Marie Stopes International (PSZ) -SRHR Zimbabwe 2018-2021

The period of review covers the period January 2020 to March 2021. The reports were submitted on time in accordance with agreed conditions. Five service delivery channels were operational during the reporting period to ensure increased access to Sexual Reproductive Health services. These include four mobile outreach teams, eleven static centres, fourteen Marie Stopes Ladies, twenty-five Public Sector Sites and an emergency response team. The 2020 Client Exit Interview survey results showed that the majority (51%) of clients were over 30 years whilst 5% were aged 15-19 years and 19%, 20-14 years. Ninety six percent of clients confirmed that they had enough privacy during their visit; 98% confirmed that they were treated with respect during their visit; 98% stated that they understood what the provider was telling them; 96% felt supported by their provider; 98% felt the provider involved them in making decisions about their care; and 97% felt comfortable asking the provider questions. The survey is a good measure of service delivery and aides Marie Stopes-PSZ to make channel specific adjustments. There were about 91 000 client visits across all channels (98% achievement against a target of 105,400), with the largest proportion being served through outreach teams (41%). Post Abortion Care services were provided to 1,700 clients through the static centre channel against a project target of 1,306. An estimated three million people were reached with accurate rights based Sexual Reproductive Health information through Community Based Mobilisers, radio programmes, social media and the call centre. The advent of Covid-19 brought about many challenges with regards to way of life and how the project operations were implemented during the reporting period. In response to the devastating effects of the pandemic, the government of Zimbabwe instituted a number of measures to include total lockdowns at different intervals. Marie Stopes-PSZ continued to provide Family Planning, sexual and reproductive health and general health services as an essential health services providing organisation, as outlined SI 83-2020. However, smooth flow of project operations were affected as follows; The initial lockdown in April 2020 led to zero provision of services in the first two weeks before Marie Stopes-PSZ was cleared by the Ministry of Health and Child Care as an essential services provider. Several outreach teams temporarily suspended service provision as some team members tested positive to Covid-19. Due to the suspension of public transport clients faced difficulties to move around and access various Family Planning services. In addition, all outreach operations were restricted to health facilities as opposed to the use of tents away from established health centres. Twelve percent of Family Planning clients who were interviewed during routine client exit interview survey expressed difficulties in accessing the SRHR services due to mobility challenges. To try and mitigate the impact of Covid-19 Marie Stopes-PSZ ensured that all staff members, including frontline staff are provided with adequate and appropriate Personal protective equipment (PPE). This included the purchase and distribution of PPE to Marie Stopes-PSZ supported public sector facilities. The Marie Stopes-PSZ support offices were decongested with maximum two staff members per office. Periodic comprehensive disinfection of all office floors and ensuring compliance to other Covid-19 infection prevention protocols provided for by the Ministry of Health and Child Care. Routine testing of staff as when they present with symptoms was initiated and continues until to date. The Embassy held bi-monthly meetings with Marie Stopes-PSZ through the different levels of lockdowns to monitor the situation and service provision. Various media channels were used to sensitise the community on the availability of services. This resulted in some positive response as the project managed to record increase in service provision figures, hence the good performance recorded against projections. Through dialogues between the Embassy and Marie Stopes-PSZ the contribution was extended by another year.

The overall goal of the project is to protect the health and rights of women and girls in Zimbabwe and achieve significant reductions in unwanted pregnancies, unsafe abortions and maternal mortality. The specific objective of the project is to increase the use of quality comprehensive contraception and safe abortion/post-abortion care services among underserved populations. Outputs: 1. Increased awareness of safe options and services among underserved populations and enhanced community support for women and girls to make and act on SRHR decisions; 2. Increased access to quality SRH services and products among underserved populations; 3. Improved quality and client experience through safe, effective and efficient client-centred care to underserved populations; and 4. Increased sustainability of quality comprehensive contraception and safe abortion/post-abortion care services among underserved populations. Sida funding is expected to directly generate 810,000 Couple Years of Protection (CYPs) by the end of the project. In turn, the programme will avert an estimated 800 maternal deaths, 250,000 unintended pregnancies, 78,000 unsafe abortions and 290,000 disability adjusted life years (DALYs) by the end of project. A minimum of 13% of all clients will be adolescents by 2020.