UNFPA East and Southern Africa Annual Report 2018: Fulfilling the promise


Making pregnancy and delivery safer

Maternal and Perinatal Death Surveillance and Response (MPDSR)�information on how many women died, where, why, and how to prevent similar deaths� is a low-cost, high-impact tool to reduce maternal mortality. MPDSR is crucial for evidence-based planning, financing and delivery of maternal and neonatal health services. With assistance from UNFPA and other UN agencies, all ESA countries have set up MPDSR systems. UNFPA provides technical support to bring MPDSR coverage, reliability, timelines and use to optimal levels.

Well-trained midwives represent the difference between life and death for mothers and babies. UNFPA invested substantial resources to support quality, client-centred midwifery training and practice in 16 countries. Along with WHO, UNFPA assisted countries with adapting evidence-based standard midwifery curricula to better prepare midwives for providing quality integrated Reproductive Maternal, Neonatal, Child and Adolescent Health (RMNCAH) services.

UNFPA effectively supported revival of the continentwide Confederation of African Midwives Association (CONAMA), established in 2013 to advance the midwifery profession and improve access to quality RMNCAH services in the region. UNFPA facilitated strategic discussions and convened a strategic planning meeting that led to the drafting of the five-year CONAMA Strategic Plan, which aims to improve midwifery training, regulation, practice, career progressing and motivation.

UNFPA supported governments to generate the evidence needed to strengthen their health systems, and to inform national strategies and plans for improving emergency obstetric and newborn care (EmONC). In 2018, with support from UNFPA, the skills of 1,079 health workers were improved on EmONC.

Regional Campaign on Early and Unintended Pregnancy (EUP). Our programme Safeguard Young People technically supported a UNESCO-led situational analysis on EUP in Lesotho, Eswatini, Kenya, Malawi, Namibia, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe. The assessment found that EUP is increasing in all 10 countries studied. Factors behind high EUP include poverty, GBV, social norms, child marriage and other harmful cultural practices. While most countries have policies to prevent EUP, implementation of large-scale programmes is scanty.

Improving quality of care and tackling stigma

WHO and UNFPA, under the umbrella of the 2gether 4 SRHR Programme, enhanced the skills of 48 health professionals�including obstetricians and gynaecologists from Botswana, Eswatini, Lesotho, Malawi, Namibia, Uganda, Zambia and Zimbabwe� to improve the quality of post-abortion care and safe abortion in the context of local laws.

In partnership with UNAIDS, UNICEF and WHO, and under the banner of the 2gether 4 SRHR Programme, UNFPA convened two values clarification workshops in 2018�one with UN Country Teams from the countries participating in 2gether 4 SRHR, to sensitize them on how to balance their personal beliefs and values with their professional duties around post-abortion care and safe abortion in the context of national laws, and meeting the SRH needs of key populations. The second was with UNFPA staff on key issues relating to UNFPA’s mandate in relation to working with key populations.

Progress towards eliminating fistula

Despite progress, obstetric fistula continues to disable thousands of women each year, preventing them from participating fully in economic, household and social activities. Most of them suffer in solitude and shame. UNFPA supported countries to accelerate progress towards fistula elimination. With UNFPA’s support, all of the high burden countries in the region developed a fistula elimination road map, and treatment and financial support were provided to 3,326 women and girls living with fistula.

Accelerating innovation for SRHR

In 2018, UNFPA supported 19 social enterprises created under the UNFPA Innovation Accelerator project. One year after inception, 30 per cent of the start-ups were making a profit. They secured investments or contracts totalling $195,000 and won prizes worth $100,000 in total. Funds were secured in Kenya, Rwanda, Tanzania and Uganda to run additional innovation challenges. A revised and expanded model has been designed based on feedback from the beneficiaries.

Source: United Nations Population Fund