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Preventing Maternal Deaths in East and Southern Africa (PreMDESA)

Preventing Maternal Deaths in East and Southern Africa (PreMDESA)

The Preventing Maternal Deaths in East and Southern Africa (PreMDESA) project has two objectives - to achieve universal access to sexual and reproductive health care services, and reduce maternal mortality in the region. In particular, it seeks to provide robust evidence to inform the successful design and implementation of sexual and reproductive health programmes - as well as support formative research in areas of innovation, demographics, and data. Launched in November 2015, the project uses a multifaceted approach that combines investment, evidence, policies, programmes, and advocacy.

Communication Strategies: 

Activities include the following (with those with relevance to media and communication elaborated on further below) :

  • Provision of reproductive health commodities for 10 countries.
  • Capacity building of health providers on new contraceptives in seven countries with critical skills gaps.
  • Roll out of social media applications and platforms to provide interactive sexual and reproductive health (SRH) information to adolescents and young people.
  • Establish a regional Innovation Accelerator and Knowledge Hub on SRH.
  • Set up regional Centres of Excellence on population data.
  • Conduct operational research and documentation to enhance the knowledge base on SRH and maternal health.
  • Develop an evidence-based regional strategy to increase access and demand for SRH services for young people with disabilities.
  • Promote high level consultations on harnessing the demographic dividend.
  • Produce research on human resources and task shifting in the health sector.
  • Conduct a feasibility study on regional supply chain management and pharmaceutical manufacturing plan.
  • Develop and maintain a regional web-based Integrated Management Information Systems.
  • Document and share the lessons learned. 

Gathering evidence for efficient planning:
Under the PreMDESA umbrella, a series of research studies will produce solid evidence on sexual and reproductive health issues in East and Southern Africa. The evidence will inform innovative policy and design of family planning activities in the region and includes the use of the Total Market Approach (TMA). UNFPA is advancing previous work looking at how the public sector, commercial suppliers, and non-governmental organisations can work together to deliver wider reproductive health choices in the region. Whether contraceptives are sold at full market price, distributed for free or subsidised through social marketing, TMA ensures that no one is left behind. Research will seek to better understand the motivations and barriers to modern contraceptive use.

Supporting quality statistics for efficient planning:
Because reliable data is the backbone of sound policies, decision-making, and accountability, PreMDESA strongly supports the production and provision of quality data. Activities include improving national digital data collection and advancing the data revolution to harness the demographic dividend in the region. This is being done through capacity strengthening activities and the use of information and communication technologies (ICT) in data capture to improve cost-effectiveness, accuracy, and timeliness.

PreMDESA is supporting three regional Centres of Excellence (CoE) on population data to be hosted in the national statistics offices of Cape Verde, Senegal, and South Africa. The Centres will serve as virtual and physical knowledge hubs to connect research, expertise, policy and practice, while engaging in South-South partnerships. The Centres will foster efficiency within national statistical systems and build local capacity to find solutions, such as developing apps based on standard census questionnaires. Young statisticians and demographers will be nurtured through training, internships, mentoring, and coaching.

Addressing young people's needs through social media sites: 
Tune Me, an interactive mobile health site for young people, is part of UNFPA’s Safeguard Young People (SYP) Programme operating in 8 southern African countries (see Related Summaries below). Launched in 2014, SYP aims to reach three million youths with sexuality education and services through social media, online platforms, events, music and a mix of communication channels. Through PreMDESA, Tune Me is expanding to Malawi, Botswana, Swaziland, Namibia, Lesotho, and Zimbabwe in association with local content partners. Besides Facebook - the  region’s most efficient channel in terms of reach and cost effectiveness - Tune Me is also expanding its marketing on other digital platforms, such as Opera Mini, BMM, To Go, and Google. PreMDESA will also support the growth in  range and volume of content, and a new feature will help youth find youth-friendly clinics by geo-location, including feedback mechanisms to track quality of care. To reach young people beyond social media, PreMDESA produced four pamphlets on youth-friendly services, human rights, HIV testing, and social media safety.

Innovation Accelerator programme:
To engage with young people, PreMDESA’s launched the Innovation Accelerator programme which provides young media entrepreneurs with mentorship, seed funding, training, and business skills to develop scalable and sustainable solutions to population and socio-economic challenges. Funded by DFID, ESA’s first Innovation Accelerator cycle kicked off in Kenya in June 2016. It was branded as the I.AM campaign and its challenge was to link young people with information and services on sexual and reproductive health.  UNFPA partnered with Nailab, a technology-driven business incubator, with the support of Kenya’s National Council for Population and Development and Ministry of Health. Three boot camps attracted more than 1,500 youths, mostly university students, while social media reached 320,000 people. Among 90 proposals received, nine were selected to pitch to five judges, who chose four winners. Between August and November 2016, each winner received mentorship, business management training, and seed capital of KES 1,000,000 (USD 10,000) to refine the prototype and market strategy. At the end of the training, on ‘Demo Day’, the winners showcased their prototypes to a jury comprised of potential investors and implementers, such as ministries, who selected one or more solutions to be tested through a pilot.  A second Innovation Accelerator programme was launched in Kigali, Rwanda in December 2016 (see video below), and Uganda and Tanzania are to follow.

Research into young people with disabilities:
Young people with disabilities face many barriers in accessing sexual and reproductive needs, information, and services. To mitigate this exclusion, UNFPA is developing a regional strategy for ESA that will expand both their access to and demand for sexual and reproductive health services. In order to inform the regional strategy, UNFPA will conduct research in 2017 which will concentrate on two countries in Southern Africa (Malawi and South Africa), and two in East Africa (Kenya and Uganda). The four case studies will identify best practices, lessons learned, and gaps in the provision of sexual and reproductive health services and commodities to young people with disabilities. The research will also illuminate the complexities, dynamism, and multidimensionality of the full range of disabilities in connection with sexual and reproductive health and rights.

Click here for more information on the project.

Development Issues: 

Maternal Health, Sexual and Reproductive Health

Key Points: 

Rationale for the programme:
Impressive progress in maternal health has been achieved in East and Southern Africa (ESA), but the region still sees far too many deaths and ill health related to pregnancy and childbirth, and far too many people, especially the young, cannot access contraception when needed. The region has the world’s second worst rate of maternal mortality at 455 deaths per 100,000 live births; on average a woman has 4.4 children, and just over one third of married women aged 15-49 use modern contraception.

Partner Text: 

UNFPA and DFID in partnership with governments, institutions, and communities.

Contacts (user reference): 
See video

Email received from Adebayo Fayoyin, UNFPA ESARO on March 10 2017, UNFPA ESARO website and Preventing Maternal Deaths in East and Southern Africa (PreMDESA) report, January 2017 [PDF] on March 14 2017, and email received from Campbell Bright, UNPFA ESARO on March 16 2017.

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