Futures Group has a successful history of implementing many projects in the sexual and reproductive health (RH) arena. Our efforts in this area include

• Working with national stakeholders to strengthen policy environments
• Establishing and strengthening advocacy networks
• Building local capacity to provide better health services
• Developing and applying approaches to youth sexual and reproductive health
• Facilitating constructive male engagement in reproductive health

Strengthening the policy environment and building advocacy networks. Futures Group’s USAID | Health Policy Initiative (HPI) collaborates with a range of political and government leaders, including heads of state and ministry officials, to strengthen commitment for reproductive health. HPI supported a policymaking process in Kenya that culminated in adoption of its first national RH policy. The policy’s framework for equitable and effective delivery of high-quality RH services countrywide—especially to those in greatest need—will guide the planning, implementation, and monitoring and evaluation of RH services provided by various stakeholders.

In West Africa, HPI supplied technical and financial assistance for developing the Contraceptive Security Strategic Plan, which led to adoption of the model RH law and development and approval of texts d’application (directives for implementing RH law provisions). Eight countries in the region have now adopted the model RH law.

Futures Group has also nurtured, established, and strengthened region- and country-specific advocacy networks in many locations. In the Dominican Republic, HPI has been building the capacity of smaller organizations to advocate on women’s health issues so the groups, functioning as a network, can effectively argue for policy change. In 2009, HPI trained 20 community-based organizations in network formation and advocacy during a four-day workshop in Santo Domingo. This led participants to form the National Network for Advocacy in Family Planning and Sexual and Reproductive Health, whose mission is to “promote public policies that guarantee the existence and execution of high-quality programs in family planning and sexual and reproductive health.” The network has engaged in policy dialogue with members of the national House of Representatives, urging them to support constitutional reform that could affect women’s health and reproductive rights.

Improving access to services. To help increase access of the poor to RH services, HPI helped poor, rural women in Guatemala establish the Network for Reproductive Health of Indigenous Women. Thanks to network advocacy, the National Program of Reproductive Health now includes specific interventions for reaching Mayan women. In addition, the Departmental Office of Health in Quiche has issued guidelines on reducing barriers to family planning among indigenous populations, including providing services in the local language.

In Kenya, Futures Group analyzed client satisfaction with public and nonpublic facilities’ RH services. Its findings and recommendations are contributing to development of the National RH Strategy and increasing dialogue between stakeholders and policymakers on the best ways to engage the poor in policy dialogue on access issues.

In India, Futures Group designed and tested a voucher scheme to reduce economic barriers to access, facilitate monitoring of program outputs, ensure access of the poor to high-quality services, and provide incentives for efficient service delivery. Within the first five months, nearly 4,000 poor women redeemed vouchers for antenatal care checkups, about 800 sought treatment for reproductive tract or sexually transmitted infections, and more than 500 women delivered in health facilities.

Focusing on youth. Futures Group’s sexual and reproductive health programs also address the critical youth demographic and improve the related policy environment and access to services. We have developed manuals, tools, and case studies, including NewGen (the adolescent reproductive health “RAPID” model) and the tool Getting to Scale in Young Adult Reproductive Health Programs. We support the online resource Youth-policy.com, which features a searchable database containing 131 full-text policies addressing youth RH from 49 countries.

With assistance from Futures Group’s POLICY Project, civil society organizations formed the Uganda Reproductive Health Advocacy Network, which decided to tackle the lack of youth-friendly RH services, developing a plan to make the issue a government priority. After network advocacy, Uganda approved its first comprehensive National Adolescent Health Policy in 2004. Overall, the POLICY Project accomplished much: producing a youth RH advocacy training manual, recruiting a multitude of youth policy “champions” (3,000 in Egypt alone), and creating a legacy of 10 national and local adolescent/youth RH policies, plans, and programs adopted in seven countries.

In Jamaica, Futures Group’s Youth.now project implemented a comprehensive approach to promoting changes in adolescent sexual and reproductive health knowledge, attitudes, and practices; increasing access to high-quality, youth-friendly services; and fostering a supportive policy environment. Futures Group provided in-depth training to healthcare providers and awarded grant funds to NGOs that focus on vulnerable youth. The project also succeeded in engaging church leadership of various denominations and trained 60 faith leaders to communicate better with adolescents on reproductive health and sexuality. These leaders later trained thousands of others and connected with more than 40,000 youth.

Our work on the Focus on Young Adults (FOCUS) Program aimed to improve the health and well-being of young adults. Futures Group worked to improve both the policy environment for youth RH and use of related data. Of particular focus was delayed exposure to sexual activity and related incidence of sexually transmitted diseases (including HIV/AIDS), and avoidance of high-risk pregnancies. Technical activities included country assessments, policy seminars, advocacy training, coalition building, studies on such issues as willingness of adolescents to pay for services and young people’s service preferences, policy analyses and interventions to remove program barriers, program documentation, surveys, monitoring, and evaluation. We also helped identify global best practices for outreach, social marketing and mass media, and school-based approaches to providing adolescents with RH information and services.

Facilitating constructive male engagement (CME). HPI serves as a vehicle for assisting the USAID Interagency Gender Working Group to implement its training component and supporting Agency efforts to integrate gender across the portfolio of the Office of Population and Reproductive Health. HPI’s training team designed a two-day training-of-trainers module entitled Constructive Male Engagement in Reproductive Health, which was piloted in Mali. Afterward, work began with the Division of Reproductive Health in the National Health Department and a multisectoral cadre of stakeholders to produce constructive CME guidelines supportting the National Reproductive Health Strategic Plan. A key result has been a marked increase in institutional support and collaboration among the government, civil society, donor, and faith-based sectors, thereby initiating dialogue and policy analysis related to CME in reproductive health and gender equity.

HPI’s current efforts in CME stem from earlier Futures Group work under the POLICY Project. In Cambodia, POLICY provided technical assistance to the Cambodian Reproductive Health Promotion Working Group in its advocacy initiative to encourage the Ministry of Health to develop guidelines for male involvement. POLICY coordinated a series of meetings between the working group and senior officials, which led to an MOH request that the working group spearhead drafting of guidelines on male involvement in RH; these came to serve as guiding principles in the Strategic Plan for Reproductive Health in Cambodia (2006-2010). Subsequently, From Adding to the Burden to Sharing the Load: Guidelines for Male Involvement in Reproductive Health in Cambodia, was published to document and share the lessons learned.