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Legacy Documents

A series of technical briefs showcasing ESD's approaches and models for delivering family planning and reproductive health services in 18 countries

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Community-Based Work


Nepal: Reaching the Urban Poor with Family Planning/HTSP Messages: This case study documents how the Nepali Technical Assistance Group (NTAG), with support from Extending Service Delivery (ESD) Project, applied a multifaceted, community-based approach providing information and education on Healthy Timing and Spacing of Pregnancy (HTSP) to a marginalized, urban poor population in Kathmandu, Nepal.


Home-based Private Midwifery Clinics Serve the Hard-to-Reach: A Promising Practice Model: This paper shows how ESD has supported the Basic Health Services Project in Yemen to assist midwives with setting up private practices in rural communities where fixed facilities and services do not exist, or are far away.

Care For Mother

Care for the Mother (Daryelka Hoyada): A Community-Based Model to Increase Use of Family Planning/RH/HIV Services in North Eastern Kenya: This paper describes how ESD worked with women's livelihood groups, influential community members, and health providers in the North Eastern Province of Kenya to educate women on safe motherhood practices, strengthen the skills of providers, and improve linkages between communities and health facilities.

Corporate Social Responsibility

Promoting HTSP through Pharmaceutical Partnerships and Professional Associations: This paper examines how ESD mobilized private sector companies and networks to support one of USAID’s technical priority areas—healthy timing and spacing of pregnancy (HTSP)—by supporting research, developing evidence-based recommendations and information on HTSP, and promoting the use of field-friendly HTSP messages, based on evidence of the health benefits of pregnancy spacing.

Integrating Family Planning/Reproductive Health in the Private Sector through Health Systems Strengthening in Manufacturing and Agriculture: This paper describes ESD's innovative approach to private sector health system strengthening in manufacturing and agriculture that (1) leverages existing global institutions that influence the behaviors of private corporations and their suppliers and (2) designs best practice tools, data and programs specifically for the business sector.

Transferring Knowledge and Skills: An Effective Approach for Promoting Public-Private Partnerships in Reproductive Health and Family Planning: This paper describes the promise and limitations of a strategy that uses training workshop to help non-governmental health organizations, governments and businesses to understand public-private sector partnerships in health and to provide them with tools for developing effective collaborations. 


Healthy Images of Manhood: A Male Engagement Approach for Workplaces and Community Programs Integrating Gender, Family Planning and HIV/AIDS: Healthy Images of Manhood (HIM) was launched in January 2008 in partnership with Unilever Tea Tanzania Ltd. at the company’s estates in south-central Tanzania. It is now being replicated at Unilever Tea Kenya Ltd., many other Kenyan companies, and community programs in Burundi focusing on Congolese refugees and internally displaced Burundians. This paper describes the HIM approach and how it can be scaled-up.

Healthy Timing and Spacing of Pregnancy

Mainstreaming Healthy Timing and Spacing of Pregnancy: A Framework for Action: This paper shows how ESD has worked in partnership with local organizations across the world to promote the healthy timing and spacing of pregnancy (HTSP).


Integration of FP/MCH/HIV/AIDS Programs 

Cover_NEP_FP_HIV_IntegrationIntegration of HIV and Other Health Services in APHIA II: Leveraging an HIV Project to Support Broad Health Service Access in Kenya's North Eastern Province: This report describes the implementation of integration approaches that enhanced health service access and quality improvement under the AIDS, Population, and Health Integrated Assistance Project: North Eastern Province (APHIA II NEP) in the areas of HIV prevention, care, and treatment; tuberculosis; maternal, newborn, and child health, including preventing mother to child transmission; and reproductive health/family planning.

Integration PaperIntegrating Family Planning into Health Programs: Experiences from Burundi, Tanzania and Kenya:This paper examines how ESD increased access and support for information and services focusing on family planning, reproductive health, and the healthy timing and spacing of pregnancy by integrating health programs across the continuum of care, from communities to health facilities in Burundi, Tanzania and Kenya.

Religious Leaders

ESD Model: Mobilizing Muslim Imams and Religious Leaders as “Champions” of Reproductive Health and Family Planning: This paper depicts ESD's model for engaging religious leaders as "champions" of reproductive health and family planning, which is applied in Bangladesh, Nigeria, Pakistan and Yemen.

nullMuslim Religious Leaders as Partners in Fostering Positive Reproductive Health and Family Planning Behaviors in Yemen: A Best Practice: The paper shows how ESD partnered with the Basic Health Services Project in Yemen to engage Muslim religious leaders as champions of reproductive health and family planning, and partners in fostering social change and development.

Scaling-Up Best Practices 

Scaling-Up Best Practices to Meet Millennium Development Goals 4 & 5: A Tailored Approach to Spreading Best Practices: A technical meeting held in Bangkok motivated public health stakeholders from across Asia and the Middle East to introduce life-saving best practices focused on family planning, and maternal, neonatal and child health. This paper describes how.

Creating a Model for Emergency Obstetric and Newborn Care: Scaling-Up Best Practices in Indonesia: This paper shows how Indonesia’s Tangerang Hospital became a model for improved emergency care for pregnant mothers and newborns with limited resources from the government and ESD. Because of the success at Tangerang Hospital and surrounding public health facilities, the Indonesian government supports continued scale-up of the intervention throughout the country’s public hospitals and health facilities.

Improving Health through Postpartum Home Visits, Family Planning Counseling: Scaling-Up Best Practices in Egypt: This paper shows how ESD helped Save the Children/Egypt improve maternal and newborn health in Egypt’s Kaliobia Governorate by scaling-up the government’s postpartum care package in 13 villages, and training community health workers and nurses to put the package into practice.

Accelerating the Spread of Best Practices in Postpartum Care: Scaling-Up Best Practices in Yemen: This paper shows how Yemen’s Al Saba’een Hospital became a model for postpartum care and family planning services with limited resources from the government and ESD. As a result of the success at Al Saba’een Hospital, the Yemeni government supports continued scale-up of the intervention to all of the country’s public hospitals and rural health facilities.

NTAG Nepal BriefIncreasing HTSP Knowledge and Postpartum Contraceptive Use Among the Urban Poor: Scaling-Up Best Practices in Nepal: This paper shows how ESD helped the Nepali Technical Assistance Group (NTAG) deliver birth spacing messages, increase Lactational Amenhorrea Method (LAM) use, and improve knowledge of postpartum contraception in Kathmandu Metropolitan City and Surkhet Municipality.

Pop Council EgyptIntegrating Family Planning into Clinic-Based Antenatal Counseling and Community-Based Postpartum Care Services:Scaling-Up High Impact Practices in Egypt: This paper shows how ESD partnered with Population Council/Egypt to deliver birth spacing messages for improving postpartum contraception use in eight districts in the governorates of Assiut and Sohag in Upper Egypt.

Pop Council IndiaIncreasing Health Service Visits and Family Planning Use Among Young Women in Rural India:Scaling-Up Best Practices in India: This paper shows how the Extending Service Delivery (ESD) Project used a best practices approach to increase health service visits among pregnant women in India and enhanced community awareness of family planning methods through public and private partnerships.

Improvement Collaborative coverThe Improvement Collaborative in Yemen: A Scale-Up Approach for Expanding Access to Postpartum Maternal and Newborn Care and Family Planning: Scaling-Up Best Practices in Yemen: This paper shows how ESD is scaling-up best practices in reproductive health and family planning in partnership with the Yemen Ministry of Public Health and Population, using an approach that combines traditional interventions and quality improvement with a shared learning methodology.


Reaching Underserved Youth with Reproductive Health and Family Planning Services: An ESD Approach: This paper takes a look at how ESD changed community norms in support of healthy adolescent behaviors, specifically in Nigeria and Yemen.

“Safe Age of Marriage” in Yemen, Fostering Change in Social Norms: A Case Study: This paper describes how ESD, with the Basic Health Services Project in Yemen and the Yemeni Women Union, implemented the “Safe Age of Marriage” program as part of a national effort to reduce maternal and neonatal mortality. 

ESD Country Briefs

ESD in Angola 

ESD in Burundi & Democratic Republic of Congo  

ESD in Guinea

ESD in Kenya (North Eastern Province)

ESD in Yemen







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