Second interim report July 2010 Contents Executive summary of the Second Interim Report of the Safe Abortion Action Fund (SAAF) 5 1·1 Brief history of SAAF 5 1·2 Achievements 5 1·3 Recommendations 7 1 Introduction 8 2 Development of the Fund 10 2·1 Support and leadership 10 2·2 Allocation of SAAF funds 11 3 Achievements of the fund: indicators from the grantees’ fi nal reports 13 3·1 Increased access to safe abortion and post-abortion services 13 3·2 Effective advocacy for safe abortion 15 3·3 Research 19 3·4 Management and fi nancing of SAAF projects 23 4 Progress and lessons to date 25 4·1 The 2009 external evaluation why SAAF is needed 25 4·2 The regional grantees meetings: strengthening networks of abortion champions 26 4·3 Lessons learnt for future grants 26 Safe Abortion Action Fund: Interim report – July 2010 3 5 On-going project activities 28 5·1 The African DFID projects 28 5·2 The NORAD extended projects 28 6 SAAF is evolving into a better structured fund 29 6·1 A pro-active Board 29 6·2 SAAF at the Women Deliver Conference 29 6·3 A new round of funding for South Asia 30 7 Conclusions and recommendations 31 7·1 Recommendations 31 8 Annexes 32 8·1 Financial statement at 31 December 2009 32 8·2 SAAF Board members as of 31 March 2010 33 8·3 Technical Review Panel members 33 8·4 List of the funded projects 2007-2009 34 8·5 List of the funded projects in Africa for the period 2008-2011 (DFID extra funding for Africa) 36 8·6 List of the extended projects 2010 (NORAD funding) 36 8·7 SAAF logical framework for the next round of funding 37 4 Safe Abortion Action Fund: Interim report – July 2010 Safe Abortion Action Fund: Interim report – July 2010 5 Executive summary of the Second Interim Report of the Safe Abortion Action Fund (SAAF) The Safe Abortion Action Fund (SAAF) is a multi-donor funding mechanism that supports in-country initiatives for increasing access to safe abortion services. It provides small fl exible grants to non-governmental organizations (NGOs) to do policy advocacy, innovations in service delivery and research. SAAF focuses on the needs of the marginalized and most vulnerable women and girls, within a comprehensive package of sexual and reproductive health services, including post- abortion family planning. Hosted by the International Planned Parenthood Federation (IPPF), SAAF has a governing board made up of donors, activists and representatives of international NGOs: it is a collaboration of experienced actors to support new grassroots efforts in abortion. SAAF’s capacity to empower new local voices and support a network of champions in a straightforward and fl exible way – an added and unexpected value – makes it an important global funding mechanism for abortion work. A 2009 external evaluation of SAAF recommended that “SAAF should continue to be funded in the short to medium term; it should be a global level fund and should continue to be managed by IPPF and apply the lessons learned in the fi rst two years of the grant mechanism.” (HLSP) 1·1 Brief history of SAAF SAAF was established in 2006 with the support of donor governments from Denmark, Norway, Sweden, Switzerland and the United Kingdom. The initial fund totalled some US$11.6 million and this was supplemented by a further US$1.5m contribution from the United Kingdom for work in Africa. Fifty projects have been carried out worldwide and 12 of them are being extended with additional funding provided by Norway. The grantees supported during the fi rst phase have delivered very encouraging results and outputs, and a second round of funding will be organized later this year thanks to continuous donor support. 1·2 Achievements (A) SAAF Projects Women reached During the fi rst phase of SAAF, and despite various challenges encountered in countries, 49 new abortion-related services have been established and more than 300,000 women have benefi ted from safe abortion-related services. Of the 30 projects focusing on service delivery, 86 per cent have reached or surpassed their targets. 6 Safe Abortion Action Fund: Interim report – July 2010 Health workers trained Some 5,200 health providers have been trained (or had refresher training) in manual vacuum aspiration (MVA) and about 300 in medical abortion. Advocacy activities Globally, around 7,500 people benefi ted from advocacy training and more than 200 networks were created or revitalized. Research undertaken The research projects that have been conducted in Thailand and South Africa have increased the quality of abortion care in their target clinics. Results from these researches have been published in professional journals (two articles in Reproductive Health Matters) or presented at international conferences and/or seminars. Close collaboration and partnerships Where SAAF grantees have been located in the same country (e.g. Argentina, Colombia, Mexico and South Africa), the organizations have pooled their resources and worked together to achieve their aims, providing mutual support to each other. This has strengthened partnerships and resulted in closer collaboration among many NGOs. The regional grantees meetings in early 2010 also enabled grantees to increase collaboration with others. In a short period of time, SAAF has effectively strengthened, legitimized and promoted the work of networks working on safe abortion. Small grantees managing funds The majority of the grantees are small organizations that have little experience managing international funding. As unknown entities, they may have been viewed by major donors as potential risks. Yet, they have been as successful as the largest organizations in managing the resources provided, implementing their activities, achieving their annual objectives and meeting the reporting requirements. (B) SAAF Management and Administration The SAAF is administered by the International Planned Parenthood Federation. A Board governs and oversees the work of SAAF; it is composed of representatives of larger NGOs working in the fi eld of abortion, donors and individuals with relevant experience. A Technical Review Panel (TRP), comprised of 15 international experts from all over the world, ensures the transparency of the proposal selection process by reviewing the submissions and making recommendations to the Board on which proposals should be funded. The agreed ‘light touch’ approach of managing the Fund has proved to be successful and the relationship between the grantees and the Fund is seen as one which is supportive and collaborative, but at the same time it ensures that objectives are met and fi nances are appropriately managed. Capacity building As the majority of the grantees were local organizations, some of them with limited experience in abortion work, the SAAF Coordinator provided ongoing support to grantees. Being able to communicate with grantees in the three working languages of the Fund, she assisted them in improving their narrative reports and provided detailed feedback on their fi nancial reporting. She also advised on how to report information in an articulate and logical way, and on effective project management. The SAAF Coordinator also enhanced the value of the SAAF projects by facilitating knowledge transfer among the grantees. Safe Abortion Action Fund: Interim report – July 2010 7 Reporting To date 96.3 per cent of the committed funds have been expended and 75 per cent of grantees submitted their reports on time. 1·3 Recommendations ■ The replenishment of SAAF by both current and new donors is a priority. Ensuring the continuity of certain projects and opening the fund to new projects is critical to reduce mortality and morbidity associated with unsafe abortion. ■ Donors should recognize the toll of unsafe abortion and inequity of access to safe abortion services in regions such as Latin America and Eastern Europe and ensure that organizations working in these areas are not excluded from SAAF. ■ The future round of funding should maintain the fl exible, ‘light-touch’ approach which worked so well in the fi rst round, but it is also important to prioritize and support local organizations with initiatives which will be innovative, strategic and sustainable. ■ SAAF should provide technical assistance through innovative channels (e.g. use of a website) to optimize the potential of limited funding. ■ Service delivery projects should place greater emphasis on the provision of post- abortion family planning. ■ Grantees should use a new logical framework to improve monitoring and evaluation, and to improve the reporting of project achievements. • A new round of projects should be organised, incorporating the recommendations from the evaluators, from the grantees and from the lessons learnt during the fi rst round of projects. This new round will ensure that the projects selected will have the following characteristics: • Innovative and strategic • Implemented by local organizations or a consortium of international and local organizations • Good reporting systems, including service statistic collection • Focused on reaching the most vulnerable women and girls • Systematic provision of post-abortion family planning (service delivery projects) ■ A new logical framework will ensure that monitoring and reporting are improved. 8 Safe Abortion Action Fund: Interim report – July 2010 1 Introduction This interim report covers the period January 2009 to July 2010 and highlights the achievements, impacts and lessons from projects supported by the Safe Abortion Action Fund (SAAF). Abortion remains one of the most sensitive and unspoken maternal health issues worldwide, yet unsafe abortion accounts for at least 13 per cent of all maternal deaths.1 Reducing unsafe abortion-related complications is one of the most important ways to lower overall maternal morbidity and mortality, since nearly all deaths from unsafe abortion are preventable. Methods for termination of unwanted or unintended pregnancies have been known since ancient times,2 and yet abortion remains a taboo issue in most societies.