The first phase of the programme, which ended in December 2016, included the following key activities:
- Developing multi-year national operational plans aligned to the regional proposal;
- Conducting a baseline study and many focused assessments;
- Capacity building for implementing partners;
- Developing/adapting programme educational packages;
- Identification and scaling up of best and promising practices.

The 2gether 4 SRHR Programme is a comprehensive regional programme with applied learning in ten countries, funded by the Regional SRHR Team of Sweden. The programme aims to improve the sexual and reproductive health and rights (SRHR) of all people in East and Southern Africa, particularly adolescent girls, young people and key populations, by promoting an integrated approach to SRHR, HIV and gender-based violence. Read more

Impressive progress in maternal health has been achieved in East and Southern Africa but the region still sees far too many maternal deaths and ill health related to pregnancy and childbirth, and far too many young people who cannot get needed contraception. The region has the world’s second worst rate of maternal mortality at 455 deaths per 100,000 live births. See our key activities - Innovation Accelerator and TuneMe - and our Knowledge Hub.

On average, a woman has 4.4 children, and just over one third of married women aged 15-49 years use modern contraception. This data underlines the need to redouble efforts in East and Southern Africa (ESA) to improve the quality and coverage of sexual and reproductive health (SRH) services. This requires a combination of investment, evidence, policies, programmes and advocacy.

UNFPA’s flagship project, Preventing Maternal Deaths in East and Southern Africa (PreMDESA), used a multifaceted approach. It aimed to provide robust evidence to inform successful design and implementation of sexual and reproductive health programmes, as well as support formative research in areas of innovation, demographics, and data.

PreMDESA’s rich basket of activities covered a continuum of interlinked areas and issues:
- Supplying life-saving contraceptives and training health providers to improve both access to and quality of family planning services;
- Research on key reproductive health issues provided hard evidence to inform policies to revitalize family planning;
- Targeting under-served, marginalized groups expanded their access to, demand for and use of reproductive health services;
- Using social media to reach young people with information drove behaviour change - see TuneMe and Innovation Accelerator;
- Improving data capture and analysis produced evidence for advocacy on how to harness the demographic dividend.

The programme provided family planning services to three million users, including nearly half a million additional users, resulting in 2,126 maternal deaths averted, 765,875 unintended pregnancies averted, and 3,725,543 couple years of protection provided.

Read how PreMDESA reduced maternal deaths
Research reports

The integration of HIV services with sexual and reproductive health (SRH) services is an important part of the global response to HIV and SRH. An integrated approach to the management of HIV and SRH makes good ‘people’ sense as it benefits clients and service providers alike, and is likely to improve efficiency in service provision. The Sexual and Reproductive Health and Rights (SRHR) and HIV Linkages in East and Southern Africa project sought to make a difference in health service delivery by linking SRHR and HIV at the policy and system levels. It supported the institutionalization of integrated SRH and HIV service delivery strategies and models in 10 countries in East and Southern Africa.

Phase I of the project was carried out in seven countries – Botswana, Lesotho, Malawi, Namibia, Swaziland, Zambia and Zimbabwe. This phase was supported by the European Union (EU) and the Governments of Sweden and Norway with a total of $15 million for the period 2011-2015.

It aimed to promote efficient and effective linkages between HIV and SRHR policies and services as part of strengthening health systems and to increase access to and use of quality services. It also contributed to the goals of universal access to reproductive health (MDGs 3, 4 and 5) and HIV prevention, treatment, care and support (MDG 6).

Phase II of the project, running from 2016-2019, built on the results of and lessons learned from phase I. Phase II extended to three further countries – Kenya, South Africa and Uganda, taking the number to ten.

Results from phase I showed that the integrated services model promoted in the project led to improvements in service uptake. Examples of this are an increase in the number of people accessing family planning (FP), HIV and other SRHR services; increased uptake of HIV testing and counselling (HTC) and anti-retroviral treatment (ART) when needed; increased coverage of prevention of mother-to-child transmission (PMTCT), in particular the number of newborns screened for HIV; and, increased number of women and girls screened for cervical cancer.

The purpose of phase II of the project was to institutionalize the provision of a minimum package of integrated, non-discriminatory SRH and HIV services in 10 ESA countries by 2019. In at least 3 countries, this included GBV services as part of the minimum package.

What were we aiming towards?       How did we plan to achieve this?      The findings      Publications and resources       For more detailed information, click here.