Updates from the 2019 Ingenuity Fund Winners
In 2019, the 120 Under 40 project launched a new funding mechanism designed to reward fresh, inventive thinking that will enable breakthroughs in family planning and reproductive health, and made this opportunity available to all 120 Under 40 Winners. Since then, nearly all the winners of the fund have completed their proposed project and reported incredible experiences and outcomes. Below a few updates from the individual projects.
Bridge The GAP (Giving Access to Planning) Phase II
By: Laraib Abid- Pakistan, Executive Director and Founder of MASHAL (Making A Society Healthier And Lively)
Pakistan was the sixth most populous country and according to 2019 reports is now at the fifth rank and has a prominent youth slot. However, the sexual and reproductive health and right concerns of the population, particularly the youth, remain unaddressed at the policy level as well in terms of implementation. It’s a fact that free SRH services are easily available in the targeted area i.e. province wide (Punjab, Pakistan), still the outreach is limited. Keeping the scenario in mind MASHAL decided to Bridge the GAP (BTG) by active engagement of youth and community and developing an innovative & one of its own kind intervention a Web Application as well as the enhancement of the already developed Android version.
The Application contains:
- All types of Contraceptive methods for both men & women
- HIV/AIDS causes, treatment & symptoms along with myths
- Geo-tagging of Family Health Clinics providing Free of cost family planning Services in respective city
- Toll Free Helplines of public Hospitals responsible for counseling I.e. Psychologists
- Content available in both English and Urdu Language 6. Development of content in Audio version
- FAQs and quizzes regarding reproductive health
- Promoting gender responsive life skills-based education
- Targeted research for adolescents and young people
- Promoting gender focused socio-cultural research to address and guide interventions for eliminating harmful cultural practices
- Promoting research, capacity development and knowledge sharing on population development
- Capacity development to mainstream and integrate population, reproductive health and gender into national policies
The application “Bridge the GAP” was launched on March 12, 2020 and is available on Google Play. Since then, Laraib has received a lot of media attention and accolades as a young innovator and entrepreneur.
IKO (I Know One)
By: Peter Ngure- Kenya, Team Lead at Pathways Policies Institute
Iko; a Kiswahili word meaning- I Know One (IKO) project is a vision of a provider-biased free society; aimed at recognizing and awarding Health care providers who are bold enough to offer Family planning to adolescent and Youth out of conventional setting i.e. normal working hours or spaces, normal ages, ‘normal’ sexual orientation.
The project was birthed through the realization that Provider bias; brought about by individual and health system values played a major role in denying youth access and choice to family planning. There lack adolescent/youth ambassadors among health workers; people who will go out of their normal schedules to engage the adolescent and youth with information and services at the spaces where the young people are most comfortable without bias or judgmental attitude.
The project aims at identifying, motivating, and recognizing the BOLD health workers and giving them a platform to speak out, mentor their peers and challenge the societal mindset. The project also aims to contribute to the reduction of unmet need for FP for adolescents in Kenya from 30% to 20% by recognizing and awarding 7 BOLD health workers in Laikipia and Samburu counties through profiling and awarding them as a way of motivating them to continue being bold. There will be a follow up to support the 7 Awarded Health workers to act as mentors to their peers on Adolescent and Youth FP access by December 2019. While the Immediate goal will be to have the 7 BOLD health workers reach at least 10 service providers within their sub counties by February 14 on Valentine’s Day 2020; The eventual goal is to scale up from the 70 to an overall pool of 60% BOLD health workers within these counties with Zero provider bias towards provision of FP to adolescent and youth within a period of three years.
Using focus group discussions, Peter and his team have been able to gather key insights from youth as to what influences their decision to seek out and engage a FP&RH provider, and have used that information to develop a score card that will be the basis of how the awards are determined.
Key Insights from Youth FGD:
- Providers are trained to communicate with youth in a respectful and non-judgmental manner
- The facility has policies of confidentiality and privacy for youth
- The facility has convenient hours to engage the youth – especially since some are in school at the hours when facilities normally open
- The location of the facility is accessible for young people, as well as a nonthreatening environment (Not near the school, church etc)
- The fees are affordable
- Youth participate in developing policies and implementing services through an advisory board, as peer educators, and in other roles
- A need to be received in a friendly manner, to be given ample time to explain themselves and to get adequate follow-up services
Since the launch of the IKO awards in September 2019, there is a new energy within the health workers and their leadership in the two counties; with just a week of sensitization, Peter and his team have received more than 20 written submissions by health workers on what they are doing that is different. This shows that health workers indeed, given the opportunity, can help create the biased free society that we are all looking forward to.
120 Under 40 Collaboration for Safe Sustainable Miscarriage Management in Trinidad & Tobago
By: Kizanne James & Alison Hathaway – Trinidad & Tobago
The loss of a pregnancy during the first 13 weeks gestation is a common occurrence, which happens in approximately 10% of known pregnancies. When someone experiences an early pregnancy loss or miscarriage, there are various options for treatment, including expectant management, medication, and surgical intervention. Currently, hospitals in Trinidad & Tobago are offering dilatation and sharp curettage (D&C) for miscarriage management.
While D&C is a surgical treatment for miscarriage management and early pregnancy loss, it is associated with more bleeding, pain, and complication than manual vacuum aspiration (MVA). According to the World Health Organization (WHO), “vacuum aspiration should replace D&C. The rates of major complications of D&C are two to three times higher than those of vacuum aspiration.” (WHO, 2012).
The Ipas Manual Vacuum Aspirator (MVA) is a small, non-electric, handheld device that can provide safe, fast, and less painful uterine evacuation for patients requiring miscarriage management. The fact the MVA can be performed under a local anesthetic, instead of general anesthesia, is safer for patients and more cost effective for hospitals.
With the support of a grant from the 120 Under 40 Ingenuity Fund, Dr. Kizanne James and Nurse Practitioner, Alison Hathaway, have partnered together as advocates for patient-centered, evidenced-based care in Trinidad & Tobago. They utilized funds to purchase Ipas MVAs and sterile cannulae for Scarborough General Hospital in Tobago. They collaborated to provide hospital-based training to impart new clinical skills to medical providers and ameliorate care to patients.
- Train medical doctors at the O&G Department in the proper techniques for Manual Vacuum Aspiration using scheduled sessions, led by Nurse Practitioner A. Hathaway.
- Provide equipment needed to perform Manual Vacuum Aspiration for a period of approximately three (3) years.
- Create a video-documentary of the implementation of Manual Vacuum Aspiration technique at the hospital.
- Create and implement monitoring and evaluation procedures, to ensure we are meeting our outcomes.
- Host a pre-implementation meeting with stakeholders to discuss concerns and ideas for improvement.
- Media interviews- to sensitize the public about the new procedure and the work the hospital is doing for the community.
- Develop hospital protocol for Manual Vacuum Aspiration.
This “positive disruption” has the capacity to improve outcomes for women who have suffered an early pregnancy loss. This pilot project will help create a model for how to bring MVA training and sustainability to other countries, ultimately decreasing maternal morbidity and mortality. Thanks to the 120 Under 40 Ingenuity Fund, this small idea may have big repercussions for family planning in Trinidad & Tobago, and beyond.
“One main insight that we have learned is that working on improving access to women’s health services in a multi-country context, involves laborious efforts and large increments of time. The bureaucracy that occurs in hospital settings, as well as the complexities of coordinating medical supply shipments without an in-country distributor, can lead to delays in moving forward. Our experience taught us that it is crucial to be flexible and have a back-up plan. It also taught us that collaboration is key to the success of a project such as this one.”
Whispa Mobile App
By: Morenike Fajemisin- Nigeria, Co-founder & CEO Whisper Health Limited
Preventing unwanted pregnancies and unsafe abortions is a health investment that young people especially stand to benefit from their entire lives. In Nigeria, modern contraceptive use is only 12% while fertility rates are high at 5.3 births per woman. This dichotomy is estimated by PMA2020 to result in 2.7million abortions annually in Nigeria. Facing social stigma from family and peers, biases from health care workers, common myths and misconceptions, and having few financial resources, young people avoid contraceptive and sexual healthcare-seeking and often have few means for taking charge of their own health and shaping the trajectory of their lives.
Morenike’s solution-WHISPA mobile app, aims to improve access to contraceptives through electronic counseling by our doctors and referrals. WHISPA is able to use technology to simplify and improve the process of contraceptive counseling and eligibility testing while following WHO’s guidelines. WHISPA mobile app intends to reduce the rate at which young people who seek any sexual health information, product or service are discouraged by myths, misconceptions, follow up, or simply meet biased health providers.
It is expected that WHISPA will in-time impact the following outcomes:
reduce myths about the side effects of contraceptive methods
increase user’s satisfaction with the quality of care and customer experience received
increase the popularity of the app as a resource for accessing a wide range of sexual health info, products, and services among young people.
Through “whispers” to friends, WHISPA expects to leverage the power of social networks since this the main way that many women become aware of contraceptive options.
WHISPA’s prospects for scalability begins with expanding from Lagos to other cities in Nigeria (Abuja, Port Harcourt). WHISPA can also be replicated in many other countries both within and outside Africa, provided there is a network of youth-friendly clinics and high smart-phone penetration among young people.
Pornography, Pleasure, Protection
By: Lucy Wilson- United States of America
As internet and smart phone access increases around the world, youth will use it – to stream pornography. Where smart phone access is already ubiquitous, it is estimated that more than half of adolescents have watched pornography by the time they turn 14. Pornhub is the 25th most visited website in the world, and 6 porn sites are within the top 100. Because porn is increasingly accessible and socially acceptable, many young people have already watched numerous sex acts by the time they have their first live sex act with another person. Their expectations of what sex is like, and what turns on or pleases other people, is thus highly influenced by what they have seen. They are acting out what they see in pornography and expecting what appears to be normal and pleasurable on their screen to be what they experience and enjoy in real life. Porn can potentially have both positive and negative effects. It may increase acceptance of LGBTQIA populations and encourage learning about pleasure. It may also increase sexual violence or discourage condom use. And from a family planning perspective, the depiction of external ejaculation may increase use of withdrawal. Regardless of its impacts, porn is not going away. So how do we address it in our work as sexual and reproductive health and rights (SRHR) practitioners?
This project will raise awareness among SRHR practitioners of the need to take account of pornography in our work. If we study the potential impacts of porn viewing on SRHR, we can begin to develop interventions to respond to those impacts – addressing the negative and highlighting the positive.
Thank you to our partners and jury participants, the Ingenuity Fund is made possible with support from Bayer.