This year marks the 40th anniversary of Marie Stopes International, one of reproductive health’s pioneer organizations.
Throughout their four-decade history, MSI has participated in and shaped gender issues in development. The organization has often been among the first to introduce interventions, advocate their effectiveness, and push for even more access.
Today, the organization works in 37 countries around the world. The challenges have changed over time — from those faced by women in London in 1976 to women in Yemen today — but their approach of working locally with communities and governments has built vital trust and respect across the sector.
“Marie Stopes International is an evolving organisation but remains constant in its mission, ‘Children by Choice, Not Chance,’” Batya Atlas, external adviser with MSI Australia, told Devex.
“Over the past 40 years, MSI has expanded their services and altered their service provision based on new and emerging best practice. However, the founding commitment to providing women with choice through comprehensive counselling and quality service provision in family planning, contraception and other sexual and reproductive health services remains unchanged.”
At the forefront of change
MSI’s approach has evolved over 40 years to address challenges for women in a variety of different socio-cultural and economic contexts. The organization has responded to significant global shifts over that time, including “changing attitudes to sexual and reproductive health, challenges around cultural and social barriers for women to make decisions about their sexual and reproductive health and fluctuations in funding,” Atlas said.
MSI was founded in London and took its first step into developing countries by providing services in Sri Lanka and Kenya. Since then, the organization has pioneered health work in developing countries, discussing the need for sexual and reproductive health services with religious and political leaders in the toughest countries for gender equality including Afghanistan, Bosnia and Yemen.
Over four decades, the organization has introduced innovative services and products, pioneered new models of service delivery and worked to tackle challenges around supply and demand in contraception markets. Initiatives include tools to measure the impact of reproductive health services, services for women who have undergone an unsafe abortion, training and monitoring to ensure high quality standards of service and using data to better target services toward communities in need. MSI has also helped strengthen capacity in sexual and reproductive service provision in partnership with governments and private providers all over the world.
Throughout its work, the organization has shaped discussion on women’s rights. MSI was as a key organization supporting maternal health initiatives under the Millennium Development Goals and now the Sustainable Development Goals. They also partner with the United Nations Population Fund to support health programming.
Their history has seen them at the forefront of clinical techniques and international standards by using the most innovative tools, products, techniques and staff available allowing them to continue scaling up work and increase impact over time.
In part through the work of MSI and other advocates, development agencies, governments and funding bodies are increasingly taking note of gender equality.
“MSI has refined and enhanced its approach to remain at the forefront of practice and delivery. From education, to providing access to contraception and reproductive healthcare,” Jo Pradela, head of policy and advocacy at the Australian Council for International Development, told Devex.
“Over 40 years, they have overcome challenges to build trust with some of the world’s poorest and most remote communities. This trust has been crucial in addressing sensitive, often taboo issues and providing women with the most appropriate help and support to plan a family,” Pradela said.
MSI Today: Responding to the needs of women where they live
Today, that experience has produced a business model for reaching women in developing countries with family planning tools.
First, the organization provides care directly through MSI centers in urban regions. Services include family planning services and sexual and reproductive healthcare, including cervical cancer screening and HIV testing.
For women living outside urban areas, mobile outreach teams made up of service providers and educators travel between local health centres, dispensaries or other available community sites to offer services.
To encourage knowledge and use of MSI services, the organization works to build support from governments, for example by working to build local public sector capacity. Social marketing, which aims to change attitudes and behavior around family planning, has also helped increased access to high quality contraceptive products and family planning commodities. MSI relies on commercial distribution networks, encouraging them to market and distribute products to users.
MSI also builds social franchising networks, which use private providers to help deliver healthcare services, increase awareness among women, build capacity and improve access to quality products, equipment, supervision and marketing.
The business model has successfully seen MSI serve 120 million clients over the last 40 years, according to the organization. In 2015, nearly 21 million people were using a modern contraceptive method provided by MSI, which also provided more than 3.4 million safe abortion and post-abortion care services.
“Together, these services helped prevent an estimated 6.3 million unwanted pregnancies and 18,100 maternal deaths,” Atlas said.
Shaping discussions on gender in development
MSI also remains a strong policy advocate, lobbying governments and international organizations to prioritize reproductive health as a fundamental of women’s rights.
“MSI strongly supports the link between reproductive rights and gender equality, and the critical importance of choice,” Atlas said. “MSI’s advocacy efforts and continued provision of information, education and quality services have played a role in improving gender equality, particularly in the fight for women in developing countries to access comprehensive sexual and reproductive health services.”
MSI works in a number of places Atlas describes as “restrictive environments which are socially, culturally and religiously quite conservative.” They have had to tailor their advocacy accordingly. “The link between the prevention of early pregnancy, girls’ education and subsequently to women’s empowerment speaks to the role family planning agencies play in advance gender equality,” she said.
Discussing rights of women with decision makers, local leaders and government enables them to address policy gaps and challenge decisions — often made by men — that limit the ability of women to choose if and when they want a child. One ongoing example is MSI’s work in Yemen, where the organization is providing services despite the country impacted by conflict.
Continuing to progress the rights of women
Despite 40 years of providing assisting to women, there is still more work to be done. Over 220 million women are still living in the world today with an unmet need for family planning.
“There is much to be done to support women in both developing and developed countries,” Atlas said. “In some countries it’s about advocating for more comprehensive access to family planning while in others it’s about improving quality of care or expanding equitable and affordable access for those with unmet need.”
Conservative politics and rising religious right movements will challenge the rights of women to choice going forward. But plans for the next 40 years are already underway. MSI will continue their work to increase women’s access to quality sexual and reproductive health and family planning services and address cultural and social barriers to help women exercise their health rights. They plan to focus on improving partnerships with both the public and private sectors to develop new and sustainable approaches to service delivery and which increases their geographic impact.
Most importantly, they will save the lives of women.
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