Our CEO, Dana Hovig, has given his support to the letter, saying:

“We are delighted by the clear, impassioned commitment to family planning that Bill Gates has shared in his annual letter. The foundation has long recognised how simple yet empowering family planning is, both to women and their families, and to their communities as a whole.

“In particular, we welcome Melinda’s personal focus on this, which we hope will motivate world leaders to invest in giving women the choice to decide whether and when to have children, and so promote international development.

“As one of the world’s leading providers of sexual and reproductive healthcare, Marie Stopes International knows that family planning is not only life changing but one of the most cost effective health interventions available.

“Marie Stopes International exists to support the 215 million women around the world who want, but cannot access, contraception.”

Read Bill Gates' annual letter on the Bill & Melinda Gates Foundation website.

“We welcome this important new research. It’s imperative that we continue to measure global abortion and unsafe abortion trends, not least so we can monitor where there may be gaps in contraception coverage.

“The research confirms what we know as one of the world’s leading providers of sexual and reproductive healthcare: women in developing countries are disproportionately affected by the consequences of unsafe abortion due to lack of access to contraception and scarce access to safe, legal abortion services, a situation which cannot be allowed to continue.

“The study also highlights an issue that has long concerned us: namely, that in several countries where safe, legal abortion services are available, such as Zambia and South Africa, women are still turning to unsafe providers because of stigma or lack of knowledge about the safe services on offer.

“Unsafe abortion is entirely preventable, yet so many women have one each year, resulting in 47,000 maternal deaths – 13% of all maternal deaths globally. Organisations such as Marie Stopes International must continue to work in partnership with governments, donors, advocates and other service providers to make sure women all over the world are able to make choices around their reproductive health irrespective of where they live.

“We’d also draw attention to the study’s strong evidence that liberal abortion laws often go hand in hand with good access to contraception and low abortion rates, rather than the opposite as some critics would have us believe. The research tells us that whatever the law, women will choose to end their pregnancy if that’s what they want to do, and providing safe and legal services which allow them to do this is imperative in ending the scourge of unsafe abortion.

“As this research notes, global abortion rates have remained fairly stable between 2003 and 2008, after a previous decline. It links this plateau to a lack of access to contraception, and we call on global leaders to recognise the urgency of meeting the needs of the 215 million women globally who want, but cannot access contraception. Family planning is one of the most cost effective health interventions and wherever we work, we see women desperate for these services. We’re pleased that many donors have begun to recognise the need for family planning, but more financial investment is needed.”

The research is available for download from the Guttmacher Institute’s website.

The World Health Organisation recognises misoprostol as a crucial intervention in the prevention and treatment of post-partum haemorrhage, as it can both be given to women in their third trimester to decrease their risk, and immediately after birth if haemorrhage occurs. Registering the drug in as many countries as possible should be a priority, so women across the world can benefit like those in Malawi.

February
New challenges to women’s health in the US
Sexual and reproductive health once more took on a political dimension in the US. Heated debates occurred in the House of Representatives, with Republicans and a small number of Democrats calling for an end to Title X funding for family planning for organisations also providing abortions. Expect to see abortion dominate the headlines throughout the 2012 Presidential election campaign.

March
Women in focus
The 100th International Women’s Day brought an opportunity to think about the 215 million worldwide who want, but cannot access modern contraception so they can choose how many children to have, and when. High maternal mortality and unsafe abortion rates in the developing world mean that many women die as a result of an unplanned pregnancy, a situation which could so easily be rectified were access to contraception improved. Governments and donors must recognise that family planning is one of the most cost effective and most needed health interventions they can support.

April
Morning-after pill controversy
The emergency contraception pill Levonelle was controversially made available free on the NHS through pharmacies in Wales. Marie Stopes International welcomed the move, with spokesperson Dr Paula Franklin saying that: “The decision by the Welsh Government to increase access to emergency contraception is an important step forward in preventing unwanted pregnancies and abortions amongst women in Wales.” In England, emergency contraception is only currently available free on the NHS via GPs and family planning clinics.

May
A wonder drug – the original
We celebrated the 50th anniversary of the oral contraceptive pill, a revolutionary development which gave women the opportunity to control their own fertility for the first time and rung the changes for women in their relationships, families and workplaces. The pill is still the contraceptive method of choice for millions of women; 215 million more desperately want that choice to be made available to them.

June
Impact revealed
Marie Stopes International published its annual Global Impact Report: 7 million couples were using a family planning method provided by the organisation by the end of 2010, and an estimated 4.8 million unintended pregnancies, 1.3 million unsafe abortions and 13,000 maternal deaths will be averted as a result. The cost saving to the health systems of the 40 countries we operate in was £428 million.

July
The biggest challenge
We often open centres in countries new to us. It’s a lot rarer that we open centres in countries that are new full stop. In July the people of South Sudan voted to break away from the north, creating both a new country and a new challenge for sexual and reproductive health organisations. Establishing legislative and judicial systems quite rightly usually take priority in newly formed nation states. But in a country which on its creation became the most dangerous place in the world to give birth, ensuring that women can access to sexual and reproductive health services is crucial.

August
Abortion hits the headlines ...
Abortion took over the British media with high profile debate on counselling. An attempt to amend the Health and Social Care Bill, led by Conservative MP Nadine Dorries, was defeated in a House of Commons vote. The amendment would have meant that leading sexual and reproductive health organisations such as Marie Stopes International and bpas would have been barred from providing counselling. A public and media campaign, and a large majority of MPs voting against the amendment meant that women’s access to independent, non directive and supportive counselling was maintained.

September
... and stays there
The UN published a groundbreaking report stating that access to safe abortion should be considered a human right. The report, by UN Special Rapporteur Anand Grover, was published after extensive research and expert consultation. Some saw it as a signal to the many states where women often turn to unsafe abortion because of a lack of access to legal and safe services.

October
Seven billion and counting
October saw a media storm and flurry of interest in family planning, as the world’s population hit seven billion. The innovative global campaign, led by UNFPA, aimed to build awareness and inspire positive action around the opportunities and challenges of the world at seven billion. This milestone had implications for a range of issues including reproductive health and rights, and hit home particularly hard at a time when donor assistance for family planning stagnated at $400 million per year worldwide, after peaking in 2002 at $700 million.

November
A snip in time might save nine
In more developed countries vasectomies as a long-term, safe and effective family planning method are commonplace. But in November Marie Stopes International performed the very first vasectomy in Burkino Faso. It’s just one more choice we can offer to couples in the country, who come to us and ask for help in controlling the number of children they have.

December
Good news, bad news
World AIDS Day on 1st December saw US Secretary of State Hillary Clinton talking about the ‘AIDS-free generation’ being in sight thanks to new research showing that anti-retroviral drugs can both keep people with the virus alive, and make it less likely that they will transmit it to others. 

At the International Family Planning Conference in Dakar, discussions focussed on the potential of integrating HIV and family planning services in the battle against the virus.

2012
Looking ahead to 2012 we believe it will be another big year in sexual and reproductive health. Marie Stopes International is preparing to help meet this need, with our priorities for the year including advocating for task-sharing to allow mid-level health professionals to offer sexual health services; a focus on youth; seeking to further reap the benefits of technological advances; working with the private sector; and investing in and sharing quality research.

January will also see the second reading of Nadine Dorries’ sex education bill, which calls for compulsory additional sex education focusing on abstinence to be provided in school. We also expect the counselling debate to re-emerge, as the Department of Health’s consultation comes to a conclusion.

We're looking forward to the year ahead and the significant steps we hope to take to reduce the number of women without access to contraception and legal safe abortion services.

Deadline to request documents: 20/02/2012 GMT 10am

Deadline for submission of hard copy bid and samples to Marie Stopes International: 19/03/2012 GMT 10am.  Documents to be sent in hardcopy with a softcopy in the documentation, for example a flash disk or a CD.

The RIPODE team, led by its president, Ed Hadj Zeidy Drame (also vice president of Haut Conseil Islamique, one of the most important Islamic groups in Mali) outlined a model which highlights the benefits of family planning from an Islamic perspective.

Using verses from the Qur’an and the Hadiths, the model highlights the demand by Islam for birth spacing and thus endorses the use of contraception.

For example, in chapter two, verse 233 of the Qur’an, it says “women giving birth should breast feed for two years”, and therefore must space at least two years between her births.

The model will be used by the team in Mali to help dispel the notion that family planning and Islam are incompatible.
 
MSI Mali would like to thank RIPODE for their invaluable contribution to the workshops, as well as the Malian Ministry of Health for their supervision and USAID for their financial support of this model.

99% of our health impact is in developing countries like Mali where in 2010 there were 15,728 women using modern contraception provided by us.

Find out more about our work in Mali

Read about our impact around the world

As part of our quality assurance procedures all generic contraceptive products (pharmaceutical and medical devices) are independently testing in a WHO/SRA accredited laboratory.

Annex 1 - Supplier Questionnaire

Annex 2 - Tech Spec and Price Form

Annex 3 - Bidders Representation Form

Annex 4 - Sample Framework Agreement Template

Annex 5 - Check List

Any queries from suppliers on the tender, must be submitted via email to tracey.brett@mariestopes.org and abdullah.adams@mariestopes.org and copy to orders@mariestopes.org by the 15/01/2012. Emails and hard copy bids must specify the bid reference.

Queries to be submitted by: 15/01/2012
Bid closing date: 27/01/2012

The specification for this bid follows the guidelines of ISO 13485. The contract will be for two years and commence on 01/04/2012 except for Pakistan which will commence as soon as the bid is finalised.

Instructions to bidders

Appendix 1 - Supplier Questionnaire

Appendix 2 - Tech Spec and Price Form

Appendix 3 - Bidders Representation Form

Appendix 5 - Framework Agreement

Please email your bid offer, appendixes and required documentation to tracey.brett@mariestopes.org and abdullah.adams@mariestopes.org.

Please read carefully all instructions and criteria. Please ensure that all relevant information and documentation is provided on time. Failure to do so may result in rejection of your bid.

Queries to be submitted by: 20/01/2012
Bid closing date: 31/01/2012

Two thirds of the Zambian population live in the sparsely populated countryside. In these rural areas women often have to travel over 10km to access their nearest health clinic and on arrival can find that contraceptive supplies have run out.

Our rural outreach model enables us to offer services to some of the most hard to reach and under-served communities so they can make informed choices from a full range of contraceptive methods.

Rural outreach: a provider’s perspective

Mukanga Sindazi leads our mobile outreach team in Zambia’s central province. He and the team work six days a week taking family planning services to communities across the region.

“We use promoters to spread the word about our services. And we visit at regular times so people know when to expect us,” said Sindazi.

Every other Wednesday afternoon, his team visits Waya, a small fishing village, 45 miles from the nearest town. Women travel up to two hours on foot and on bicycles from the surrounding communities to attend.

Breaking barriers to family planning

Each visit opens with a talk from the outreach team where they go through the range of family planning methods available. It’s an opportunity to talk about the benefits and drawbacks of each method and to counter some of the widespread misconceptions women have about family planning.

“One of our biggest challenges is the stories that are going around about family planning methods. I meet women who are worried about having the implant because they’ve heard stories.

“We have to talk to them and tell them about the benefits and drawbacks of various methods. And we show them examples of other family planning users in their community.”

“There are always a lot of questions after group counselling. We bring along props and pictures to help women understand the information we are giving them. And we hand round different methods so that women can touch them and see them for themselves.

“Women who can get to this clinic easily like the injectable – they don’t have to remember to take a pill every day. Those women who have further to travel often choose a longer term method.”
Increasing delivery out of centre

Elizabeth, and Malorie both come regularly to the clinic for the injectable. Elizabeth, who is 18, walks for an hour from her home, with her baby on her back to attend. She used to get the pill from a government clinic, but experienced side-effects and found it difficult to remember to take it – “the injectable is much easier for me.”

“I live close by so it’s convenient” said Malorie, 25, who has five children. Married at 10, she had her first child when she was 13. It was after the birth of her third child that she and her husband decided to think about family planning to space the births of their children. “The injection means I can easily choose when I have another child.”

On a typical outreach visit, the team see up to 60 women like Elizabeth and Malorie. For some women, the team’s visits mean they have a wider choice of family planning methods. For others, they bring access to contraception for the very first time.

Download our ‘Increasing family planning access and choice’ report now

Find out more about our work in Zambia

She has been visiting her local BlueStar clinic for advice about her pregnancy. BlueStar is a social franchise designed to improve access to quality maternal healthcare and family planning through a network of private clinics. 

Elaine used to go to a reproductive health unit run by the government, but after getting to know the BlueStar midwife, Amezena, she wants to use the Blue Star clinic. “I am going to deliver my baby at BlueStar this time because I know Amezena (the midwife) will look after me”.

This local clinic offers a personal service, in a clean, well equipped and welcoming environment close to her home. It offers her the ability to have a safe delivery and in addition Elaine has been able to find out about her contraceptive options for after the birth.

Sadly, 94 women die per 100,000 live births in the Philippines and the country is one of the most off track to meeting the UN’s Millennium Development Goal 5 for maternal health. Some women still give birth at home in the Philippines without healthcare support and Elaine has made this choice so she can reduce the risk of any potential complications.

Amezena Bourbon, joined BlueStar in 2008 and has built up a strong reputation in her area. People come from all over to see her and with the clinic based in converted rooms of her house, Amezena offers a 24 hour service for safe delivery, “after all, a baby won’t wait!”

The BlueStar network seeks to reach the underserved and help increase access to high quality, voluntary family planning, and reproductive healthcare. Prices for services are affordable and clinics have an informal sliding scale of costs to ensure no one is turned away. Amezena explains “It’s negotiable. If people don’t have enough money I give them an IOU. Sometimes people can’t pay at all and I give them free support. It is my job to help”.

An important part of the service for Elaine is the family planning advice and support she can receive at the clinic. She has seven siblings and knows what a struggle it can be to raise and provide for so many children.

Elaine wants to do things differently and has decided she only wants two children. Having concentrated on her first child and her marriage after graduating from high school, she is keen to start working when her second child is old enough.

If she wanted, Elaine could have an IUD for free as part of her maternal health package but after discussing the different types of family planning methods she has chosen the contraceptive injection.

Elaine is excited about the future. She is looking forward to the new addition to her family and the prospect of finding herself a job.

Population Services International Pilipinas Incorporated, Marie Stopes International’s country partner, launched BlueStar in 2008 and now has more than 200 BlueStar midwives working throughout the country. The programme also delivers family planning through 11 clinics and extensive outreach services, 758,470 clients were using contraception provided by the organisation.

Find out more about our work in the Philippines

Download our report, Social Franchising: reaching the underserved

We are committed to tackling the high unmet need for quality family planning and the high HIV prevalence in some of the communities we work in around the world. This year, we have provided 379,748 STI/HIV services.

Much of this work offering essential STI/HIV services has been made possible thanks to the USAID funded Support for International Family Planning Organizations (SIFPO) project.

In Ghana, we have a SIFPO-funded programme working with young migrant women employed as head porters - locally known as Kayayei. These women have little or no access to education and often lack even basic shelter. Many are the victims of sexual exploitation, violence, and human trafficking.

But now we’re helping them access education so they can learn how to avoid HIV/AIDS and other sexually transmitted diseases, as well as having a choice of a range of family planning and reproductive healthcare, for the first time.

Our mobile outreach teams visit the Agbogbloshie, Mallam Atta and Abuja Markets in the capital, Accra, to increase HIV and STI prevention practices and improve knowledge and attitudes resulting in the adoption of safe sex practice amongst Kayayeis.

At the same time, the team is developing structures and referral systems around the Kayayei community to enable the victims of sexual and gender based violence to receive support and services. 

And we’re not working alone. Marie Stopes International Ghana is working closely with the Society for Women Against Aids in Africa (SWAA) to reach the Kayayei communities. And the team is receiving support from the Domestic Violence and Victim Support Unit (DOVVSU) of the Ghana Police Service to help increase access to information and services.

In Accra the Metropolitan Authority is providing space in the markets for the provision of reproductive health services by our mobile outreach team. In the event that there is a need for a safe house, we work with local organisations with experience in preventing gender based violence. And our BlueStar Healthcare Network is also helping by providing services and treatment for the Kayayeis.

By working closely with our partners on the global stage and in local communities, in the public and private sectors, we’re giving women access to education about HIV/AIDS and access to reproductive healthcare in the places where it’s needed most and are helping to strengthen the health systems that are already in place.

Download our Integrating sexual reproductive health and HIV services factsheet to learn more about the range of HIV services we offer globally, how we work with our partners, and how we’re making a real and lasting difference to the lives of women and men in the countries we work in around the world.

World AIDS Day is held on 1st December each year and is an opportunity for people worldwide to unite in the fight against HIV. We are proud to support this important campaign.

Visit the World AIDS Day website

Download our new Integrating sexual reproductive health and HIV services factsheet

Integrated family planning and HIV services make sense.

Heidi Quinn, Technical Advisor for the Strengthening International Family Planning Organizations (SIFPO) project at Marie Stopes International said: “By linking HIV and family planning services we can reduce vulnerability to HIV, reduce sexually transmitted infections, and provide men and women with HIV prevention information and family planning.

“That’s why the partnership between the Alliance and Marie Stopes International is so important.”

The partnership

The partnership was launched in recognition of the fact that the international community needs to accelerate progress on access to integrated family planning, maternal, newborn and child health services and make more effective the global response to the HIV epidemic, if we are to achieve Millennium Development Goals 4, 5 and 6.

A self-assessment tool

Thanks to the USAID-funded SIFPO project, the Alliance has successfully developed and tested a self-assessment checklist in Marie Stopes International’s Zambia and Tanzania country programmes, which can eventually be rolled out across our network.

Divya Bajpai, Senior Advisor on SRH at the Alliance said: “The new tool measures the current level of HIV integration in Marie Stopes International’s and family planning services, and allows staff to develop appropriate actions based on the assessment results.”

The self-assessment tool aims to assess:

•  readiness to integrate services at different levels, including the support office and various delivery points
• type and coverage of HIV services, where these have been integrated already
• quality of integrated services, from the perspective of clients and providers.
  

The tool enables us to better understand how well we’re integrating services, and plan how to increase the coverage and quality of integrated services. It will be used initially to understand the current situation, but can then be repeated to review progress and used as part of an ongoing system for monitoring integration and quality programming.

Pilot results in Zambia and Tanzania

The Alliance has conducted assessment visits to Marie Stopes International’s Zambia and Tanzania programmes. They visited country offices, clinics, mobile outreach teams, members of the community and clients. They also met with representatives of the National AIDS Commission (NAC) and other local partners.
In both countries, the Alliance found good examples of integration, but also a number of ways to continue improving the delivery of HIV interventions.

In Tanzania, the Alliance met Zawadi, one of our nurse midwives who is one of two team members trained to drive a bajaji or motor rickshaw in Zanzibar. The bajaji also serves as a mobile clinic providing family planning information and contraceptives to vulnerable and hard to reach communities on the island.

Divya Bajpai, who conducted the assessment, said: “We discovered that Zawadi is already providing referrals for testing for HIV and other sexually transmitted infections, and for Prevention of Mother to Child Transmission in order to support clients and ensure relevant follow-up within the community.”

“Zawadi identified that she needed more training and support around HIV and AIDS, as well as organisational support in the form of greater monitoring and supervision, and a clear strategy to help her to integrate HIV and SRH services more systematically.”

“We found that Marie Stopes International staff were committed to integration and wanted to do more at country office and clinical level.”

Pilot recommendations

There were a number of recommendations, including:

• ensure clear quality indicators to measure and monitor integration
• provide training in HIV and stigma reduction within various Marie Stopes International delivery channels
• ensure there are regular supplies of HIV test kits and condoms, along with integrated SRH / HIV messaging within Marie Stopes International’s information and education campaign materials
• ensure safer sex counselling, condom demonstrations and dual protection for all family planning clients
• expand the role of community outreach workers to enable them to refer women to health settings.

To find out more about the self-assessment tool being developed for Marie Stopes International country programmes, contact Divya Bajpai or Heidi Quinn. The tool will be finalised in 2012.

For more information about the Alliance’s work on  reproductive health, rights and HIV linkages, download this new Good Practice Guide.

Consultancy objectives

The project commenced on 1st August, 2011 and will be implemented over four years. As part of the project monitoring and evaluation and information gathering to inform project design, MST is intending to conduct a cross sectional population-based survey, sampled from the 12+ regions that will be covered by the SIFPO outreach project in Tanzania mainland and Zanzibar. The study population will be men and women in their reproductive age. This study intends to employ mixed methods including a representative knowledge, attitudes, practices and behaviours (KAPB) survey and qualitative information related to attitudes and behaviours related to use of modern family planning methods in Tanzania.

The tendering process 

Tendering will be conducted through International Competitive Tendering procedures. Interested bidders must confirm their intention to tender indicating all relevant contact information including an email address to tenders@mst.or.tz, Attn: Procurement Manager. Bidders will be responsible for following up to ensure that MST has received the notifications.

Within 72 hours of receiving the bidder’s confirmation of receipt of Invitation to Bid and intention to bid, bid documents in the English language will be sent to interested bidders by email. Bidders will be responsible for confirming receipt of bid documents within 24 hours. MST will not be held responsible for any costs related to printing or preparing of the bid documents.

Bidders must submit the bid documents in a sealed envelope by hand or post to: The Country Director, Marie Stopes Tanzania, Plot no. 421/422 Mwenge, Kijitonyama Area, P.O. Box 7072, Dar es Salaam before 05 PM EAT Wednesday 25th January 2012, marked “Tender No. MST/SIFPO/01/2011-2012 for Consultancy Services to Conduct Population Based-Baseline Survey’’. Not to be Opened Before 05:00 PM EAT Wednesday 25th January, 2012.

Bids will be opened promptly thereafter in public and in the presence of Bidders’ representatives who choose to attend in the opening at the MST Board Room.

About Marie Stopes Tanzania

Marie Stopes Tanzania (MST) is a non-governmental organisation (NGO) that specialises in delivering maternal and child, and sexual and reproductive health (SRH) services and information. MST has been operating in Tanzania since 1989 and currently has 13 centres across the country and provides long term and short term family planning methods to rural communities through mobile outreach services.

Marie Stopes International is honoured to have been invited to deliver 21 presentations, panels and posters at the esteemed International Conference on Family Planning in Dakar, Senegal this week.

Our experts will bring a range of family planning priorities to the fore, delivering: five posters, 13 oral presentations and two panels at the conference, along with a very prestigious slot for our CEO Dana Hovig, who will chair the closing plenary: Securing the Right to Family Planning and its Benefits.

We would like to take the opportunity to thank our global partners for all their support in our preparations for this conference – many of whom have helped enrich our contribution to the event. With support from the UN Foundation, Marie Stopes International is running a session with Pathfinder International to look at how to harness the experience of field implementers for US based advocacy work. With guidance from USAID meanwhile, we have collaborated with Population Services International and EngenderHealth to design two interactive sessions: Implementing Best Practice on Expanding Contraceptive Choice, and Integrating Family Planning in and Beyond the Health Sector.

As well as our official contribution at the conference, we are leading and participating in several auxiliary sessions:

• Dana Hovig, CEO is leading an Emerging Leaders Luncheon Roundtable on Innovative financing mechanisms
• we are showcasing our latest Impact Estimator tool at the conference’s technology café. Impact 2 brings together our two previous models, the REACH Calculator and the Impact Estimator
• we are speaking at Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP),  session about accelerating progress on improving research and translating it into practice
• in addition, our newest country programme, Marie Stopes International Senegal will be hosting several site visits with key donors and stakeholders.

Only the second of its kind, this high level meeting brings together global leaders in service delivery, research, advocacy and policy making to share research and best practice. Our organisation will focus on strategic areas including reaching the underserved, engaging the private sector, task shifting and the importance of data.

The health community has an invaluable opportunity to learn, engage and take action. The 2011 International Conference on Family Planning is sure to be a key milestone for international development and one that Marie Stopes International is proud to be so actively involved in.

Find out about our events at the conference

Read the full conference programme

For Marie Stopes International, the answer is a resounding “yes”. We believe that social franchising is a key element in expanding access to modern contraception to the 215 million women around the world who want to choose how many children to have and when, but aren’t currently able to.

We took part in the First Global Conference on Social Franchising in Mombasa last month. It proved an excellent opportunity to share best practice with our global partners and meet leading thinkers from around the world. Our Head of Social Franchising, Cynthia Eldridge and Social Franchise Managers Senanu Arkutu and Moses Mwaniki have been blogging about the challenges and opportunities that this exciting approach presents. Visit the First Global Social Franchise Conference website to read all the blog posts.

By training healthcare providers we are able to guarantee quality service delivery. These franchisees can be doctors, nurses, midwives, clinical officers or pharmacists. In total, we now have almost 1,500 providers in developing countries across the world, all delivering the same high quality voluntary family planning services to clients.

And we now have social franchise networks in ten countries; some well-established like our seven year old network in Kenya, while others are reaching their first underserved clients through this innovative new model. Our BlueStar network in Uganda is just a few months old, but already has 50 providers offering voluntary family planning and reproductive healthcare services to the community. Thanks to support from USAID and UK aid, that number will soon reach 500.

The benefits of social franchising for clients are clear: improved access to a range of reproductive healthcare services close to their home. For instance, in the Philippines we launched BlueStar in 2008 to increase the accessibility of high quality family planning services. Prices are affordable and clinics have an informal sliding scale of costs to ensure no one is turned away. Clients can choose a full range of voluntary family planning and reproductive healthcare services.

Social franchising also has a positive impact on providers, transforming both their physical clinic and their ability to serve their community by improving the range and quality of services. Franchisee Anna Miranda joined our BlueStar Philippines network two years ago. At the time, she was barely surviving on the earnings she made as the village midwife in a shanty town perched on reclaimed land in the Philippines’ capital city, Manila. Her home – where she saw clients so that she could be on hand around the clock – was basic.

Her home has now been extended into a clean and welcoming BlueStar clinic. And with the training and ongoing support given by Marie Stopes International, Anna says that she is now “changing lives in an area where people really have nothing”. She is offering clients voluntary contraception and counselling, and even organising birthing parties where she gives advice to local mothers-to-be.

Marie Stopes International’s Head of Social Franchising Cynthia Eldridge explains why social franchising is such an important concept for us:

“Because of the sheer scale of unmet need for family planning, social franchising is crucial if we want to accelerate the provision of these services close to the client.”

“In countries where we’ve invested in social franchising, there’s a large existing network of private health providers who people trust with most of their health needs. These private health providers often offer few or no reproductive healthcare services.”

“Training these trusted, local providers to provide quality services to the Marie Stopes International ‘gold standard’, giving them access to high quality contraceptive commodities and monitoring their level of care means that women in hard to reach areas are given choice over their reproductive health, quickly and in a cost effective way. Organising and strengthening the private sector through social franchising allows us to strengthen the national health system and achieve national health impact,” Eldridge concludes.

So far this year our social franchise networks have seen 2.8 million clients and delivered 1.4 million CYPs (couple years of protection), a 162% increase on last year. Their efforts will prevent 406,856 unintended pregnancies, 55,124 unsafe abortions, and 611 maternal deaths as a result of unsafe abortion. 

We’re playing a leading role in using social franchising to expand access to family planning and reproductive health services. So it’s clear to us that social franchising isn’t just something that might increase access to family planning in the future. It’s happening now. 

Visit the First Global Social Franchise Conference website to read our blog posts 

Download our report, Social Franchising: reaching the underserved

Marie Stopes International’s Communications Manager, Media and Public Affairs, Michael Tirrell explains: "This is the fourth year Marie Stopes International has supported the competition, and we do it because it's key to improving awareness, commitment and support for international development. Journalists are able to give a voice to people in developing countries that may otherwise not have a chance to be heard and we are proud to motivate new and existing journalists to bring international development stories to life.”

Fighting off tough competition from over 400 entries, the 16 shortlisted writers visited developing countries in Africa or Asia on assignment for the Guardian. Manini Sheker, who entered as an amateur, travelled to the Philippines with Marie Stopes International to research the role of social franchises in reproductive health. And freelancer Alice Klein travelled to Zambia with us to look at unsafe abortions for the professional category.

The shortlisted pieces are to be published in two Guardian newspaper supplements (published on the 21st and 23rd November). The entire longlist of 40 entrants will have their articles published on The Guardian online.

Renwick Rose was honoured with the International Development Achievement Award for his passion, dedication and contribution to the Windward Islands community in the Caribbean. Affectionately known as the ‘Banana Man’, Renwick Rose formed the Windward Islands National Farmers’ Network Association (WINFA). While the banana trade was spiraling this cooperative of small scale farmers secured Fair Trade Certification and kept their place on supermarket shelves. Earning a premium of a dollar per box of bananas, the WINFA farmers invested back into the community, sustaining and developing the social, educational and trade infrastructure of the islands.

Read Alice Klein's report on how abortion is putting women's lives at risk in Zambia

Read all the professional finalist' stories on The Guardian website

The report by our Innovations and Best Practice team, and produced with support from USAID, details key lessons and emerging practices around how to improve access to our services through outreach. It is designed to help service providers, programme managers and donors implement and strengthen outreach programmes which are offering family planning services.

Globally, we now have outreach programmes in 26 countries providing family planning services and comprehensive counselling at 6,000 sites in places like Ethiopia, Ghana, Papua New Guinea and Bangladesh. These teams typically adopt one of three approaches: the mobile clinical service delivery team approach; the mobile quality improvement team approach; and the mobile community outreach worker approach.  

In Bangladesh, where the mobile quality improvement team approach is used, we have been reaching underserved communities across the country, giving women - including adolescent girls and the homeless - access to family planning services, counselling and awareness raising, for the first time.
 
The team has had success in reaching adolescent girls from poor families by using peer training and theatre to educate them about the consequences of early marriages.

Poorer families often prefer early marriage because of perceived financial and social benefits, but aren’t aware of the risk it poses to their daughters’ health. The risk of maternal mortality is five times higher for mothers aged 10 to 14 years than those aged 20 to 24 years.

Girls like Sharmeen, aged 15, who has been married for four years, are already seeing the benefits of access to family planning services and education. Sharmeen is one of ten children and her parents couldn’t afford to reject the offer of marriage she received at just 11 years old.

By 13, she was living with her husband. By 14, she was pregnant with her first child. Unable to afford the quality maternal health care she needed, her mother suggested she consider an abortion but her husband wouldn’t allow this.

Forced to go through with her pregnancy, Sharmeen experienced complications during labour which left her with psychological scars. But now she can make the right choice for her and her family by accessing the services we now offer her community.

Our Senior Director of Services for Bangladesh, Reena Yasmin, said: “Early marriage is a deeply-rooted problem in Bangladesh, and one that it’s difficult to prevent. However, what we can do is raise awareness of the family planning services available through our centres and outreach teams.”

By working in partnership with the government, and using the latest Demographic and Health Survey data, the outreach team in Bangladesh is leaving a lasting legacy that is helping to strengthen existing public health services and raise awareness of the range of family planning choices available to women.

Reproductive health and family planning services are essential to good health among mothers and their children. These services save lives and empower women. The report shows that outreach programmes have increasing potential to provide quality family planning services in communities where they have not been available before.

The publication of the report was funded by USAID to help share family planning experiences and best practices.

Download our ‘Increasing family planning access and choice’ report now

Learn more about USAID’s Family Planning program

Our team members, midwives Mborika Fall and Fatou Kine Ndoye and driver Kalidou Kane, headed for the slums around Dakar this morning to work in Ministry of Health posts where long-term methods of contraception are not otherwise available.

After only two hours they had already helped 10 women – proof of the huge need for access to voluntary family planning that exists in Senegal.

This is only the first day. Marie Stopes International in Senegal is working with the Ministry of Health and other partners to try and meet the high demand for contraception.

As the team continues to visit different sites across Dakar - soon they will travel even further into rural areas - thousands more women will benefit from having a choice when it comes to their sexual and reproductive health.

And as the outreach services begin their work, the health centre in Dakar has reached a milestone of its own. After opening less than two months ago it has now served its 250th client.

Of the women that have received family planning from the centre, many are choosing longer term options with 43% of the women choosing an implant and 19% opting for an IUD (intrauterine device).

Congratulations to the team in Senegal for reaching two significant milestones and expanding choice for women in their country.

Find out about our family planning impact around the world

It’s 8am and the MSI Zambia team meet at their office in Roma. They’re busy printing leaflets and referral slips for community educators to distribute during the performance. From here, they drive to our mini-clinic in the Mtendere compound where they find the Africa Directions drama group finalising and rehearsing their script. They pick up the actors, musicians, dancers and community educators and move on to Kalikiliki, a nearby compound with limited access to health services and the location for the day’s performance.

Spreading the family planning message

They pull up in the heart of the compound at 10am and it takes the team just moments to set up on a piece of unused land. And then, local celebrity Miyoba Sumaili takes the stage to introduce the performance. Miyoba is the Drama Coordinator at Africa Directions. He also stars in a popular Zambian soap, Banja, and is well known to the audience. His celebrity status, as well as that of his co-star Chilufya Mifumbi, keep the crowd excited and alert to the unfolding drama.

Today, the focus of their performance is unsafe abortion. They’re telling the story of Faith*, a young woman, recently married. Although Faith and her husband decide they don’t want to start a family right away, she becomes pregnant because they aren’t using contraception due to lack of availability. She then turns to a traditional healer in her village who gives her herbs to abort the pregnancy. Faith collapses and is rushed to an MSI Zambia clinic where she is treated for the complications caused by her unsafe abortion. She also receives counselling from the clinic and is given access to a range of family planning services.

Within the crowd are Africa Directions and MSI Zambia peer educators. Their role is to speak to the audience about the performance and answer questions people may have about family planning and safe abortion. Women who are interested in accessing family planning services are given referral slips to our mini-clinic located in the nearby compound, a short walk from the performance. The mini-clinic is open five days a week, and family planning services are available free of charge.

Educating young women in their communities

One peer educator, Kaunda Ngulube, spoke to us about why his work is so important to the community: “We have a lot of women who get in to marriage at a tender age and who are not using contraceptives. So you find that 18-year-old girls are already married with three kids. Most of them are unplanned so we need to be telling people about condom use and contraceptives. Our work would be difficult without theatre. If you come with a drama group people are attracted to us. They come in numbers so it becomes easier for us to talk to them.”

Miyoba agrees: “Here in Zambia, [drama is] the most effective way of communicating with people. People don’t always accept what they hear in a one to one conversation but when they see a performance, they do. You play the drums, they come, you act. It’s easy for them to get information and ask questions straight away. Before we came there were a lot of abortions in the community but since we’ve been coming the numbers have reduced because they are using contraception.”

As with all of the educational performances, Faith’s story is a true one. Every day women across this southern African country turn to unsafe abortion providers because of high rates of unintended pregnancies and the barriers they face accessing safe, legal services. The outcomes are devastating. An estimated 30% of the maternal deaths in Zambia are a result of unsafe abortion.

What’s more shocking is that this is happening in a country with some of the most liberal abortion laws in sub-Saharan Africa. Two key reasons for the high rate of unsafe abortion are limited access to voluntary family planning services and a lack of knowledge about the legal status of abortion. By educating women about family planning methods and the facts around abortion in Zambia, and by getting accurate information in innovative and dynamic ways to these communities, MSI Zambia is reducing the number of Zambian women who, in desperation, risk their lives by turning to unsafe abortion providers.

The services provided by MSI Zambia in 2010 will avert 2,534 unsafe abortions.

View a slideshow from the visit on the Department for International Development (DFID) website

Find out more about our work in Zambia

*Her name has been changed to protect her identity.

In his introduction to the report Dr Babatunde Osotmehin, Executive Director of UNFPA, reaffirmed the importance of reproductive health, saying “governments that are serious about eradicating poverty should also be serious about providing the services, supplies, information that women need to exercise their reproductive rights.”

Yet, many women are still unable to exercise these rights. Globally, some 215 million women want to take the decision to use family planning, but can’t. As one of the largest international family planning organisations in the world, Marie Stopes International remains committed to giving women the choice of a range of quality family planning and reproductive healthcare services.

And as the world population nears 7 billion, Marie Stopes International is partnering with UNFPA for the 7 Billion Actions campaign, raising awareness around reproductive healthcare and the empowerment of women and girls.

To mark the launch, an event was co-hosted in the European Parliament in Strasbourg by the EPWG, the Working Group on Reproductive Health, HIV/AIDS and Development in the European Parliament, to which Marie Stopes International acts as Secretariat. Speakers included Ms Sophie in ‘t Veld MEP, Chair of EPWG, and Sietske Steneker, Director of UNFPA’s Brussels Office.

Read the State of World Population report 2011
Find out more about our family planning impact around the world

The innovative global campaign, led by UNFPA, aims to build awareness and inspire positive action around the opportunities and challenges of a world of 7 billion.

Reaching this population milestone has implications for a range of issues including reproductive health and rights, women and girls empowerment, and young people. And it is an opportunity to renew global commitment for a healthy and sustainable world.

The 7 Billion Actions campaign seeks to achieve two key objectives:

• building global awareness around the opportunities and challenges associated with a world of 7 billion people
• inspiring governments, NGOs, private sector, media, academia and individuals to take actions that will have a socially positive impact.

Samantha Guy, Associate Director, Policy and Partnerships Team at Marie Stopes International, said:

“We are delighted to be taking a leading role in this innovative campaign with our valued partner, UNFPA. Building awareness and inspiring positive impact around the issues of reproductive healthcare and the empowerment of women and girls are objectives that we wholly support.

“By providing high quality SRHR services where they are needed the most, we are making a sustainable impact on the lives of millions of people every year.”

Meanwhile, as the secretariat of the EPWG we will launch, in collaboration with UNFPA, the State of the World Population report at the European Parliament in Strasbourg on the 26th October 2011.

This year’s report sees a focus on Members of the European Parliament who we are seeking to reach by organising the launch to coincide with their plenary meeting. The launch event will be preceded by three days of awareness raising in the Parliament building itself.

The campaign culminates in “7 Billion day” on the 31st October 2011, which will be recognised around the world.

You can see the world’s current population for yourself by viewing the population counter on the 7 Billion Actions campaign website which also features a wide range of news, blogs, personal stories, music and film.

Visit the campaign website to share your story and be counted as one of the 7 Billion

Sister Anne is just one of the public sector health workers we have helped to provide family planning services to the underserved communities of Karamoja in the northeast of Uganda.

In this part of Uganda contraceptive prevalence is very low, family planning service provision has been almost non-existent and ongoing violence and insecurity makes providing services difficult. Many thousands of women in the region have not heard of family planning and face huge cultural barriers to controlling their own fertility.

Building capacity

That’s why we‘re training public health workers like Sister Anne, building the capacity of the public sector to do its work.
 
Sister Anne was excited to receive training in providing long term methods of family planning from Marie Stopes Uganda. She’s the first nurse on her ward to learn how to insert and remove IUDs and contraceptive implants, skills that were largely absent from the national curriculum on which she was trained.
 
Programme Director, Social Marketing, Christine Namayanja, said: “We are proud to contribute to health systems strengthening and make major strides in the achievement of the Government of Uganda’s commitment to accelerate the reduction of maternal mortality.”
 
Today, the manager of the facility identifies Sister Anne as their biggest champion of family planning, both providing services herself and referring women to Marie Stopes Uganda outreach teams when they visit.

Improving access

Marie Stopes Uganda operates two mobile clinical outreach teams, one funded by USAID and another by UNFPA, in the rural areas of Karamoja. And these outreach teams continue to be important as the public sector builds capacity.

Our research shows that many women do wish to space births or stop having children once the choices are explained to them in one of our health education sessions or community dialogues.

In 2010 alone, we served over 200,000 clients in Uganda, mostly in poor, rural areas with little access to family planning. And these services will prevent approximately 870 maternal deaths.

Combining our provision of services with training public health workers means that we are having a lasting and sustainable impact on the lives of the people of Uganda.

Visit the Marie Stopes Uganda website to find out more about our impact

Read more about our UNFPA partnership

Most of our logistics team have worked in the field, so they know what works. They get tweezers made for our tubal ligation kits with a millimetre of extra bend in the tips because women told our clinicians it was more comfortable that way. They find suppliers who make tents with separate rooms, because tents with one big space inside don’t offer enough privacy to clients.

We don’t often talk about how we get all the resources we need to places, but the logistics team is the engine room of Marie Stopes International, so we thought it was time we highlighted how their actions impact our family planning services across the world.

But how can we explain the complex work they do? The best way is to talk you through just one set of goods they delivered.

The amount of resources our centres, outreach teams and social franchisees need to provide quality family planning services day in, day out is astonishing. And if supply is ever threatened by matters beyond our control – whether by red tape or natural disasters befalling production factories – the line of women with unmet contraceptive needs queuing up for our family planning services doesn’t get any smaller.

“Sometimes women are surprised this kind of thing exists,” said Aziza, an Afghan team member who provides advice to women about the range of contraception available then distributes the chosen family planning product door to door. “One woman was so happy to have the pills that she hugged me, ripped open the package and swallowed a pill immediately with a gulp of water,” Aziza recalled. The woman had given birth 17 times, with three dead and 14 living children. Had Aziza had no pills to hand out that day, there might have been more.

Delivering access through innovation and partnerships

We don’t work alone in ensuring our centres are fully stocked: that’s where our partners come in.

Faced with a stock crisis caused by political restrictions three years ago, UNFPA’s help proved vital. With our Ghanaian and Tanzanian centres among others due to run out of contraceptive supplies in just weeks – and knowing that in many of the countries affected we provide a quarter of the contraception – they gave us an astonishing 45,000 IUDs, 103,000 implants, 700,000 injectable contraceptives and 3.3 million packets of the combined pill, all of which our logistics team delivered to underserved populations around the world.

Sometimes the contraceptives got held up along the way (one batch of contraceptive pills was delayed for almost four months waiting for a hard to obtain certificate, a final counter-signature, one last inspection) but the logistics team’s perseverance and expertise got them through customs and delivered them safely to the people who needed them in the end. We continue to deliver UNFPA-donated commodities to this day, along with supplies that we receive from our other valued partners.

Making a sustainable impact around the world

To list some of those who have benefitted from UNFPA’s generosity is to list many of the world’s most underserved countries: Afghanistan, Sierra Leone, Sudan, Uganda and Zimbabwe. In all these countries the unmet need for contraception is high and we work hard to keep up with demand in order to limit the number of unplanned pregnancies and women forced to resort to unsafe abortion.

UNFPA help us to serve those in most need. Their support so far has resulted in a staggering 3.2 million CYPs, which means 943,840 unplanned pregnancies will be averted, which in turn means 127,543 unsafe abortions will not occur, which finally and most importantly means 2,759 maternal deaths will be prevented.

So almost three thousand lives saved, almost three thousand holes in families and communities avoided. Together UNFPA and Marie Stopes International are having a real impact on the reproductive health of women in some of the world’s most underserved communities. We look forward to this continuing.

Find out more about the ways you can support our work

Read our UNFPA partnership spotlight

The programme was officially launched at the new Marie Stopes International Senegal health centre by Ousseynou Ba, of the Ministry of Health, who said “our government is committed to improving maternal health in Senegal; partnerships with NGOs like Marie Stopes International help us to achieve our objectives.”

Maaike van Min, Country Director of Marie Stopes International Senegal added: “We are absolutely delighted to bring the expertise of Marie Stopes International to the people of Senegal. Our friendly and professional team are there to offer high quality, non-judgemental, affordable services which will be available at times convenient for all.”

Providing women with voluntary family planning options

The new health centre in Dakar provides comprehensive family planning options to women that want to plan the number and spacing of their children. They will have the option to choose the method that is best for them from a range which includes short term options such as the contraceptive pill and condoms, and long-term options such as contraceptive implants and intrauterine devices (IUD) that will provide women and couples with years of protection.

This health centre also offers services for pregnant women including vital ante-natal care which can prevent maternal deaths, and STI/HIV tests and general health care for both men and women, young and old.

Outreach teams to reach the underserved

In addition to the health centre, there will be two outreach teams in operation. The first outreach team will be working with the people that live in the slums in Dakar, who often do not go to health centres because they cannot afford to access their services. This team will ensure that the women who live in the slums have the same access to long-acting methods of contraception as everyone else.

The second outreach team will work further afield in rural areas of Senegal, providing long-term family planning options to people who would otherwise have to travel for hours to find a health centre.

In Senegal there are currently 410 maternal deaths per 100,000 live births – 1900 deaths in 2008 alone – caused by child birth or pregnancy related causes, partly due to lack of access to family planning options. The purpose of this new programme is to reduce this number, and to increase the availability of family planning.

Download our Global Impact Report 2010

Or you’re a newly married young woman, living with your husband you barely know and his mother – your new mother-in-law – at their family compound near Dhaka. You go into labour at home but it’s taking too long, way too long. You want to go to hospital but your mother-in-law doesn’t believe hospitals are a good place to give birth – in the market last week she heard about a woman who knew a woman who went to the hospital to have her baby and she died. If her daughter-in-law is going to die, she may as well do it in the comfort of her own home.

Rumour and tradition are barriers to maternal health

So you don’t get to go to hospital and have the reassurance of having a skilled birth attendant overseeing your labour, even though you’re scared and you desperately want to, and you’re begging your husband to take you, but he can’t cross his mother.

According to Sabina Faiz Rashid, a medical anthropologist living and working in Bangladesh, getting women out of the home and into the hospital to give birth is the key to cutting the maternal mortality in the country. She says that tradition, rumour and familial power relations are the main barriers to this happening.

In 2008, an estimated 358,000 women died in pregnancy and childbirth; around 1,000 women each day. Some of the main causes of maternal death are haemorrhage, sepsis (infection), high blood pressure (eclampsia) and obstructed labour. Have any of these happen to you while giving birth at home and the prognosis is usually pretty grim.

Improving access to services is key

Evidence shows that more lives could be saved if women had access to skilled attendance while delivering, and emergency obstetric care on hand in case anything goes wrong. Both of these recommendations are fundamental to achieving MDGs 4 and 5, yet only 58% of all deliveries are attended by skilled health providers, dropping to as low as four percent in some developing countries. In Bangladesh 85% of births are at home, and only 18% of all births are attended by a skilled professional. These disparities in healthcare provision are reflected in maternity mortality statistics: a woman’s lifetime risk of dying during pregnancy, giving birth or shortly afterwards is 1 in 20 in some parts of the world, compared to less than 1 in 5,000 in the US, Canada, UK, Australia and most of Europe.

An innovative voucher scheme is just one way the Marie Stopes Clinic Society improves maternal health in three underserved regions of Bangladesh. Our volunteers identify which women would benefit most from the scheme, then each woman gets a voucher card, entitling them to at least two ante-natal check-ups, one hospital admittance during their pregnancy, a hospital delivery (either normal delivery and caesarean section) and any medicine or treatment they need, and one post-natal check-up. Women are also given vouchers for travel to and from the clinic.

It’s amazing to see how some small pieces of paper can overcome the pernicious double influence of tradition and ill-informed market rumour.

Find our more about our work in Bangladesh

Download our Global Impact Report 2010

“I’ll start using them … but only when I get sick.”

“I’m scared of them … people say they get stuck inside you.”

“If I get sick [contract HIV] I’ll just get cured.”

Almost every young person she quizzed had serious misconceptions about condoms and diseases such as HIV/AIDs. Some knew that not using condoms increased their risk of sexually transmitted infections and unplanned pregnancy; this knowledge just took a poor second place to received wisdom from the street.

More awareness needed

Vickie’s vox pops suggest that these misconceptions often translate into risky sexual behaviour. The World Health Organisation confirms this: only 6% of the 2.6 million-strong female population in Sierra Leone were using modern contraceptive methods in 2008. Only one in ten women aged 15–24 used a condom the last time they had high-risk sex between 2005 and 2009, and one in two men.

Pregnancy rates and HIV incidence amongst young women are correspondingly high in Sierra Leone, a country struggling to recover from civil war and ranked amongst the least developed in the world.

In 2008, 146 women aged 15–24 in every thousand gave birth in Sierra Leone, compared to 41 per thousand in the US. Although HIV is less pervasive in Sierra Leone than the rest of Africa, it’s still a world away from the incidence rates seen in developed countries. UNAIDs estimates that up to 2.5 % of women aged 15–24 in Sierra Leone were living with HIV in 2010, more than twelve times the UK and US prevalence.

Education is key

Vickie thinks that ongoing educational campaigns are a must in Sierra Leone, to make sure every young person has accurate information about contraception, and how it decreases the risk of STIs and unplanned pregnancy.

Sebastien Barraud, Marie Stopes Sierra Leone Country Director agrees: “Accurate information and high quality services are crucial. We provide 44% of all contraception in Sierra Leone, disseminated from 700 distribution points including our 12 centres and eight outreach teams. Our innovations in the country include the introduction of long-term and emergency contraception, and behavioural change campaigns which have significantly increased their uptake.”

In 2009 50% (100,000) of our clients in Sierra Leone were under 25 years old. Hopefully some of the young people Vickie Remoe interviewed will join their number soon.

Find out more about our work in Sierra Leone

Watch Vickie's video on the Make Women Matter website

The track was too narrow to drive down, so Glenda left her car and ran to find a young woman in a house. She was horrified by what she saw. Lying in agony, Nosipho had inserted a wire coat hanger into her cervix in an attempt to terminate her pregnancy.

Nosipho was bleeding heavily so time was precious. Glenda carried the young woman on her back to her car then drove her to hospital, where they found out that Nosipho had got septicaemia (more commonly known as blood poisoning) as a result of her unsafe abortion. Sadly, Nosipho had lost so much blood and the infection was so severe that she died. Nosipho’s other two other children now have to live without a mother.

Glenda explained: “Nosipho was prepared to take this risk with her health so she could finish her education, get a job and be able to look after the children she had already. I don’t want what happened to Nosipho to happen to anyone else.”

Unfortunately, what Glenda saw isn’t unusual. It’s estimated that around 47,000 women die every year because of unsafe abortions – a staggering 13% of all maternal deaths – and more than 245,000 unsafe abortions are estimated to have taken place in South Africa alone. Women all over the world use extreme measures to end their pregnancy either because the law doesn’t allow them to access safe services, or because they don’t know where to turn for help and support. 

Increasing access to voluntary family planning

Marie Stopes International is working to reduce unsafe abortion and its consequences by increasing access to voluntary family planning, safe abortion and post-abortion care around the world. In South Africa, nearly 170,000 women and men trusted Marie Stopes International to provide them with sexual and reproductive health services. As a result of these services more than 40,000 unsafe abortions will be averted, and many fewer families like Nosipho’s will be left to cope with the devastating consequences.

“For me, the most important change is that all women, from all walks of life are given proper access to the sexual and reproductive healthcare they need,” said Glenda.

You can hear the story of Nosipho from Glenda herself by visiting the Make Women Matter website

• Ethiopia’s Federal Ministry of Health
• Engender Health
• Hiwot Ethiopia
• Addis Ababa Women’s Association.

MSI Ethiopia provided more than 135,000 people with family planning in 2010, and those services will prevent 863 maternal deaths and 77,000 unsafe abortions.

With the launch of the Men as Partners programme and a renewed effort to engage Ethiopian men in sexual and reproductive health, MSI Ethiopia hopes to be able to make an even greater positive impact on the lives of Ethiopian women, men and families over the coming years.

Commenting at the launch of the programme, MSI Ethiopia’s Country Director said, “we are on the right direction when we seek for enlightened and educated men who have the right to make decisions based on the right information.”

Read more about our work in Ethiopia on the MSI Ethiopia country programme page

Your bid should be sent clearly marked “Tender for the supply and delivery of Motor Vehicles.” and addressed to the Operations Manager, Marie Stopes International Zambia, Plot No. 18944 Off Katima Mulilo Road, Olympia Park Lusaka, email info@mariestopes.org.zm 

The closing date for the receipt of bids is the 30th of September at 14.30 hours local time and any bid received after the time and date stipulated above will not be accepted.

The deadline for submission of documents is 30th September 2011

Miles away, worlds apart

Just a few miles across the city, Khadeja’s life is very different. She is 28 and lives with her husband, son and mother-in-law.

Khadeja and her husband met in the garment factory where they both work. After marrying they decided to wait for a year before starting a family. Khadeja started taking the pill, which she was able to get every month from a family planning clinic run by Marie Stopes International in the factory where she works. As well as providing voluntary family planning services, the centre’s trained nurses provide counselling to the factory workers about the full range of contraception choices  they have available on site and at low cost.

Khadeja took the pill until she and her husband decided the time was right to have a child. When she returned to work after having her son she spoke with one of Marie Stopes International’s family planning nurses, and decided the pill was the best option for her, and started taking it again.

Because they are able to control the size of their family, Khadeja and her husband have a good quality of life today, and are able to plan for their family’s future. “Without the pill we’d have had lots of children by now and it would have been impossible for my husband to support us. Life’s not so tough when you’ve only got a small number of children. Our family is small but we are happy.”

Striving to do more

Providing voluntary family planning makes a difference. And yet 215 million women in the world currently want to access contraception, but are unable to do so.

Family planning is one of the most cost effective public health interventions. It means that women like Khadeja can make informed choices about the timing and spacing of their pregnancies and the number of children they have. It can help women achieve gender equity, allow them to engage politically, and contribute to economic growth.

We strive to ensure that more women have the choices Khadeja does, irrespective of their education, where they live or what money they have. Choices about whether to use contraception or not, choices about the type of contraception to use, choices about where they get their contraception from.

That’s why in 2010 nearly 1.2 million women in Bangladesh trusted us to provide them with a modern method of contraception. By providing these services in Bangladesh, we estimate that there will be 1,897 fewer maternal deaths and 189,893 fewer unsafe abortions. And around the world, every year 7 million women and men choose to trust us to provide them with family planning. As a result there will be over 4 million fewer unintended pregnancies, many more lives like Khadeja’s and many fewer like Jahanara’s.

Learn more about our family planning impact around the world

The leading causes of maternal and child death in many developing countries are the lack of quality antenatal care and family planning services, increasing rates of HIV infection and the gap in access to life-saving HIV treatment.

Linking HIV and sexual and reproductive health services in order to reduce vulnerability to HIV, sexually transmitted infections and other sexual and reproductive health issues including reduction in maternal mortality, has long been recognised as a highly efficient and cost effective intervention. The International HIV/AIDS Alliance and Marie Stopes International are now leveraging their extensive experience and service delivery platforms to achieve a comprehensive response. The partnership will work to: 

• prevent HIV/AIDS and sexually transmitted infections
• improve the lives of those living with HIV/AIDS, including broadening access to quality, stigma-free family planning and HIV/AIDS treatment
• decrease maternal mortality and reduce unwanted pregnancy.

Michael Holscher, Senior Vice President at Marie Stopes International said: “Through this new partnership between Marie Stopes International and the International HIV/AIDS Alliance, we are working towards a shared vision of a world with good sexual and reproductive health, free from HIV and where every birth is wanted.”

“The partnership will promote and advocate for the sexual and reproductive, and HIV-related needs and rights of all people, and integrate HIV and sexual and reproductive health across the policies, programmes and services of both organisations.”

Integrating HIV and sexual reproductive health

The first phase of the partnership will focus on programmes in Zambia, Uganda and Cambodia.

In Cambodia, Marie Stopes International and Alliance linking organisation KHANA have begun an assessment of the current level of sexual and reproductive health and rights integration in KHANA’s HIV programmes, and how to increase this in the future.

Marie Stopes International has already integrated HIV into its sexual and reproductive health services in many country programmes, including voluntary counselling and testing, activity around the prevention of mother-to-child-transmission, male circumcision and sexually transmitted infection testing and treatment.

But the partnership will ensure comprehensive action across all 40 countries Marie Stopes International operates in. In Zambia and Tanzania, thanks to the USAID-funded SIFPO project, the Alliance successfully tested a self-assessment checklist which will be rolled out to all country programmes so they can measure the level of HIV integration in their sexual and reproductive health services, and develop appropriate actions based on the assessment results.

Alvaro Bermejo, Executive Director of the International HIV/AIDS Alliance said: “This partnership is being launched at a time when the international community recognises that it needs to accelerate progress on access to reproductive, maternal, newborn and child health services and make more effective the global response to the HIV epidemic, if we are to achieve Millennium Development Goals 4, 5 and 6.”

“As an HIV organisation working with communities most at risk of HIV, particularly women in Africa, sex workers and among people who use drugs, we see on a daily basis the need for better access to quality sexual reproductive health and family planning services.” 

“Community action supported by the Alliance has had real impact on improving access to HIV services. Through this new partnership with MSI, we hope to share that experience to improve access to sexual and reproductive health education and services.”

For more information about the Alliance’s work on sexual and reproductive health, rights and HIV linkages, download this new Good Practice Guide.
To read more about Marie Stopes International’s work in countries most affected by HIV/AIDS visit www.mariestopes.org.

Madagascar has one of the highest fertility rates in the world, with women expected to give birth to an average 5.02 children in their lifetime . 

82 percent of women living in Madagascar can't afford family planning

Since the age of 18, Noeline had given birth to nine children, now aged from six months to 21 years.

Like 78 percent of Madagascar’s urban population, Noeline and her family live in a makeshift house in a slum on the edge of the city. They have just two small rooms to live in, one for sleeping with a bed and mat on the floor, and one for cooking.
 
And like 82 percent of women living in Madagascar , Noeline couldn’t afford even the most basic forms of family planning.

At her appointment, Noeline explained that while she loved her children and was thankful they were all healthy, she didn’t want to continue living the way she was.

She felt that part of the problem was lack of access to family planning methods that would allow her to take control of her fertility and prevent any more unplanned births. 

The implant works immediately and can be removed at any time

After listening to Noeline’s story, Nampoina described the family planning methods available to her. Noeline chose a contraceptive implant – a small flexible rod inserted under the skin of the upper arm which slowly releases the hormone progestogen, allowing Noeline to control her fertility by preventing the release of eggs from her ovaries.

The implant is an excellent choice for women in remote areas, because it lasts for three years and requires no further medical intervention once inserted, which reduces the need to visit clinics. The implant works immediately and can be removed at any time, allowing the menstrual cycle to return as normal.

Because she couldn’t afford the full cost of the implant, Noeline purchased a £0.06 / US$0.10 voucher from Nampoina, which she then redeemed at a local BlueStar clinic.

BlueStar clinics are social franchises supported by Marie Stopes International  and because there are three close to where Noeline lives, she was able to choose her preferred doctor, centre and location and get the procedure carried out at a time convenient for her and her family. 

Marie Stopes International aims to provide clients like Noeline – and the 215 million women like her around the world who don’t have access to basic family planning – the information, choice and availability they need to take control of their fertility.

Find out more about our work in Madagascar on our Madagascar website

The eight amateur and eight professional writers were chosen from hundreds of entries by a judging panel comprised of journalists and international development specialists.

In September each finalist will visit a country in Africa or Asia to investigate international development issues first-hand, and write a feature article based on their experience.

The Guardian will publish their work in a series of special supplements in November.

Read amateur entrant Ella Smyth’s analysis of how Peru’s forced sterilization campaign in the 90s has left women distrustful of contraception, with obvious repercussions on the number of unplanned pregnancies in the country.

While professional journalist and fellow finalist Hanna Hindstrom tells the shocking tale of dangerous backstreet abortions carried out in the Philippines, a country with a blanket ban on pregnancy termination.

Director of Strategy and External Affairs at Marie Stopes International, Michael Holscher, said:

"We’re proud to provide this opportunity for a new generation of journalists to learn more about international development.

“The initial entries we received from this year’s journalists – both amateur and professional – were thought-provoking and inspiring.

“The articles they write after their forthcoming country visits will highlight crucial issues that are often underrepresented in the media, and help readers better understand how international development programmes can deliver significant return on investment.”

Visit the Guardian website to see the full list of finalists and read their articles

The Guardian International Development Journalism Competition is sponsored by Barclays and GlaxoSmithKline.

NGO partners in 2011 include Marie Stopes International, CARE International UK, The David Rattray Memorial Trust (UK), Direct Relief International, FHI, International Childcare Trust, Malaria Consortium, Plan UK, and Syngenta Foundation for Sustainable Agriculture.

The deadline for submission of documents is 28th September 2011

The deadline for submission of documents is 18th July 2011

How to nominate
The competition is open to individuals (NOT organisations) of any nationality and from anywhere in the world who, through achievements in work or life, have made an exceptional contribution to efforts to alleviate poverty in the developing world.

After the deadline, 31st July 2011, a highly qualified judging panel will select a shortlist of five finalists. Descriptions of the five finalists will be featured on this site and Guardian readers and site visitors will be invited to vote for the one they think most deserves the award.

The winner will be announced jointly with the winners of The Guardian International Development Journalism Competition 2011 at an awards ceremony in November 2011 in London.

Please go the nomination page on the Guardian website to nominate your choice for the award.

Judging criteria
The Guardian International Development Achievement t Award aims to honour the unsung heroes of international development; those who have gone above and beyond the call of duty to make a positive difference to the lives and livelihoods of some of the world's most marginalised people.

Nominations are welcome for individuals of any nationality and based anywhere in the world, who - through achievements in work or life - have made an exceptional contribution to efforts to alleviate poverty in the developing world.

Nominees for the Award will be evaluated based on the following criteria:

• the extent to which their activities and achievements have had a demonstrable and positive impact on poverty alleviation – either directly or indirectly
• the sustainability of their achievements in terms of longevity, legacy and impact
• the extent to which the nominee's activities and achievements have changed social situations, public attitudes, structures or policies that may be behind the poverty, exclusion or disempowerment of the people affected
• the ways in which the nominee has demonstrated inspirational leadership.

Judges
The five finalists will be selected based on both the relevance of their nomination and their achievements in that category.

The judging panel is made up of professionals who are either working in or have an excellent knowledge of international development issues:

Please note the judges' decision will be final and the organisers will not enter into any discussion or correspondence concerning the results.

Confirmed judges for 2011 include:

Dana Hovig
Marie Stopes International

Jimmy Whitworth
Wellcome Trust

Lawrence Haddad
Institute of Development Studies, Sussex

Caroline Nursey
BBC World Service Trust

Madeleine Bunting
The Guardian

Find out more about how you can support our work around the world

The report demonstrates that as a result of services delivered by Marie Stopes International in 2010 an estimated 4.8 million unintended pregnancies, 13,600 maternal deaths and 1.3 million unsafe abortions will be prevented.  

The report highlights that millions of the world's poorest and most vulnerable women continue to trust Marie Stopes International to provide them with quality family planning and reproductive healthcare. 

Download the Global Impact Report 

We are dedicated to increasing access to a range of family planning options. So we are proud to be able to say that in in 2010 alone, more than seven million couples were using a modern method of contraception as a result of the services we provide across 40 country programmes, and 40% of those family planning clients reported that they had never used family planning before coming to Marie Stopes International.   

Commitment to measuring impact

CEO Dana Hovig hailed the continued commitment to measuring the quality and impact of our services, saying: “Family planning is one of the most cost effective preventative healthcare interventions available.  These results once again demonstrate that we are making an ever greater difference to the lives of our clients, and an increasing contribution to our mission of children by choice, not chance.

“As an organisation, we are continually striving to enable more women to exercise their fundamental reproductive rights.  We are committed to measuring the quality and impact of our services in order to keep improving what we do.”

Innovative service delivery

Mobile clinical outreach programmes, social marketing and social franchising have allowed us to serve even more women than before and these new service delivery routes accounted for 82% of the contraceptives we provided in 2010.

Using the our Impact Estimator, we estimate that the services provided by our country programmes in 2010 will prevent approximately:

• 4.8 million unintended pregnancies
• 13,600 maternal deaths
• 1.3 million unsafe abortions
• 3.1 million disability adjusted life-years (DALYs).

And through reductions in maternal and infacnt morbidity and mortality and unsafe abortion the savings to healthcare systems in the developing world resulting from our 2010 service provision will be approximately £428 million through reductions in maternal and infant morbidity and mortality and unsafe abortion.

Access the Impact Estimator and REACH Calculator

Download the Global Impact Report

With nine international development agencies involved, shortlisted finalists have the opportunity to travel abroad to Africa or Asia and report on the issues firsthand. This year’s supporting charities are Marie Stopes International, CARE International UK, The David Rattray Memorial Trust (UK), Direct Relief International, FHI, International Childcare Trust, Malaria Consortium, Plan UK, Syngenta Foundation for Sustainable Agriculture

Marie Stopes International CEO Dana Hovig said:

“Development is often sidelined by more attention grabbing headlines. This initiative offers an opportunity for journalists to bring international development stories to life and put them on the news agenda. The standard of entries to the competition is always high and we are looking forward to seeing what this year brings”.

We encourage everyone to enter; all you need to do is write a 650-1000 word article on one of the 16 themes offered concerning global poverty.

One of the two themes provided by Marie Stopes International looks at the socio-cultural barriers to family planning. The other considers the impact on unsafe abortions on achieving MDG5 – improving maternal health. 

Click the links below to read the full briefs, and submit your entries online by Monday 13th June 2011.

Theme: The impact of unsafe abortions on MDG 5: Improve maternal health

Theme: Socio-cultural barriers to family planning

In the Tanzanian island’s predominantly Muslim culture, highly conservative attitudes towards modern forms of contraception mean women are often denied family planning advice.

On average, women in Zanzibar will have five children in a lifetime, with contraception rates
as low as 7.4% among married women in some areas.

But the rickshaws are changing this. The two nurses trained to use them
will offer family planning counselling and long term family planning treatment including implants and intrauterine devices at dispensaries, community
centres and in women’s homes.

The goal is to give 40% of women of reproductive age access to family planning advice.

The nurses – Zawadi Mchulila and Jane Mkeleja – can travel as far as 60km from Stonetown, the Zanzibar capital, on the Marie Stopes Tanzania rickshaws, and it is hoped that between them they will deliver more than 880 intrauterine devices (IUDs) and 2,200 implants each year.

In addition sterilisation surgery will be offered to both sexes at the Marie Stopes Tanzania centre in Stonetown.

Justine Coulson, Country Director for Tanzania explained how the rickshaws, which are part-funded by the Marie Stopes International SCALE project, are targeted. She said:

“Marie Stopes International is launching its mobile family planning service to support the government of Zanzibar in its efforts to increase family planning uptake in
those areas where women are struggling to access the service.”

The rickshaws promise to be a cost effective means of spreading family planning advice and treatment - they have low overheads and running costs and could be subsided by the nurses offering separate paid-for treatments.

There are also plans to give businesses the opportunity to sponsor the rickshaws.

At a ceremony in December to launch the rickshaw scheme, guest of honour Hassan Musa Takrima, the Zanzibar West District Commissioner, welcomed the scheme – but he added that it was also important to convince Zanzibari men that modern contraception methods are safe.

Marie Stopes Tanzania will look to expand the programme to other cities in Tanzania at the end of the year if it is deemed a success.

Read more about Marie Stopes International's work in Tanzania

Visit our facebook page for more news

The 16 finalists gathered at the Royal Academy of Art in London to see Natasha Kaplinski announce Libby Powell (amateur category) and Simon Akam (professional category) as the winners of this prestigious journalism award.

Once again, the judges hailed the extremely high quality of writing from all finalists who wrote on a number of international development subjects including maternal health, eye care, disability and malaria. These articles will help to raise awareness with the general public on the need for continued investment in international development and support for the Millennium Development Goals.

The submissions from all 16 finalists have now been made available as two special supplements in the Guardian newspaper and are available to view on the newspapers website . The articles are based on visits that the finalists made to countries in Africa, Asia and South America that had been facilitated by the competition’s supporting NGO consortium of Marie Stopes International, Orbis, Leonard Cheshire Disability, CBM UK, Hives Save Lives, Malaria Consortium , Saferworld and Save the Children .

At the same ceremony, Odette Kayirere was announced as the winner of the International Development Achievement Award. Odette is a founding member of the eastern branch of the Rwandan organisation Avega – the Association of Widows of the Genocide.

For more information on both awards, please visit www.guardian.co.uk/journalismcompetition and read these inspiring stories.

1. Watch, download and share the films
2. Follow the Make Women Matter campaign on Twitter, Facebook, Flickr and YouTube
3. Add Make Women Matter to your website/blog
4. Send a postcard to your friends, MEP or teacher about Make Women Matter so that they can learn about the issues and get involved
5. Add your logo to the message board on our website and show your support

• learn about the countries featured in our five films 
• learn why MDG 5 is so important 
• learn that every year approximately 350,000 women die during pregnancy and
• childbirth, and that almost all of these deaths could be prevented. (The Lancet 2010; 375: 1609–23) 
• learn that we have the power and we have the solutions to meet MDG 5 and save women’s lives – all we need is the support.

www.makewomenmatter.org

• Emily Arnold-Fernandez; founder and director of Asylum Access, an advocacy group for the rights of refugees in South America, Africa and Asia
• Odette Kayirere; founding member of the eastern branch of the Rwandan organisation Avega, the Association of Widows of the Genocide
• Keshwa Nand Tiwari; founding member of Disha Social Organization, a civil society group which has been committed to fighting poverty in the northern Indian states of Uttar Pradesh and Uttaranchal since 1984
• Lynne Patterson; founder of Pro Mujer, a Bolivian women’s development and microfinance organisation
• Kees Waaldijk; a fistula surgeon and public health activist who has worked in Nigeria and Niger for over 24 years.

• added 55 clinics to an existing network of 560 clinics, and hundreds more outreach sites in rural areas and urban slums
• expanded and improved the quality of its BlueStar social franchising network, launched in 2007, to over 1,000 private sector franchisees in Ethiopia, Ghana, Kenya, Malawi, the Philippines, Sierra Leone, Pakistan, Madagascar and Viet Nam
• provided over 1.6 million women or men with long-acting and permanent methods of contraception, a 33% increase on 2008
• delivered over 920,000 safe medical and surgical abortions, a 56% increase on the previous year’s results
• accounted for 20% of all modern method contraceptive use in Malawi, Sierra Leone and Tanzania, and 10% of all use in Kenya, Nepal, the Philippines, Uganda and Yemen.

“Achieving record results in 2009 cannot be an excuse for complacency,” said Hovig. “Quite the contrary, there is so much for all of us to do. We will continue to strive until every one of the 215 million women who want to use modern contraception but cannot access it is able to do so.”

Every year in January and February Marie Stopes International (MSI) sees a rise in the number of women with unplanned pregnancy. National statistics support this with the highest numbers of abortions taking place in the first quarter of the year.

This year MSI is urging everyone to wrap up for Christmas and is providing free condoms through a special text service which is being promoted 'up in lights' on the world famous Piccadilly Circus screens.

Remember condoms are the only method of contraception that can help prevent unplanned pregnancy and sexually transmitted infections.

So if you are partying this year plan ahead, pack a condom and always play safe.

How to get your free Christmas condoms

The campaign runs from 8th December up until Christmas or until stocks last.
To apply for your free condoms, text safesex plus your name and address to 86122.

To an audience of nearly 800 doctors, politicians, pro-choice activists, donors and members of civil society from over 60 countries, the architect of the 1967 Abortion Act said:

“Many argue that the “two doctors” requirement causes undesirable delay, and since 1967 many of our European neighbours have legislated for abortion up to the 12th or 13th week of pregnancy without such a requirement. The [Parliamentary Science and Technology] Committee should address that.”

Lord Steel also appeared to back the Department of Health position on retaining the current 24 week limit for most abortions.

“There needs to be convincing evidence of viability earlier than that to justify a further change – improvements in photographic technique are not themselves sufficient.”

Lord Steel also clarified his position on the number of abortions carried out in Britain today.

“There can be no such thing as a “correct” number of abortions,” he said. “We in Britain have a much lower rate than in the USA where the subject is a bigger and sometimes more violent debate.

“Each individual case has to be considered on its merits, and the best person to judge that is in most cases the pregnant woman herself.”

Lord Steel was speaking at the final plenary session at the conference, which was organised by Marie Stopes International in association with Abortion Rights and Ipas. The conference was convened to mark the 40th anniversary of Lord Steel’s groundbreaking act (27 October, 2007) and also explored abortion as a global public health and rights issue which annual claims 66,000 women’s lives.

This first-ever conference dedicated specifically to the issue of unsafe abortion will seek to build momentum around international efforts to reduce the unacceptable toll unsafe abortion has on women’s lives. Millions of women suffer severe injuries and more than 66,000 die needlessly each year from abortions that are self-induced or procured unsafely from unskilled providers, almost all in developing countries.

Conference speakers include Bert Koenders, the Netherlands’ Minister for Development Cooperation; Prof. Fred Sai of Ghana; Dr Eunice Brookman-Amissah, former health minister of Ghana and Ipas Vice- President for Africa; Jon O'Brien, President of Catholics for a Free Choice; Dr Akinrinola Bankole of the Guttmacher Institute; and Marie O'Riordan, editor of the influential UK Marie Claire magazine.

The Conference, in association with Ipas and Abortion Rights, will take place at the QEII Conference Centre in London between 23-24 October. For more information please visit www.globalsafeabortion.org

Download the pdfs to see the images used on the bikes and vans.

• MSI – Promo Vans
• MSI - Promo Bikes
  

In response to this Marie Stopes International are currently conducting our own survey of young peoples views of sex education through our youth website www.likeitis.org, the results of this will be published here shortly. In the meantime, click here to listen to our radio interviews.

“It’s too soon to say whether the figures we have recorded will be reflected across the country in official national statistics to be published later this year,” said Liz Davies, Director of Marie Stopes International’s UK Operations.

“It does seem, however, that we may be seeing the consequences of the festive season, when partying excess and alcohol consumption combine to increase libido and lower inhibition, with the inevitable consequences of unprotected sex resulting in unplanned pregnancies.”

Press release

As an added incentive if they book before May 1 clients will also be entered into a prize draw to win £100 towards a romantic dinner for two at a restaurant of their choice.

“Vasectomy is a quick and simple procedure already chosen by 13% of British men,” says MSI’s Marketing Manager Julie Douglas. “It’s a very effective method of contraception for couples whose families are complete".

Press release