In 2023, EPSCF partnered with PSI Ethiopia to expand Counseling for Choice (C4C) to 40 sites in Oromia and South Ethiopia regions of Ethiopia. C4C is a person-centered contraceptive counseling method that builds trust between providers and patients, allowing women and girls to feel more confident about making contraceptive decisions.

For three years, EPSCF is supporting PSI’s Strengthening Adolescent Health and Quality Improvement (SAHQI) initiative, which represents and expansion of C4C to 40 health facilities by training 100 health providers. C4C was built upon years of foundational and systemic SRH work supported by PSI, Marie Stopes International, Children’s Investment Fund Foundation (CIFF), Gates Foundation, and Global Affairs Canada. 

Intervention sites are measured against current contraceptive counseling practices and evidence gathered will be used to advocate for a change in existing contraceptive counseling approaches with the Ministry of Health. Key objectives include:

1. Train 100 primary healthcare unit (PHCU) supervisors, family planning service providers and HEWs to strengthen their capacity on C4C

2. Implement the C4C approach to family planning counseling at 40 facilities 

3. Provide quality contraception counseling and linkages to services for 10,500 adolescent girls and young women 

Key Achievements (January - December 2024)

• 116 healthcare providers and HEWs trained, surpassing the original target of 100 through three rounds of cascading C4C training conducted for Primary Health Care Unit (PHCU) directors, HEW supervisors, and family planning providers. 

• 10,592 AGYW ages 15-24 years received C4C counseling at SAHQI sites between May and December 2024. 

• 10,387 (98% of AGYW counseled) AGYW 15-24 years adopted a contraceptive method of their choice, of which 44% of opted for long-acting reversible contraceptives (LARCs) 

• 4,889 new acceptors adopted a contraceptive method for the first time. 

• 5,498 repeat acceptors continued using a contraceptive method.

• 166% increase in contraceptive uptake among 15-19 year olds compared to pre-SAHQI implementation. 

• This performance exceeded project targets, demonstrating the impact of the C4C approach in improving access to and continuation of family planning services among AGYW. The team is revising targets for the remaining project period. Based on the current outperformance PSI hopes to reach an additional 25K AGYWs with counseling and a total of 16,095 with FP acceptance. Further analysis is required and will be shared on our next update call next week. 

• Annual Quality of Care (QoC) Evaluation conducted in collaboration with the Ministry of Health, showing >80% performance scores. 

Sustainability 

• PSI is actively engaging the Ministry of Health to advocate for the integration of the C4C approach into national policies and training frameworks.