Table 2

Preliminary impacts of PLGHA on health services and systems *

The Associção Moçambicana Para o Desenvolvimento da Família (AMODEFA), an International Planned Parenthood Federation (IPPF) affiliate (did not certify PLGHA)Mozambique
  • Referral system

  • Partnerships

  • Clinic closures

  • HIV testing

  • Lost 60% of its budget

  • Closed 10 of its 20 youth-friendly clinics throughout the country

  • Terminated 30% of its staff

  • Severed referral partnerships with foreign NGOs that did certify the policy, disrupting patient flows and technical collaboration

  • An 89% drop in the number of adolescent girls and young women receiving HIV testing in Xai-Xai district from a 3-month period before the implementation of PLGHA to a 3-month period following implementation of PLGHA40

Asociación Pro-Bienestar de la Familia de Guatemala (APROFAM), an IPPF affiliate (did not certify PLGHA)Guatemala
  • Zika

  • FP

  • Community outreach

  • Subsidised care

  • Forced to close the 2-year USAID-funded ‘Ensuring Family Planning Access during Zika Outbreaks’ project early, which undercut ability to sustain and expand community education activities and provider trainings

  • Reduced community-based health educators from 12 to 3

  • Reduced subsidies to cover FP methods and IUD insertion (K Roberts, personal communication, 26 July 2018)

Botswana Family Welfare Association (BOFWA), an IPPF affiliate (did not certify PLGHA)Botswana
  • Clinic closures

  • HIV services

  • Partnerships

  • Closed HIV clinics in two districts; clients on ART were referred to other (government) sites against their wishes

  • HIV services scaled down, expected to fall by 62.3% on BOFWA-supported sites

  • Men who have sex with men (MSMs) and female sex workers (FSWs) were forced to discontinue seeking care in safe spaces at BOFWA sites to government facilities serving the general population (I Onyango, personal communication, 6 November 2018)

Marie Stopes Madagascar (did not certify PLGHA)Madagascar
  • FP

  • Mobile health

  • Adolescent health

  • Subsidised care

  • Forced to end clinical outreach work and an FP voucher program, which supported over 170,000 free and voluntary contraception services that were otherwise unavailable to women in rural, remote regions.47

Anonymous NGO (did not certify PLGHA)Uganda
  • Prevention of maternal mortality

  • Chilling effect

  • Discontinued advocacy on maternal mortality from unsafe abortion due to over interpretation of PLGHA48

Anonymous NGO (certified PLGHA)Uganda
  • Prevention of maternal mortality

  • Chilling effect

  • Stopped training health workers on using misoprostol to prevent postpartum haemorrhage due to fear of reprisal by USG donor48

  • *These are preliminary impacts that have been documented by international NGOs.

  • FP, family planning; NGO, non-governmental organisation; PLGHA, Protecting Life in Global Health Assistance; USAID, US Agency for International Development; USG, US government.