*Are you registered for the International Conference on Family Planning 2022?
First name/Last name
Country of residence, City, State/Province
Type of Organization
- Youth-led, youth-run organization
- Community-based organization
- Global INGO
- Other, please describe_________________________
Title of your project (500 characters with spaces)
Briefly describe the specific problem you aim to address in order to bring care closer to all people so that sexual and reproductive health information and services can be accessed equitably and universally. (1500 characters with spaces)
Briefly describe your innovative solution and explain how it will bring quality care closer to all. (1500 characters with spaces)
Clearly define the population you aim to serve with your innovative solution. (500 characters with spaces)
How would you classify your approach to improving access to quality reproductive and sexual health care? (Please select all that apply)
- Community engagement
- Service provision/models of care
- Other (please specify) ____________________________
Briefly explain how your solution will contribute to the broader global discourse and learning around sexual and reproductive health. (500 characters with spaces)
Please tell us the role youth and/or the communities you seek to engage will have in designing and implementing this project. (500 characters with spaces)
How do you envision that you might continue the work you’ve begun when QIC funding ends? Please elaborate on any linkages you plan to build with local government, health policymakers and community-based organizations to foster continuity of this work? (1500 characters with spaces)
Location (Country, State/Province) for innovation (250 characters with spaces)
Approximate budget needed to implement this innovation.
Duration required to implement this innovation (in months).
Are you currently a grantee with the Foundation’s RH program. Y/N
If yes, please list the project name and country.
Complete the following sentence: Quality reproductive and sexual health services matter to me because… (500 characters with spaces)