1. Malawi: Family Planning Program

2. Where we started
Family Planning programme was re-introduced as a vertical program in 1982
1992 CPR 7%
2000 CPR 26%
2006 CPR 38%
1997 Reproductive Health Unit was established & FP became an integrated part of RH services
2000, concept of EHP was adopted
2004, concept of SWAp was adopted and MOU signed with the major development partners
Important characteristic of the situation is the high fertility rate, teenage pregnancy, and a young population. According to the Demographic and Health Survey, Malawian women have, on average, just over six births and 34% of 15 to 19 year olds have begun childbearing. According to the 2008 Preliminary Census 52% of the population is under 18 years old.

3. Demographic data Total Population 13 million Population under 18 52%
Rural population
83%
MMR
807/100,000
Teens bearing children
35%
Total Fertility Rate
6.0
Contraceptive Prevalence Rate
38%
Neonatal Mortality Rate 33
Infant Mortality Rate per 72
Unmet need for FP 28
The population of Malawi is largely rural and 54 percent of its population is younger than 18 years. With a total fertility at 6, it has a CPR of 41% (38% modern contraception and 3% from traditional methods. The unmet need stands at 28% and has a high prevalence of unintended pregnancies (35%).

4. SRH Programme Goal
Improved sexual & reproductive health for all men, women and young people in Malawi, especially the vulnerable and underserved
Malawi’s SRH goal which largely includes family planning is have “improved sexual & reproductive health for all men, women and young people in Malawi, especially the vulnerable and underserved.”
Over the past 15 years contraceptive prevalence among currently married women in Malawi has steadily grown from 13% in 1992 to 41% in The number of users has increased 4-fold—from 210,000 to 880,000. 4

5. O B S T A C L E S Inadequate resources for SWAp POW; Donor Dependence;
Human resources - adequate number of well trained and deployed
Limited access and quality of services
Clients seeking, adopting and consistent use.
Male involvement; Youth services
Inadequate resources for SWAp POW translates into inadequate drug budget at district level; prioritizing procurement of drugs for curative services; inadequate FP activities in district implementation plans.
Minimal Involvement of the private sector
Inconsistent and inadequate supplies 5 5

6. Reproductive Health Policy 2009
Government of the Republic of Malawi
Roadmap for the Acceleration of the reduction of maternal and Neonatal Mortality and Morbidity
Government of the Republic of Malawi
What has worked well: - Political commitment; - Conducive Policies RH activities, including FP, incorporated and costed in the POW - All family planning methods are part of the EHP and provided free of charge in public facilities - Contraceptive Logistics Management Information System has been expanded to the LMIS in support of all commodities required for the delivery of the EHP
National Reproductive Health Strategy 2006 – 2010
Government of the Republic of Malawi
Maputo Plan of Action
Government of the Republic of Malawi
Implementation Plan for Sexual and Reproductive Health 2007 – 2010
Government of the Republic of Malawi
Guidelines for Community Initiatives for Reproductive Health
May 2007
Government of the Republic of Malawi
The policy environment is very conducive and supportive to development and implementation of programmes that seek to improve the quality of sexual and reproductive life of Malawians including family planning. A number of policy documents and guidelines (both local and international) exist to support the development and implementation of programmes 6 6

7. Promising Strategies
Liberalization of policies through reviews and updates
Integration of FP into pre- service training
Introduction of long term methods at community level.
CBD of Orals and condoms using volunteers
Introduction of Emergency Contraception
Community provision of DMPA
CBD program to include DMPA
long-term strategy for reducing maternal disease burden and mortality
FP being repositioned as part of development agenda to achieve targets for both MDGs and MGDS
Increasing partnerships with private sector (Service Level Agreements with CHAM & BLM
Malawi recognises family planning as a long term strategy for reducing maternal disease burden and mortality. Family planning will promote the small family size concept to improve the economic as well as health and social status of its population. As such family planning is being repositioned as a key strategy in achieving the millennium development goals as well as the Malawi Growth and Development Strategy (MGDS). Currently the contraceptive prevalence is at 38% for modern contraception. It is worthy to note that from the late 1980s to mid 1990s, Malawi had significantly registered its rapid growth in contraceptive use through a number of initiatives including, human resource development, facility upgrading and innovations to increase uptake of contraceptives such as community based initiatives and male participation. For example from --- to ---- the CPR jumped from 7 to 14 percent and then moved to from 14 to ( fill in the figures and years. I intend to put this graphically). The guidelines for the provision of contraceptives were liberalised and a youth friendly health service provision concept was adopted and scaled up. Family Planning training was integrated into pre-service curriculum. Emergency contraception was introduced and recently depo provera has been introduced into the community based programmes
Despite all these efforts there is a great need to promote and provide family planning, as shown by the number of potential users of FPAM who are currently not using contraceptives (unmet need - 28 percent ). The statistics also reveal that the country continues to experience a high rate of unintended pregnancy (35%). 7 7

8. What needs to be strengthened
Advocacy at the highest levels –use of RAPID
Engage multiple sectors to prioritize FP
Strengthen community-based distribution programs including DMPA
Implement a sustained, nationwide communication campaign to stimulate demand for FP
Increase private sector-based FP service delivery
Improve FP services for youth
Sustain commitment and support from leaders at national and district levels and donors
Guarantee availability of contraceptive commodities
Overall Resource Envelope for POW

9. Zikomo
Thank you 9 9