Family Planning, Financing and Aid Effectiveness, International Policies

Zambian Family Planning Advocates: “Think Like an Ant, Not An Elephant.”

Amos andYoram
Amos Mwale of Youth vision Zambia and Yoram Siame of Churches Health Association of Zambia strategize together.

“In Zambia, family planning is not part of the nursing school curriculum.”

It seems unbelievable, but our partners from the Planned Parenthood Association of Zambia explain that unless nurses get special post-training, they are not routinely taught how to insert intrauterine devices (IUDs) or contraceptive implants.

DianaPPAZ
Diana Mubanga Macauley of PPAZ speaks up at the advocacy workshop.

PAI is here in Chisamba for a three-day strategy session which brings together Zambian advocates with experts from Tanzania and Uganda to share best practices and strategize around emerging advocacy opportunities.  As I listen, I realize these challenges are just the tip of the iceberg when it comes to meeting the need for contraception. For example, Zambia has roughly half of the skilled health providers the country needs to serve its population. Further, the Zambian government allocated just 17 cents per person for reproductive health in 2013, according to reproductive health budget tracking expert Dr. Moses Muwonge.  Add to that the fact that the Catholic Church—the service provider second only to the government in its reach—does not provide family planning, and the work of Zambian family planning advocacy seems … well … exhausting. Overwhelming even.

But this group of advocates—ranging from policy experts to community advocates to service providers—is not dejected. They are energized and hopeful for the future. I am inspired. I want to know their secret.

“If ants are organized they can kill an elephant,” declares Edford G. Mutuma, Executive Director of Planned Parenthood Association of Zambia (PPAZ). “Our elephant is the unmet need for family planning.” It’s a critical reminder of the importance of coalitions like this one that divide up the work into manageable parts and together move the advocacy agenda forward  to improve women’s lives.

The analogy is especially fitting for this particular strategy session, sponsored by the Opportunity Fund. The Fund is an initiative of Advance Family Planning (AFP) and PAI that provides funding for family planning advocacy to help achieve FP2020 commitments. It uses the AFP SMART advocacy approach, which emphasizes smaller “quick wins” to make large policy goals more targeted and achievable. These quick wins build on each other to create momentum, as well as keep advocates motivated and inspired. Opportunity fund recipients like PPAZ have used the SMART approach to tackle a number of issues, including funding challenges.

ZamGraph
Source: Analysis by Dr. Moses Muwonge, Health Logisitcs Consultant at SAMASHA (click to view larger)

And it is working.

Seventeen cents per person might not seem like much, but compared to neighboring Malawi, Tanzania and Uganda, Zambia is years ahead. That’s in no small part due to the work of civil society organizations. Because of PPAZ’s advocacy, in January, the Zambian government approved its first-ever budget line for reproductive health supplies, allocating $9.3 million for fiscal year 2014. The government has emerged as a family planning champion in the region, and its budget line fulfills Zambia’s FP2020 commitment. These victories now provide the foundation for even more progress.

At the end of the strategy session, advocates emerged with five new objectives. They include:

  • Making sure the Zambian government spends the new budget line.
  • Increasing the 2015 reproductive health supplies allocation by 10 percent.
  • Removing protocols which require young people under the age of 16 years to get parental consent before they can access sexual and reproductive health services.

It’s exciting, and finally, even I get it. Family planning advocacy isn’t about insurmountable obstacles or going it alone. It’s about thinking like an ant, not an elephant.

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