Universal Access to Female Condoms (UAFC) | Reproductive Health | Oxfam

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First published by Oxfam Novib in March 2014, this case study focuses on the advocacy component of the Universal Access to Female Condoms (UAFC ) programme, which is aimed at increasing choice and financial and political support for female condoms among donors and implementers. Access to female condoms is far from universal and for a long time there was only one female condom available. Female condoms are also often not included in family planning or HIV programmes. UAFC advocates for more female condoms to enter the international market to give women more choice. The Universal Access to Female Condoms programme has three overall objectives: to ensure available and affordable condoms
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  OXFAM NOVIB CASE STUDY www.oxfamnovib.nl UNIVERSAL ACCESS TO FEMALE CONDOMS (UAFC)  This case study focuses on the advocacy component of the Universal Access to Female Condoms (UAFC ) programme, which is aimed to increase choice and financial and political support for female condoms amongst donors and implementers. Access to female condoms is far from universal and for a long time there was only one female condom available. Female condoms are also often not included in family planning or HIV programmes. UAFC advocates for more female condoms to enter the international market to give women more choice. The Universal Access to Female Condoms programme has three overall objectives: to ensure available and affordable condoms; to create increased demand for and sustained use of female condoms; and to ensure financial and political support from global and local policy makers, donors and implementing organisations. In 2013 the programme was active in Cameroon, Mozambique and Nigeria. In November 2013 UAFC was awarded the public private partnership award, to celebrate successful partnerships between the Dutch government, private sector and non governmental organisations. This Case Study was a background briefing for Oxfam Novib’s 2013 Annual Review, prepared in partnership with Rutgers WPF, i+solution s, the Netherlands’ Ministry of Foreign  Affairs, and describes the programme in Cameroon, Mozambique and Nigeria. Although it is not a formal evaluation it does consider lessons learned by both Oxfam Novib and its partner organisations. These Case Studies are shared in the form in which they were submitted, often written by partners whose first language is not English, and have not been edited since submission. We believe that the meaning is clear enough, and the authenticity of the reporting and the availability of Southern Voices on development makes their inclusion in the Oxfam iLibrary worthwhile for sharing with external readers. Programme Partners: Rutgers WPF, i+solutions, the Netherlands’ Ministry of Foreign Affairs    2  AIM OF THE PROJECT  Access to sexual and reproductive health is a universal right. Globally, there are around 34 million people living with HIV, half of which are women. In addition, there are 200 million women worldwide that would like to use modern contraceptives, but do not have access to this. Furthermore, the majority of women and girls (especially in developing countries) are still unable to negotiate condom use with their partners, while they should be able to freely decide about their own sexuality and the spacing of their children. Female condoms potentially give women a greater sense of control over their sexual and reproductive health and have an enormous potential to address problems of inadequate access to family planning and protection against sexually transmitted infections (STIs), including HIV. However, universal access to female condoms is not a given. They are not or insufficiently included in condom programmes of major institutions such UNFPA and major donors such as USAID. Donors, international organizations and governments in the Global South are hindered by a lack of awareness, knowledge and motivation concerning the potential of female condoms. In addition, many large-scale SRHR implementing organizations still lack the skills and motivation for scaling-up or starting female condom programmes. The UAFC advocacy component directs targeted advocacy messages to convince donors and large institutions that female condoms should be included, procured and programmed so that women and men will have access to a choice of affordable female condoms. CONTEXT This case study will focus on the advocacy component of the UAFC programme, which is aimed to increase choice and financial and political support for female condoms amongst donors and implementers. Access to female condoms is far from universal and for a long time there was only one female condom available, the FC2. Female condoms are also often not included in family planning or HIV programmes. UAFC advocates for more female condoms to enter the international market to give women more choice. More available designs on the international female market will increase competition which will drive down the (procurement price) of female condoms. With more competition manufacturers are stimulated to improve their products. More choice will also lead to more uptake as women have different preferences and would like to use different methods and condom design in the course of their lives. The UAFC programme advocates the need for more choice, procurement, distribution and programming towards a score of large international actors because they have the ability to accelerate progress towards this under-utilized and under-valued commodity.  Advocacy is directed towards main actors that include the UN Secretary General Initiative Every Woman Every Child, bilateral donors, UNFPA, UNAIDS, World Health Organization (WHO), Private Foundations, Governments, large NGOs, social marketing organizations, SRHR implementing organizations and female condom manufacturers. UAFC advocates are present at high level and strategic meetings such as the Women Deliver Conference, UNAIDS Programme Coordination Board Meetings, Reproductive Health Supplies Coalition Annual General Meeting, the Family Planning, Social Marketing and Social Franchise Conference and SOA-HIV-SEKS Conference. Large international institutions and donors have to some extent included female condoms in their policies, programmes and budgets but still a lot of work needs to be done to ensure that female condoms are put side by side to male condoms in procurement so as to increase their availability. Over the years, our work has contributed to the fact that some major institutions and big-time procurers of female condoms such as UNFPA and USAID have become much more open and positive towards female condoms. UAFC has become a reliable neutral partner and has been invited to participate in different working and technical groups to influence global initiatives such as the Family Planning 2020 initiative, and the UN Commission on Life-saving Commodities (UNCoLSC), the latter have included female condoms as an affordable and effective, but under-funded and under-utilized life-saving commodity.  3 UAFC has contributed/ influenced the process leading up to the final list of the life-saving commodities. Since the start of the UAFC programme we have reached out to different stakeholders to become member of the international advocacy platform. UAFC is the secretariat of this platform and keeps members involved with relevant information. Sign-on letters for joint advocacy are sent, for example to the Belinda and Bill Gates Foundation to plead for making funding available for in-country comprehensive female condom programming. Next to the work at the global level, it is equally important to advocate for female condoms at the local level. Inclusion of female condoms in the plans of the local governments is crucial for creating a sustainable environment for female condoms. In the UAFC country programmes of Nigeria, Cameroon and Mozambique, local advocacy organizations have been identified to direct advocacy efforts to local organizations and government institutions to include female condoms in their policies, programmes and budget lines. Next to targeted advocacy, visibility in (social) media is important, UAFC uses twitter and facebook and has reached out to numerous media in the Global South as well as in the Netherlands. ONL got involved in this work as ONL supports women and girls’ rights to autonomy and self determination in the areas of sexuality and reproduction. ONL believes that strengthening individual awareness, knowledge and self esteem can reinforce the agency of women and girls, encouraging and supporting movement building to claim their rights, bringing the issue to national and international agendas. The UAFC programme further supports the work in the field of HIV/AIDS, therefore women and girls will be able to protect themselves against unwanted pregnancies and HIV infections. To really change the international female condom market a comprehensive approach was needed, that is why ONL together with Rutgers WPF, i+solutions as well as the Netherlands’ Ministry for Foreign Affairs decided to join forces and set up the Universal Access to Female Condoms (UAFC) Joint Programme to implement an innovative and holistic approach. The programme works at three levels, that of ensuring availability and affordability of female condoms, that of creating sustained demand and national and international advocacy. The three levels strengthen each other and are implemented concurrently. METHODOLOGY Theory of change of the UAFC Joint Programme  Access to female condoms is hindered by a lack of availability, affordability and variety in the global market as well as for end users. In addition, new female condom types need to comply with international and national quality standards, in order to be accepted for distribution. Demand for and sustained use of different types of female condoms is hindered by lack of knowledge about female condoms, lack of skills regarding how to use them or negotiate their use with one’s partner, and by prejudices and socio -cultural barriers with end users and community gate keepers. In addition, local SRHR organisations and public and private health providers often lack the knowledge and skills for female condom programming and distribution. International and national (financial and political) support for sustained female condom procurement, programming, manufacturing and regulatory support, and advocacy is hindered by a lack of awareness, knowledge and motivation on the part of donors, international organisations and governments in the Global South about the potential of female condoms. In addition, many large-scale SRHR implementing organisations still lack the skills and motivation for scaling up or starting female condom programmes.  4 Overall Programme Objectives The UAFC Joint Programme has formulated three overall programme objectives (OPOs) for the period 2012-2015: The overall programme objective for advocacy is formulated in OPO 3: increased  –  financial and political  –  support from global and local policy makers, donors and implementing organizations for female condom procurement, programming 1 , research & development and advocacy, referred to as “increased international and na tional support  ”  . Under this overall objective, the UAFC Joint Programme implements the following strategies:  Address gaps in female condom knowledge by commissioning studies and research;  Advocate towards partners and allies in UAFC target countries to integrate female condoms in existing SRHR programmes and services; Strengthen national female condom advocacy in UAFC country programmes and make advocacy part and parcel of UAFC country programmes. Increase awareness and support for female condoms among high-level stakeholders, decision makers and opinion leaders by presenting them with up-to-date information and evidence-based advocacy messages Make female condom advocacy a sustainable part of advocacy strategies of international SRHR, HIV/AIDS and women’s  organisations  Advocate towards large implementing organisations to start or scale-up female condom programmes Capacitate large implementing organisations to engage in female condom programming Increase awareness and support for female condoms among large scale SRHR-implementing organisations through increased media coverage on female condom programming Mobilise the International Female Condom Platform to support and participate in international advocacy activities Increase awareness and support for female condoms among the media In-country and international advocacy activities are: National level  Advocacy visits to relevant key stakeholders Identification of existing networks and work with them to promote female condoms Participate in state and national for a and events to promote visibility of female condom programming Support the implementation of a joint female condom advocacy plan with stakeholders Organise a forum for National Advisory Committees to mainstream female condoms into national SRHR programmes Participate in joint advocacy visits to policy makers for policy review Participate at and provide support to national for a / conferences on HIV/AID and SRHR to promote female condoms Support advocacy meetings with key groups at focal states and national level to build synergy Review of female condom materials International level Monitor policy developments of donors and key stakeholders Formulate advocacy evidence-based messages and sign-on letters Get female condoms o n  the agenda of relevant high-level meetings Contribute to Female Condom Community UNConLSC Connect grass root with international policy level Prepare regular updates to the international advocacy platform Distribute advocacy toolkits among potential advocates
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