Delivering High-Quality DSD Services at Scale in Ethiopia

Current Delivery Service Delivery (DSD) models of care and Family Planning (FP) integration in Ethiopia, addressing unmet FP needs, challenges in measuring FP quality, and providing recommendations. Learn about DSD models for PLHIV, FP methods available, and data reporting structures. Join the workshop in Johannesburg, South Africa on April 26-29, 2022, featuring insights from DSD coordinator Alemtsehay Abebe. Enhance your knowledge on FP integration with ART clinics, unmet FP needs, and data analysis for quality improvement.

• DSD services
• Family Planning integration
• Ethiopia
• HIV
• FP methods

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1. Delivering High-Quality DSD Services at Scale A CQUIN Learning Network Workshop April 26 29, 2022 Johannesburg, South Africa Ethiopia HIV-FP Integration Alemtsehay Abebe DSD coordinator to MOH _ Ethiopia,

2. Outline 1. Overview of current DSD models of care and FP methods in Ethiopia 2. Unmet need for FP in Ethiopia 3. FP Integration data analysis 4. Challenges and Opportunities in measuring quality of FP in DSD services 5. Recommendations Delivering High-Quality DSD Services at Scale, April 26-29, 2022

3. DSD Models of Care for PLHIV in Ethiopia DSD implementation in Ethiopia (2017-2022) R.no TYPE OF MODELS Less Intensive Models 6MMD (Appointment Spacing) 1. 2. 3. 3MMD Fast Track ART Refill(FTAR) 4. HEP managed_ CAG 5. Peer led community ART distribution (PCAD) More intensive model 1. Conventional care 2. Other More-Intensive Models 2.1. DSD for KP(FSW) 2.2. DSD for Adolescent 2.3. DSD for AHD (in Progress) DSD For MCH through integration Delivering High-Quality DSD Services at Scale, April 26-29, 2022 3

4. Background 91% ART coverage for HIV pregnant women 61% Infant prophylaxis coverage 67% EID coverage at 2 months Source *EDHS 2016, **HMIS/DHIS 2019/2020, + Need for FP appears to be greater for HIV-positive women compared to the general population The CQUIN Project meeting on MCH, May 2021

5. Family Planning methods available in Ethiopia FP methods provided within ART clinics Yes No FP method # # facilities % % facilities Male condom 33 100.0% 0 0.0% 27/33 (82%) ART units provide short-term methods Oral Pills 27 81.8% 6 18.2% Injectable 27 81.8% 6 18.2% Emergency pill 10 30.3% 23 69.7% Implant IUCD 3 1 9.1% 3.0% 30 32 90.9% 97.0% but ARTs units rarely provide LARCs

6. Unmet need for FP in Ethiopia Unmet need for FP decreased from 37% in 2000 to 22% in 2016* (EDHS trend) Delivering High-Quality DSD Services at Scale, April 26-29, 2022 6

7. Data recording and Reporting structure Data Source:- For overall FP programming data is captured by standard register at FP clinic. For FP integration with ART is captured at separate register at ART and PMTCT clinic. Reporting Facilities will report to the next level by using standard reporting mechanism(DHIS 2) Delivering High-Quality DSD Services at Scale, April 26-29, 2022 7

8. Family Planning data Family planning on last quarter(April- June, 2021) Treatment current 2021 (June 2021) Number of PLHIV women aged 15-49 reporting the use of any method of modern family planning Federal Ministry Of Health organisationunitname periodname Mia to Sen 2013(Apri- Jun,2021 Period / Data Total(15-49) Federal Ministry Of Health Addis Ababa Regional Health Bureau Afar Regional Health Bureau Amhara Regional Health Bureau Beneshangul Gumuz Regional Health Bureau 224594 Miazia 2013 Ginbot 2013 333,351 336,779 Mia to Sen 2013 Mia to Sen 2013 Mia to Sen 2013 36284 1200 90275 FP Sene 2013(June,2021) coverage=22459 4/336386= 66% 336,386 324,111 323,776 322,950 301,455 298,628 303,400 319,543 328,671 Mia to Sen 2013 2714 Hamle 2013 Nehase 2013 Meskerem 2014 Tikemet 2014 Hidar 2014 Tahesas 2014 Tir 2014 Yekatit 2014 Dire Dawa Regional Health Bureau Mia to Sen 2013 2387 Gambella Regional Health Bureau Mia to Sen 2013 Harari Regional Health Bureau Oromiya Regional Health Bureau 390 838 Mia to Sen 2013 Mia to Sen 2013 72305 Sidama Regional Health Bureau SNNP Regional Health Bureau Somali Regional Health Bureau South Western Ethiopia RHB Tigray Regional Health Bureau Mia to Sen 2013 Mia to Sen 2013 Mia to Sen 2013 Mia to Sen 2013 Mia to Sen 2013 3901 9378 31 4891 8

9. Challenges and Opportunities in measuring quality of FP in DSD services in Ethiopia Coordination and collaboration is weak at all levels Level of integration is not as expected Data resource for generating report is poor Health care workers do not prioritize Family Planning integration service. Demand Creation is not given as expected Delivering High-Quality DSD Services at Scale, April 26-29, 2022 9

10. Recommendations Strengthen the coordination and collaboration at all levels. Strengthen the integration of FP services with ART and PMTCT clinics. Capacity building of HCWs on FP services Improve the data capturing and reporting of clients who us FP services at ART and PMTCT clinics. Delivering High-Quality DSD Services at Scale, April 26-29, 2022 10

11. THANK YOU! Delivering High-Quality DSD Services at Scale, April 26-29, 2022 11