Materials by Country :


From 2010 to 2014, in partnership with the Ministry of Health Directorate for Reproductive Health, local organizations, donors, and global and bilateral projects, RESPOND improved support for and implementation of family planning programs at the national and district levels in Malawi.

Expanding Access to Modern Contraception Using Advocacy to Spur Action: RESPOND’s Experience in Malawi (Project Brief No. 26)
In Malawi, use of modern contraception among married women increased from 28% to 42% between 2004 and 2010, yet the number wanting to use modern methods will continue to increase, as nearly half of all married women and men state that they want no more children. RESPOND provide the government and local partners with technical assistance to advance access to and use of family planning—particularly long-acting reversible contraceptives and permanent methods—to support their ongoing on-the-ground efforts. As the result of a combination of gathering stakeholders, introducing Reality Check tool to advance understanding of the importance of providing family planning, strengthening district planning efforts, improving contraceptive security, inspiring local champions, and preparing providers to offer permanent methods, the country now has multiple tools, models, and approaches with which to expand access to and use of a wide range of family planning methods.
Available in English (PDF, 3.1 MB)

Reality Check Experiences: Use of a Program Planning and Advocacy Tool for Family Planning Initiatives (Project Brief No. 22)
Reality Check is an easy-to-use tool that family planning (FP) programs can use to set realistic FP goals and plan for service expansion to meet them, as well as to generate data for advocacy purposes. Between 2010 and 2014, RESPOND conducted Reality Check activities in Bangladesh, Burkina Faso, Ghana, Kenya, Malawi, Senegal, Tajikistan, and Togo. This brief summarizes outcomes from and experiences in these countries and identifies keys to successful adoption.
Available in English (PDF, 3.2 MB)

The Female Sterilization Standardization Plus Initiative: Building Capacity for Providing Minilaparotomy in Four Countries (Project Brief No. 21)
While a large number of couples in developing countries have an unmet need to limit future births, many of these countries lack easy access to female and male sterilization services. RESPOND undertook an activity to increase service providers’ capacity to deliver high-quality female sterilization services in four countries in Africa. Its objective was to standardize the skills of minilaparotomy trainers in Ethiopia, Ghana, Kenya, and Malawi, who would then conduct cascade trainings with additional providers in their home countries.
Available in English (PDF, 3.4 MB)

Views on Family Planning and Long-Acting and Permanent Methods: Insights from Malawi (Project Brief No. 11)
Despite high levels of contraceptive knowledge in Malawi and a recent climb in the contraceptive prevalence rate, fertility rates remain elevated. As part of a broader study of attitudes about contraception, RESPOND conducted qualitative research among current female users of long-acting and permanent methods, postpartum women not practicing contraception, women who had discontinued method use, married men, and health care providers. Results revealed concerns and misunderstandings about modern contraceptives, particularly about permanent methods. Gender norms were seen as hindrances to contraceptive adoption. Satisfied clients could be deployed to talk about their chosen method, explain their reasons for adopting it, and discuss the advantages they derive from it.
Available in English (PDF, 3.5 MB)

Making Family Planning Accessible, and Affordable: The Experience of Malawi (Project Brief No. 6)
Malawi has made notable strides in the provision of family planning services. In addition to a dramatic increase in the use of modern contraceptive methods overall, Malawi has seen sustained use of injectable contraceptives and of long-acting and permanent methods. This review of Malawi's family planning program provides a better understanding of the factors that underpin its recent successes, by highlighting key achievements, relaying the story behind the program's success, and examining plans for sustaining and building on its recent achievements.
Available in English (PDF, 3.6 MB)

Lessons From the Recent Rise in Use of Female Sterilization in Malawi
Although female sterilization is the most widely used modern contraceptive method in the world, most family planning programs in Africa have had difficulty providing it. Despite daunting constraints, Malawi has made female sterilization widely and equitably accessible, thereby increasing method choice and helping its citizens better meet their reproductive intentions. Ten percent of currently married Malawian women of reproductive age rely on female sterilization for contraceptive protection, compared with less than 2% across Africa, and demand to limit births now exceeds demand to space births. Female sterilization prevalence in Malawi surpasses that of some high-resource countries. Supportive policies, strong public-private partnerships, and mobile services delivered at no cost by dedicated providers all have contributed to this achievement. Malawi's experience offers lessons for other countries with low female sterilization availability and similar resource constraints. Studies in Family Planning, Volume 44, Number 1, March 2013, pages 85-95.
Available online in English

Fragile, Threatened, and Still Urgently Needed: Family Planning Programs in Sub-Saharan Africa
Using the latest evidence about trends in modern contraceptive use, fertility, unmet need, urbanization, and poverty in eight key African countries (Ghana, Kenya, Malawi, Nigeria, Senegal, Tanzania, Uganda, and Zambia), this commentary discusses the ongoing threats to family planning programs from such factors as HIV and AIDS, inadequacy of the health care workforce, health sector reform, and decreased funding. The article underscores the continuing validity of the health, equity, demographic, and development rationales for increased support to organized family planning programs, many of which are experiencing stagnation or falloff in performance, and also summarizes what service approaches and interventions have been found to be most efficacious in increasing access to such services. Studies in Family Planning, Volume 40, Number 2, June 2009, pages 147-154.
Available online in English

Approaches to Mobile Outreach Services for Family Planning: A Descriptive Inquiry in Malawi, Nepal, and Tanzania (Report No. 13)
Mobile outreach services for family planning are widely used in the global South to reach underserved populations, yet documentation on them is sparse. Between 2010 and 2012, The RESPOND Project studied mobile outreach services in Malawi, Nepal, and Tanzania. Observations at 20 facilities and interviews with more than 150 providers, clients, managers, and policymakers led to several key findings: Program managers and staff must ensure quality of care, even under difficult circumstances; attention must be paid to ensuring the availability of contraceptives, equipment, and expendable supplies; supervision is an important component of mobile outreach; mobile services offer opportunities for on-the-job training, coaching, and skills improvement for new staff and for those needing refresher training; and demand creation efforts (particularly by community health workers) are important for reaching underserved populations.
Available in English (PDF, 2.0 MB)

Three Successful Sub-Saharan Africa Family Planning Programs: Lessons for Meeting the MDGs
Ethiopia, Malawi, and Rwanda appear to be moving more rapidly than other Sub-Saharan African countries toward Millennium Development Goal 5B, which calls for universal access to reproductive health, including family planning. How did these three countries make such strides? This report examines the similarities and differences among the countries, including the roles of individual leadership, financing systems, and country-specific geopolitical and demographic issues. The report also presents lessons that other countries can learn from experiences in these countries. It was compiled by USAID/Africa Bureau, USAID/Population and Reproductive Health, Ethiopia Federal Ministry of Health, Malawi Ministry of Health, and Rwanda Ministry of Health. The section on Malawi in this report was prepared by RESPOND Project staff.
Available in English (PDF, 1.3 MB)

Meeting Malawi’s FP 2020 contraceptive prevalence goal: How will we get there?
National Post–FP2020 Summit Meeting, January 23, 2013, Lilongwe, Malawi
Available in English (PDF, 3.5 MB)

Lessons from Malawi’s FP Program about Successful Private Sector Provision of LA/PMs
SHOPS LAPM E-Conference, May 8-10, 2012
Available in English (PDF, 4.0 MB)

Don’t Call Me Fragile: The Remarkable Performance of Malawi’s FP Program and What It Teaches Us
International Conference on Family Planning: Research and Best Practices, November 29–December 2, 2011, Dakar, Senegal
Available in English (PDF, 3.5 MB)

© 2009-2014 EngenderHealth/The RESPOND Project.
COPE, Men As Partners, and MAP are registered trademarks of EngenderHealth. SEED is a trademark of EngenderHealth.
Photo credits: M. Tuschman/EngenderHealth; A. Fiorente/EngenderHealth; C. Svingen/EngenderHealth.

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The RESPOND Project Digital Archive, Version 2.0