Transforming the health of women and girls for 25 years
Over the last 25 years, Options has transformed the health and lives of women and girls experiencing injustice and inequality in countries around the world.
Options began in 1992 as a group of experts specialising in maternal and reproductive health. Over the last 25 years we have grown into a global team delivering transformative programmes across health systems in more than 60 low income countries. Our experts work at all levels, from national and local governments to health facilities and communities. In countries such as Nepal, Kenya and Yemen, this has enabled more people to access services they were previously unable to reach or pay for. Our advocacy and communications teams have catalysed social change, including equipping local champions with the evidence needed to advocate for action to address health issues.
Where we've worked
Access for All
Nepal | 1997 - current
Reducing costs and distance to health services
Options has been working in Nepal for 20 years with the UK and Nepal governments; a period in which the survival rates for women and babies during pregnancy and childbirth have dramatically improved. Our work has focused on enabling women to access the healthcare they need by overcoming financial, geographic and social barriers. Simultaneously we have helped to strengthen the volume and quality of maternity services. We designed and introduced the first health financing scheme in 1997, with transport subsidies for pregnant women now an inherent part of government provision. Today, 70 of the 75 districts offer emergency obstetric care compared with just 6 in 2003. All districts, including those in the high mountains, now provide safe delivery and family planning services. Through our advisers embedded in the Ministry of Health we are supporting the government to develop gender and socially inclusive policies and plans so that no one is left behind. And we are helping to build a strong and resilient health system by making sure new infrastructure can withstand future natural disasters.
Increase in deliveries assisted by skilled birth attendants in remote mountain districts
Reduction in the under-five mortality rate per 1,000 live births
Nowadays women have more benefits than ever before…we receive incentives for transport, free delivery care, clothes for babies…there were no such provisions in my mother’s time! I also received transport incentive and free care after the devastating earthquakes.
Kenya | 2015 - current
Bringing services closer to those hardest to reach
To support Kenya’s transition to a devolved system of government, we are working in Bungoma County to support the delivery of better access to high quality health services. Bungoma county government now has the capacity to ensure health services are planned and budgeted for, so that facilities have the equipment, drugs and staff they need to deliver quality services. We have trained community health volunteers to support women throughout their pregnancy, and educated mothers in pre- and post-natal care. Nearly 20,000 women from poor communities can now access essential health services that they previously could not afford.
Women have received transport vouchers enabling them to reach health facilities for delivery
Increase in deliveries assisted by skilled birth attendants in 6 sub-counties in Bungoma
More facilities able to provide emergency obstetric and newborn care services in 6 sub-counties in Bungoma
2015 – 2017
Women were referred by Birth Companions to health facilities to give birth
Our role is to educate mothers. It is so important because previously many women died from the lack of knowledge. They didn’t use the facility to deliver their babies. Now that we have community health volunteers, it is improving. There are fewer maternal and neonatal deaths.
Community Health Volunteer, Bungoma County
Yemen | 2012 — current
Increasing access to reproductive health services for poor women in remote areas
The war in Yemen has exacerbated the challenge of providing reproductive health services across a country in which 62% of women want to use family planning methods, but in rural areas only 27% have access to them. We operate a voucher scheme which enables women to access family planning and maternal services free of charge and at the same time enables the health facilities to sustain their services. Due to the conflict, the reimbursements that facilities receive from the voucher programme represent one of their only funding sources. It allows them to pay salaries, purchase drugs and supplies, conduct repairs and improve the quality of their services.
2013 – 2016
Safe motherhood and family planning vouchers have been distributed to women
2013 – 2016
Safe deliveries have taken place as a result of the voucher scheme
2013 – 2016
Women have used a family planning service using the vouchers
In our fragile Yemen, the Voucher Programme addressed poverty in communities and proved to be a lifeline for thousands of needy women to access safe motherhood services while enhancing health system and supporting public health facilities to recover, albeit lack of public financing.
Strong and Resilient Health Systems
India | 2008 – 2016
Integrating health, nutrition and WASH
Working in one of India’s poorest states, we supported the Government of Odisha to improve the health and nutritional status of women and children. We helped to integrate nutrition and water, sanitation and hygiene services into the broader health system. At community level we empowered women’s groups and village organisations to address local barriers to better health and nutrition. Our support for community-led sanitation led to many more households having their own toilet. To reduce malaria, we worked with government to distribute and promote treated mosquito nets, especially for pregnant women and young children in highly affected areas. Over the period of our work, infant and under five mortality rates fell significantly and stunting in children under five in Odisha declined at an average annual rate of 2.7% between 2006 to 2016; higher than the national rate. Also, the use of health services increased, especially amongst the poorest and most vulnerable groups.
Reduction in number of infant deaths from 69 to 51 per 1000 births
For every 1000 children below 5 years old deaths reduced from 95 to 63
Households access to sanitation facilities increased from 14% to 44%, with the greatest increase among vulnerable groups
All the 12 families belonging to the Bhuian tribe of the particularly vulnerable tribal groups have toilets of their own now. There is a strict prohibition of open defecation in the village.
Leader of the hamlet
Nigeria | 2009 – current
Enabling communities to hold decision makers to account
Communities play a central role in holding local government and service providers accountable for improving the functioning of health systems. In Nigeria, we worked to establish Village Health Committees in communities across eight states. These Committees are made up of volunteers who together represent and act as spokespersons for people in the community. They work with health workers and local government representatives to identify problems in the health system and work together on solutions to address these. Village Health Committees contributed to improving the quality of health services provided and patient’s experiences of care, resulting in more people using services.
Village Health Committees were established across 8 states to monitor and improve health services
of Village Health Committees in Enugu improved health services in their community
raised by Ward Health Committees in Lagos to pay for improvements in health facilities in 2014
This is the first time that we here in Sankara have seen the impact of a committee. Maternity services started at the clinic, we have been sensitized so much so that the number of people that are now going to the clinic has jumped from a trickle to hundreds. The clinic has come alive for us and our neighbours.
Malam Dauda Abubakar
Chief Imam of Sankara Community in Jigawa State
Sierra Leone | 2014-2016
Strengthening capacity of laboratory testing services
Health systems need to be resilient to ensure essential services respond rapidly and effectively during periods of crisis. We helped transform the Sierra Leone Directorate of Hospitals and Laboratory Services into a strong unit within the Ministry of Health and Sanitation, actively collecting and using data to improve the capacity of laboratories. At the height of the Ebola epidemic, we were contracted by the UK government to support the government in Sierra Leone to improve laboratory performance. To stop the virus from spreading it was essential to reduce the time taken from specimen collection to communication of test results to less than 24 hours. Together with partners, we reduced the average turnaround time of Ebola testing in Western Area district, from above 48 hours to below 24 hours in just two months. To help prevent future epidemics, we worked with local stakeholders to build stronger laboratory data systems which support early detection of disease outbreaks.
Average turnaround time of Ebola testing in Western Area reduced by half in 2 months, to stop transmission
Over half of problems in the Ebola testing system were resolved with our support
District Hospital Laboratories showed improved capacity between 2015 and 2016
By establishing the Laboratory Information System and associated standardised tools, Sierra Leone will be better placed to respond to any public health issue.
Dr Victor Matt Lebby
Director Hospitals and Laboratory Services, Sierra Leone Ministry of Health and Sanitation
Changing Social Norms
Ethiopia, Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania | 2012 — current
Using evidence for action on maternal and newborn survival
Evidence is essential to achieving better decision making about how to improve health services. Through the Evidence for Action-MamaYe (E4A-MamaYe) programme, we deliver a unique approach to accountability that drives quality health services and improves maternal and newborn survival. We empower decision makers to be more transparent and accountable in how they plan, budget, monitor and take action for better quality health services. We support activists, NGOs, media, health professional groups and government, to use scorecards to catalyse improvements in quality of care. In Nigeria, State Led Accountability Mechanisms (SLAMs) transform how decisions are made and have achieved increased health budget commitments. In Tanzania, we helped government translate the national RMNCH policies into effective regional and district plans and budgets. In Ethiopia, findings from Maternal and Perinatal Death Surveillance and Response systems are now acted upon to reduce preventable deaths. E4A-MamaYe’s practical accountability approach has led to sustainable improvements in maternal and newborn health services across 7 countries.
Our accountability approach helped health professionals, media and CSOs to successfully advocate for increased health budget in Bauchi State, Nigeria
Health professionals trained in Ethiopia to report and review maternal deaths to improve the quality of maternal and newborn health services
% 2012- 2014
E4A-MamaYe contributed to a 37% decrease in the number of women dying from pregnancy and childbirth related complications in Mara region, Tanzania
This scorecard will help the people of Rumphi to hold to account people in authority. The mechanism is particularly helpful because we are sure it will improve our budget efficiency while ensuring that every player is more transparent and accountable.
Chairperson, Harry Mnyenyembe
Rumphi District Council, Malawi
Burkina Faso, Egypt, Ethiopia, Kenya, Mali, Nigeria, Senegal, Somalia, Sudan, The Gambia | 2014 – current
Empowering young people to end FGM
Globally, over 44 million girls affected by FGM are below the age of 15. Through The Girl Generation and End FGM Grants Programme, we have brought together the largest collective of organisations across Africa, working to end FGM in one generation. Our youth networks in Kenya, Nigeria, The Gambia and Sudan are working alongside our Ambassadors to influence decision makers. These young people reach tens of thousands through events and media, ensuring a more sustainable and powerful movement to drive forward the social and systemic changes required to end FGM. We also support grassroots organisations to work with communities to protect and promote the value of young girls. We are investing in young people through leadership training and providing rapid grants to youth activists and grassroots organisations to scale up sustainable change to end FGM.
Channelled to over 100 frontline organisations working to end FGM, reaching over 35,000 people across 3 countries
People have heard end FGM messages through the radio
Engaged in youth initiatives, via work carried out directly or indirectly by The Girl Generation
The Girl Generation gave young people in Nigeria an opportunity to work together and speak in one voice boldly towards the abandonment of FGM. We launched the Youth Anti-FGM Network; the very first organised platform where young people who desire change, work together to intensify efforts to end FGM in one generation.
Kelechukwu Lucky Nwachukwu
Programme Officer for Nigeria
Over these 25 years Options has contributed to the huge gains that have been made towards internationally agreed goals, particularly for women and girls accessing essential services and making choices that enable them to lead healthier lives.
Looking ahead, the Sustainable Development Goals provide a great opportunity for shared, coherent strategies that can address critical environmental, economic, political and security challenges. Our work has positioned us to contribute to this agenda. The approaches that have been effective in promoting women’s health and survival, through strengthening governance, accountability, and galvanising social movements, can help the global community reach key objectives for which commitments have been made. We believe we can foster effective partnerships that will advance the SDG agenda, including ensuring women’s access to family planning, improved maternal and child nutrition, and responding to new global health threats. Options will grow our partnerships in these and other areas to help deliver further transformative change.
I’d like to thank all those in the Ministry of Health and the partners for this excellent programme. In particular, congratulations for having such important impacts for the poorest members of society in the most remote areas. You have really been able to provide vital care and life saving support to people way out in the remotest districts. I think it’s a great tribute to you all that you’ve been able to reach so many people, living in so many difficult situations. Many congratulations.
Team Leader, Governance and Service Delivery Team, DFID Nepal