Reproductive Health

Overall Goal: The Reproductive Health Programme supports women and children’s right to healthy lives free from harmful traditional practices and to access quality health services in their communities. The programme’s ambitions align with those of SDGs three and five.

Problem analysis: Each year, 5.4 million children under the age of five and 303,000 mothers die from causes we know how to prevent1. According to the WHO, countries need to allocate 10-15% of their national budgets to health to have a viable healthcare system9. African countries on average spend 1% of their national budgets on health but have some of the highest rates of disease. Access to healthcare is therefore an issue of good governance and economic justice. Sexual and reproductive health plays a critical role in social and economic development. As of 2017, an estimated 58 million women of reproductive age in Africa have an “unmet need for contraception”10. As a result, an estimated 21.6 million unintended pregnancies occur each year in Africa11.


Implementing Countries

Our Results

Outcome 1

Women, men, girls and boys utilised maternal and neonatal health services

In TanzaniaNCA’s support to Haydom Lutheran Hospital and the continued delivery of quality health services has resulted in delivery of services to over 120,000 patients annually within the catchment area. Additionally, the Maternal Mortality Rate (MMR) was reduced from 206/100,000 in 2015 to 183/100,000 in 2018.

Outcome 2

Adolescent birth rate reduced

In Malawi175,943 adolescents have undergone comprehensive sexual education against a target of 34,751. This has resulted in an uptake in the utilisation of family planning services with 9,983 (788 Male and 9,195 female) adolescents have reported access.

Outcome 3

Women, men, girls and boys preferred conventional reproductive health services over harmful traditional practices

In Sudanhome visits by Community-Based Health Workers and health promoters were conducted in 10 villages in 2016-2017 and 20 villages in 2018, reaching 7,180 households. Over the course of the reporting period, 56% of deliveries occurred at conventional health facilities, while 41% of home deliveries were attended by skilled personnel.

Outcome 4

Communities contributed to disease prevention

In Malawicommunities have contributed to disease prevention by scaling up of cervical cancer awareness campaigns, outreach clinics and the addition of screening sites. A total of 85 health workers were trained in cervical cancer screening and 27,686 women (target of 5,000) were screened for cervical cancer during the reporting period.

Outcome 5

Quality health facilities available in local communities

In MalawiNCA and CHAM constructed seven health facilities with a capacity of 17 beds (13 in the prenatal ward and 4 in the postnatal ward). 

Key innovations from the programme area

Haydom Lutheran Hospital in Tanzania has become a regional centre for safer births and midwifery training in Eastern Africa. NCA, in collaboration with Lærdal Global Health (LGH) and HLH, developed a hands-on training programme for midwives covering retained placenta management, stopping bleeding after birth, new-born resuscitation, new-born care after birth, respectful maternity care and family planning (including how to insert intra-uterine devices and implants).

In Malawi, a new method for HIV drug resistance testing has been supported by NCA since 2016. DREAM laboratory, in cooperation with the University of Siena, conducted a validation process of 750 samples, which showed that this system has a specificity of 99% and sensitivity of 100%, which means that the results are comparable to the Abbott Platform12.

Lessons Learned and Adaptation

Collaboration with relevant local and national authorities at the district and community level is a key success factor in RH programme implementation. In Sudan, coordination meetings with various departments within the Sudanese Ministry of Health have helped NCA and partners to facilitate policy changes and scaling up of projects. Additionally, the close coordination and involvement of stakeholders in the target areas has help to consolidate and scale up results, as well as keeping NCA and partners well informed of the progress of results.

In Darfur, the use of traditional birth attendants (TBAs) with adequate training in conventional health practices plays an important role in the decrease in maternal mortality rates. Additionally, outreach by TBAs has been partly responsible for a 10% increase in deliveries at conventional health facilities. NCA plans to further strengthen the links between TBAs and conventional health facilities.

Results case

Fighting cervical cancer through improving increased access to diagnostic and treatment services among the undeserved communities in Malawi

Malawi has the highest age-standardised incidence rate of cervical cancer in the world (72.9/100,000)13