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Scaling Up Community–Based Long Acting RH/FP Service through the HEP

1. Project Title:   Scaling Up Community – Based Long Acting RH/FP Service Including Implanon through the Health Extension Program (HEP)
2. Project Donor: The David and Lucile Packard Foundation

3. Project Summary: The Ethiopian Public Health Association has been implementing repositioning RH/FP project since 2006 and entered into the second phase with the generous support of the David and Lucille Packard Foundation in North Wollo and South Wollo of Amhara regional state. EPHA initiated and implemented this collaborative project together with Federal Ministry of Health to strengthen family planning program by improving performance of Health Extension Workers.

As a result of the project,   Health Extension Workers (HEWs) obtained knowledge and gained new hands on skills on family planning service provision especially long acting family planning that is implanon insertion at the health post level which they did not apprehend in the pre-service training.  This was made possible by training 190 HEW, 37 supervisors and 53 RH leaders as well as by developing and distributing 84,000 copies of quarterly newsletters on regular bases. During the training session 1,001 mothers and post training 195 (only three woredas report of six month) mothers received long acting family planning services (implanon) at health post level. 
  The project clearly showed that there is great demand for Long Acting Family Planning (LAFP) services specifically implanon insertion at the community level and that HEWs can effectively meet this need. Provision of LAFP services at health posts increases the number of users and addresses unmet need by reducing transportation, geographical, and knowledge barriers to service. With proper follow up and technical support, HEWs are technically capable of managing Implanon insertion without difficulty, as was demonstrated during the clinical practicum, supportive supervision and follow-up.
The project at Amhara region enhanced the capacity of FP/RH leaders to contribute to the achievement of the Millennium Development Goals (MDGs), especially 4 and 5. The project at Amhara region has also helped EPHA to learn more about the challenges and opportunities available for scaling-up its intervention and maximize the impact of repositioning FP.  
In recognition of EPHA’s experience and knowledge in North and South Wollo zones, the Federal Ministry of Health has requested joint partnership between EPHA and FMOH to expand long acting family planning services including Implanon in the Southern Nations, Nationalities and Peoples Regional State (NSSPRS).  In this regard, EPPHA has prepared a scaling up project for community based service delivery of long acting family planning including Implanon in SNNP Regional State  to be implemented in partnership with the Federal Ministry of Health. This project that is built on the achievements of the past project and informed by the lessons learned 
4. Project Justifications: Long term methods of contraception are rarely practiced in SNNPRS women, as elsewhere in the country. Therefore, strengthening the capacity of Health Extension Workers who are providing family planning services at Health Posts on long term method of contraception is becoming priority issue. 
5. Project Goal: Scale up community based RH/FP service delivery including Implanon in the SNNPRS through the HEP
6. Implementation Location:  13 zones and three special Woredas of Southern Nations Nationalities and Peoples Regional State