QUARTERLY PERFORMANCE REPORT April to June, 2014

Agir Pour La Planification Familiale – AgirPF Agreement No. AID-624-A-13-00004

Submitted to USAID/WA

by EngenderHealth, Inc. Futures Institute Table of Contents

ACRONYMS AND ABBREVIATIONS ...... iii

I. EXECUTIVE SUMMARY ...... 5

II. DESCRIPTION OF ACTIVITIES COMPLETED/INITIATED ...... 5

III. DISCUSSION OF CHALLENGES TO IMPLEMENTATION ...... 16

IV. ACTIVITIES PLANNED FOR THE FOLLOWING QUARTER……………………………………………………..13

V. FINANCIAL BRIEF ………………………………………………………………………………………………….…………14

VI. OTHER ……………………………………………………………………………………………………………………………15

VII. ANNEXES ………………………………………………………………………………………………………………………16

AgirPF Quarterly Performance Report ● April to June 2014 ii ACRONYMS AND ABBREVIATIONS

ABBEF Association Burkina Bé de Bien-Être Familial ADESCO Appui au Développement et à la Santé Communautaire AMACACH Association des Militaires, Anciens Combattants, Amis et Corps Habillés ATBEF Association Togolaise pour le Bien-Être Familial BASP96 Bureau d’Appui en Santé Publique 96 BUMESP Bureau Mauritanien en Santé et Population BUMIGEB Bureau des Mines et de la Géologie du Burkina CBRS Comité de Bioéthique pour la Recherche en Santé CHU Centre Hospitalier Universitaire CHR Centre Hospitalier Régional CHW Community health worker CKA Consulting Cabinet Koffi Argoze Consulting CM Country Manager CMA Centre Medical avec Antenne Chirurgicale (District Hospital with Surgical Wards) COP Chief of Party CPT Contraceptive Procurement table CPR Contraceptive Prevalence Rate CNSR Centre National de Santé de la Reproduction CSO Civil Society Organization DAC Direction des Affaires Communes DPLET Direction des Pharmacies, des Laboratoires et des Equipements techniques DQA Data quality assessment DRK Direction Régionale de Koudougou DSF Division de la Santé Familiale ECOWAS Economic Commission of West Africa States EH EngenderHealth FP Family planning HPP Health Policy Project IBC Interventions à Base Communautaire IPPF International Planned Parenthood Federation IRB Institutional Review Board M&E/R Monitoring, Evaluation, & Research MOH Ministry of Health MOU Memorandum of Understanding MSI Marie Stoppes International NGO Non-Governmental Organization ONEA Office Nationale de l’Eau et de l’Assainissement PMP Performance Monitoring Plan PPIUD Post-Partum Intra Uterine Device PSA Professional services agreement RAPID Resources for Analysis of the Population and its Impact on Development RH Reproductive Health

AgirPF Quarterly Performance Report ● April to June 2014 iii RHO Regional Health Office (USAID/West Africa) SBCC Social and Behavior Change Communication SEED Supply/Enabling Environment/Demand SOFITEX Société des Fibres et Textiles du Burkina SIFPO Support for International Family Planning Organizations SONABEL Société Nationale Burkinabé d’Electricité SPO Senior Program Officer TD Technical Director URCB Union des Religieux et Coutumiers du Burkina URD Demographic Research Unit USAID/WA U.S. Agency for International Development/West Africa WAAF West Africa Ambassadors’ Fund WAHO West African Health Organization WHO World Health Organization WHS Worker health Service

AgirPF Quarterly Performance Report ● April to June 2014 iv I. EXECUTIVE SUMMARY The Agir Pour la Planification Familiale (AgirPF) Project was awarded as a Cooperative Agreement by the USAID/West Africa Regional Health Office to EngenderHealth on July 5, 2013 and was launched in January 2014 in , and Niger. The purpose of AgirPF Project is to increase access to and use of quality family planning (FP) services in select urban and peri-urban areas of five francophone West African countries: Burkina Faso, Côte d’Ivoire (starting in Year 3), Mauritania, Niger, and Togo. The Project works closely with Ministries of Health (MOHs) and other local partners to support the national action plans for strengthening FP that followed the February 2011 Francophone West Africa Regional Conference on Population, Development, and Family Planning in , Burkina Faso.

The technical approach of AgirPF includes: (i) improving FP service quality; (ii) bringing FP services to underserved communities; (iii) educating and empowering clients and grassroots advocates; (iv) reducing financial barriers; and (v) solving logistics issues and estimating commodity needs. To achieve its strategic objective, AgirPF aims to achieve three results and six sub-results:

. Result 1: Delivery of quality FP information, products, and services strengthened and expanded. o Sub-result 1.1: Partners strengthened to implement evidence-based approaches and deliver quality FP services. o Sub-result 1.2: Local leaders, civil society, service providers, municipal government support and promote FP. . Result 2: Evidence-based service delivery approaches selected, adapted, and implemented. o Sub-result 2.1: Efficiency and effectiveness enhanced through adaptation and implementation. o Sub-result 2.2: Lessons documented and disseminated from adaptation and implementation. . Result 3: Efforts to remove policy barriers and improve contraceptive commodity security coordinated. o Sub-result 3.1: Policy barriers identified and new/revised policies adopted and implemented. o Sub-result 3.2: Contraceptive commodity needs identified and coordinated among partners and country commodity security and logistics management committees.

This report represents the fourth quarterly report (April-June 2014) for AgirPF. Key accomplishments during this quarter include: 1. Providing FP refresher training to 35 trainers in Burkina and Niger via Technical Start-up Orientation Workshops; 2. The elaboration of three Memorandums of Understanding (MOUs) with the Ministry of , Niger and Togo; 3. The completion and signing of two important Professional services agreements (PSA) in Burkina and Togo enabling the baseline studies; 4. The development of Sub-grants with the IPPF Member Associations of Burkina (ABBEF) and Togo (ATBEF); 5. Conducting the Baseline study data collection in Togo and Burkina Faso; (vi) Coordinating efforts to Remove Policy Barriers and Improve Contraceptive Commodity Security; and Presentation of RAPID Togo to 103 high level officials and stakeholders, and development of RAPID Niger with 36 participants (12 women and 24 men) including representatives from the President and Prime Minister Offices, the National Parliament and Niger strategic Ministries.

Page 5 of 41 AgirPF Quarterly Performance Report ● April to June 2014 During the reporting period, critical assumptions1 for achieving AgirPF results remained stable.

II. DESCRIPTION OF ACTIVITIES COMPLETED/INITIATED UNDER EACH PROJECT OBJECTIVE/ COMPONENT Project activities continue to be implemented under the leadership of EngenderHealth in partnership with its core partner, Futures Institute2. Activities implemented during this reporting period are summarized in Table 1 and described in more detail below.

Table 1. Major activities and accomplishments in the period April – June 2014

April – June 2014 Activities and accomplishments AgirPF Burkina Mauri Togo Niger Region Faso tania Staffing - Hired one Bookkeeper ■ ■ - Hired a Country Manager for Burkina Faso ■ ■ Management and Coordination activities - Held coordination meetings with partners ■ ■ ■ ■ - Participated in stakeholders and partners meetings ■ ■ ■ ■ ■ - Conducted a Finance and Operations Review in Niger and ■ ■ ■ Burkina Faso Offices Project implementation activities R1. Delivery of Quality FP Information, Products, and Services Strengthened and Expanded 1.1.2 Plan activities in coordination with partners - Held Technical Workshop for Trainers skills ■ ■ ■ standardization in Burkina and Niger - Developing a sub-grant with ANBEF ■ - Finalizing sub-grant with ATBEF ■ ■ - Finalizing sub-grant with ABBEF ■ ■ - Sub-grant with AMACACH and CAMEG in progress ■ ■ 1.1.3 Conduct baseline assessments - Baseline study protocol approved by W/IRB and local ■ ■ ■ ■ ethics committees - Baseline study team recruited and trained ■ ■ ■ ■ - Baseline study data collection completed ■ ■ ■ - Baseline data being analyzed ■

1Critical assumptions are: (1) Social, political and legal environments will remain favorable to implementation of AgirPF’s interventions; (2) Governments will not implement new policies, standards, or protocols that restrict FP services; (3) Commitment and cooperation from the Ministries of Health and partners to implement the proposed strategy is sustained throughout the life of the project; (4) There will be adequate equipment, expendable supplies and contraceptive products in the intervention areas to support the delivery of FP services; and (5) There will be timely and continuous availability of funding to support work plan implementation.

2 Futures Institute has contributed to the design and implementation of planned activities in the area of advocacy and policy in close collaboration with the AgirPF policy advisor.

Page 6 of 41 AgirPF Quarterly Performance Report ● April to June 2014 April – June 2014 Activities and accomplishments AgirPF Burkina Mauri Togo Niger Region Faso tania 1.1.6 Building training systems around Centers of Excellence - Center of Excellence identified ■ ■ 1.1.8 Organize industry-based activities, including health fairs - Industry-partners identified ■ ■ ■ - Health Fair organized in collaboration with MOH ■ R2. Evidence-Based Service Delivery Approaches Selected, Adapted, and Implemented 2.1.2 Secure necessary approvals, including MOUs - Draft MOUs revised by EH/NY and USAID and transmitted ■ ■ ■ to MOH for review and signature - MOU with MOH signed ■ ■ R3. Efforts to Remove Policy Barriers and Improve Contraceptive Commodity Security coordinated 3.1. Policy barriers identified and new/revised policies adopted and implemented - Training in SPECTRUM held and RAPID Model developed ■ ■ - Conducted advocacy activities, including the first ■ ■ presentation of the RAPID model to stakeholders 3.2 : Contraceptive commodity needs identified and coordinated among partners, country commodity security, and logistics management committees (in collaboration with DELIVER) - Participated in Togo’s Contraceptive logistics tools review ■ ■ workshop organized in collaboration with DELIVER - Orientation of AgirPF Team on new Reality Check tool ■ ■ - Provided Technical Assistance for the logistic management system design in Mauritania in ■ ■ collaboration with DELIVER PROJECT - MOU with UNFPA signed ■

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2.1 - PROGRAM MANAGEMENT ACTIVITIES

. Staffing A total of two new staff members were hired this quarter. This includes a Bookkeeper for AgirPF Niger, M. Soumana Abdoulaye, and the Country Manager for Burkina Faso, M. Koalga Djabada Oscar. M. Koalga is a Burkina Faso native, and holds a master in Planning and Development. He has 29 years of experience in managing projects in Burkina Faso and in West Africa Region. He worked with several local and international NGOs including: (i) ABBEF, IPPF affiliate in Burkina Faso as Executive Director; (ii) Caritas International as National Coordinator; (iii) Oxfam Great Britain as Zonal Program Manager for Burkina Faso, , Mali and Niger; (iv) Axios Foundation as National Activities Coordinator in Burkina Faso; and (v) Oxfam-Quebec as Country Representative in Burkina Faso. He is experienced in family planning, reproductive health, HIV/AIDS, and youth reproductive health with a great knowledge in gender equity, women and youth rights, a vast experience in civil society organization capacity building and empowerment, and in community based services development. He will start on July 25, 2014.

■ Management and coordination of meetings At the regional and countries levels, AgirPF held coordination meetings with partners, participated in several stakeholder and partner meetings, and organized regular monthly country office staff meetings as well as AgirPF All staff meetings. In particular, coordination meetings with partners enabled AgirPF staff to identify potentials for sub-grants in Togo, Burkina Faso and Niger as indicated in the table below. Process for finalizing these sub-grants is underway. Country IPPF-MA Other Sub-Grants WAAF Grants Togo ATBEF (CoE)3 ADESCO AMACACH Burkina Faso ABBEF TBD (CoE) URCB, RH/FP Champions Network Niger ANBEF CNSR (CoE) RH/FP Champions Network of Niger

It is also noteworthy to mention the potential for collaboration between AgirPF and the Peace Corps Management team in Togo as well as between AgirPF and the US Embassy in Togo through AMACACH, an organization of military and veterans of Togo Armed Forces providing support to health facilities based in military bases and camps of Togo. First, AgirPF met with the Togo Peace Corps Management team to discuss possible avenues for cooperation that include: (i) recruiting a 3rd year Peace Corps volunteer to work with AgirPF as an intern, (ii) including Peace Corps volunteers in AgirPF FP training for CHWs so they can use it in their respective locations, (iii) using the PC volunteers that are in AgirPF intervention areas to support our project objectives, and (iv) using the Peace Corps Summer Camps organized in 2014 in Togo to develop and provide IEC and SBCC messages for youth. The collaboration with the Peace Corps can be formalized by a simple Letter of Commitment. The two parties agree to develop a SOW to move forward.

Secondly, AgirPF team met with a US Embassy Togo team working on HIV/AIDS programs and AMACACH, which receives support from the US Embassy to assist the military health facilities on HIV/AIDS prevention, care and treatment. Given that military health facilities do not provide FP services, AgirPF is considering filling this gap through a WAAF grant on recommendation of the embassy.

3 CoE: Center of Excellence

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Thirdly, the Regional Finance and Operations Manager undertook a field visit in Burkina Faso and Niger from 8 to 24 June 2014 to orient Bookkeepers and strengthen the internal control system. As accountable for the use of USAID funds, one of the regional project responsibilities is ensure that the two offices are adequately equipped and the management of resources at their disposal complies with the "Standard Operating Procedures" (SOPs) in place. During this field visit, the activities performed in the two countries included the following:  Procurement procedures  Procedures for Travel: Travel Authorization Form (TAF), Travel Expenses Report (TER), and Per diem policy  Procedures for the preparation of the financial report and close of the month  Use of QuickBooks and Insight reports  Internal control  Budget management  Cost sharing between projects  Reconciliation of balance sheet accounts and work year-end  The grading system and internal control

At the end of this review, a debrief session was made to stress some recommendations for Finance and Operations improvements in the two country offices (see Appendix 1).).

2.2 - IMPLEMENTATION OF ACTIVITIES APPROVED IN THE WORKPLAN

. R1. Delivery of Quality FP Information, Products, and Services Strengthened and Expanded

1.1.3. Conduct baseline study During the reporting period, a substantial amount of time was devoted for the design and implementation of the baseline study which is by far the most important activity carried out in terms of time and budget allocations. Key activities implemented include: the study standard protocol and tools ethical and technical review by EngenderHealth in-house ethical review process; their review and approval by the Western Institutional Review Board (WIRB)4, a US based Institutional Review Board on April 22; their adaptation to Togo, Burkina Faso and Niger local contexts; the submission and approval of these study protocol and tools by local Health Research Ethics Committees in Togo on April 10th, in Burkina Faso on May 20th and in Niger on June 16th; the recruitment and orientation of a research group for the implementation of the baseline study in Togo, Burkina Faso, Niger and Mauritania. In addition, four local research groups including URD, BASP 96, CKA CONSULTING and BUMESP were competitively selected for the implementation of the baseline study respectively in Togo, Burkina Faso, Niger and Togo; and two Professional Services Agreements (PSA) were signed with URD and BASP 96 in Togo and Burkina and negotiations are underway with CKA CONSULTING and BUMESP Niger and Mauritania. The two research groups for Togo and Burkina Faso recruited and trained data collection teams, and organized field data collection in these two countries.

4 Western Institutional Review Board® 3535 7th Avenue SW l Olympia, WA 98502-5010 Office: (360) 252-2500 l Fax: (360) 252-2498 l www.wirb.com

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Photo 1: Data collector with a Sokodé District Health Photo 2: Data collection in a Household at Sokodé, in manager in Togo Togo

Data collection tools used for the study includes the following: Facility Audits Consent Process and Guide, Provider Interview Consent Process and Questionnaire, Female Household Interview Consent Process and Questionnaire, Male Household Interview Consent Process and Questionnaire, Female CHW Interview Consent Process and Questionnaire, Male CHW Interview Consent Process and Questionnaire, and Key informant Interview Consent Process and Guide. Five-day interviewer trainings were trainings were organized for the examination and pretest of these tools in Togo as well as in Burkina Faso. The table below gives the number of personnel oriented or trained for the data collection in Togo and in Burkina Faso:

Country Researchers Supervisors Interviewers Togo 3 4 28 Burkina Faso 3 4 32 Data collection is now completed in Togo and in Burkina Faso. In Togo, data entry completed includes 72 health facilities audited, 149 FP service providers interviewed, 172 CHW interviewed, 811 men and 1607 women interviewed using household questionnaire, and also 42 disabled men and women interviewed using also the household questionnaire. Detailed information on the study samples is available in Annex 5. In Togo, six data entry clerks were also trained on CSPro software for the data entry, which is almost complete. 1.1.6. Building training systems around Centers of Excellence (CoE) . Selection of Center of Excellence5

5 The desired Model of Centre of Excellence integrates EngenderHealth facility audit tool. It combines five key elements and fundamental domains, and Quality Improvement as follows: - (i) Accessibility and Availability of services and commodities for clients and their families, (ii) Security (availability of skilled providers and high quality services), (iii) Service integration, (iv) Respect of Health Ethics with respect of client rights, and (v) Social responsibility (taking care of the poorest clients) - Fundamental domains for a Centre of Excellence: (i) Knowledge Management taking into account the 3 learning dimensions (knowledge, Skills and attitudes), (ii) Good management of Processes of care, (iii) Good practices in

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The process for identifying a health facility to become a Center of Excellence is completed in Togo, but is underway in Burkina Faso and Niger. AgirPF/Burkina collected information in four major Health Facilities in Ouagadougou: CMA de Kossodo, CMA de Pissy, and CMA du secteur 30. But the analysis of this information collected indicates that these health facilities do not meet the standard of criteria for selection. Burkina Faso continues the exploration to finalize the choice of a Center of Excellence. In Niger, the final decision for CoE identification is awaiting for the baseline audit study results.

1.1.8 Organize industry-based activities, including health fairs The process for the identification of Industry Partners continues in Burkina Faso and in Niger, while at the same time there was an opportunity to organize a health fair in collaboration with the MOH of Niger.

. Selection of industries and companies for health fairs The selection of sites for "health fairs” is complete in Togo. Three industries have been selected: “La Brasserie du ”, “Port Autonome de Lomé” and “Société Mèche Amina”. AgirPF is still awaiting the signature of a MOU with these industries.

In Burkina Faso, a total of 11 sites were selected in the three focus cities for fixed and outreach service delivery strategies. Health fairs at these sites will be organized to provide information about FP and immediate access to services for interested clients. These events will be used as an opportunity to strengthen the capacity of the companies’ health facilities to provide quality FP services. Specifically, the health fairs will be used as a forum for strengthening providers’ skills in FP counseling and method provision, as well as addressing gaps in essential FP equipment and instruments at these sites The list of selected sites is given in the table below.

Region/City Fixed Sites strategy Sites for Outreach strategy Ouagadougou Rood Wooko, SITARAIL, Roads General Direction, ONEA, BUMIGEB OST MCH Clinic Bobo-Dioulasso SOFITEX, SN Citec SONABEL Koudougou SOFITEX, Centre de la DRS

In Niger, AgirPF is still exploring the possibilities of partnering with Microfinance Bank of ASUSU, Ecobank, Niger Enterprises’ and Societies Coalitions against AIDS, Tuberculosis and to collaborate in the organization of health fairs. In the meantime, during the reporting period, AgirPF, in collaboration with the MOH, organized a health fair in three health centers: the National Center for Reproductive Health, and the Integrated Health Centers of Taladjé and Lazaret. A total number of 1400 women and men benefited from FP Counselling Services, STI/HIV/AIDS screening, precancerous lesions and FP service provision.

terms of client right-based service provision, (iv) Able of showing tangible results, (v) Demonstrates good Leadership provision (good governance, quality data production, good level of communication), (vi) Improved Facility Environment, (Vii) Satisfaction of Provider needs, (Viii) Community Participation - Finally, Quality improvement

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Health Fair activity results in Niger (June 06 – 11, 2014)

Health Facilities Activities Total CSI Talladje CSI Lazaret CNSR Uterus and Cervix Pre-cancer screening 78 155 355 588

HIV Testing 63 17 154 234 Family Planning (PF) 94 86 283 463

HIV Counseling and Testing for Young people 0 0 84 84

HIV Counseling and Testing for Adult 0 0 37 37 Blood collection 0 0 43 43 1449

R2. Evidence-Based Service Delivery Approaches Selected, Adapted, and Implemented

2.1.2 Secure necessary approvals, including Memorandum of Understandings (MOUs)

MOUs between AgirPF and the MOHs were already signed in Burkina Faso and in Niger. However, due to USAID/WA RHO request to involve USAID/US Embassy in the approval and signature of the MOUs, the last versions of the MOU were sent back to the US Embassy. Country MOU status Burkina Faso Signed on May 26, 2014 Niger Signed on June 4, 2014 Togo Not signed6

2.4. FP trainers’ skills standardization workshop preparation for Burkina Faso and Niger. Two Technical Start-up workshops were organized in Burkina Faso and Niger. Their purpose was to orient AgirPF staff and partners to EngenderHealth’s approaches, tools, resources and policies for improving the quality of technical assistance provided for clinical services supported by AgirPF. Their specific objectives were to: 1. Explain EngenderHealth’s SEED programming model, 2. Orient participants to EngenderHealth’s and US Government’s policy requirements, 3. Orient participants to the Ensuring Clinical Quality framework and its components, 4. Provide an update on counseling using the REDI model, and on Infection Prevention, 5. Provide an update on contraceptive technology, 6. Standardize skills for the provision of long-acting reversible contraceptives (IUD and implants), and 7. Identify action points and next steps in the implementation of AgirPF work plan.

Fifteen participants from Burkina Faso and twenty from Niger attended these training. The disaggregation of these participants by city, sex and profile is given in Annex 5. All training

6 USAID/WA RHO requested AgirPF country offices to send back the MOUs for review, approval and signature by USAID or US Embassies.

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participants in Burkina Faso and all but three participants in Niger mastered the IUD and Jadelle clinical skills using anatomic models. In both countries, teams at each workshop developed action plans for their next steps.

Technical Start-up workshop participants from Burkina Faso Technical Start-up workshop participants from Niger

Some key next steps, among others include: - The MOH/Burkina Family Health Direction Team of Trainers FP Skills standardization using EngenderHealth technical approaches - The Review MOH Supervision tools integrating EngenderHealth new FP counseling approach (REDI) on counseling and IDU and Implants service provision. - The Integration into MOH Policy, Norms and Protocol as well as in FP training curriculum, EngenderHealth technical approach of providing IUD and Implant

R3. Efforts to Remove Policy Barriers and Improve Contraceptive Commodity Security coordinated

3.1. Policy barriers identified and new/revised policies adopted and implemented In this reporting period, in-country training on SPECTRUM7 and RAPID8 Models development workshops were prepared for Mauritania, Burkina Faso and Niger. The training on SPECTRUM was held and RAPID Models developed for Niger and Mauritania with support from Futures Institute. In addition, the first presentation of the RAPID model to stakeholders, as well as the advocacy training to stakeholders, was conducted in Togo.

. Contribution to the preparation of training session on SPECTRUM and Country and Urban RAPID Model development workshops in Burkina Faso, Mauritania and Niger These preparations concern training on SPECTRUM, RAPID models for Burkina Faso, Mauritania and Niger as well as the urban RAPID models for Ouagadougou, Koudougou, Bobo-Dioulasso, Nouakchott, and Maradi . The process includes the participation of UNFPA, WAHO, HPP, DELIVER and other partners.

7 SPECTRUM is a suite of easy-to-use policy models which provide policy makers with an analytical tool to support the decision- making process. 8 RAPID means “Resources for Analysis on Population and its Impact on Development” and is a powerful advocacy tool that highlights the overarching importance of family planning for most socio-economic development sectors. It encourages decision makers to put promotion of family planning in their agenda as a priority.

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3.1.2. Develop RAPID models

. Training on SPECTRUM and Mauritania RAPID model and Nouakchott Urban RAPID model development workshop at Mauricenter hotel in Nouakchott from May 26-29, 2014

A four-day workshop, including 25 participants (8 women and 17 men), was organized to train on SPECTRUM and develop RAPID Mauritania 2014 and specific Urban RAPID model for Nouakchott in the view of providing Mauritania with performing advocacy tools.

. SPECTRUM Training and RAPID models development workshop, June 24-27, 2014 at Africa Hall in Niamey. This workshop gathered 36 participants (12 women and 24 men) including participants from the President and Prime Minister Offices, the National Parliament and Niger strategic Ministries. The purpose of the workshop was to develop RAPID Niger 2014 as well as RAPID models specifically for Niamey and Maradi in order to provide national and municipal partners with tailored advocacy tools. The RAPID models developed in Mauritania and Niger have clearly illustrated the great benefits of fertility control on a range of socio-economic development sectors in these countries and constitute powerful tools to support advocacy campaigns designed to eliminate FP political barriers. At the end of each RAPID development process, the following next steps are planned in close collaboration with the West African Health Organization (WAHO): - Advocacy Training, including analysis of political barriers to contraception and development of advocacy plans to remove the said barriers - Technical and financial support (through grants) to advocacy networks to implement their advocacy plans and remove political barriers to contraception - Support for the development of specific tools for advocacy towards religious leaders to help improve the socio-cultural environment of contraception - Training for networks of religious leaders in advocacy, including the development of advocacy plans - Technical and financial support (through grants) to Networks of Religious Leaders, in collaboration with WAHO in order to implement their advocacy plans and then to improve the socio-cultural environment of contraception.

3.1.3. Build the capacity of a coalition of advocates that effectively and expediently implement AgirPF advocacy strategies

. Presentation of RAPID Togo 2014 to 103 high level authorities and various stakeholders on May 13 at EDA OBA hotel in Lomé This activity was organized in collaboration with HPP during the launch ceremony of the National Family Planning Action Plan of Togo 2013-2017. A presentation on the 2014 RAPID model illustrated the benefits of family planning on a range of socio-economic development sectors in Togo. Participants included US and France Ambassadors, UNFPA Representative, MOH General Secretary and 21 Press representatives.

. Advocacy training workshop at Kpalimé in Togo, June 11-13, 2014.

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. This workshop brought together 33 participants (9 women and 24 men) from the Ministries of Health, Social Action and Women Promotion, the Network of Advocacy Champions for Adequate Funding of Health (RCPFAS), the West African Health Organization (WAHO), and UNFPA, the regional health teams of Lomé, Sokodé and Small group work facilitated by AgirPF Policy Advisor Kara, and representatives of other civil society organizations of Lomé, Kara and Sokodé. The specific objectives of the training were to (1) Familiarize participants with policy barriers to FP in Togo; (2) Help participants understand the importance of data in policy dialogue in addressing political barriers on access and use of PF in Togo; (3) Involve participants in the design of advocacy plans to address policy barriers to FP in Togo; (4) Familiarize participants with the advocacy tools developed9; and (5) Provide opportunities to plan for the implementation of an advocacy strategy by using Togo RAPID model 2014, Urban RAPID models for Lomé, Kara and Sokodé. WAHO was deeply satisfied with the training and sought AgirPF technical and financial support for the finalization and implementation of the drafted advocacy action plans10.

3.2: Contraceptive commodity needs identified and coordinated among partners, country commodity security, and logistics management committees (in collaboration with DELIVER)

. AgirPF Team Orientation on Reality Check New version In Year-1 Work plan, AgirPF included the introduction of Reality Check tool in the improvement of contraceptive Quantification exercises. On May 9, 2014, from 9:00 to 13:00, the Togo AgirPF Country Manager and the senior project Manager participated to a Reality Check Orientation workshop. Organized by EH/HQ, Program Associate in M&E/R in collaboration with AgirPF Technical Director, and the Regional Contraceptive Security Program Officer. USAID DELIVER Project Country Program Officer participated to the workshop. The workshop aimed to introduce Reality Check to AgirPF staff and discuss about the next steps for the tool introduction in the other AgirPf implementing countries and at the MOHs officials’ levels. The workshop focused on PPT presentations, exercises on the use

9 Togo RAPID model 2014, Urban RAPID models for Lomé, Kara and Sokodé. 10 After a thorough analysis of the political barriers to FP within a country, it is held one for which an advocacy plan is developed, detailing the purpose of that plan, a description of decision-making process, activities/actions to be implemented, the method and tools for policy dialogue, audiences (primary and secondary), alliances required, messages/data, the period of performance and indicators for monitoring and evaluation.

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of the new tool, and the participants to the workshop decided to prior introduce Reality check to MOH officials, convince them and then expose the tool to the CPT Team members before training Districts’ team and providers to the use of the tool. . Technical assistance for Mauritania logistic management system design In May, AgirPF participated to a workshop in Nouakchott organized by the National Program for Reproductive Health (PNSR) of MOH/Mauritania in collaboration with DELIVER PROJECT, and UNFPA. The purpose of the workshop was to improve the availability of contraceptives at all levels of the FP service delivery system in Mauritania. The next step is to organize a national training on the contraceptive procurement chain and quantification of supplies for key logistics management personnel at all levels of the system. . Development of a sub-grant between AgirPF and CAMEG in Togo. Following the signature of a MOU between UNFPA and EngenderHealth, a sub-grant is being developed between AgirPF and CAMEG11. The purpose of this sub-grant is to contribute to reducing stock-outs at the health center level in the region of Lomé-Maritime.

III. DISCUSSION OF CHALLENGES TO IMPLEMENTATION AND THEIR IMPLICATIONS FOR ACHIEVING ANNUAL RESULTS

The challenges AgirPF faced this quarter are as follows: (i) The implementation of planned activities in Mauritania is still pending EngenderHealth registration in this country. The challenge for AgirPF is to secure this approval prior to the end of the FY1. (ii) Secure all necessary approval from EngenderHealth CCU and USAID/WA for our sub-grants with ABBEF, ATBEF, AMACACH and CAMEG. (iii) AgirPF ended its partnership with EXP Agency due to unsatisfactory performance in meeting expected deliverables. The challenge for the project will be to quickly fill this gap to avoid delays in the implementation of SBCC activities.

IV. ACTIVITIES PLANNED FOR THE FIFTH QUARTER (Q5) The following activities will be undertaken during the next quarter:

Project management activities . Complete hiring and orientation of project staff for open positions; . Sign contracts with the research study consultant and implementation of baseline survey in Niger and Mauritania; . Obtain the registration of EngenderHealth in Mauritania and launch the project; . Identify, secure and equip office spaces in Mauritania; . Procure project vehicles for Togo, Burkina Faso and Niger; . Procure a generator for the Niger Office; . Develop AgirPF Year 2 Workplan; and . Identify a new partner for demand generation activities.

Result 1. Delivery of Quality FP Information, Products, and Services Strengthened and Expanded

11 Togolese-Essential Generic Drugs Procurement Centre

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. Develop sub-awards with ABBEF in Burkina Faso, ATBEF, CAMEG and AMACACH in Togo and RH Champions in Niger; . Assess local partners’ management, planning, and leadership capacity at baseline using EngenderHealth’s participatory Organizational Capacity Assessment Tool (OCAT) . Follow up with US Embassy Togo for eligibility of AMACACH as WAAF grantee. . Identify and establish agreements with industry partners for Health Fairs . Adapt the facility walk-through methodology and tools, . Develop draft tools for the “3 Is” approach, . Recruit a consultant to start working on SBCC strategy , . Organize providers training on FP counseling using the REDI model include a component on couples FP counseling in Togo and Burkina Faso, . Organize TOT session on MAP for AgirPF staff in Niger, Mauritania and Lomé.

Result 2. Evidence-Based Service Delivery Approaches Selected, Adapted, and Implemented . Hold consultative meetings with stakeholders to select best practices in Togo; . Research and adapt "Gold Circle" materials, . Develop and Adapt job aids on the selected best practices.

Result 3. Efforts to remove policy barriers and improve contraceptive commodity security coordinated 3.1. Operational Policy barriers identified and new/revised policies adopted and implemented . Organize a SPECTRUM training and RAPID models development workshop in Burkina Faso . Organize an advocacy training workshop in Burkina Faso, as well presentation sessions of the country RAPID model and urban RAPID models of Ouagadougou, Bobo-Dioulasso and Koudougou to the national and city level authorities . Organize an advocacy training workshop in Niger, as well presentation sessions of the country RAPID model and urban RAPID models of Niamey and Maradi to the national and city level authorities.

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V. FINANCIAL BRIEF At the end of the quarter, the financial status of AgirPF project presents the following: . The expenditures for the quarter is $995,322 with the breakdown below: - AgirPF Regional Office: $461,562 - AgirPF Togo: $336,421 - AgirPF Burkina Faso : $85,785 - AgirPF Niger: $91,800 - AgirPF Mauritania: $19,754 . The cumulative expenditures as of June are $3,115,364 which represents 55.13% of the initial obligated amount ($5,651,222). . On 16 June, USAID obligated an additional amount of $3,500,000 to ensure that AgirPF has sufficient funds to implement activities from now to December 2014. This new Obligation will be programmed during the next quarter. . At the close of June 2014, the total obligated amount is $9,151,222 which brings up our pipeline at $6,035,658.

The historical average monthly burn rate is about $332,000. With the end of data collection in Togo and Burkina Faso, we expect to see spending increase in the next quarter (July, August and September) especially as additional staff come onboard in Burkina Faso; vehicles and a generator will be purchased; the project will be launched in Mauritania and related activities will be implemented.

We are slightly overspending under ODC mainly in Occupancy and Other. This is related mainly to two causes: the extended period of rental of vehicles for project use which was not planned to go beyond six months and is only now being resolved with the acquisition of vehicles for Togo and Burkina, and the payment of VAT imposed on the project in Burkina and Togo (even though the VAT paid in Burkina will be reimbursed at the end of the year). Based on the previous expenditures, projected expenditures on this line item from July, August and September 2014 represents $71,752 which will create a slight increase in the ODC line item of our approved budget. However, this variation represents less than 1% of the overall Year 1 approved budget.

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VII. ANNEXES

ANNEX 1. Year 1 Implementation table showing activities completed and yet to be completed

*In the following implementation plan, Q1 corresponds to the partial quarter from July 5 to September 30, 2013. Q5 refers to July 1 to September 30, 2014.

Result 1. Delivery of Quality FP Information, Products, and Services Strengthened and Expanded Activity/Tasks Q1 Q2 Q3 Q4 Q5* Illustrative Status Output/Result (Year 1) SR 1.1: Partners strengthened to implement evidence-based approaches and deliver quality FP services 1.1.1 Staff and equip offices Complete hiring and X X 26 staff members Activity underway orientation of project staff hired and oriented Register EngenderHealth in X X EngenderHealth Initiated but not yet Mauritania registered completed Identify and secure office X Two leases signed Completed spaces in Burkina Faso and Togo Identify and secure office X X Two leases signed Completed for Niger spaces in Mauritania and and Niger initiated but not completed for Mauritania Equip offices in Burkina Faso X X Two offices Completed and Togo equipped Equip offices in Mauritania X X X Two offices Completed for Niger and Niger equipped and not completed for Mauritania Establish Standard Operating X X X SOPs available for Completed for Togo, Procedures for offices four offices Burkina, under review in Niger but yet to be completed in Mauritania Procure project vehicles X X X Five vehicles Activity underway procured 1.1.2 Plan activities in coordination with partners Establish sub-agreementwith X X sub-agreement Completed Futures Institute signed Identify local partners and X X X X At least one sub- initiated but not yet finalize sub-awards award signed per completed country (ongoing) Finalize Year 1 work plan and X X Regional work plan Completed budget, including initial approved country work plans Develop Performance X X Regional PMP Completed Management Plan (PMP) approved

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Activity/Tasks Q1 Q2 Q3 Q4 Q5* Illustrative Status Output/Result (Year 1) Refine country-level work X X X X Four country work Completed plans through consultative plans completed meetings with local and available stakeholders, aligning work plans with countries’ Ouagadougou action plans Conduct a participatory review X X Review conducted Yet to be completed of processes, flow, and reporting systems for FP data in the Health Management Information System of each country Develop/adapt monitoring X X X X Monitoring tools Yet to be completed tools and databases available for each PMP indicator Develop financial and X X X X X Quarterly reports Completed performance reports submitted on time Hold project launch meetings X X Two launch Completed in Burkina Faso and Togo meetings held Hold project launch meetings X X Two launch Completed for Niger in Mauritania and Niger meetings held and Yet to be completed for Mauritania 1.1.3 Conduct baseline assessments Develop protocol and tools for X Four protocols Completed baseline facility audits and approved stakeholder interviews (for FP effort index); secure necessary approvals Train data collectors in x Six data collectors Completed Burkina Faso and Togo trained per country Collect data in Burkina Faso X Data collected Completed and Togo Train data collectors in X Six data collectors Initiated but to be Mauritania and Niger trained per country completed Collect data in Mauritania and X X Data collected Activity underway Niger Analyze data; draft reports X X X Four reports and In progress and presentations presentations completed 1.1.4 Identify and implement quick wins Identify quick win strategies; X X X One strategy Initiated update strategy based on developed and facility audit results updated per country Provide quick win assistance X X X Assistance provided Activity underway, (e.g., FP equipment) to Niger Center of facilities and MOHs in Burkina Excellence has been Faso and Togo partially equipped Page 20 of 41 AgirPF Quarterly Performance Report ● April to June 2014

Activity/Tasks Q1 Q2 Q3 Q4 Q5* Illustrative Status Output/Result (Year 1) Send out call for proposals X Proposals solicited Yet to be completed from CSOs/NGOs eligible for WAAF grants Award and monitor WAAF X X Sub-grants awarded WAAF grant for Togo sub-awards/grants underway Assess local partners’ X X X Four capacity Yet to be completed management, planning, and assessments leadership capacity at baseline conducted and using EngenderHealth’s reviewed with participatory Organizational partners Capacity Assessment Tool (OCAT)

1.1.5 Improve curricula for FP services Integrate exercises on gender X X Two updated Activity underway: sensitivity, couples counseling, curricula validated - FP manual that and youth and male-friendly includes more services into the FP curricula gender exists; for Burkina Faso and Togo; - There is a half-day validate updated curricula training curriculum on couples FP counseling; - There is a 3-day training curriculum on youth-friendly services; Collaborate with stakeholders X X X Two updated Completed in Niger, on curricula review and curricula validated Mauritania. Initiated in update in FP counseling, Burkina Faso and Togo clinical, and infection prevention for Mauritania and Niger 1.1.6 Building training systems around Centers of Excellence Identify one health facility per X Nine Centers of Health centers urban focus area to become a Excellence identified identified in Togo and Center of Excellence Niger, Initiated in Burkina Faso, Yet to be completed in Mauritania Equip Centers of Excellence to X X X 4 Centers of Initiated for Niger meet service delivery Excellence equipped (anatomic models standards provided) and Togo (anatomic models and Audiovisuals materials procured) 2 centers out of 4 have

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Activity/Tasks Q1 Q2 Q3 Q4 Q5* Illustrative Status Output/Result (Year 1) been equipped with anatomic models Refresh trainers on facilitation X X X 10 trainers Completed skills and orient them to the refreshed/ updated curricula oriented Introduce COPE in Centers of X X 9 COPE exercises Yet to be completed Excellence held Support and coach trainers to X 80 providers trained train providers 50 providers trained: completed Produce Gold Circle materials X X X Materials produced Initiated but Yet to be to promote clinics that meet completed quality standards, starting with Centers of Excellence 1.1.7 Support special and mobile FP services Coordinate with Ministry of X 10 Special Days and Special days and Health to plan Special FP Days mobile services mobile services and mobile services in Burkina scheduled scheduled with MOHs Faso and Togo Hold Special Service Days in X X X 10 Special Days held Yet to be completed Burkina Faso and Togo Conduct mobile services in X X Mobile services Yet to be completed Burkina Faso and Togo conducted Coordinate with Ministry of X X 10 Special Days and Completed Health to plan Special FP Days mobile services and mobile services in Niger scheduled and Mauritania Hold Special Service Days in X X 10 Special Days held Organized in 3 facilities Niger and Mauritania with 1440 people reached in Niger but Yet to be completed Conduct mobile services in X X Mobile services Yet to be completed Niger and Mauritania conducted 1.1.8 Organize industry-based activities, including health fairs Identify industry partners X X X Agreements Industries partners established with identified in Togo, four industry Niger and Burkina, partners Agreements and letters of commitment being signed. Yet to be completed in Mauritania Conduct health fairs X Four health fairs Yet to be completed held 1.1.9 Support/supervise CHWs and prepare for handover to local political/health authorities (Togo only) Examine results of AWARE II, X X Results Initiated but Yet to be RESPOND, and interim support documented; completed of CHWs by communities; strategy designed Page 22 of 41 AgirPF Quarterly Performance Report ● April to June 2014

Activity/Tasks Q1 Q2 Q3 Q4 Q5* Illustrative Status Output/Result (Year 1) design approach to scale-up and sustainability Hold quarterly meetings to X X X Strategy validated Yet to be completed discuss handover with political/health authorities Support/supervise CHWs X X X Services offered by Yet to be completed CHWs Organize refresher trainings to X X X 420 CHWs trained Yet to be completed CHWs SR 1.2: Local leaders, civil society, service providers, municipal government support and promote FP 1.2.1 Conduct formative/market research 12Conduct Sixth Sense X Sixth Sense 1 workshop held but Methodology in Togo workshops held to be completed Conduct Sixth Sense X Sixth Sense Yet to be completed Methodology in Burkina Faso workshops held Develop KAP survey protocol X Four protocols Completed and tools approved Secure necessary approvals X Approvals secured Completed

Conduct KAP surveys in Togo X Data collected Completed and Burkina Faso Conduct KAP surveys in Niger X X Data collected Initiated but yet to be and Mauritania completed Analyze data X X Four reports Initiated in Togo, produced Burkina Faso Yet to be completed in Niger and Mauritania 1.2.2 Develop/adapt SBCC strategies and messages Using formative research X X SBCC messages and Yet to be completed findings, adopt/adapt/develop approaches drafted messages and approaches, including radio shows, outreach to youth, social marketing, and mobile technology to engage clients Adapt EngenderHealth’s X X X Curriculum for youth Initiated: Draft Gender Matters curriculum adapted curriculum available and EXP’s materials for use with youth in AGIR countries 1.2.3 Implement SBCC strategies and messages Air couple communication X X X Videos aired; Yet to be completed video in facilities and at outreach events outreach events utilizing held; participants

12 In Q3 Report, there was an error indicating that task 1 of activity 1.2.1. Conduct formative/Market research was completed. Rather read activity initiated and yet to be completed.

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Activity/Tasks Q1 Q2 Q3 Q4 Q5* Illustrative Status Output/Result (Year 1) existing SBCC materials while reached new materials are under development Conduct community events X X X Community events such as theaters presentations held; participants Yet to be completed reached Organize community group X X X Community Yet to be completed conversations using existing conversations held; messages/materials participants reached 1.2.4 Develop 3Is package and conduct workshops to create gender-sensitive FP champions Gather/adapt materials for X X Materials gathered champions from Yet to be completed EngenderHealth and partners Develop 3Is resource package X X X Resource package 3Is resource package (including curricula for developed available excepted engaging religious leaders) Religious engagement curriculum Train partners in 3Is approach X X 135 Yet to be completed partners/facilitators trained Conduct 3Is workshops with X Four workshops Yet to be completed champions held 1.2.5 Conduct facility walk-throughs to engage the community in identifying and addressing barriers to service use Adapt the facility walk- X Tools adapted Initiated: Facility walk- through methodology and throughs methodology tools for Burkina Faso and exists, Togo Draft Guide exists for Burkina and Togo Identify and train facilitators X Facilitators trained Facilitators training for facility walk-throughs in initiated in Togo (7 Burkina Faso and Togo persons oriented) but yet to be done in Burkina Faso and pursued in togo Hold facility walk-throughs in X X 4 walk-throughs Yet to be completed Burkina Faso and Togo that held; action plans engage youth, women’s developed groups, CHWs, and local leaders in identifying and addressing barriers to access

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Result 2. Evidence-Based Service Delivery Approaches Selected, Adapted, and Implemented

Activity/Tasks Q1 Q2 Q3 Q4 Q5* Expected Status Output/Result (Year 1) SR 2.1: Efficiency and effectiveness of approaches enhanced through the adaptation and implementation process 2.1.1 Select best practices to be introduced; adapt approaches to local context Conduct desk review of best X X Presentation Desk review done practices and prepare prepared Presentation prepared presentation for stakeholders but stakeholders not oriented Hold consultative meetings with X X Best practices Yet to be completed stakeholders in Burkina Faso and selected Togo to select best practices Hold consultative meetings with X X Best practices Yet to be completed stakeholders in Mauritania and selected Niger to select best practices Conduct South-to-South study X X Lessons 1 Study trip organized (6 trip with stakeholders documented persons from Burkina, Togo and Niger attended the PPIUD) Rapport and next steps available 2.1.2 Secure necessary approvals, including MOUs and IRB approvals Develop protocol and tools to X X X Protocol approved Yet to be completed study best practices; secure necessary approvals 2.1.3 Test best practices Develop/adapt job aids (“how X X X Job aids Job aids gathering to”) on the selected best developed: fliers, initiated but to be practices for ease of wall charts, posters completed implementation by local organizations Conduct workshops to build X Four workshops Yet to be completed capacity of local organizations to held implement best practices SR 2.2: Lessons documented and disseminated on learning from adaptation and implementation processes and experiences 2.2.1 Hold start-up workshops for project and partner staff on learning, documentation, and advocacy (LDA) strategies; develop LDA objectives Hold start-up workshops on X X Four workshops Yet to be completed learning, documentation, and held advocacy Develop objectives for learning, X X Objectives agreed Yet to be completed documentation, and advocacy in upon collaboration with partners and policymakers 2.2.2 Establish a Community of Practice for FP in West Africa Convene the first meeting of X X Regional Meeting One meeting initiated by members of a small Core Group held AgirPF and held with to start the process WAHO for Community of Page 25 of 41 AgirPF Quarterly Performance Report ● April to June 2014

Activity/Tasks Q1 Q2 Q3 Q4 Q5* Expected Status Output/Result (Year 1) practice establishment. But to be pursued

Result 3. Efforts to Remove Policy Barriers and Improve Contraceptive Commodity Security Coordinated

Activity/Tasks Q1 Q2 Q3 Q4 Q5* Expected Status Output/Result (Year 1) SR 3.1: Operational policy barriers identified and new/revised policies adopted and implemented (in collaboration with HPP) 3.1.1 Develop a strategic action plan to address policy barriers Develop advocacy strategy X X X Strategy documents Advocay strategies exist for each country completed for Burkina, Togo, Niger but to be completed

3.1.2 Prepare RAPID presentations Develop or update RAPID X X X Two RAPID Completed presentations for Togo, presentations Burkina Faso, Niger, and prepared Mauritania 3.1.3 Build the capacity of a coalition of advocates that effectively and expediently implement AgirPF advocacy strategies Conduct advocacy training X Four advocacy 33 from MOH and Local for MOH and local partners, trainings held; 80 Partners including WAHO using 3Is tools such as advocates trained trained in Togo Spectrum and Reality Check 14 partners trained in partnership with WAHO Yet to be completed 3.1.4 Launch initial advocacy activities including outreach to stakeholders Conduct advocacy activities X X X X Six advocacy activities 1 advocacy activity conducted conducted and 7 to come in the next quarter Yet to be completed SR 3.2: Contraceptive commodity needs identified and coordinated among partners, country commodity security, and logistics management committees (in collaboration with DELIVER) 3.2.1 Introduce Reality Check in annual CPT exercises Present and explain Reality X Reality Check Check data to CPT teams introduced in annual during quantification CPT exercises Yet to be completed exercises Hold stakeholder meetings to X Four stakeholder Yet to be completed introduce Reality Check to meetings held decision-makers Train CPT teams and other X CPT teams trained Yet to be completed partners to use Reality Check

3.2.2 Support DELIVER trainings on monitoring and reporting on stock levels Page 26 of 41 AgirPF Quarterly Performance Report ● April to June 2014

Activity/Tasks Q1 Q2 Q3 Q4 Q5* Expected Status Output/Result (Year 1) Support DELIVER trainings at X 40 facility staff trained Yet to be completed the facility level to improve contraceptive security 3.2.3 Establish/support FP committees or Technical Working Groups Participate in MOH X X X X AgirPF involvement in AgirPF staff already committees and TWGs all MOH FP participated to at least 5 Committees and TWGs Committees and TWGs held meeting. To be continued Hold annual synchronization X Annual meeting for CAs and the RHO synchronization Completed at the regional level meeting held Support quarterly meetings X X X Quarterly meetings of the MOH and partners to held Pending to Meetings support contraceptive organized, AgirPF staff security participated to 1 quarterly meeting 3.2.4 Introduce COPE for Contraceptive Security in Burkina Faso and Togo Analyze COPE for X X Produce baseline map Cope for CS available but Contraceptive Security for each urban focus Yet to be completed baseline information from area facility audits (activity 1.1.3) and produce baseline maps Introduce COPE for X Hold nine COPE Yet to be completed Contraceptive Security and exercises and Breakthrough Collaboratives Breakthrough at Centers of Excellence and Collaboratives other facilities where basic COPE methodology has been introduced 3.2.5 Introduce mHealth technology to continuously report on stocks, link with DELIVER advances in logistics systems in each country Develop SMS stock X X X SMS stock monitoring Draft TORs exist for Niger monitoring system in system developed and for AgirPF regional collaboration with MOHs office. But yet to be completed

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ANNEX 3. INDICATOR ACHIEVEMENT BY RESULT

*In the following implementation plan, Q1 corresponds to the partial quarter from July 5 to September 30, 2013. Q5 refers to July 1 to September 30, 2014.

INDICATOR UNIT OF Q1 Q2 Q3 Q4 Q5* ANNUAL and/or PERCENT COMMENTS MEASUREMENT LOP BENCHMARK ACHIEVED SO. Increase access to and use of quality FP services in select urban and peri-urban areas of five francophone West African countries 1. Number of CYP achieved in AgirPF CYP N/A N/A N/A N/A N/A N/A All AgirPF technical supported areas interventions are pending on baseline data collection and measurements will be available starting on Q5 2. Percent of Women of Woman of N/A N/A N/A N/A N/A N/A All AgirPF technical Reproductive Age reported using Reproductive Age interventions are pending on family planning services baseline data collection and measurements will be available starting on Q5 3. Contraceptive Prevalence Rate Prevalence rate N/A N/A N/A N/A N/A N/A All AgirPF technical (CPR) interventions are pending on baseline data collection and measurements will be available starting on Q5 4. Total number of FP method users FP method user N/A N/A N/A N/A N/A N/A All AgirPF technical interventions are pending on baseline data collection and measurements will be available starting on Q5

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INDICATOR UNIT OF Q1 Q2 Q3 Q4 Q5* ANNUAL and/or PERCENT COMMENTS MEASUREMENT LOP BENCHMARK ACHIEVED 5. Number of Acceptors New to New Acceptor N/A N/A N/A N/A N/A N/A All AgirPF technical Modern Contraception interventions are pending on baseline data collection and measurements will be available starting on Q5 6. Total number of FP continuing FP continuing user N/A N/A N/A N/A N/A N/A All AgirPF technical users interventions are pending on baseline data collection and measurements will be available starting on Q5 Result 1: Delivery of quality FP information, products, and services strengthened and expanded

7. Percent of FP service providers FP service provider N/A N/A N/A N/A N/A N/A All AgirPF technical deemed technically competent deemed technically interventions are pending on based on an assessment competent baseline data collection and according to national measurements will be international or other defined available starting on Q5 standards Sub Result 1.1: Partners strengthened to implement evidence-based approaches and deliver quality FP services

8. Number of health centers Health facility N/A N/A N/A N/A N/A N/A All AgirPF technical receiving “quick wins” services interventions are pending on baseline data collection and measurements will be available starting on Q5 9. Number of local organizations AgirPF local N/A N/A N/A N/A N/A N/A All AgirPF technical with improved organizational implementing partner interventions are pending on and management capacity as baseline data collection and measured by a defined measurements will be organizational assessment tool available starting on Q5

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INDICATOR UNIT OF Q1 Q2 Q3 Q4 Q5* ANNUAL and/or PERCENT COMMENTS MEASUREMENT LOP BENCHMARK ACHIEVED 10. Number of local organizations Local NGO N/A N/A N/A N/A N/A N/A All AgirPF technical following defined guidelines for interventions are pending on a monitoring and evaluation baseline data collection and plan measurements will be available starting on Q5 11. Number of FP curricula updated FP curriculum N/A N/A N/A N/A N/A N/A All AgirPF technical to include gender sensitivity, interventions are pending on couple counseling, youth and baseline data collection and male friendly services measurements will be available starting on Q5 12. Custom Number of local non- Local NGO N/A N/A N/A N/A N/A N/A All AgirPF technical government organizations interventions are pending on trained and providing quality baseline data collection and family planning and reproductive measurements will be health services available starting on Q5 13. Number of people trained in Person trained in FP N/A N/A N/A 50 N/A N/A All AgirPF technical family planning and reproductive and RH interventions are pending on health with USG funds baseline data collection and measurements will be available starting on Q5 14. Custom Number of local Local organization N/A N/A N/A N/A N/A N/A All AgirPF technical organizations that meet USG interventions are pending on financial reporting standards baseline data collection and measurements will be available starting on Q5 15. Number of HIV positive women HIV positive woman N/A N/A N/A N/A N/A N/A All AgirPF technical who received comprehensive FP interventions are pending on services baseline data collection and measurements will be available starting on Q5

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INDICATOR UNIT OF Q1 Q2 Q3 Q4 Q5* ANNUAL and/or PERCENT COMMENTS MEASUREMENT LOP BENCHMARK ACHIEVED 16. Number of HIV positive pregnant HIV positive pregnant N/A N/A N/A N/A N/A N/A All AgirPF technical women who received woman interventions are pending on sensitization on FP services baseline data collection and during Ante Natal Care (ANC) measurements will be available starting on Q5 17. Number of HIV positive women HIV positive woman N/A N/A N/A N/A N/A N/A All AgirPF technical who received Post Abortion FP interventions are pending on (PAPF) services after an abortion baseline data collection and measurements will be available starting on Q5 18. Percent of HIV positive women HIV positive woman N/A N/A N/A N/A N/A N/A All AgirPF technical sensitized in FP during ANC who interventions are pending on effectively received Post-Partum baseline data collection and FP (PPPF) services measurements will be available starting on Q5 19. Number of local organizations Local organization N/A N/A N/A N/A N/A N/A All AgirPF technical following defined guidelines for interventions are pending on a monitoring and evaluation baseline data collection and plan measurements will be available starting on Q5 20. Number of Centers of Excellence Center of Excellence N/A N/A N/A N/A N/A N/A All AgirPF technical reinforced interventions are pending on baseline data collection and measurements will be available starting on Q5 21. Number of special FP days Special FP day N/A N/A N/A 1 N/A N/A All AgirPF technical conducted interventions are pending on baseline data collection and measurements will be available starting on Q5

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INDICATOR UNIT OF Q1 Q2 Q3 Q4 Q5* ANNUAL and/or PERCENT COMMENTS MEASUREMENT LOP BENCHMARK ACHIEVED 22. Number of industry based health Industry based health N/A N/A N/A N/A N/A N/A All AgirPF technical fairs conducted fair interventions are pending on baseline data collection and measurements will be available starting on Q5 23. Number of CHWs supported and CHW N/A N/A N/A N/A N/A N/A All AgirPF technical supervised interventions are pending on baseline data collection and measurements will be available starting on Q5 24. Number of community-based Community-based N/A N/A N/A N/A N/A N/A All AgirPF technical services that have been service interventions are pending on transferred to local/national baseline data collection and health authorities measurements will be available starting on Q5 Sub Result 1.2: Local leaders, civil society, service providers, municipal government support and promote FP

25. Number of experiential message Experiential message N/A N/A N/A N/A N/A N/A All AgirPF technical development workshops held development interventions are pending on workshop baseline data collection and measurements will be available starting on Q5 26. Number of men and women Man and woman N/A N/A N/A N/A N/A N/A All AgirPF technical reached with FP messages interventions are pending on through interpersonal baseline data collection and communication measurements will be available starting on Q5 27. Proportion of women and men Man and woman N/A N/A N/A N/A N/A N/A All AgirPF technical reporting increased dialogue interventions are pending on with their partner about FP baseline data collection and measurements will be available starting on Q5

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INDICATOR UNIT OF Q1 Q2 Q3 Q4 Q5* ANNUAL and/or PERCENT COMMENTS MEASUREMENT LOP BENCHMARK ACHIEVED 28. Changes in community/religious Community/religious N/A N/A N/A N/A N/A N/A All AgirPF technical leaders’ attitudes toward FP leader’ attitude interventions are pending on toward FP baseline data collection and measurements will be available starting on Q5 29. Proportion of target population Man and woman N/A N/A N/A N/A N/A N/A All AgirPF technical with gender-equitable attitudes with gender-equitable interventions are pending on attitude baseline data collection and measurements will be available starting on Q5 30. Changes in provider attitudes on Provider attitudes on N/A N/A N/A N/A N/A N/A All AgirPF technical gender issues gender issues interventions are pending on (outcome indicator) baseline data collection and measurements will be available starting on Q5 31. Number of the targeted Individual reached N/A N/A N/A N/A N/A N/A All AgirPF technical population reached with with individual and or interventions are pending on individual and or small group small group level HIV baseline data collection and level HIV prevention prevention measurements will be interventions that are based on interventions available starting on Q5 evidence and or meet standards required 32. Number of MARP reached with Individual in MARP N/A N/A N/A N/A N/A N/A All AgirPF technical individual and/or small group interventions are pending on level HIV preventive baseline data collection and interventions that are based on measurements will be evidence and/or meet the available starting on Q5 minimum standards required

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INDICATOR UNIT OF Q1 Q2 Q3 Q4 Q5* ANNUAL and/or PERCENT COMMENTS MEASUREMENT LOP BENCHMARK ACHIEVED 33. Number of individuals who Individual who N/A N/A N/A N/A N/A N/A All AgirPF technical received Testing and Counseling received T&C interventions are pending on (T&C) services for HIV and baseline data collection and received their test results. measurements will be available starting on Q5 34. Number of youth who A young individual N/A N/A N/A N/A N/A N/A All AgirPF technical participate in educational interventions are pending on program on gender, FP, and SRH baseline data collection and measurements will be available starting on Q5 35. Number of health facility walk- Health facility N/A N/A N/A N/A N/A N/A All AgirPF technical throughs conducted interventions are pending on baseline data collection and measurements will be available starting on Q5 Result R2: Evidence-based service delivery approaches selected, adapted, and implemented

36. Number of BPs for family BP for FP and MCH N/A N/A N/A N/A N/A N/A All AgirPF technical planning and maternal and child and/or HIV/AIDS interventions are pending on health and/or HIV/AIDS baseline data collection and incorporated into local, district measurements will be or national health protocols or available starting on Q5 standards 37. Percent coverage of children Child under 5 years N/A N/A N/A N/A N/A N/A All AgirPF technical under five years of age reached old interventions are pending on with health services (malaria, baseline data collection and pneumonia, and diarrhea). measurements will be available starting on Q5 Sub-result 2.1: Efficiency and effectiveness enhanced through adaptation and implementation

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INDICATOR UNIT OF Q1 Q2 Q3 Q4 Q5* ANNUAL and/or PERCENT COMMENTS MEASUREMENT LOP BENCHMARK ACHIEVED 38. Number of new family planning New FP approach N/A N/A N/A N/A N/A N/A All AgirPF technical approaches successfully interventions are pending on introduced through USG baseline data collection and supported programs measurements will be available starting on Q5 39. Number of best practices piloted Best Practice N/A N/A N/A N/A N/A N/A All AgirPF technical through operations research interventions are pending on studies baseline data collection and measurements will be available starting on Q5 Sub-result 2.2: Lessons documented and disseminated from adaptation and implementation

40. Number and type of lessons Lesson documented N/A N/A N/A N/A N/A N/A All AgirPF technical from adaptation and and disseminated interventions are pending on implementation that have been baseline data collection and documented and disseminated measurements will be available starting on Q5 41. Custom Number of regional of technical meeting, N/A N/A N/A 1 N/A N/A All AgirPF technical technical meetings organized conference call interventions are pending on and supported by the Regional baseline data collection and Health Office and its partners measurements will be available starting on Q5 42. Custom Number of publications, publication, N/A N/A N/A N/A N/A N/A All AgirPF technical presentations and meetings to presentation and interventions are pending on disseminate program data to key meeting baseline data collection and stakeholders measurements will be available starting on Q5 Result R3: Efforts to remove policy barriers and improve contraceptive commodity security coordinated

Sub-result 3.1: Policy barriers identified and new/revised policies adopted and implemented

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INDICATOR UNIT OF Q1 Q2 Q3 Q4 Q5* ANNUAL and/or PERCENT COMMENTS MEASUREMENT LOP BENCHMARK ACHIEVED 43. Number of policies, national policy, national health N/A N/A N/A N/A N/A N/A All AgirPF technical health standards and guidelines standards and interventions are pending on developed or changed, including guidelines baseline data collection and scale-up measurements will be available starting on Q5 44. Number of policies or guidelines new policy, law and N/A N/A N/A N/A N/A N/A All AgirPF technical developed or changed with USG guidelines interventions are pending on assistance to improve access to baseline data collection and and use of family planning and measurements will be reproductive health services available starting on Q5 45. Number of advocacy strategies Advocacy strategy N/A N/A N/A N/A N/A N/A All AgirPF technical developed by organization interventions are pending on baseline data collection and measurements will be available starting on Q5 46. Number of advocacy Advocacy N/A N/A N/A 11 N/A N/A All AgirPF technical presentations created or presentation interventions are pending on updated (in collaboration with baseline data collection and FI and HPP) measurements will be available starting on Q5 47. Custom Number of new New Maternal and N/A N/A N/A N/A N/A N/A All AgirPF technical Maternal and Child Health Child Health policy interventions are pending on policies implemented after 6 baseline data collection and months according to defined measurements will be standards available starting on Q5 48. Number of advocacy activities Advocacy activity N/A N/A N/A 1 N/A N/A All AgirPF technical conducted interventions are pending on baseline data collection and measurements will be available starting on Q5 Sub-result 3.2: Contraceptive commodity needs identified and coordinated among partners and country commodity security and logistics management

Page 36 of 41 AgirPF Quarterly Performance Report ● April to June 2014

INDICATOR UNIT OF Q1 Q2 Q3 Q4 Q5* ANNUAL and/or PERCENT COMMENTS MEASUREMENT LOP BENCHMARK ACHIEVED 49. Number of Contraceptive Contraceptive N/A N/A N/A N/A N/A N/A All AgirPF technical Procurement Table (CPT) team Procurement Table interventions are pending on members and partners trained baseline data collection and to use Reality Check measurements will be available starting on Q5 50. Number of COPE exercises for COPE exercise N/A N/A N/A N/A N/A N/A All AgirPF technical Contraceptive Security held interventions are pending on baseline data collection and measurements will be available starting on Q5 51. Number of SDP reporting stock- SDP N/A N/A N/A N/A N/A N/A All AgirPF technical outs of contraceptives per interventions are pending on quarter baseline data collection and measurements will be available starting on Q5

Page 37 of 41 AgirPF Quarterly Performance Report ● April to June 2014 ANNEX 4. AgirPF staff positions by country

Country Name Title Sex Regional Rouguiatou Diallo Chief of Party F staff based Andre Koalaga Technical Director M in Togo Martin H. Laourou Policy Advisor M Diouratie Sanogo Monitoring, Evaluation, and M Research (M&E/R) Advisor Macka Barry Operations and Finance M Manager Eric B. Yendoutie Regional Contract Officer M Komlambigue Agodomou Adjito Regional Senior Program M Officer Contraceptive Security To be filled Regional Senior Program Officer SBCC/Marketing To be filled Driver Burkina Koalga Djabada Oscar Country Manager M Faso Habibou Romba Ouédraogo Senior Program Officer F Zakari Congo Regional ME&R Officer M Salif Savadogo Administrative M Assistant/Bookkeeper To be filled Driver Togo Eloi Ayaménou Koami Country Manager M Amegan Cyrille Kossi Mawuko Guede Senior Program Officer M (Technical) Adjoa-Sika Amegadjen Administrative Assistant/ F Ekoue Bookkeeper To be filled Driver Niger Fatimata Moussa Country Program Manager F Mariama Moussa Senior Program Officer F (Technical) Soumana Abdoulaye Administrative M Assistant/Bookkeeper To be filled Driver Mauritania Amadou Kane Country Manager M To be filled Administrative Assistant/Bookkeeper To be filled Driver Total 16 full-time staff with 11 men and 5 women 16 AgirPF

Page 38 of 41 AgirPF Quarterly Performance Report ● April to June 2014 ANNEX 5: Activities tables

Table 1: AgirPF Baseline study samples surveyed in Togo Summary Table Of Field Data Collection In Togo (AgirPF Baseline study, May 2014)

Health Facilities Community Health Workers Household survey Disabled Site Inventory FP service providers Men Women Men Women Men Women P* R** P R P R P R P R P R

LOME 1 14 14 27 27 28 22 28 16 154 154 308 308 8 10 LOME 2 14 14 34 34 28 18 28 19 154 164 308 321 0 0 SOKODE 21 21 43 43 42 25 42 13 228 235 456 477 7 6 KARA 23 23 45 45 46 34 46 25 249 258 498 501 6 5

TOTAL 72 72 149 149 144 99 144 73 785 811 1570 1607 21 21 Completion rate 100 100 69 51 103 102 *P= Planned; **R = Realized

Table 2: Trained participants during start-up skill standardization workshop in Burkina Faso

Participants Sex and Profile Focused Cities in Burkina Physicians Medical Assistants Midwives Total Faso M F M F F Ouagadougou 0 0 0 3 6 9 Bobo-Dioulasso 1 0 1 0 2 4 Koudougou 0 0 0 2 2 Total 1 0 1 3 10 15

Page 39 of 41 AgirPF Quarterly Performance Report ● April to June 2014 Table 3: Trained participants during start-up skill standardization workshop in Niger.

Participants Sex and Profile Technical Health Nurse Focused Cities in Niger Physicians Midwives Total (TSS) M F M F F Maradi 1 0 1 0 3 5 Niamey 3 3 1 5 3 15 Total 4 3 2 5 6 20

Table 4: Distribution of workshop participants during Mauritania Training on SPECTRUM and RAPID model in Nouakchott Urban RAPID model elaboration in May 26-29, 2014

Institution Number of participants by sex Men Women Total Ministry of Health (central level) 3 3 6 Ministry of Economy and Development 1 0 1 Ministry of Primary and Secondary Education 0 1 1 Ministry of social action and women 1 0 1 Ministry of Agriculture 1 0 1 Ministry of Communication 1 0 1 Ministry of Labor 1 0 1 National Office of Statistics 1 0 1 Regional Health Team Nouakchott 1 1 2 Business coalition 0 1 1 Civil Society Organizations 3 1 4 UNFPA and HPP 2 1 3 CNLS AIDS national committee 1 0 1 AgirPF 1 0 1 TOTAL 17 8 25

Page 40 of 41 AgirPF Quarterly Performance Report ● April to June 2014 Table 5: Repartition of participants in SPECTRUM Training and RAPID models development workshop from June 24-27, 2014 at Africa Hall in Niamey Institution Participants by sex Men Women Total Office of the Republic President (FP/RH WAHO 0 1 1 Champions) Office of the Prime Minister( FP/RH WAHO 1 0 1 Champions) National Parliament 1 0 1 Ministry of Health (central level) 5 0 5 Ministry of Finances 1 0 1 Ministry of Planning (SP/PDES) 0 1 1 Ministries of Education 2 1 3 African Union (CELTHO) 1 0 1 Ministry of Population 0 1 1 Ministry of Agriculture 1 0 1 Ministry of Communication 1 0 1 Regional Health Teams 2 2 4 Business coalition 1 0 1 Civil Society Organizations 4 4 8 UNFPA and DELIVER PROJECT 3 0 3 AgirPF 1 2 3 TOTAL 24 12 36

Table 6: Distribution of participant in Advocacy training workshop at Kpalimé in Togo from June 11- 13, 2014 Participants byby sex Institution Men Women Total Ministry of Health 2 0 2 Ministry of Social Action and Women Promotion 0 1 1 Regional Health Teams 3 3 6 Network of Advocacy Champions for Adequate Funding of Health 9 2 11 (RCPFAS) Other Civil Society Organizations 5 1 6 UNFPA 1 1 WAHO 1 1 2 AgirPF 3 1 4 TOTAL 24 9 33

Page 41 of 41 AgirPF Quarterly Performance Report ● April to June 2014