication. Multisectoral strategies for promoting reproductive and sexual health education have been implemented thanks to the collaboration of the Ministries of Planning, Health, Youth, and Education. Normative family health protocols were also developed and disseminated as well as various communication materials. The country carries awareness raising campaigns and provide contraceptives through the national Family Planning Weeks. Moreover, Family Planning services are provided through outreach services during Child Survival Week allowing the free provision of an integrated package of services, including Family Planning. Contraceptive products are heavily subsidized and available/sold through different channels (pharmacy, health center, community relays, social marketing etc.).

To foster ownership of Family Planning, both among politicians and the population, parliamentarians, civil society members, and community/religious leaders have been involved in its promotion. Civil Society Family Planning promotion projects are being implemented in several regions of the country. 

In terms of monitoring and evaluation, technical committees are established to monitor the implementation of Family Planning interventions. There are regularly monitoring and evaluating strategies through specific coordination meetings, health sector activities and integrated supervision. 

Finally, the capacities of health service providers are also strengthened, and special attention is paid to the sexual health of adolescents and youth.

Burkina-Faso: A strong political commitment to Sexual and Reproductive Health and Family Planning

In Burkina Faso, thanks to actors' combined efforts in Sexual and Reproductive Health Sector, including members of the SRHR Initiative team, Family Planning has been included in the Sexual and Reproductive Health Policies, Standards, and Protocols, which were revised in 2018-2019. The government's commitment to universal access to Family Planning is robust. These services are free of charge in all health facilities nationwide as of July 1, 2020. The country also has a National Plan for Accelerated Family Planning 2017-2020 and National Guidelines for Post-Partum and Post Abortion Family Planning.

Burkina-Faso benefits from a rich experience in Family Planning research appreciation goes to the Ministry of Health partnership, the Institute for Research in Health Sciences, and the World Health Organization. The country places Family Planning within the Essential Services Packages in the context of Humanitarian Emergencies.

Moreover, specific actions are carried out for adolescents and young people, both in strategy development and Information, Education, and Communication actions. Thus, a Strategic Plan for Adolescent and Youth Health 2015-2020, that has been developed at the national level, considers strengthening of reproductive health services for adolescents and youth, including Family Planning. Also, we note the use of interactive platforms such as social media to create demand for Family Planning among adolescent girls/young people and the organization of National Family Planning Campaigns every year during the National Family Planning Week.

The country has established a National Experts Group/Champions trained on national and WHO policies in Sexual and Reproductive Health and Rights including for Post-partum and Post Abortion Family Planning.

Finally, the National Essential Drugs List, revised in 2020, includes medical abortion products to be provided in accordance with the national laws, Family Planning products, counting emergency contraception. The country is implementing the policy of delegating Family Planning tasks and introducing subcutaneously-administered depot medroxyprogesterone acetate (DMPA-SC) for self-injection.

Rwanda: coordination and monitoring-evaluation mechanisms for sexual and reproductive health at the national level

In Rwanda, the SRHR team has been involved in ongoing advocacy efforts and technical guidance to facilitate policy dialogue. The country has developed a Family Planning strategic plan, a costed implementation plan, and monitoring framework with clear deliverables in collaboration with all the key partners.

The SRHR team, as well as the Sexual and Reproductive Health (SRH) actors in Rwanda, have established a coordination mechanism such as a Technical Working Group on Family Planning/Sexual and Reproductive Health as a subgroup of the broader Reproductive Maternal Neonatal Child and Adolescents Health Working Group with clear terms of references led by the Ministry of Health.

Finally, there is a strong commitment from all stakeholders and health authorities, because of the efficient and effective coordination mechanism under the Technical Working Group.

South Africa: WHO Guidance is key for Sexual and Reproductive Health and Rights National Programs

The SRHR team in South Africa, in collaboration with other Sexual and Reproductive Health actors in the country, has participated in the development of various policies and guides. The National Integrated Sexual and Reproductive Health and Rights Policy (2019) that serves with guiding principles, policy framework, counseling and advocacy for Family Planning and Termination of Pregnancy among others, and take WHO and other global evidences into account, has recently been endorsed, along with other clinical implementation guidelines including Comprehensive Contraception and Termination of Pregnancy Act.

The Medical Eligibility Criteria (WHO MEC) for contraception is being widely used by Sexual and Reproductive Health program managers and front-line healthcare providers.

The SRHR team in South Africa, in collaboration with other Sexual and Reproductive Health actors in the country, has continued participation in the regular Technical Working Group meetings virtually despite engagement in national COVID-19. Among the outcomes of these meetings, development of consolidated Sexual and Reproductive Health training package over ten modules including Termination of Pregnancy and Family Planning is ongoing.