Brush Foundation Core Grant Recipient
Strengthening Abortion and PAC Services YFPAC
Over the past year, Pathfinder has been using private unrestricted funds to address unsafe abortion among adolescent women by incorporating youth-friendly postabortion care (YF PAC) into Pathfinder’s ongoing PAC and general reproductive health (RH) programs in Africa. This groundbreaking initiative is being implemented in eight African countries: Angola, Ethiopia, Ghana, Kenya, Mozambique, Nigeria, Tanzania, and Uganda.
The first step in increasing YF PAC services has been to train providers. To do so, Pathfinder developed materials for an 8-day YF PAC training program, which has been used to train more than 65 service providers. In addition, 96 peer educators have been trained to provide information and refer youth to the facilities. A total of 22 facilities have also been assessed, using the Pathfinder-developed assessment tool, with baseline results showing that, on average, existing PAC services were of very poor quality, especially postabortion counseling and family planning, with a lack of skilled providers, lack of outreach services and peer educators, lack of non-medical staff orientation, and inadequate rooms for PAC services. In response, Pathfinder is working with the project facilities to improve infrastructure and develop and implement training plans to address the gaps.
Empowering Individuals to improve their RH and the Health of Others
In all of the countries in which Pathfinder works, the organization aims to make safe and comprehensive FP/RH services available, through training providers, improving facilities, and building the capacity of local NGOs and health facilities. However, in order to effectively increase women’s ability to access those FP/RH services and information, Pathfinder often must also address a variety of cultural barriers. Some of these barriers include lack of investment in girls’ education and the existence of harmful traditional practices (HTPs), such as female genital cutting and gender-based violence (GBV). These barriers reduce women’s decision-making power and have a significant negative impact on girls’ and women’s sexual and reproductive health and rights. In Ethiopia, Pathfinder is combating those practices and behaviors by conducting “community conversation” meetings, which promote community awareness on key RH, HTP, GBV, HIV/AIDS and gender issues in the communities; the meetings are held by local project-trained peer educators, and they have reached millions of individuals in FY08 alone.
Targeting Vulnerable and Underserved Populations
Pathfinder’s programs often serve the neediest members of communities and specifically target disadvantaged and under-served populations. In North Eastern Province (NEP) of Kenya, for instance, Pathfinder has begun working to prevent the spread of HIV among the mostly nomadic ethnic Somali Muslims inhabiting the region. Although the HIV prevalence rate in NEP, at 2.3%, is considerably lower than the national average, unlike in the rest of the country that rate is rising, having increased fourfold in NEP since 2001. Additionally, risk factors such as transient populations, lack of adequate health service infrastructure, and less than 1% of the population utilizing any form of family planning pose increasing cause for concern. In response, Pathfinder has been working in nomadic health clinics to improve equipment, provide staff trainings, and build capacity; conducting community outreach activities to raise awareness of HIV and how it is spread, specifically targeting religious leaders to help promote healthy behaviors; and extending care and support services to those already infected with HIV/AIDS. The project has been gaining acceptance among religious leaders and policymakers, having recently collaborated with the Ministry of Health and Islamic bodies to hold a conference called: “Health and Islam in the Context of NEP.” In doing so, Pathfinder was able to mobilize Islamic medical professionals and scholars as resource persons and 70 Islamic leaders and district Medical Health Officers as participants. The conference, which received local media coverage, addressed HIV/AIDS issues surrounding prevention, stigma, youth, maternal and child health, condom use, and gender.