DKT International

The reported results achieved by the cooperation partner are combined results based on the support through this contribution together with mobilisation of internal resources and additional development partner resources. Sida's contribution to overall results varies depending on the country and markets. As DKT is a social enterprise it pools resources from various donors together with its own resources and margins from product sales in order to increase demand for, access to, and availability of contraceptives and medical abortion products. DKT reported that during the final programme period January to November 2020, support from Sida contributed to DKT generating 5.92 million Couple Years of Protection (CYPs), against a target of 6.5 million, through the sales of a mix of contraceptives and medical abortion (MA) products in the six focus countries. Using the MSI Health Impact Calculator*, DKT calculated that it averted approximately 1.1 million unintended pregnancies, 7,800 maternal deaths, and 1.3 million unsafe abortions (*the use of the MSI Health Impact Calculator is based on sales of various contraceptives and medical abortion products rather than actual follow-up with client purchases and thus these figures do not necessarily reflect actual numbers, and they include sales to NGOs, public and private sectors). During 2020, Women First Digital (WFD), expanded significantly, particularly regarding the abortion virtual assistant (Ally), offering certificated medical abortion training online for providers, and hosting an online forum for users to engage with each other on SRHR discussions. WFDs three platforms (HowToUse, safe2choose, and FindMyMethod) hosted 2.65 million visits to their websites and supported 55,500 direct user interactions during the reporting period. In terms of the six specific outputs in the DKT results matrix that are not related to sales, results included: Output 1: Despite COVID-19 restrictions, 909 health providers and pharmacists trained by DKT on comprehensive abortion care (target was 250) by using digital courses rather than in-person sessions. Output 2: Although DKT did not budget for market research, they have conducted brand awareness and found that e.g. Kiss condoms had 88% awareness in Kenya and 75% in Uganda. Also in Uganda, the EC Lydia had 38% overall total awareness. DKT reported that brand and product awareness among providers for DKT's safe abortion products was also strong (67% of pharmacists surveyed had spontaneous brand awareness of DKT's combipack). Output 3: 30 Community Mobilizers (target was also 30) and 144 Youth Ambassadors (target was 50) on SRHR were trained on how to promote the use of youth-friendly SRHR clinics. Output 4: In Mozambique, 58 health providers trained on IUD and implants and safe abortion. The target was 225 but COVID-19 restrictions meant training could not take place. Output 5: In Tanzania, 278 health providers (target of 45) were trained on contraception and DKT's products to improve provider knowledge. Output 6: 16 of DKT's products are considered affordable in the region according to the affordability guidelines and purchasing power parity (see discussion below on affordability and underserved communities). The target was to have 2 products per country, but this varied and in Uganda it was 1 while in Ethiopia it was 5. In addition, following recommendations in a Mid-term review conducted in 2018, DKT has strived to strengthen the programme's regional approach and cross-pollination to help DKT enjoy economies of scale and share best practices to help more young people access contraception and safe abortion care. In 2020, DKT Tanzania adopted an automated sales process from DKT Ethiopia to improve efficiency of sales reporting and better anticipate gaps in distribution. In Mozambique, DKT saw the success of call centers throughout sub-Saharan Africa and implemented a call center geared specifically for young people. In Kenya and Uganda, DKT was able to begin supporting product supply for NGOs working in Somalia (via the Kenya office) and lay the groundwork to start-up operations in South Sudan (through the Uganda office). Also following the MTR in 2018, DKT built on partnerships with governments and NGOs. Results included joint awareness building campaigns, youth-focused activities, capacity building, more resilient supply chains. In some cases, DKT donated products, for example in Uganda where DKT donated condoms to the armed forces and in Ethiopia where DKT donated 70,000 IUDs to mitigate stock-outs (this despite the challenges for DKT in Ethiopia due to the change in the donor landscape). DKT also partnered with Ipas to conduct joint training on medical abortion. In some countries, DKT also supported local governments with COVID-19 responses, and incorporated COVID-19 protection messaging into marketing campaigns for contraceptives. In Ethiopia, DKT also distributed hand sanitizer, face masks and COVID-19 info posters and brochures.

The programme by DKT International aims to reverse the high number of unwanted pregnancies and unsafe abortions by ensuring that a wide range of contraceptive methods are available, affordable and of high quality. The programme also intends to increase access to safe abortion services (where legal) including post-abortion care (PAC) counselling and SRHR information. By expanding the scale and scope of the procurement of contraceptives, to prevent regular stock-outs of commodities, more women and men will have a broader access to a wide range of contraceptive methods. In addition to focusing on supply of contraceptives and medical abortion products, strategic marketing and brand-building that caters to different segments of the population, creates demand. By reducing the barriers to accessing contraceptives and informing the general public of the value of using contraceptives, DKT operates from the assumption that many people will ultimately use their own funds to pay for the products and services they want as long as they are affordable and accessible. This has proven to be the fact in many countries around the world, where DKT is operating and even in low-income countries. The poorest of the poor and those who do not have the money to pay for contraceptives or health services are often targeted by other NGOs, UN, donors (for example with free condoms) and governments themselves. DKT does not claim to target this segment of the population as the prime objective of the programme. They do however also focus on the poor, underserved communities and high-risk groups and they engage with young people through different marketing strategies to reach those who are not able to pay and they also procure commodities which are distributed for free by other organisations. The intended outcome of this programme is to increase the contraceptive prevalence rates through increased number of Couple Years Protection (CYP) and reduced costs per CYP as well as ensuring safe abortion services are available wherever legal. Sida funds will result in increased sales and services and contribute to the drive for health impact with focus on reduced number of unwanted pregnancies and unsafe abortions with a general impact on peoples' SRHR.