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Family Planning/Reproductive Health

HP+ More recent Family Planning/Reproductive Health publications are available.

  • Tracking health budget allocations is critical in assessing whether resources allocated in the health sector are aligned to key policy objectives as articulated in policy documents. In Kenya, the Constitution requires that at least 15 percent of the national revenues should be allocated to the county governments to fund the devolved functions that include health. This study assessed the trends in allocations between 2013/14 and 2014/15, and sought to establish whether the allocations were aligned to sector priorities both at the national and county level.

  • The Uganda Family Planning Costed Implementation Plan, 2015–2020, published by the Ministry of Health, was launched by the government in November 2014. Its objective is to reduce unmet need for family planning to 10 percent and to increase the modern contraceptive prevalence rate among married women to 50 percent by 2020. The plan includes strategies to improve demand creation; service delivery and access; contraceptive security; policy and enabling environment; financing; and stewardship, management, and accountability. The cost of the total plan is $235 million USD between 2015 and 2020, which will increase the number of women in Uganda currently using modern contraception from approximately 1.7 million users currently in 2014 to 3.7 million in 2020.

    Uganda's gap analysis found a total financial gap of about $113 million for all six years of the FP-CIP. As the total cost for the FP-CIP is $235.8 million, less than half of the activity costs in the CIP are covered by currently planned funding between 2015 and 2020. The size of the gap in Uganda differs by year; the largest gap is in 2019, with a gap of $21.8 million. The larger gaps in the later years are due to a steady increase in reach of activities within Uganda in line with projected scale-up of demand and services for FP in line with the country’s goal to reach a 50% modern contraceptive prevalence rate among married women by 2020. In addition, government and development and implementing partners often have insufficient knowledge of what would be funded past the initial first few years of the FP-CIP due to funding cycles and programme timelines.

    The gap analysis provides clear evidence that the Ugandan government and in-country development partners are focusing significant effort on financing the purchase of contraceptives. However, evidence has shown that for family planning interventions to be effective, financial support and efforts need to be dedicated to providing a holistic rights-based FP programme that includes demand generation efforts, improvement in the quality of service provision, supply chain improvements, strong policies and financing, and coordinated planning, management and supervision at national and decentralized levels.

  • In response to the need for a standard analytical framework by which to evaluate PHE programs, the USAID-funded Health Policy Project (HPP) developed the present tool to define the interactions between interventions in each of the three sectors—population, health, environment—and to show the synergies that can result from an integrated, multisectoral approach. HPP built a generalized PHE computer model/framework that can be applied to any PHE program. To access the PHE Framework, please contact the Health Policy Project, www.healthpolicyproject.com. 

  • Developed with support from the USAID-funded Health Policy Project, A Guide for Advocating for Respectful Maternity Care is a comprehensive resource centered on the Respectful Maternity Care charter, a groundbreaking consensus document that demonstrates the legitimate place of maternal health rights within the broader context of human rights. Written for national-level advocates, this guide presents a variety of ways to (1) build a sense of entitlement among women and communities regarding respectful maternity care (RMC) and (2) advocate for the institutionalization of RMC as a core value of the maternal care system. Specifically, the guide provides information and user-friendly tools and techniques to help advocates

    • Raise awareness and generate demand from civil society for RMC rights;
    • Mobilize communities to hold local leaders and service providers accountable for RMC rights; and
    • Secure commitment at the national level to institutionalize RMC as the standard of care.

    Also available for download as individual documents are the charter, titled Respectful Maternity Care: The Universal Rights of Childbearing Women, and accompanying brochure and poster (in English, Arabic, French, and Spanish).

  • The potential economic benefits of the demographic dividend and the policies required to achieve it are well-documented at the global level. However, no universally applicable model exists in the public domain to project the demographic dividend in individual countries. This poster presents a study by the USAID-funded Health Policy Project to develop an empirically sound projection model that can be readily applied in any high-fertility country using national data on standard economic, demographic, and social indicators to estimate the effects of a future demographic dividend and specific policies required. The poster was presented at the 2014 Population Association of America Annual Meeting.

  • The presence of supportive FP/RH policies is considered an integral component to successful programs. However, much remains to be known about how policies are implemented, especially in a complex political, sociocultural and economic environment. This poster outlines the various methodologies that can be used to study policy implementation, which include descriptive methodologies such as literature reviews and case studies; analytic methodologies such as stakeholder mapping and analysis, cross-sectional surveys and system dynamics; quasi-experimental and experimental studies; studies describing policy implementation within complex adaptive systems, such as, path dependence; and mixed methods as well including focus groups, document analysis and interviews. This poster was presented at the Population Association America conference on May 1, 2014.

  • Civil society organizations (CSOs) can make an important contribution to health programs and public welfare by encouraging governments to involve citizens and technical specialists in identifying and addressing important human needs. Good governance exists when decisionmakers are accountable to the public; processes are transparent; institutions and information are directly accessible; and the government is able to serve the needs of its people effectively. The Health Policy Project prepared this brief to provide leaders of CSOs working in family planning, HIV care and treatment, and maternal health with guidance on ensuring good governance, social accountability, and transparency.

    This is one of two briefs focused on advancing country ownership for improved health. The other brief can be accessed here: Networking and Coalition Building for Health Advocacy: Advancing Country Ownership.

  • The demographic dividend is an important opportunity for economic development that arises through population change. As fertility rates fall and the share of working-age adults rises, the dividend can boost economic growth and productivity, raising incomes and allowing families and governments to invest more in the health, education, and well-being of future generations. There is the potential for a dividend in Malawi based on demographic trends such as its age structure and dependency ratio. To open the window of opportunity and achieve a demographic dividend, sustained and integrated investments in demographic, economic, and social policies and programs are required beginning today.

  • This USAID-funded Health Policy Project analysis summarizes how one strategy— reducing the unmet need for family planning in line with Malawi’s FP2020 goals—can make achieving and sustaining the MDGs more affordable in Malawi, in addition to directly contributing to the goals of reducing child mortality and improving maternal health. Calculations show that for every dollar invested in family planning between 2013 and 2025, the government of Malawi could save five dollars in other social services such as education, immunization, malaria, maternal health, and water and sanitation.

  • The Millennium Development Goals (MDGs)—a set of eight important, time-bound goals ranging from reducing poverty in developing countries to providing universal primary education—represent a blueprint for global development agreed to by member states of the United Nations and international development institutions. Uganda has made significant progress in reducing maternal and child mortality, but areas such as improved sanitation coverage, malaria, and universal primary education have seen less improvement. This analysis by the USAID-funded Health Policy Project shows how one strategy— reducing the unmet need for family planning (FP) in line with Family Planning 2020 (FP2020) goals—can make achieving and sustaining the MDGs more affordable in Uganda, and directly contribute to further reducing child mortality and improving maternal health.

  • The United Nations Population Fund, the Zimbabwe National Family Planning Council, and the USAID-funded Health Policy Project collaborated to analyze how investment in family planning can contribute to achievement of the Millennium Development Goals (MDGs) in Zimbabwe. The Family Planning Cost-benefit Calculator was used to estimate the cost savings to achieve five of the eight MDGs.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide FP services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing FP by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Updated analyses on the costs of meeting the Millennium Development Goals (MDGs) indicate that countries would save money by investing in family planning programs. For example, in the nine francophone countries in West Africa, if governments provide family planning services to women who want to space or limit future births, countries would realize considerable savings in programs designed to address MDGs for maternal and child health, environmental sustainability, communicable diseases, and primary education. The savings in reduced costs outweigh the additional costs of providing family planning by a factor of 3 to 1 for the nine francophone countries as a whole. Summaries of the findings for the region in each country are available in English and French.

  • Over the past decade, large scale global health initiatives have had great successes in supporting improved health outcomes in many countries. Each country is unique in building its approach to public health programming, but these partnerships are beginning to identify common principles toward working together. In fall 2012, a consultation cosponsored by amfAR, the Health Policy Project (HPP), International Planned Parenthood Federation (IPPF) Africa Region, and Planned Parenthood Global brought together multi-disciplinary stakeholders to identify priorities and models for ensuring civil society engagement in health decision making. This report presents the findings of the consultation, examines civil society’s role in sustaining public health and transitioning to the country ownership model, and offers recommendations for civil society, governments, donors, and international development partners.

  • With support from the USAID-funded Health Policy Project, the White Ribbon Alliance for Safe Motherhood (WRA) is striving to promote midwifery and improve midwives' working conditions by (1) influencing policymakers, (2) involving the media, (3) engaging youth, (4) mobilizing the community, and (5) strengthening the capacity of midwives as advocates at the global, national, and local levels. This brief demonstrates how advocacy approaches can lead to a more supportive environment for midwives and ultimately better maternity care and birth outcomes. Advocates need to inform policymakers of the priority issues needing their attention and the steps necessary to improve midwifery. The brief includes a number of examples for advocates to learn from and include in their advocacy strategies. It also provides an opportunity for WRA to share advocacy learning and models with global partners to foster continued and additional advocacy efforts that are needed to further position midwifery as a central component of integrated maternal and newborn health systems.  

  • For several decades, civil society organizations (CSOs) in Nigeria have been advocating for increased resources for reproductive health (RH) and family planning (FP) services and commodities. Many people assume that once policymakers make a public commitment to provide funding for a specific purpose, the funds are assured. However, such a commitment is only the first step in securing budgetary allocation. The necessary steps include formal approval for the budgetary allocation, inclusion of the funds in the approved budget, release of the funds for the program, and expenditure of the funds intended.

    CSOs can play a key role in ensuring that public funds are used for the intended purpose and actually reach the intended beneficiaries. To do so, they need to understand the budgetary process and the role of nongovernmental stakeholders in the process. The inner workings of the state-level budget process in Nigeria are not well understood, and there is little documentation of the process to provide guidance.

    To help CSOs in Nigeria understand and actively participate in the budget process, the Health Policy Project conducted an assessment to identify the differences between theory and practice in state-level budgeting. In doing so, several entry points emerged for CSOs to make a difference in FP/RH funding; the key tasks identified include

    • Advocate for increased funds for FP/RH programs and commodities
    • Ensure that adequate funds are budgeted, obligated, and released in a timely manner
    • Track state-level budget expenditures, especially funds actually expended for FP/RH services and commodities
    • Hold policymakers and program managers accountable for the effective use of public funds

  • This USAID and PEPFAR-funded Health Policy Project report analyzes the integration of HIV and sexual and reproductive health services in the Cote d’Ivoire. 

  • In 2013, the government of Kenya abolished all user fees in public dispensaries and health centers. In 2015, the Health Policy Project conducted a nationally representative study to examine how the removal of user fees affected health utilization; whether facilities were adhering to the policy; how health workers and clients perceived the policy; and whether quality of service before and after the policy’s implementation had changed. This evaluation report provides findings from the study and recommendations for the successful implementation of Kenya’s abolition of user fees policy.  

  • To achieve the greatest possible improvement in family planning (FP) and maternal, neonatal, and child health (MNCH) outcomes, successful interventions, practices, and approaches must be "scaled up," that is, implemented on a larger scale and incorporated into the laws, policies, and structures that govern health systems. In recent years, growing recognition of the importance of scale-up has led to intensified efforts to identify and scale up best practices in FP/MNCH and improve scale-up processes. Policy development and implementation are central to successful and sustainable scale-up.

    This package of materials presents a programming approach designed to help countries advance the integration and measurement of policy development and implementation into the scale-up of FP/MNCH interventions and best practices. The approach provides planners and implementers with initial guidance and suggestions on how to systematically address policy development and implementation as they scale up FP/MNCH programs.

  • To achieve the greatest possible improvement in family planning (FP) and maternal, neonatal, and child health (MNCH) outcomes, successful interventions, practices, and approaches must be “scaled up”—that is, implemented on a larger scale and incorporated into the laws, policies, and structures that govern health systems. Gender equality is central to successful and sustainable scale-up because it significantly influences health outcomes, and many barriers to program scale-up are related to inequitable gender norms.

    The Health Policy Project’s Gender, Policy, and Measurement program (GPM) has designed an approach to help countries advance the systematic integration of gender equality into the scale-up of FP/MNCH interventions and best practices. The approach draws heavily on the process for integrating gender equality into programs and policies—the steps of which include

    • Conduct gender assessments
    • Prepare for gender-integrated scale-up
    • Develop a gender-integrated scale-up strategy
    • Implement and monitor gender-integrated scale-up
    • Evaluate gender and health outcomes

  • In Barbados and Jamaica, the PEPFAR- and USAID-funded Health Policy Project (HPP) has delivered two-day stigma-reduction trainings to health facility staff. Adapted from a longer curriculum, the trainings comprehensively address stigma and discrimination by involving all health facility staff (including receptionists, pharmacists, nurses, and administration staff). HPP is also helping facility staff develop posted “codes of conduct” which outline the expectations for stigma-free services, regardless of HIV status, sexual orientation, or gender.

    The codes of conduct posters feature health facility staff photos and contact information for clients to report instances of discrimination. The codes of conduct are being rolled out across health facilities in Jamaica, Barbados, and other countries across the Caribbean.

  • For the global health community, 2015 is a year to celebrate progress achieved and prepare for the future. The past two decades have seen unprecedented gains in global health: the mortality rate for children under age five has been cut almost in half, access to antiretroviral therapy (ART) for HIV-positive individuals has saved 6.6 million lives since 1995, and maternal mortality ratios have declined significantly. Yet, as the deadline for achieving the Millennium Development Goals (MDGs) approaches, developing countries face a host of persistent and emerging health challenges. This brief, prepared by the USAID- and PEPFAR-funded Health Policy Project presents five ways to prepare for the future of health policy, taking into account the changing global health landscape. 

  • This summary presents the findings, observations, and recommendations of the quantification of the costs of the Strategic Development Plan for the Health Sector (PDSS) from 2015 to 2019 in Madagascar. The PDSS includes an articulation of global health priorities, approaches to the implementation, and resource commitments required by the Government of Madagascar to meet healthcare goals. The Health Policy Project team used the OneHealth model to quantify the costs. The OHT can calculate the cost not only health interventions but also those of managing these health programs and cross-cutting costs of health systems, such as human resources, infrastructure and governance. 

  • As a group, non-users of contraception differ greatly in their likely motivation to adopt a method or resume use. This poster, presented at the 2014 Population Association of America Annual Meeting, summarizes a study conducted under the USAID-funded Health Policy Project that presented a new approach by defining high- and low-motivation groups among current non-users according to: stated intention to use, past use, and unmet need.  

  • In December 2012, the Health Policy Project (HPP) supported the ARC Coalition to bring together 20 consortium members and project partners to develop a common advocacy plan. Facilitators from HPP and the Advance Planning Project led the process by building focus, commitment, and consensus among consortium partners on a common advocacy issue. At the end of two days, the consortium members had identified key areas for policy advocacy that have the highest probability of success for ARC in the next year, identified the relevant key stakeholders, and began to develop action plans. Within the broader goal of contraceptive choices being expanded, the key areas identified included expanding the mix of spacing methods and increasing access to current methods of spacing.

  • This presentation, "Communicating Research Findings to Policymakers," was part of a satellite session on policy implementation hosted by the USAID-funded Health Policy Project at the Second Symposium on Health Systems Research in Beijing, China, on October 31, 2012.  

  • The Government of Ghana in 2012 included family planning commodities and services in the benefit package of the National Health Insurance Scheme and thus the need to assess the cost. The analysis in this report focuses on costing family planning services provided in the National family planning protocol of 2007 which are currently being delivered in health facilities and NGOs in Ghana. The objective of the study was to determine the unit cost (direct and indirect) of providing family planning services in Ghana and also project the resource requirements for scaling up family planning services in Ghana from 2012 to 2016.

  • Costed Implementation Plans (CIPs) are concrete, detailed plans for achieving the goals of a national family planning program over a set number of years. A CIP details the program activities necessary to meet the goals and the costs associated with those activities, thereby providing clear program-level information on the resources a country must raise both domestically and from donors. The Health Policy Project, with various partners, has developed a collaborative, 10-step approach to creating a CIP that aligns with ongoing government planning and coordination efforts. This brief outlines these 10 steps, which when implemented, should result in a consensus-driven strategy, roadmap, and budget for achieving family planning targets under the Ouagadougou Partnership, FP2020, and/or other national programs. To date, the following countries have completed CIPs for family planning: Senegal, Burkina Faso, Niger, Togo, Mauritania, Guinea, and Zambia.

  • Costed Implementation Plans (CIPs) for family planning are concrete, detailed plans for achieving the goals of a national family planning program over a set number of years. A CIP details the program activities necessary to meet stated goals and the costs associated with those activities, thereby providing clear program-level information on the resources a country must raise both domestically and from donors to achieve their goals. The CIP addresses and budgets for all components of a family planning program—demand, service delivery and access, procurement and supply chain, policy and enabling environment, financing, supervision, and monitoring and evaluation. The USAID-funded Health Policy Project’s 10-step approach creates a CIP aligned with ongoing government planning and coordination efforts. By including processes to ensure inclusion of often-marginalized populations and civil society groups, this approach ensures that the national CIP is collaborative, country-owned, and country-driven from inception. The 10-step approach also utilizes custom tools to develop detailed cost estimates, to identify financing gaps, and to estimate the demographic, health, and economic impacts of successful CIP implementation (e.g., number of women’s and children’s lives saved, healthcare costs saved, etc.). The CIP process culminates in a consensus-driven strategy, as well as a detailed activity roadmap and budget to make the strategy actionable. The 10-step approach results in strategies that promote people-centered health systems that improve healthcare outcomes through respecting rights, addressing social exclusion and inequities (with a focus on gender, adolescents, and people living in rural and underserved areas). This presentation is relevant to a wide cross-section of the Symposium’s diverse target audiences, particularly policy-makers, managers, and civil society participants, who would benefit from learning about the experiences of various countries in developing costed health strategies that are participatory and inclusive.

  • Newer CIP resources are available from the HP+ CIP toolkit.

    This guide distills the experience of technical experts, governments, and donors in developing costed implementation plans (CIPs) for family planning  into a 10-step process, implemented in three phases: planning, development, and execution.

    This tool provides an overview of the complete CIP process, including details on each of the 10 steps and sub-steps, and illustrates how and when specific tools and approaches can be applied. This guide is the foundational document of the CIP Resource Kit, which can be accessed at http://www.familyplanning2020.org/cip.

  • Newer CIP resources are available from the HP+ CIP toolkit.

    Countries have developed costed implementation plans (CIPs) for family planning (FP) using a variety of approaches and tools. As CIPs become a more common tool for planning and mobilizing resources, standardization of their format and development process can help promote accountability and ensure that all key components are considered.

    This checklist presents recommended thematic areas and standards to guide overall CIP development. These areas include demand creation; service delivery and access; contraceptive security; policy and enabling environment; financing; and stewardship, management, and accountability. This resource is part of the CIP Resource Kit, which can be accessed at http://www.familyplanning2020.org/cip.

  • Newer CIP resources are available from the HP+ CIP toolkit.

    This document provides background information on costed implementation plans (CIPs) for family planning, including information on what the plans typically include and how CIPs can help governments translate their FP commitments and goals into concrete programs and policies.

    This resource is part of the CIP Resource Kit, which can be accessed at http://www.familyplanning2020.org/cip.

  • Health financing was the theme of a major national conference held in Calabar, Nigeria in November 2011. The specific focus of the three-day conference was “Improving Financial Access to Health Services for the Poor in Nigeria.” Participants shared information on a wide range of health financing strategies and mechanisms employed in Nigeria as well as other countries. The 255 participants represented a broad range of expertise; they included health managers and providers, insurance specialists, health economists, government officials, and media representatives from all 36 states and the national capital. State representatives met in regional groups to discuss the approaches most applicable to their area and formulate plans to apply these approaches at the state or community level. The conference generated many “actionable” policy and program initiatives that the states and federal government can adopt.

    This presentation was one of five presentations made by the Health Policy Project. The presenter gave a brief overview of various software models available to help health planners and managers to estimate and project costs for various health services. These tools can be adapted for use at the state and local level and used to estimate costs to reach a specific goal or to expand or upgrade services.

  • HPP worked with the Kenya Ministry of Health to create 47 County Health Fact Sheets that provide a county-level snapshot of selected health indicators in Kenya. They display county-specific health data and compare those data to national figures. The fact sheets bring together data from a wide array of sources and are intended to be a quick reference for a broad audience, including advocates, policymakers, health sector stakeholders, and development partners. The facts sheets were last updated July, 2015.

    You may download individual fact sheets on this page.

  • The Crosswalk of Family Planning Tools provides a comparison of 19 commonly used family planning costing, planning, and impact analysis tools. The Health Policy Project designed the guide to help advocates, program planners, decisionmakers, and others to (1) select which tool might best fit their goals or questions and (2) interpret the outputs of each tool. The guide contains information on each tool's overall goal; intended use; primary target audience; interventions included; unit costing approach (if applicable); and health, cost, economic, or demographic outputs. In addition, the guide compares the requirements for each tool related to data needs, training and skills, and usability.

    The guide is accompanied by a chart to use as a quick reference for general information and comparison. To print the chart, 11 x 17 paper is required and "fit to page" and "landscape orientation" must be selected under printer properties.

  • To meet the data needs of policymakers, whose enthusiasm for the potential economic benefits of the demographic dividend is growing, the Health Policy Project developed DemDiv, a new, customizable projection model. DemDiv is a user-friendly, evidence-based tool that informs policymakers in high-fertility countries of the potential benefits of the demographic dividend and can increase their support for investments in the multisectoral policies required to achieve those benefits. The model can be applied in any country, and allows users to design multiple scenarios showing how the combined power of policy investments in family planning, education, and the economy can generate a demographic dividend not possible under the status quo.

    DemDiv was created by the Health Policy Project (HPP), with support from USAID. It is available at no cost for use by anyone. All uses of DemDiv should credit HPP and USAID as the source of the model, using the citation listed on the model overview page. HPP does not verify the results of applications performed independently, and results should be presented as estimates. HPP kindly requests that individuals, institutions, and programs using the model inform Futures Group of such use so that we better understand its reach and impact, by contacting policyinfo@futuresgroup.com. Users are also welcome to submit comments and suggestions to improve the model to the same address.

  • This PowerPoint presentation was used to present HPP's new DemDiv model for projecting the demographic dividend, and preliminary results for the pilot application in Kenya. It will be presented to members of the Technical Working Group in Kenya for validation, scenario development, and refinement. 

  • This brief describes the potential for a demographic dividend in Kenya, based on the pilot application of DemDiv, a new modeling tool developed by the USAID-funded Health Policy Project that projects the demographic and economic effects of interacting policy changes in the family planning, education, and economic sectors. The DemDiv model was piloted in Kenya by a multisectoral Technical Working Group chaired by the National Council for Population and Development. Four scenarios for the period between 2010 and 2050 were developed. The results show that combined family planning, education, and economic policies boost investment and employment, with GDP per capita growing more than 12 times above current levels and a potential demographic dividend of US$2,500 per person. The brief includes specific and multisectoral policy recommendations for Kenya to successfully achieve the demographic dividend.

  • Newer CIP resources are available from the HP+ CIP toolkit.

    Effective development of a costed implementation plan (CIP) requires a country-led, systematic, and highly participatory process, involving a range of stakeholders and technical experts led by the Ministry of Health. While the CIP team’s exact make-up, responsibilities, and relationships should be tailored to the country’s context, this document presents the key recommended groups and positions needed for CIP development, along with proposed scopes of work. Responsibilities for plan implementation and monitoring are assigned and documented in the CIP technical strategy.

    Additional guidance on developing a CIP can be found in the document "Costed Implementation Plans for Family Planning: 10-Step Process for CIP Planning, Development, and Execution," which is part of the CIP Resource Kit, and can be accessed at http://www.familyplanning2020.org/cip.

  • The Health Policy Project assembled this directory to help government agencies, development partners, and other local and international organizations identify Kenyan institutions with the skills and experience to support their health policy, finance, and governance needs. The directory is also designed to promote information sharing among the institutions it lists, as well as collaboration and partnerships, both international-local and local-local. The capabilities and accomplishments of 14 Kenyan organizations and consulting firms are highlighted, along with their mission, program and geographic areas, and contact information.

  • Poster for the 2015 Population Association of America Conference summarizing results of the USAID-funded Health Policy Project paper, "Inconsistencies in the Total Fertility Rate and Contraceptive Prevalence Rate in Malawi."

  • Access to information and reproductive health services, especially related to family planning, can help to improve the alarming rates of maternal and infant mortality and reduce malnutrition within a framework of respect for human rights.

    This publication by the Health and Education Policy Project presents two scenarios developed with the Spectrum projection system for what could happen in Guatemala between 2010 and 2050. Through analysis of a set of indicators, it estimates the future needs of programs and interventions related health.

  • The Policy Unit of the National Institute of Health and Family Welfare (NIHFW), the USAID-funded Health Policy Project (HPP), the National Health Systems Resource Centre (NHSRC), and the Government of the State of Uttarakhand conducted a study to understand the effectiveness of National Rural Health Mission (NRHM) financing in terms of allocation, disbursement, efficiency, and utilization. The study was designed to identify barriers in the flow of NRHM funds from state to district and sub-district levels of the public health system in Uttarakhand State. It found evidence of highly centralized, top-down planning, despite NRHM’s intent for a bottom-up approach. The state often does not allocate funds according to district requests, and below the district level funds are not fully utilized. There is some evidence that expenditures were efficient in that resource use was connected with performance. This study is the follow-on report to Effectiveness of Fund Allocation and Spending for the National Rural Health Mission in Uttarakhand, India: State and District Report.

  • India's National Rural Health Mission (NRHM) is one of the world's largest government-funded primary healthcare programs. Improving the effectiveness of financing for this program is crucial for both the central and state governments in India. In partnership with the National Institute of Health and Family Welfare and the National Health System Resource Centre, the USAID-funded Health Policy Project examined the allocation and spending of funds for NRHM in Uttarakhand, one of the program's "high focus states." This report summarizes the results of the first phase of the analysis, which examined fund flows from the state to the 13 districts using financial records from fiscal years 2008–09 to 2011–12. The analysis explored three questions: 1) whether funds are allocated to districts according to their health needs, 2) whether districts are able to spend the funds allocated to them, and 3) how districts spend funds relative to health needs. Results indicate that NRHM funding in Uttarakhand could be made more efficient by aligning allocations and spending with health needs, and improving districts’ ability to spend all the funds available to them. 

  • The Plano Estratégico do Sector da Saúde (PESS) 2014-2019 (the Health Sector Strategic Plan), is the overall expression of the priorities, implementation approaches, and resource commitments for health of the government of the Republic of Mozambique (GRM). With support from the USAID-funded Health Policy Project (HPP), the Ministry of Health (MISAU) applied the OneHealth model to estimate the financial and health system resources need to implement the plan, and the likelihood of meeting key indicators in maternal and child health and HIV/AIDS related to the Millennium Development Goals. Detailed cost analysis was conducted for over 40 disease programs across primary and secondary health. Financial requirements for the overall human resources for health (HRH), logistics, health infrastructure, governance and leadership, and health information systems were also estimated. The report identifies potential constraints for the scale-up of services, such as inadequate human resources, and includes an HRH gap analysis. It also contains a review of the strategic planning process at MISAU, and recommendations for the institutionalization of the OneHealth approach.

    The report is available in English and Portuguese.

  • As the Government of Botswana (GOB) moves forward with a plan to expand coverage of health services, increasing the “value for money” of current health service delivery and identifying new financing sources is critical. As part of the 2010 Integrated Health Service Plan, a 10-year strategic plan for the health sector, the Ministry of Health (MOH) will introduce the Essential Health Services Package (EHSP)—health interventions to be provided as part of a package to the entire population. Although understanding the costs of delivering health interventions and the major cost drivers is critical to expanding the health sector, current knowledge of these costs is limited. This study aims to shed light on the overall costs of key interventions that address the major disease burden in Botswana.

    The study comprised two parts. In Part I, the Health Policy Project (HPP) technical team assessed the unit costs of providing specific HIV interventions at two levels of service delivery. In Part II, the team used the OneHealth tool (Avenir Health, n.d.) to project the overall resources required between 2013 and 2018 to provide EHSP services, based on normative inputs.

  • HPP undertook a policy analysis to determine the level of FP-HIV integration that appears in national government policy documents and explored the extent to which the policies outline and address the integration of services. For the purpose of this review, we defined policies to include policies, strategies, guidelines, action plans, implementation plans, clinical and service delivery standards, and other similar documents.

    We retrieved 30 Government of Malawi policies, strategies, and guidelines on family planning, HIV and AIDS, and general health, of which 19 addressed the provision of FP and/or HIV/AIDS services or discussed integration. There was significant mention on the need to integrate FP services into HIV services, for example through ART clinics. The policy documents are well aligned, providing supplementary guidance and information, but the fact that various elements of integration of FP-HIV services are spread out across a dozen health documents likely results in a disjointed vision for FP-HIV integration in Malawi, as well as inconsistent implementation. Furthermore, although these documents mention multisectoral collaboration, either in the development of policies or the implementation of programs, specific details on how to increase and strengthen multisectoral collaboration efforts are unclear. Since the different policies use a variety of approaches to FP-HIV integration, the MOH may want to consider developing an implementation and monitoring plan that will outline the various elements of integration noted across all the policy documents and identify how they should be measured.

  • Family planning (FP) advocacy plays a key role in policy development. Despite a significant body of evidence-based advocacy promoting family planning, there are few systematic studies on decisionmakers’ opinions of such advocacy; how advocacy and evidence are used by decisionmakers; what types of evidence and advocacy are persuasive from the perspective of decisionmakers themselves; and how and why decisionmakers support FP policies. This USAID-funded Health Policy Project study was designed to address these issues. The findings draw from structured interviews in three countries: Ethiopia, Kenya, and Malawi.

  • This is a copy of the presentation made when Uganda launched its Costed Implementation Plan (CIP) for Family Planning. Users can review this presentation as an example of the kind of information to present to stakeholders at the plan launch.

    This resource is part of the CIP Resource Kit, which can be accessed at http://www.familyplanning2020.org/cip.

  • These evidence-based advocacy materials, based on Spectrum projections, were produced under the USAID-funded Health Policy Project by the White Ribbon Alliance Nigeria to support national- and state-level advocacy efforts aimed at increasing access to family planning.

  • Under the Gender Policy and Measurement (GPM) activity, funded by the Asia and Middle East Bureaus of USAID, the Health Policy Project (HPP) hosted an expert meeting in December 2012 on experiences with scaling up best practices in family planning and maternal, neonatal, and child health. The meeting, held in Washington, DC, focused on gender integration and policy implementation in the scale-up of programs. Experts identified the gaps, priorities, and entry points for addressing gender and policy in scale-up. Initiatives to scale up programs aim to strengthen health systems and expand the reach of essential services to those who need them most.

    Related resources: 

    The Policy Dimensions of Scaling Up Health Initiatives

    Integrating Gender into the Scale-Up of Family Planning and Maternal, Neonatal, and Child Health Programs

  • Malawi is one of the fastest-growing countries in sub-Saharan Africa. The country’s population has more than tripled over the past 40 years, and is expected to triple again by 2040. This growth is undermining Malawi’s economic development, destroying its natural resources, and placing immense strain on social services such as health and education. Malawi’s population growth is fueled by high fertility, in combination with a lack of access to family planning services. Religious leaders in Malawi have a key role to play in addressing population and family planning issues.  The Health Policy Project worked in partnership with the Government of Malawi to engage religious leaders to become active partners in addressing these issues. With the project’s support, representatives from Malawi’s religious “mother bodies”—the Evangelical Association of Malawi (EAM), the Episcopal Conference of Malawi (ECM), the Malawi Council of Churches (MCC), the Muslim Association of Malawi (MAM), the Seventh Day Adventists (SDA), and the Qadria Muslim Association of Malawi (QMAM)—came together in an interfaith effort to draft this advocacy guide. Two versions of the guide were created, one for Muslim leaders and one for Christian leaders. These guides are intended to serve as tools to support religious leaders’ advocacy efforts on population and family planning. The guides were translated into the local Chichewa language to reach a wider audience of religious leaders.

  • Malawi is one of the fastest-growing countries in sub-Saharan Africa. The country’s population has more than tripled over the past 40 years, and is expected to triple again by 2040. This growth is undermining Malawi’s economic development, destroying its natural resources, and placing immense strain on social services such as health and education. Malawi’s population growth is fueled by high fertility, in combination with a lack of access to family planning services. Religious leaders in Malawi have a key role to play in addressing population and family planning issues.  The Health Policy Project worked in partnership with the Government of Malawi to engage religious leaders to become active partners in addressing these issues. With the project’s support, representatives from Malawi’s religious “mother bodies”—the Evangelical Association of Malawi (EAM), the Episcopal Conference of Malawi (ECM), the Malawi Council of Churches (MCC), the Muslim Association of Malawi (MAM), the Seventh Day Adventists (SDA), and the Qadria Muslim Association of Malawi (QMAM)—came together in an interfaith effort to draft this advocacy guide. Two versions of the guide were created, one for Muslim leaders and one for Christian leaders. These guides are intended to serve as tools to support religious leaders’ advocacy efforts on population and family planning. The guides were translated into the local Chichewa language to reach a wider audience of religious leaders.

  • A newer version of this product is available on the HP+ website.

    The Family Planning CIP Costing Tool helps countries understand the costs associated with implementing the detailed roadmap of FP activities outlined in their family planning costed implementation plan (CIPs). This tool was developed to both standardize the CIP costing approach across countries and streamline a sometimes complex process to make it easier for countries to revise inputs as commitments and implementation strategies are updated. The tool is Excel-based and includes pre-loaded equations, making it easier and quicker for new users to generate data.

    The tool can be used at the national level—and at subnational levels where lower-level CIPs have been developed—to help policymakers, decisionmakers, partners, and donors better plan and advocate for an effective FP strategy. 

    The Family Planning CIP Costing Tool was developed as part of the CIP Resource Kit, and is meant to be used in conjunction with the The Family Planning CIP Gap Analysis Tool. The CIP Resource Kit can be accessed at http://www.familyplanning2020.org/cip. The CIP Costing Tool User Guide provides step-by-step instructions for applying the tool.

  • A newer version of this product has been integrated with the CIP Costing Tool available on the HP+ website.

    The Family Planning CIP Gap Analysis Tool is an Excel-based tool that helps countries estimate the financial gap between the costs associated with implementing detailed costed implementation plan (CIP) activities and the annual funding commitment by government and donors for supporting the plan’s implementation. The gap analysis tool is designed to be used in conjunction with the Family Planning CIP Costing Tool (also part of the CIP Resource Kit), but allows the user to input cost data from any source (for instance, if the original CIP was costed using a different methodology). The tool can be used at the national level—or subnational levels—to help policymakers, decisionmakers, partners, and donors better plan and advocate for an effective FP strategy and is most effective as part of the initial CIP development or an annual CIP review process. The CIP Gap Analysis Tool User Guide provides step-by-step instructions for applying the tool. 

    The Family Planning CIP Gap Analysis Tool is designed for use in developing a comprehensive plan that meets the standard level of costing and gap analysis detail recommended for CIPs, which includes costs associated with specific activities within each CIP thematic area. For countries that wish to apply the CIP Gap Analysis Tool in support of an existing CIP or strategic plan that does not include activity-level costs, the Simplified CIP Gap Analysis Tool may be more appropriate.

    This resource is part of the CIP Resource Kit, which can be accessed at http://www.familyplanning2020.org/cip.

  • From May through July 2015 HPP conducted a financial gap analysis of CIPs in six West African countries: Burkina Faso, Cameroon, Côte d’Ivoire, Mauritania, Niger, and Togo. This allowed HPP to compare the annual funding available from the government and partners for family planning relative to each of the CIP budgets. In this study, “funding available” can be defined as any future funding that is promised, expected or estimated to be allocated to FP; in the case of past years, “funding available” refers to actual funds spent on FP, excluding overhead costs. The CIP Gap Analysis Tool, developed by Futures Group, was used to estimate additional resources needed to fully implement each thematic area identified in the CIP (contraceptive commodities, demand creation, service delivery and access etc.).

  • Tackling undernutrition and achieving food security will require cross-sector collaboration, innovative approaches, and optimizing the use of all available interventions. In 2014, the USAID-funded Health Policy Project conducted two reviews of the empirical evidence on the impacts of one intervention—family planning—on food security and nutritional status, respectively. 

    This brief on food security shows that voluntary family planning can decrease fertility rates and slow the pace of population growth, thus reducing food needs as well as strains on agricultural resources. In this way, family planning supports the four main pillars of food security—availability, access, utilization/consumption, and stability—and can help ensure that people have both physical and economic access to sufficient food. 

    The accompanying report can be found here, and a companion brief on nutrition is available here.

    Also see the companion desk review synthesizing the programmatic experiences of integrating family planning with food security and nutrition. It was conducted by the Food and Nutrition Technical Assistance III Project (FANTA) and is available here: http://www.fantaproject.org/focus-areas/food-security/desk-review-programs-integrating-family-planning-food-security-and-nutrition. 

  • Tackling undernutrition and achieving food security will require cross-sector collaboration, innovative approaches, and optimizing the use of all available interventions. In 2014, the USAID-funded Health Policy Project conducted two reviews of the empirical evidence on the impacts of one intervention—family planning—on food security and nutritional status, respectively. 

    This brief on nutrition shows that when women exercise their freedom and right to access voluntary family planning to meet their fertility intentions, there is a natural decline in the prevalence of high-risk and unintended pregnancies; and that by averting such pregnancies, improvements in key maternal, infant, and child nutrition outcomes can be achieved. 

    The accompanying report is available here, and a companion brief on food security is available here.

    Also see the companion desk review synthesizing the programmatic experiences of integrating family planning with food security and nutrition. It was conducted by the Food and Nutrition Technical Assistance III Project (FANTA) and is available here: http://www.fantaproject.org/focus-areas/food-security/desk-review-programs-integrating-family-planning-food-security-and-nutrition. 

  • In 2014, USAID requested the Health Policy Project (HPP) to undertake an assessment of the status and extent of FP-HIV integration in Malawi. Since integration at the policy level is important and the first step to a well-guided implementation of health service delivery (EngenderHealth, 2014), HPP undertook a policy analysis to determine the level of FP-HIV integration that appears in government policy documents and explored the extent to which the policies outline and address the integration of services. For the purpose of this review, we defined policies to include policies, strategies, guidelines, action plans, implementation plans, clinical and service delivery standards, and other similar documents. Other research components on the status of FP-HIV integration, including stakeholder interviews and a facility-level assessment, are documented in separate reports (forthcoming).

  • In order to better understand how FP-HIV integration is being implemented, HPP conducted a situational analysis of the policy and program environment by speaking to 48 national- and district-level stakeholders. The purpose of the interviews was to understand stakeholders’ perspectives on how integration of FP and HIV services as mentioned in the policies was being implemented and how integration of services could further be improved. The semistructured interviews covered various topics including institutional arrangements; processes for addressing integration within health systems such as human resources, commodities, infrastructure, and monitoring and reporting; financing mechanisms; integration within health facilities; the role of the private sector; and behavior change communication (BCC).

    Our findings cover stakeholder perspectives on the institutional arrangements at the national and district levels through which health services and programs are being implemented within the public sector. We further assessed opinions on the progress made in integrating FP and HIV services across the components of the health systems, such as trained healthcare workers, availability of commodities, facility structures to ensure integration, and joint monitoring and reporting. Stakeholders also described how FP and HIV services are currently being implemented in the majority of the facilities and shared some successful pilot programs of integration. This report also describes how information on FP and HIV is currently being addressed in BCC and mass media campaigns, highlights the role of the private sector in assisting to provide FP and HIV services, and also pays special attention to the progress made in reaching youth. 

  • The public health community increasingly recognizes the importance of incorporating strategies to address gender equality in programs to improve health outcomes for women, men, and children. To strengthen gender integration efforts in the island nation of Timor-Leste, the Gender, Policy, and Measurement (GPM) program, funded by the USAID Asia and Middle East (A/ME) Bureaus, undertook a gender assessment. The GPM program is implemented by the Health Policy Project and MEASURE Evaluation. The assessment aimed to discover the normative, socioeconomic, and political variables that impede or facilitate utilization of health services in Timor-Leste. This analysis can be used by donors and implementing organizations to incorporate gender into the formulation, implementation, and evaluation of family planning and maternal, neonatal and child health programs.

  • The Partners in Population and Development global alliance, through its Africa Regional Office (PPD ARO), uses South-to-South dialogue as an effective mechanism to hold leaders and countries accountable for stated international and regional commitments related to health. Through the Health Policy Project, PPD ARO is sharing expertise, best practices, effective models, and high-level policy dialogue surrounding population and health issues with African policymakers and partners at the national and regional levels. Specifically, to raise awareness among parliamentary health committees on the linkages between improving family planning/reproductive health and achieving national development goals, PPD ARO is developing and disseminating policy briefs on family planning in Ethiopia, Ghana, Malawi, and Uganda.

    At the request of and in partnership with Ethiopia’s Federal Ministry of Health (FMOH), PPD ARO developed a policy brief for initial dissemination at the Women Parliamentarians Meeting: Enhancing Leadership for Family Planning and Reproductive Health in Kampala, Uganda, August 27–28, 2012. The brief highlights the important role of family planning in achieving maternal health and other development goals, as well as presents policy recommendations for increasing family planning use. FMOH stakeholders contributed to the recommendations, which focus on increasing financing for family planning commodities, especially long-acting methods (permanent and non-permanent). Expanded dissemination to policymakers across Ethiopia will help foster more champions of family planning as the country builds momentum for further progress.

  • The USAID-funded Health Policy Project applied its new ImpactNow model to estimate the near-term benefits of achieving family planning goals in Kenya. This brief describes some key benefits associated with achieving these goals, and offers recommendations for the government of Kenya and development partners to increase investment in and improve family planning services in the country.

  • The USAID-funded Health Policy Project supported partners at Gondar University to use the FamPlan model to analyze the demographic and family planning program implications of meeting Ethiopia’s Family Planning 2020 (FP2020) targets. The projections show that, if Ethiopia achieves a contraceptive prevalence rate of 73.3 percent by 2020 (the target set by the Federal Ministry of Health), the total fertility rate would fall to less than two children per woman in 2020 and the annual population growth rate would slow to less than 1 percent by 2020. In addition, under-five and infant mortality rates would drop significantly due to increased use of family planning. The model projection also estimated the number of contraceptive commodities required to achieve the target, which can be used to ensure contraceptive security.  

  • This report covers an evaluation of the collaboration between the Ministry of Health of the Indian State of Jharkhand and the Health Policy Project to conduct a program (Nov. 2012-July 2013) to strengthen capacities at state, district, and sub-district levels to effectively implement the 2010 family planning  strategy.  It included training, mentoring, and supportive supervision. A State Resource Group of master trainers from government and civil society supported the 4-person Family Planning Cell. A pre/post-implementation quantitative and qualitative assessment highlighted that although the implementation period was short, systems were strengthened and laid a solid basis for achieving  Jharkhand’s FP goals.  The assessment highlighted improvements in timely data updates (from 27% to 91%),  increased stocks of FP commodities and IEC materials, and wider availability of doctors trained in clinical services. Budget allocations for spacing methods increased and the FP Cell invested in training health staff on counseling and  IUD skills. Staff reported an improved attitude toward information sharing and joint problem solving.  The 3-district pilot program has been scaled up in 11 additional high-need districts.  

  • For a country to successfully achieve its family planning goals and targets, stakeholders must fully understand the investment needed to attain them. The Health Policy Project, in collaboration with Ghana's National Population Council, recently reviewed data on demographic patterns, family planning costs, and projected funding to inform an application of the GAP (Gather, Analyze, and Plan) Tool. The tool is designed to project the contraceptive, service provision, and program support funding gaps in a country to ultimately help policymakers, decisionmakers, and development partners understand the costs involved in reaching national family planning goals and addressing challenges to progress. This presentation and brief summarize the current policy environment in Ghana for family planning, the targets set by the National Population Policy, and the gap in current and estimated resources needed. These evidence-based advocacy materials aim to bolster financial and political support for the family planning program in Ghana.

    For more information on the GAP Tool, visit the Software and Models page of the Health Policy Project website.

  • The U.S. Government has embraced gender equality and female empowerment as core development objectives. These commitments are articulated through the USAID policy on Gender Equality and Female Empowerment, the President’s Emergency Plan for AIDS Relief gender program guidance for HIV, and the U.S. Global Health Initiative first principle on Women, Girls, and Gender Equality. This document is a tool for USAID country health offices to operationalize these commitments strategically and effectively.

  • The Health Policy Project (HPP), with support from USAID and in cooperation with national policymakers and advocates, undertook a systematic assessment to better understand and document the current policy environment, along with the challenges and opportunities Malawi faces in implementing more gender-responsive population and family planning policies. The assessment included both a desk review of current policies, and a series of key informant interviews that sought also to assess the role and impact of gender stewardship mechanisms on sexual and reproductive health-related policies and programs, and to document first-hand perspectives on policy implementation.

  • Performance monitoring lessons learned available in the HP+ brief.

    A CIP is a multi-year roadmap that identifies evidence-based strategies and approaches to improve FP programs, and estimates the cost of implementing those strategies. All components of an FP program—demand, service delivery and access, procurement and supply chain, policy and enabling environment, financing and resource mobilization, supervision, and monitoring and evaluation—are addressed and budgeted in the CIP. The approach to developing and executing CIPs varies across countries, as the plans align with ongoing initiatives and systems and address each country’s unique context. Each new CIP provides an opportunity to tailor technical assistance and tools to help countries achieve their goals, apply lessons learned, strengthen the CIP development process, and enhance the potential impact of the plans when executed.

    The learnings and examples presented in this brief have been informed by the combined experience of the USAID-funded Health Policy Project (HPP) and Futures Group in supporting sixteen countries to develop and implement CIPs; and by the experiences of other technical assistance providers, donors, and governments who have shared their learnings through a variety of CIP expert consultations, interviews, and public events.

  • The Health Policy Project, in collaboration with the National Population Council (NPC) of Ghana, supported the development of a RAPID application for the Volta region in Ghana. The NPC, comprising governmental and nongovernmental organizations, focuses on the state of family planning in Ghana and the need for more support and funding for the national family planning program. “RAPID” stands for “Resources for the Awareness of Population Impacts on Development,” and it is a tool designed to help policymakers understand the relationships between fertility, population growth, health, education, agriculture, and economic growth. The presentation uses RAPID projections to highlight the impact of Ghana's population growth on national development and its ability to provide education, health, and nutrition to all its citizens. It also highlights the policies the government must put in place to benefit from the demographic dividend.

  • The Health Policy Project, in collaboration with the National Population Council (NPC) of Ghana, supported the development of a RAPID application for the Ashanti region in Ghana. The NPC, comprising governmental and nongovernmental organizations, focuses on the state of family planning in Ghana and the need for more support and funding for the national family planning program. “RAPID” stands for “Resources for the Awareness of Population Impacts on Development,” and it is a tool designed to help policymakers understand the relationships between fertility, population growth, health, education, agriculture, and economic growth. The brief uses RAPID projections to highlight the impact of Ghana's population growth on national development and its ability to provide education, health, and nutrition to all its citizens. It also highlights the policies the government must put in place to benefit from the demographic dividend.

  • The Health Policy Project, in collaboration with the National Population Council (NPC) of Ghana, supported the development of a RAPID application for the Brong Ahafo region in Ghana. The NPC, comprising governmental and nongovernmental organizations, focuses on the state of family planning in Ghana and the need for more support and funding for the national family planning program. “RAPID” stands for “Resources for the Awareness of Population Impacts on Development,” and it is a tool designed to help policymakers understand the relationships between fertility, population growth, health, education, agriculture, and economic growth. The brief uses RAPID projections to highlight the impact of Ghana's population growth on national development and its ability to provide education, health, and nutrition to all its citizens. It also highlights the policies the government must put in place to benefit from the demographic dividend.

  • The Health Policy Project, in collaboration with the National Population Council (NPC) of Ghana, supported the development of a RAPID application for the Central region in Ghana. The NPC, comprising governmental and nongovernmental organizations, focuses on the state of family planning in Ghana and the need for more support and funding for the national family planning program. “RAPID” stands for “Resources for the Awareness of Population Impacts on Development,” and it is a tool designed to help policymakers understand the relationships between fertility, population growth, health, education, agriculture, and economic growth. The brief uses RAPID projections to highlight the impact of Ghana's population growth on national development and its ability to provide education, health, and nutrition to all its citizens. It also highlights the policies the government must put in place to benefit from the demographic dividend.

  • The Health Policy Project, in collaboration with the National Population Council (NPC) of Ghana, supported the development of a RAPID application for the Eastern region in Ghana. The NPC, comprising governmental and nongovernmental organizations, focuses on the state of family planning in Ghana and the need for more support and funding for the national family planning program. “RAPID” stands for “Resources for the Awareness of Population Impacts on Development,” and it is a tool designed to help policymakers understand the relationships between fertility, population growth, health, education, agriculture, and economic growth. The brief uses RAPID projections to highlight the impact of Ghana's population growth on national development and its ability to provide education, health, and nutrition to all its citizens. It also highlights the policies the government must put in place to benefit from the demographic dividend.

  • The Health Policy Project, in collaboration with the National Population Council (NPC) of Ghana, supported the development of a RAPID application for the Greater Accra region in Ghana. The NPC, comprising governmental and nongovernmental organizations, focuses on the state of family planning in Ghana and the need for more support and funding for the national family planning program. “RAPID” stands for “Resources for the Awareness of Population Impacts on Development,” and it is a tool designed to help policymakers understand the relationships between fertility, population growth, health, education, agriculture, and economic growth. The brief uses RAPID projections to highlight the impact of Ghana's population growth on national development and its ability to provide education, health, and nutrition to all its citizens. It also highlights the policies the government must put in place to benefit from the demographic dividend.

  • The Health Policy Project, in collaboration with the National Population Council (NPC) of Ghana, supported the development of a RAPID application for the Northern region in Ghana. The NPC, comprising governmental and nongovernmental organizations, focuses on the state of family planning in Ghana and the need for more support and funding for the national family planning program. “RAPID” stands for “Resources for the Awareness of Population Impacts on Development,” and it is a tool designed to help policymakers understand the relationships between fertility, population growth, health, education, agriculture, and economic growth. The brief uses RAPID projections to highlight the impact of Ghana's population growth on national development and its ability to provide education, health, and nutrition to all its citizens. It also highlights the policies the government must put in place to benefit from the demographic dividend.

  • In 2013, the USAID-funded Health Policy Project, in collaboration with the National Population Council (NPC) of Ghana, supported the development of a Ghana RAPID application. The NPC, comprising governmental and nongovernmental organizations, focuses on the state of family planning in Ghana and the need for more support and funding for the national family planning program. “RAPID” stands for “Resources for the Awareness of Population Impacts on Development,” and it is a tool designed to help policymakers understand the relationships between fertility, population growth, health, education, agriculture, and economic growth. The presentation uses RAPID projections to highlight the impact of Ghana's population growth on national development and its ability to provide education, health, and nutrition to all its citizens. The presentation also highlights the policies the government must put in place to benefit from the demographic dividend.

  • The Health Policy Project, in collaboration with the National Population Council (NPC) of Ghana, supported the development of a RAPID application for the Upper East region in Ghana. The NPC, comprising governmental and nongovernmental organizations, focuses on the state of family planning in Ghana and the need for more support and funding for the national family planning program. “RAPID” stands for “Resources for the Awareness of Population Impacts on Development,” and it is a tool designed to help policymakers understand the relationships between fertility, population growth, health, education, agriculture, and economic growth. The brief uses RAPID projections to highlight the impact of Ghana's population growth on national development and its ability to provide education, health, and nutrition to all its citizens. It also highlights the policies the government must put in place to benefit from the demographic dividend.

  • The Health Policy Project, in collaboration with the National Population Council (NPC) of Ghana, supported the development of a RAPID application for the Upper West region in Ghana. The NPC, comprising governmental and nongovernmental organizations, focuses on the state of family planning in Ghana and the need for more support and funding for the national family planning program. “RAPID” stands for “Resources for the Awareness of Population Impacts on Development,” and it is a tool designed to help policymakers understand the relationships between fertility, population growth, health, education, agriculture, and economic growth. The brief uses RAPID projections to highlight the impact of Ghana's population growth on national development and its ability to provide education, health, and nutrition to all its citizens. It also highlights the policies the government must put in place to benefit from the demographic dividend.

  • The Health Policy Project, in collaboration with the National Population Council (NPC) of Ghana, supported the development of a RAPID application for the Volta region in Ghana. The NPC, comprising governmental and nongovernmental organizations, focuses on the state of family planning in Ghana and the need for more support and funding for the national family planning program. “RAPID” stands for “Resources for the Awareness of Population Impacts on Development,” and it is a tool designed to help policymakers understand the relationships between fertility, population growth, health, education, agriculture, and economic growth. The brief uses RAPID projections to highlight the impact of Ghana's population growth on national development and its ability to provide education, health, and nutrition to all its citizens. It also highlights the policies the government must put in place to benefit from the demographic dividend.

  • The Health Policy Project, in collaboration with the National Population Council (NPC) of Ghana, supported the development of a RAPID application for the Western region in Ghana. The NPC, comprising governmental and nongovernmental organizations, focuses on the state of family planning in Ghana and the need for more support and funding for the national family planning program. “RAPID” stands for “Resources for the Awareness of Population Impacts on Development,” and it is a tool designed to help policymakers understand the relationships between fertility, population growth, health, education, agriculture, and economic growth. The brief uses RAPID projections to highlight the impact of Ghana's population growth on national development and its ability to provide education, health, and nutrition to all its citizens. It also highlights the policies the government must put in place to benefit from the demographic dividend.

  • As countries increasingly make national commitments to family planning (FP), there is also a need to foster accountability for fulfilling them. In Tanzania, as in many countries, those commitments can be manifested in many different ways. Top-down, high-level policy documents, including poverty-reduction strategy papers and national development strategies, often include commitments to FP. Within the Ministry of Health, which bears the responsibility for implementing FP commitments, strategy documents, such as Tanzania’s One Plan for Maternal and Child Health, incorporate FP as a priority. In addition, Tanzania’s costed implementation plan (CIP) for FP-developed in 2010 and later rolled into the One Plan-identifies challenges to achieving commitments, presents appropriate strategies and the costs for implementing them, and estimates the benefits if the country is successful.

  • A lack of comprehensive knowledge about HIV/AIDS and sexual reproductive health (SRH), financial insecurity, gender-based violence, and other risk factors can leave students of higher education institutions (HEIs), especially women, more vulnerable to HIV infection. It is therefore important to consider the specific needs of this population group when designing and implementing HIV interventions. In Ethiopia, the Health Policy Project (HPP) is supporting the Federal HIV/AIDS Prevention and Control Office and HEIs to prioritize and target HIV interventions in HEI settings. As part of this effort, HPP assisted the government's HEI Partnership sub-Forum against HIV/AIDS with developing a Planning, Monitoring, and Evaluation Framework for HIV/AIDS and SRH interventions in HEIs. Establishing a standardized system for planning, monitoring, and evaluating interventions will facilitate the generation and use of high-quality program-related data to inform decision making, thus helping to boost program effectiveness. Training and implementation of the framework has begun, and the next step will be to evaluate its effectiveness and standardization across HEIs in Ethiopia.

  • This brief by Uganda’s National Planning Authority describes how Uganda and its people could benefit from the demographic dividend, based on results from DemDiv, a new modeling tool developed by the USAID-funded Health Policy Project. DemDiv shows that a combined scenario of investments in family planning, education, and economic policies would provide the strongest benefits in terms of health, investment, employment, and GDP per capita. Specific policy recommendations for the three sectors are included.

  • The Indian state of Jharkhand has shown commitment to improve the implementation of its family planning (FP) program and undertook a capacity-building program, with technical assistance from the USAID-funded Health Policy Project (HPP), to strengthen capacities of the state Family Planning Cell, civil society organizations, and district- and block-level health functionaries to operationalize the state's FP strategy and oversee its effective implementation. This program was piloted in three focus districts—Simdega, West Singhbhum, and Giridih—and followed an intensive approach that included a capacity needs assessment and development of a program that was in line with the findings of the needs assessment.

    This toolkit was developed as an aid for HPP’s capacity-building program in the Jharkhand. It consists of the Manager's Tool to record data during mentoring and supervisory visits; the Manual for District and Block Managers and accompanying PowerPoint slides that provide training and guidance to build capacity for a stronger health system that supports family planning programs; and the Training of Trainers Manual and accompanying PowerPoint presentations to build participants' skills to become trainers of district- and block-level managers in health systems strengthening and effective management to improve FP programming.

  • Access to maternal health services in Ghana has improved significantly over the past 15 years—most dramatically since 2008, when the government began providing free general care for pregnant women, as well as a maternal benefit package covering deliveries, antenatal and postnatal care, and pediatric care for the first three months of life. The National Health Insurance Fund finances all of these services. To help Ghana’s policymakers anticipate the health and economic benefits at varying levels of investment in family planning from 2014–2020, the USAID-funded Health Policy Project (HPP) conducted this analysis, using its new ImpactNow model.

  • One major issue involved with expanding FP services is identifying direct and indirect costs of service delivery. Accordingly, the Gather, Analyze, and Plan (GAP) tool is being applied in the Amhara region of Ethiopia to understand what is needed to achieve the regional FP target set for the year 2020. GAP is a simple Excel-based tool developed by the USAID-funded Health Policy Project (HPP) to help policymakers, ministry officials, and health officials understand the costs associated with expanding family planning to achieve national or regional contraceptive prevalence or fertility goals. Information is urgently needed to ensure that FP programs are fully funded as the shift in agenda and ownership takes place. The GAP tool allows countries to project funding gaps in contraceptives, service provision, and program support. In collaboration with the Amhara Regional Health Bureau and other partners, HPP organized a regional GAP workshop in June 2014.

  • This Excel workbook is a customizable file associated with the document,"Costed Implementation Plans for Family Planning: 10-Step Process for CIP Planning, Development, and Execution." The file presents an illustrative activity roadmap and sequencing for completing a CIP process. Users can customize this template by changing the schedule dates, editing or adding actions, and changing due dates.

    This resource is part of the CIP Resource Kit, which can be accessed at http://www.familyplanning2020.org/cip.

  • To generate evidence to support Kenya’s investment in family planning and motivate elected leaders and decisionmakers at the national and county levels to act, Kenya’s National Council for Population and Development (NCPD) and the USAID-funded Health Policy Project (HPP) applied the ImpactNow policy model. The Microsoft Excel–based model uses different scenarios to quantify the short-term health and economic benefits of family planning. Since most existing models focus on the long-term gains of increased family planning uptake, ImpactNow fills an important knowledge gap in family planning policy and advocacy.

  • ImpactNOW, a new family planning advocacy model, generates evidence to make the case for immediate FP investments by modeling gains in maternal and child deaths averted, unintended pregnancies, and financial savings to the healthcare system as a result of FP uptake. ImpactNOW is currently being pilot-tested in Ethiopia's Amhara Region. On August 27, 2013, the Health Policy Project held a one-day stakeholders meeting to introduce ImpactNOW, provide a live demonstration of the model, and obtain feedback and impressions of it from family planning stakeholders, advocates, and policymakers. Stakeholders included representatives from the Amhara Regional Health Bureau (ARHB), the Regional Finance and Economic Development Bureau (BoFED), university partners, and nongovernmental organizations. Their primary focus in applying ImpactNOW will be the linkage between FP uptake and maternal and child deaths.

  • The USAID-funded Health Policy Project applied its new ImpactNow model to estimate the near-term benefits of achieving family planning goals in Kenya. This PowerPoint presentation describes some key benefits associated with achieving these goals, and offers recommendations for the government of Kenya and development partners to increase investment in and improve family planning services in the country.

  • ImpactNow is an Excel-based model that estimates the health and economic impacts of family planning (FP) in the near term. It is designed to model the impacts of different policy scenarios, and to compare the results of those scenarios in advocacy materials. It can help to estimate the impacts of many “what if” questions about policy options. ImpactNow is designed to analyze impacts in the two- to seven-year time horizon; for example, it could be used to estimate the impacts of meeting Family Planning 2020 (FP2020) commitments. The outcomes are focused on reproductive health metrics, as well as economic metrics, such as cost-benefit ratios and incremental cost-effectiveness ratios (ICER).

    ImpactNow was adapted from Marie Stopes International’s (MSI) Impact 2 as a collaboration between MSI and the Health Policy Project (HPP), with support from USAID. The ImpactNow Manual: Estimating the Health and Economic Impacts of Family Planning Use is also available to help health analysts use the ImpactNow model to estimate the health and economic impacts of FP programs.

  • ImpactNow is an Excel-based model that estimates the health and economic impacts of family planning in the near term. It is designed to model the impacts of different policy scenarios and to compare the results of those scenarios in advocacy materials. It is designed to estimate the impacts of many "what if" questions about policy options in the two- to seven-year time horizon; for example, it could be used to estimate the impacts of meeting Family Planning 2020 (FP2020) commitments. The outcomes are focused on reproductive health metrics, as well as economic metrics, such as cost-benefit ratios and incremental cost-effectiveness ratios.

    ImpactNow was adapted from Marie Stopes International's Impact 2 in collaboration with the Health Policy Project, with support from USAID. The USAID-funded Health Policy Project authored the users’ manual to help health analysts apply the ImpactNow model to estimate the health and economic impacts of family planning programs at national and subnational levels.

    Under Health Policy Plus, ImpactNow was revised in September 2018. This 2.0 version of ImpactNow features the following additions:

    • Youth-only option: users now have the option to calibrate the model for a youth population only (either all youth ages 15–19 or only youth in union, ages 15–19)
    • New default database: the model now features an updated database, with the latest available values for each country or region across model input data categories
    • New display features: the model features an infographic option, embedded in the results section, allowing users to present model results in a visually compelling way for diverse audiences
    • Expanded methodological alignment: the ImpactNow 2.0 methodology has been revised in an effort to harmonize the computation of select outputs with other family planning modeling efforts

  • The USAID-funded Health Policy Project applied its new ImpactNow model to estimate the near-term health and economic benefits of achieving family planning goals in the Amhara region of Ethiopia. This report presents the proceedings of the preliminary results dissemination meeting, held in Bahir Dar in May 2014, attended by the Amhara Regional Health Bureau and representatives from the Federal Ministry of Health. Following presentation of the draft results, attendees' discussions and recommendations were recorded to inform the final ImpactNow analysis, to be completed in late 2014.

  • Tackling undernutrition and achieving food security will require cross-sector collaboration, innovative approaches, and optimizing the use of all available interventions. In 2014, the USAID-funded Health Policy Project conducted two reviews of the empirical evidence on the impacts of one intervention—family planning—on food security and nutritional status, respectively. 

    The review on nutrition showed that when women exercise their freedom and right to access voluntary family planning to meet their fertility intentions, there is a natural decline in the prevalence of high-risk and unintended pregnancies; and that by averting such pregnancies, improvements in key maternal, infant, and child nutrition outcomes can be achieved. 

    The review on food security showed that voluntary family planning can decrease fertility rates and slow the pace of population growth, thus reducing food needs as well as strains on agricultural resources. In this way, family planning supports the four main pillars of food security—availability, access, utilization/consumption, and stability—and can help ensure that people have both physical and economic access to sufficient food. 

    Evidence from both reviews also suggests that the role of voluntary family planning in decreasing rates of maternal mortality and improving women’s empowerment can have profound impacts on food security and nutrition.

    Summary briefs are available for each report: food security here, and nutrition here.

    Also see the companion desk review synthesizing the programmatic experiences of integrating family planning with food security and nutrition. It was conducted by the Food and Nutrition Technical Assistance III Project (FANTA) and is available here: http://www.fantaproject.org/focus-areas/food-security/desk-review-programs-integrating-family-planning-food-security-and-nutrition. 

  • In November 2011 in Nigeria, a landmark national conference, "Improving Financial Access to Maternal, Newborn, and Child Health Services for the Poor in Nigeria," was held. The conference organizers included three federal agencies, the African Health Economics and Policy Association, four United Nations agencies, three donor countries, and five health projects, including the Health Policy Project. A total of 255 experts from all 36 Nigerian states and the Federal Capital Territory came together to discuss strategies to improve financial access to integrated MNCH services, with the aim of achieving universal health coverage. These strategies highlighted the need for advocacy and policy change, innovation in the design and implementation of health financing schemes, strengthening of the social health insurance scheme, and collaboration with private sector health providers.

    A complete list of sponsoring agencies and all conference materials and presentations are available on the conference website at http://www.healthfinancenigeria.org.

  • Two commonly used measures of population policy effectiveness and family planning programs are the total fertility rate (TFR) and the contraceptive prevalence rate (CPR). Over the past 18 years in Malawi, CPR increased dramatically from 13 percent in 1992 to 46.1 percent in 2010 among reproductive-age women in union. Surprisingly, this dramatic increase in CPR resulted in only a modest decline in TFR from 6.7 to 5.7 births per woman in the same period. According to international correlations, the increase of 33 points in CPR would have lowered TFR by 2 births.

    This study, conducted by the USAID-funded Health Policy Project (HPP), uses available data from the Demographic and Health Surveys (DHS) to explore why the rise in CPR has not translated into significant reductions in TFR in Malawi. It employs the Proximate Determinants of Fertility Model developed by Bongaarts to estimate TFR at the national level, and urban and rural levels in 2000, 2004 and 2010. The observed (as calculated from DHS data) and estimated (as calculated by HPP) TFR values are compared and explanations of any differences are explored.

  • Injectable contraception has been available in the private sector in India since 1986, but is not accessible to public sector clients. With support from the USAID-funded Health Policy Project, the Policy Unit of the National Institute of Health and Family Welfare conducted a stakeholder analyses to understand the barriers to introducing injectables in the package of methods available through the public sector. This descriptive brief combines primary and secondary data to provide a status update and policy analysis to stakeholders advocating for policy change to expand the basket of contraception in the public sector.

  • Over the past two years, the Health Policy Project (HPP) has been working with religious organizations (mother bodies) in Malawi to organize districtwide “Population Weekends.” The purpose of these weekends is for communities to hear about population and development issues, including family planning (FP), in their places of worship. In March and April 2015, HPP worked with the Institute of Public Opinion and Research (IPOR) to conduct public polling in two districts (Salima and Thyolo) to see if any insights could be gleaned to inform future design and implementation of FP programs. The findings in this brief are drawn from a survey of 754 respondents that took place in March 2015 (before implementation of population weekend activities).

  • Developed by the USAID-funded Health Policy Project, the Integrating Gender into Scale-up Mapping Tool is designed to provide program managers with a methodology to systematically integrate gender into scale-up initiatives. The process begins with a gender-based analysis to identify factors that influence women’s and men’s experiences related to health and the best practice to be scaled up. The findings from the analysis are then used to inform development of a scale-up road map with a gender lens. The mapping tool enables the user to identify when gender-based constraints may arise during the scale-up process, and develop strategies to address constraints and opportunities to reduce gender inequality during scale-up. Lastly, the user will develop indicators to monitor both the scale-up process and the gender strategies incorporated into the scale-up process. At the end of the mapping exercise, the user will have a concrete plan outlining the gender barriers that may arise throughout the scale-up process, strategies for addressing these barriers, and indicators to monitor both the scale-up process and the gender strategies incorporated into the process.

    This tool features a gender analysis template and the Integrating Gender into Scale-up Mapping template. Illustrative examples for completing the mapping template are also provided. 

  • International initiatives, including the Millennium Development Goals, are increasingly recognizing that gender strongly influences the health outcomes of women, men, and children. Relevant literature indicates that the incorporation of strategies to address gender inequality can lead to improved health and program outcomes. Many donors and program implementers have begun to incorporate strategies and approaches that address gender barriers and constraints. However, it is not clear that regular attention is being paid to gender factors during program scale-up.

    The Health Policy Project (HPP) conducted a literature review to identify and analyze whether systematic attention to gender factors during the planning and process of scaling up family planning (FP) and maternal, neonatal, and child health (MNCH) programs improves the effectiveness of that process. This working paper focuses on efforts to scale up interventions in FP and MNCH in developing countries. It defines “scale-up” and describes some of the frameworks and approaches to scaling up found in recent health literature and how they address gender. The paper also reviews the experience of selected organizations in scaling up best practices and addressing gender. It identifies a number of lessons learned from scale-up initiatives and lists key recommendations for systematically integrating gender into the scale-up process.

    Related resources:

    Expert Meeting on Policy Implementation and Gender Integration in the Scale-Up of Family Planning and Maternal, Neonatal, and Child Health Best Practices

    The Policy Dimensions of Scaling Up Health Initiatives

  • At the request of the USAID Mission in Malawi, the USAID-funded Health Policy Project (HPP) undertook a comprehensive facility-based assessment to ascertain the extent to which FP services have been integrated into HIV services in Malawi through different integration models and across various types of facilities (public and non-profit private). The study was also designed to examine how the reproductive rights of people living with HIV (PLHIV) are being respected and addressed through approaches such as PIFP and access to method choice. Finally, the study aimed to identify any systems-level barriers to integration and provide practical recommendations for the Ministry of Health (MOH) and other stakeholders to improve FP-HIV integrated services in Malawi.

  • Since 2012, the USAID-funded Health Policy Project (HPP), in partnership with the Ethiopia Public Health Association (EPHA), has trained 52 public health professionals from government entities, universities, and nongovernmental organizations (NGOs) in the use of the Spectrum Policy Modeling System suite of tools. Driven by the vision of furthering this initiative, four faculty members from the Department of Reproductive Health at the College of Medicine and Health Sciences, the Department of Population Studies in the Faculty of Social Sciences, and the Institute of Public Health at the University of Gondar developed a proposal to integrate four Spectrum Model tools—DemProj, FamPlan, RAPID, and LIST—into the Master of Public Health (MPH) and Master of Science (MSc) curricula.This report summarizes the process followed, as well as successes and lessons learned from the integration of Spectrum tools into the academic curricula at the University of Gondar.

  • In Barbados and Jamaica, the PEPFAR- and USAID-funded Health Policy Project (HPP) has delivered two-day stigma-reduction trainings to health facility staff. Adapted from a longer curriculum, the trainings comprehensively address stigma and discrimination by involving all health facility staff (including receptionists, pharmacists, nurses, and administration staff). HPP is also helping facility staff develop posted “codes of conduct” which outline the expectations for stigma-free services, regardless of HIV status, sexual orientation, or gender.

    The codes of conduct posters feature health facility staff photos and contact information for clients to report instances of discrimination. The codes of conduct are being rolled out across health facilities in Jamaica, Barbados, and other countries across the Caribbean.

  • In 2013, the Health Policy Project conducted a series of trainings for government leaders, local media, and other stakeholders in Jordan. The effort aimed to highlight the importance of policy in strengthening family planning programs to advance the health of Jordanians. The first workshop focused on HPP's policy framework, which links family planning policy to health outcomes. The team

    • Presented global initiatives that affect family planning and discussed how they relate to Jordan
    • Presented new advances in health policy analysis—linking health policy, health systems, and health outcomes
    • Discussed policy analysis, from problem identification to impact assessment
    • Built capacity for policy
    • Discussed FP policy issues in Jordan, including barriers to FP

    The second workshop, held at the request of Jordan's Higher Population Council, focused on examining the framework in the context of the country's Demographic Opportunity Policy. Challenges and recommendations in meeting the goals of the policy were discussed, followed by the identification of which aspects of the framework could be applied to help implement those recommendations. The next step is to identify the appropriate authority to ensure implementation and coordination of follow-up efforts.

  • To improve FP services and availability in Jordan, the Higher Population Council (HPC), with support from the Health Policy Project and in cooperation with all stakeholders, developed the National Reproductive Health/Family Planning Strategy 2013–2017. The strategy assesses the reproductive health (RH)/family planning (FP) environment in Jordan and describes the interventions required to improve RH/FP services and use and ultimately achieve the goals of the Demographic Opportunity Policy.

    This brief summarizes the three main challenges to Jordan’s FP program—policy, access, and beliefs and behaviors—and outlines the interventions planned to address them.

  • Energy is extremely expensive in Jordan, and 97 percent of all energy used in Jordan is imported. Energy costs are equivalent to nearly 21 percent of the total annual gross domestic product; energy costs are equivalent to 32 percent of the value of all annual imports; and energy costs are equivalent to the value of 83 percent of all exports. As the population grows, so will the consumption of energy, and consequently, the expenses to provide the amount of energy required in the future. If Jordan is to meet its future needs for energy, it must address multiple issues, including the scarcity of local oil, rising prices of oil in the international market, critical and serious supply-demand imbalances, costly new sources (infrastructure and operating), and the increasing pressure on resources from changes in population, development, and lifestyles. Resolving these issues will take a concerted effort and commitment from the government and the people of Jordan; and each of these issues needs to be addressed in multiple and different ways. One of the least expensive approaches that can be taken immediately, and is the underlying theme of this presentation, is to reduce population growth. 

    This RAPID presentation, developed by the Health Policy Project in collaboration with the Jordan Higher Population Council, demonstrates that future population growth will directly affect the ability of Jordan to provide sufficient energy resources. While reducing population growth will not be sufficient in eliminating all of the energy issues facing the country, it is a necessary step that needs to be taken in combination with many others if Jordan is to successfully resolve its pressing energy situation.

  • In March, the Kenya Ministry of Health convened an international consultation forum in collaboration with the World Bank Group and the United States Agency for International Development (USAID) through the Health Policy Project to deliberate on the challenges of providing universal health coverage (UHC) to all Kenyans, regardless of their ability to pay, and to explore strategic and sustainable health financing options. The Kenya Health Policy Forum reviewed options and lessons learned from other countries, and proposed recommendations on how the country can improve efficiency to achieve UHC.

    The meeting brought together local and international experts with diverse expertise spanning the health sector, including both the public and private sectors. Participants from Kenya included representatives from both levels of government, nongovernmental organizations, faith-based organizations, and the private sector. International speakers shared experiences from Brazil, Ethiopia, Ghana, India, and Mexico. Development partners who support Kenya’s health sector were also represented, including the USAID, the UK Department for International Development, the German Federal Enterprise for International Cooperation, and the World Bank.

  • This report is the product of a budget tracking study regarding the engagements for family planning completed by the USAID-funded Health Policy Project in Niger, Mauritania, Burkina Faso and Togo. The study examined the budget cycle process, identified  budget line items dedicated to family planning and analyzed financial commitments to family planning in each of the four countries through key informant interviews and a literature review. Stakeholders can use these results for informed and effectively timed advocacy for resources for family planning. 

  • This policy brief highlights the USAID-funded Health Policy Project's in-depth analysis of fertility and family planning trends in the Amhara Region, based on the Ethiopia Demographic and Health Survey (EDHS) 2011. The findings demonstrate that early marriage is pervasive in Amhara (leading to earlier childbearing), and that 22 percent of married women in the region have an unmet need for family planning. There are disparities in the uptake of family planning, with rural women and those with no formal education being particularly difficult to reach. The quality of family planning services was also found to be a barrier to family planning use, with many women receiving inadequate counseling about available contraceptive methods or side effects. Based on the study's findings, crucial actions are recommended for expanding and improving family planning services and reducing fertility in the Amhara Region, which can inform family planning policy development and advocacy in the region.

  • Health-related policy and its implementation is complex. This conceptual framework, prepared by the Health Policy Project, is designed to show the flow from health-related policy development to health-related policy and program implementation. The framework has been developed based on an extensive review of health policy and health systems literature and decades of experience in the policy areas related to family planning, reproductive health, HIV/AIDS, and maternal health. The framework includes the four stages of policy, which starts with the identification of a problem and moves to policy development, policy implementation, and policy monitoring and evaluation. The conceptual framework situates the process within the context of an enabling environment, comprising broader governance and political, sociocultural, and economic factors. It is meant to guide governments, organizations, and communities in understanding the links among health-related policies, programs, systems, outcomes and better implementation and monitoring and evaluation of health-related policies. It can also be used to frame research questions and design studies.

  • Newer CIP resources are available from the HP+ CIP toolkit.

    Obtaining early buy-in from key decisionmakers is critical for securing the human and financial resources required to develop a family planning costed implementation plan (CIP). Many stakeholders may be unfamiliar with CIPs, how they support the achievement of family planning goals, and what the process requires. An initial effort to educate key stakeholders on these topics can help instill a sense of ownership and accountability that translates into sustained support and commitment for robust participation throughout the CIP process.

    This presentation can be customized to obtain buy-in and approval to engage in the CIP process. This resource is part of the CIP Resource Kit, which can be accessed at http://www.familyplanning2020.org/cip.

  • This presentation aims to raise awareness about the impact of rapid population growth on Malawi’s development. It includes projections of population growth from 2008 to 2040 based on two hypothetical population scenarios. One scenario assumes that women in Malawi will continue to have 5.7 children on average during their lifetime, while the other scenario assumes a gradual decline in fertility to three children per woman. The first scenario with continued high fertility shows the population growing from about 13 million people in 2008 to 38 million people in 2040. By contrast, the second scenario with lower fertility shows an increase from about 13 million people to 30 million. By 2040, Malawi would have over 8 million fewer people if women were to have three children instead of nearly six.

    These projections demonstrate the impact that rapid population growth can have on various sectors, such as education, health, agriculture and food security, environment and land use, and the labour force and employment.

  • This briefing book aims to raise awareness about the impact of population growth on Malawi's development. It includes projections of population growth from 2008 to 2040 based on two hypothetical population scenarios. One scenario assumes that women in Malawi will continue to have 5.7 children on average during their lifetime, while the other scenario assumes a gradual decline in fertility to 3 children per women. The first scenario with continued high fertility shows the population growing from about 13 million in 2008 to 38 million in 2040. By contrast, the second scenario with lower fertility shows an increase from about 13 million in 2008 to 30 million in 2040. By 2040, Malawi would have more than 8 million fewer people if women were to have three children instead of nearly six. 

    These projections demonstrate the impact that rapid population growth can have on various sectors, such as education, health, agriculture and food security, environment and land use, and the labor force and employment. In the case of education and health, a slower population growth rate results in less pressure on the government budget to provide free primary education and public health services. 

  • This 2-page briefer aims to raise awareness about the impact of rapid population growth on Malawi's development. 

  • Tanzania’s sustained development and transition to middle-income status depend on the health of its people. In recognition of this fact, the Government of Tanzania (GOT) has prioritized reproductive, maternal, newborn, child, and adolescent health (RMNCAH), adopting a broad foundation of policies to inform RMNCAH programming. Yet, in recent years, progress toward achieving Millennium Development Goal (MDG) targets for child, maternal, and neonatal health has been uneven, in large part due to funding and implementation challenges. To overcome these challenges and accelerate progress, the GOT developed a National Road Map Strategic Plan to Improve Reproductive, Maternal, Newborn, Child and Adolescent Health in Tanzania (2016-2020): One Plan II. In 2015, the USAID-funded Health Policy Project (HPP) conducted an analysis to project the costs and health impacts of achieving the government’s new commitments outlined in the One Plan II, and to identify the remaining challenges for implementing the plan.

  • This presentation was given during a satellite session on policy implementation hosted by the Health Policy Project at the Second Symposium on Health Systems Research, in Beijing, China, October 31, 2012.  

  • To meet growing enthusiasm among policymakers for the potential economic benefits of the demographic dividend with a deeper understanding that can promote tailored and effective policy investments, the USAID-funded Health Policy Project has developed a cross-national, customizable projection model, DemDiv. This technical guide describes the rationale and design of the two-part model, which consists of equations describing capital formation, employment growth, and total factor productivity as a function of age structure and other social and economic variables. Applied to any country, DemDiv allows users to design multiple scenarios that capture the effects of different policy interventions and quantify the demographic dividend.

  • This presentation is a summary and report of findings regarding varying motivational intensity of unmet need for family planning and is based on a study conducted by the USAID-funded Health Policy Project. The oral presentation was delivered at the November 2013 International Family Planning Conference in Addis Ababa, Ethiopia.

  • With a high government debt burden and declines in donor assistance, Jamaica faces challenges in sustaining its national HIV and family planning programs. To heighten efficiency and sustainability, the Jamaican Ministry of Health (MOH) integrated elements of its national HIV program into its family planning (FP) program to create a new national agency for sexual health. The new sexual health agency absorbs all the functions previously carried out by the national FP and HIV/STI programs except for treatment and clinical services. In undertaking this reform, the MOH found a dearth of guidance about national HIV-FP program integration. Thus, the MOH collaborated with the USAID- and PEPFAR-funded Health Policy Project to develop this case study assessing lessons to date in Jamaica and next steps.

  • The Government of Malawi recognizes that the health of young people is a component of public health, which is of concern in this country. However, lives of most young people continue to be threatened by a number of factors such as sexually transmitted infections including HIV and AIDS, teenage pregnancies, unsafe abortion complications, nutrition inadequacies, alcohol and drug abuse and mental health problems. This contributes significantly to the high mortality and morbidity rates in Malawi. The Ministry of Health through the Directorate of Reproductive Health and partners initiated the program evaluation of youth-friendly health services to assess the extent to which young people access the health services they need at various levels of care. The findings and recommendations from the evaluation stressed the need to have a robust adolescent and youth sexual and reproductive health strategy.

    This strategy, therefore, aims at giving direction and guidance to the implementation of SRH services for all young people countrywide, so as to achieve the highest possible level of quality integrated services.

  • Networks and coalitions can be effective in mobilizing political will, influencing policy and financing, and strengthening health programs. By sharing resources and workload, networks and coalitions can take advantage of their members' capabilities and skills to plan and implement joint advocacy campaigns, present a unified front, and make collective demands to government. The Health Policy Project prepared this brief to provide leaders of civil society organizations with guidance on working within networks and coalitions to advocate for improved family planning, HIV care and treatment, and maternal health policies and programs.

    This is one of two briefs focused on advancing country ownership for improved health. The other brief can be accessed here: Accountability and Transparency for Public Health Policy: Advancing Country Ownership.

  • In 2011, the Health Policy Project, in collaboration with the Family Planning Action Group (FPAG), supported the development of a Nigeria RAPID application. The FPAG, comprising governmental and nongovernmental organizations, focuses on the state of family planning in Nigeria and the need for more support and funding for the national family planning program. “RAPID” stands for “Resources for the Awareness of Population Impacts on Development,” and it is a tool designed to help policymakers understand the relationships between fertility, population growth, health, education, agriculture, economic growth, and national security. This package of materials uses RAPID projections to highlight the impact of Nigeria's population growth on national development and its ability to provide education, health, and nutrition to all its citizens. By lowering average fertility, savings in primary education and health could amount to $37 billion and $45 billion, respectively, by 2040.

    Also see the RAPID package of materials highlighting the impact of high fertility on maternal and child health: Nigeria RAPID Population and Development: Why Fertility Affects Health.

  • In 2011, the Health Policy Project, in collaboration with the Family Planning Action Group (FPAG), supported the development of a Nigeria RAPID application. The FPAG, comprising governmental and nongovernmental organizations, focuses on the state of family planning in Nigeria and the need for more support and funding for the national family planning program. “RAPID” stands for “Resources for the Awareness of Population Impacts on Development,” and it is a tool designed to help policymakers understand the relationships between fertility, population growth, health, education, agriculture, economic growth, and national security. This package of materials uses RAPID projections to highlight the large unmet need for family planning in Nigeria and its impact on maternal and child health. By lowering average fertility in the country, 31,000 maternal deaths and 1.5 million child deaths could be averted by 2021.

    Also see the RAPID package of materials highlighting the impact of rapid population growth on the country's development: Nigeria RAPID Population and Development: How Fertility Affects Development.

  • In 2014, the Health Policy Project, in collaboration with the United Nations Population Fund (UNFPA), supported the development of a subnational family planning advocacy booklet in Adamawa, Nigeria. Using Resources for the Awareness of Population Impacts on Development (RAPID), this booklet highlights the impact of the state’s low contraceptive use and high population growth on its development prospects, principally its ability to provide education, health, nutrition and employment to all its citizens.

  • In 2014, the Health Policy Project, in collaboration with the United Nations Population Fund (UNFPA), supported the development of a subnational family planning advocacy materials in Adamawa, Nigeria.Using the Resources for the Awareness of Population Impacts on Development (RAPID) model, this brief highlights how smaller families would relieve pressure on the provision of primary education and public health services, and alleviate food insecurity as well as unemployment in Adamawa state by 2050.

  • With a current population exceeding 170 million, the Federal Republic of Nigeria is the seventh-largest country in the world and the most populous in Africa. Despite the introduction of policies and programs over the last 30 years to address Nigeria’s rapid population growth and the challenges it poses for development, the country is projected to become the third-largest nation in the world by mid-century (United Nations Population Division, 2015). These continuing demographic trends—coupled with emerging national priorities and new international development frameworks—created the need to assess the implementation of Nigeria’s 2004 Policy on Population for Sustainable Development (henceforth NPP, or the policy). Results from this USAID-funded Health Policy Project assessment are intended to guide the formulation of a revised policy and the approaches needed to realize its goals and objectives.

  • “Population, Development, and Family Planning: The Urgency to Act” highlights the health benefits and cost savings associated with meeting all unmet need for family planning in nine francophone West African countries by 2030. If governments invested in meeting family planning needs, an estimated 500,000 infant deaths and 7,400 maternal deaths could be averted over the next decade. Similarly, if the nine governments invested US$84 million in family planning services over the next decade, they would save $195 million needed for programs to reach the Millennium Development Goals by 2020. In other words, for every dollar invested in family planning programs, governments could save US$2.30 in reduced expenditures for maternal health, malaria, immunization, education and water and sanitation programs.

    Dr. Johanna Austin Lucinda Benjamin, Director of Primary Health Care and Disease Control of the West African Health Organization, presented these findings at the West Africa regional conference on Population, Development and Family Planning, held in Ougadougou, Burkina Faso, on February 8–11, 2011.

  • The USAID-funded Health Policy Project (HPP), in collaboration with the Family Health Division of the Ministry of Health and Population in Nepal, and members of the multi-sectoral technical working group (TWG), completed applications of three models: ImpactNow, DemDiv, and RAPID Women. The integrated modeling package provided evidence to reinvigorate support for family planning among national-level policymakers. 

    HPP developed three policy briefs to summarize model results around three key themes: family planning, education and gender equality. HPP also developed two booklets. The first booklet, Planning for Nepal’s Demographic Dividend, makes a case for increased investment in family planning, education and economic policies to promote health and development. The second booklet, Gender Equality and Social Inclusion: Investments for Improved Health and Development, presents results from the RAPID Women model and makes the case for investing in women-centered strategies for improved health outcomes. The materials represent the key messages developed by the TWG and family planning stakeholders that participated in HPP’s message development workshop. 

  • This report describes two pilot technical assistance programs implemented by the USAID-funded Health Policy Project to strengthen policy development and implementation related to contraceptive security at decentralized levels in Peru and the Dominican Republic. Over a two-year period, three regional and municipal committees engaged a multisectoral group of political leaders, technocrats, civil society representatives, and healthcare providers to collaboratively assess policy and funding barriers related to family planning and design and implement solutions. The compilation of experience and results is intended to inform programs to strengthen contraceptive security at the decentralized level in other settings, whether through committees or other mechanisms. As decentralization continues to evolve in Latin America and other regions, it is critical to strengthen subnational capacity in the public sector and civil society to ensure that high-quality and equitable services are demanded, delivered, and monitored at all levels of the health system in a manner that promotes sustainability and local ownership.

  • This checklist, developed by the USAID-funded Health Policy Project, draws from lessons learned and best practices moving from policy to action. It is meant to provide guidance to stakeholders on how to contribute to a policy environment that supports countries to fulfill their FP2020 commitments. The tool allows users to compare current policies with the best practices discussed in this document, to assess whether current policies need to be revised or better implemented, and whether new policies should be developed. 

  • International health programs and donors throughout the world increasingly recognize the importance of promoting gender equality to improve health and development outcomes. International initiatives such as the Sustainable Development Goals include specific gender equality goals and targets. Yet, translating gender equality goals into action is challenging. Practical tools for integrating gender into health policies and programs are needed. The USAID-funded Health Policy Project (HPP) prepared this brief to provide policymakers, donors, and program managers with real examples of methods for promoting gender equality in family planning, maternal and child health, and gender-based violence policies and programs.

  • In sub-Saharan Africa (SSA), expected national fertility levels and country-level observations demonstrate repeated mismatches in magnitude and/or direction.Thus there is an unfulfilled demand for better explaining, understanding, and communicating how fertility changes. Accurately predicting fertility is critical for understanding how populations may be expected to change, and for managing expectations about the possible impacts of TFR-affecting policy levers. The USAID-funded Health Policy Project produced this poster for the 2015 Population Association of America conference to determine to what extent can the accuracy of predicting fertility in SSA using the proximate determinants framework be improved by implementing revisions, with emphasis on the contraception index.

  • With support from the USAID-funded Health Policy Project, the Ethiopian Public Health Association applied the DemProj module of the Spectrum suite of models to project the size of the Ethiopian population from 2012 to 2050. The projection showed that the population is expected to increase steadily from 83.7 million in 2012 to 171.8 million in 2050. The young (0 to 14 years) age group is projected to decline after 2030, while the working-age population (15 to 64 years) and older age population (65 years+) are expected to continue growing. Ethiopia’s window for capturing a possible demographic dividend is projected to peak around 2040. Based on the data from the model, recommendations were made to accelerate access to family planning services and to increase investments in health, education, and other development sectors to take advantage of the demographic dividend.

  • Since 2003, the U.S. Agency for International Development's Latin America and the Caribbean (LAC) Contraceptive Security (CS) Initiative has fostered country ownership through CS committees established in eight priority countries. Among the countries in the LAC region, Paraguay’s experience establishing and strengthening a national CS committee serves as a success story for the improvement of reproductive health indicators in a context of increased country ownership. This brief documents the steps taken to ensure that in less than a decade, the CS Committee in Paraguay successfully fostered an enabling policy environment that led to increased financing and political commitment to making contraceptive supplies more easily available.

    This brief is based on the following report (only available in Spanish): Sistemitización de la Experiencia del Comité DAIA Paraguay.

  • The Nepalese government has prioritized mainstreaming gender equality and social inclusion in the country’s health policies and programs in order to improve the quality of equal access to health services for all. In support of this goal, management of local health facilities was handed over to Health Facility Operation and Management Committees (HFOMCs) to increase the involvement of local communities in planning for the provision of high-quality health services. HFOMCs work to bridge the gap between communities and health providers and their guidelines require wide and inclusive community participation, especially of women and other disadvantaged groups. To strengthen the committees’ capacity to make health services more inclusive, the Gender Policy and Measurement Program (GPM), an activity of the Health Policy Project (HPP) and MEASURE Evaluation, has partnered with the Suaahara Project to design, implement, and evaluate a scalable intervention to overcome barriers to HFOMC participation for women and other disadvantaged groups. This intervention will ultimately strive to improve family planning and neonatal health outcomes among marginalized groups.

  • The Gender, Policy and Measurement (GPM) program, funded by the Asia bureau of the United States Agency for International Development (USAID), is collaborating with USAID and other partners in the Asia region to strengthen programs for scale-up in Family Planning and Maternal, Neonatal, and Child Health (FP/MNCH). As a part of this effort, the GPM program, under the USAID-funded Health Policy Project (HPP), along with partner institutions in India—the International Center for Research on Women and the Public Health Foundation of India—sought to examine how successful gender-integrated health programs (identified through a systematic review of gender-integrated health programs in low- and middle-income countries have been scaled up, with a focus on programs that were scaled up through government structures in India.

    This report assesses the processes, challenges, successes, and lessons learned from scaling up gender-integrated programs through government systems in India; it provides an in-depth, comparative analysis of the scale-up experiences of three programs: Gender Equity Movement in Schools, PRACHAR, and Avahan. It identifies wide variations in government motivations for adoption and scale-up, approaches to scale-up, partnerships and engagement with key stakeholders, resource mobilization, and the modification or lack of attention to important gender components or aspects of the original pilot program(s). Finally, the study offers distinct and critical snapshots of gender throughout scale-up.

  • The public expenditure tracking survey with service delivery indicators (PETS-Plus) survey was a comprehensive exercise conducted in 2012 by the Ministry of Health, Kenya in collaboration with the USAID- and PEPFAR-supported Health Policy Project, Kenya Institute of Public Policy Research and Analysis, the World Bank, and the Kenya Medical Research Institute. The PETS-Plus combines the expenditure tracking surveys previously conducted in Kenya with health service indicators (SDI) to provide a comprehensive view of health facilities' overall performance and the impacts of key policy reforms in the sector. Data collected from 294 sampled facilities across 15 counties provide information on the adequacy of infrastructure, medical equipment, medical drugs, human resources for health, and financial planning and management at the facility level. Levels of adherence to key health financing policies on user fees (10/20 policy) and the Health Services Sector Fund/Hospital Management Service Fund (HSSF/HMSF) were also measured, providing critical insights into levels of readiness for devolution in the health sector and the implementation of policies such as free maternal healthcare and removal of user fees at the primary level. 

    Results of the survey suggest that counties in Kenya need to pay urgent attention to essential drug availability and improve human resource levels by reducing absenteeism and through redeployment. Access to IT equipment and electronic data record systems is needed. Adherence to past user fee policies has been non-uniform, suggesting that implementation of current user fee removal policies should be carefully monitored, and the delivery of HSSF/HMSF funds needs to be improved and strengthened. The PETS-Plus report is supported by three focused policy briefs that examine the results from different perspectives, diving deeper into the findings: effective implementation of the health financing policies; quality of primary healthcare services (using the SDI results); and county readiness for healthcare delivery (a comprehensive look across health inputs). These briefs are available on this page alongside the main report.

  • As global leaders look more critically at how to simultaneously advance women’s health and rights, particularly in light of the Sustainable Development Goals, it is important to examine where the momentum for respectful maternity care has led thus far, lessons learned in the process, and essential components that must be prioritized moving forward. This USAID-funded Health Policy Project and White Ribbon Alliance policy brief – informed by program documents, global and national policies, and interviews with key stakeholders who have worked for years to advance attention to this issue – seeks to review progress and provide recommendations for advancing maternity care that places women at the center. 

  • Health financing was the theme of a major national conference held in Calabar, Nigeria in November 2011. The specific focus of the three-day conference was “Improving Financial Access to Health Services for the Poor in Nigeria.” Participants shared information on a wide range of health financing strategies and mechanisms employed in Nigeria as well as other countries. The 255 participants represented a broad range of expertise; they included health managers and providers, insurance specialists, health economists, government officials, and media representatives from all 36 states and the national capital. State representatives met in regional groups to discuss the approaches most applicable to their area and formulate plans to apply these approaches at the state or community level. The conference generated many “actionable” policy and program initiatives that the states and federal government can adopt.

    This is one of the five presentations made by the Health Policy Project. The presenter explains how to measure poverty and inequality, how to display poverty data to illustrate inequities in health status and use of health services, and, finally, how to understand and address common data challenges.

  • This USAID-funded Health Policy Project presentation aims to raise awareness about the impacts of rapid population growth on Mozambique's socioeconomic development. It includes projections of population growth from 2015–2040 based on three hypothetical fertility scenarios: high fertility (5.9 children per woman, or status quo based on a 2011 baseline figure), medium fertility (4.5), and low fertility (3.0). Continued high-fertility growth will increase the pressure on Mozambique’s health, education, economic, and agricultural sectors to meet the population’s demand for basic needs. However, slowing population growth through increased use of family planning will allow the country to invest more in long-term measures to improve the quality of health services, guarantee universal education, expand employment opportunities, and attain food security. If strategically implemented, these measures could catalyze progress toward a healthier, more prosperous country.

  • In recent decades, Ethiopia has made impressive progress in improving socioeconomic outcomes and reducing child and maternal mortality. This brief, prepared by the Health Policy Project, outlines the current status of women and girls in Ethiopia and provides recommendations on how to improve girls' education, gender norms, and family planning to benefit women, their families, and the country.

  • In order to assess the pricing policies of family planning (FP) products and understand the impact of these policies on the accessibility of family planning services, the USAID-funded Health Policy Project (HPP), collaborated with the USAID | DELIVER Burkina Faso, Mauritania, Niger and Togo to formulate regional and national recommendations for improving contraceptive pricing policies to ensure the availability and sustainability of FP programs in West Africa.

  • Demographic pressures and lack of progress toward the Millennium Development Goals have encouraged countries in West Africa to "take a new look" at repositioning of family planning (RFP)---an initiative established to ensure that FP remains a priority for donors, policymakers, and service providers in sub-Saharan Africa. USAID requested that the Health Policy Project apply the newly developed "Framework for Monitoring and Evaluating Efforts to Reposition Family Planning" in Niger and Togo. The framework results represent a baseline that can subsequently be used to measure progress in RFP by country FP stakeholders. USAID also requested an assessment of policy barriers to community-based distribution of FP---the findings for which are included in this report. Niger’s family planning program has made considerable progress in the past five years. Signs of progress are a favorable policy environment, growing public support for family planning, and increased funding for contraceptive commodities. Family planning is provided free of charge and is included in the Minimum Package of Services that all public health facilities must provide. Still, challenges remain to meet unmet need for family planning, extend services to rural areas, and ensure that people have adequate information about contraceptive methods.

    To read the results of the application in Togo, view the report and brief, Repositioning Family Planning in Togo: A Baseline.

    Applications in six other countries (Benin, Burkina Faso, Guinea, Mali, Mauritania, and Senegal) were later conducted by Futures Group, with funding from the Hewlett Foundation. To access those reports and briefs, visit the Futures Group Publications webpage.

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  • Demographic pressures and lack of progress toward the Millennium Development Goals have encouraged countries in West Africa to "take a new look" at repositioning of family planning (RFP)---an initiative established to ensure that FP remains a priority for donors, policymakers, and service providers in sub-Saharan Africa. USAID requested that the Health Policy Project apply the newly developed "Framework for Monitoring and Evaluating Efforts to Reposition Family Planning" in Niger and Togo. The framework results represent a baseline that can subsequently be used to measure progress in RFP by country FP stakeholders. USAID also requested an assessment of policy barriers to community-based distribution of FP---the findings for which are included in this report. Although considerable progress has taken place in Togo in terms of RFP, much remains to be done. Efforts to date appear to have improved acceptance of FP and present opportunities for additional improvement.

    To read the results of the application in Niger, view the report and brief, Repositioning Family Planning in Niger: A Baseline.

    Applications in six other countries (Benin, Burkina Faso, Guinea, Mali, Mauritania, and Senegal) were later conducted by Futures Group, with funding from the Hewlett Foundation. To access those reports and briefs, visit the Futures Group Publications webpage.

     

  • The francophone West African countries are experiencing a critical shortage of health service providers, which affects access to and the provision of essential family planning services and contraceptives. Task sharing, or task shifting, a strategy endorsed by the World Health Organization, aims to shift family planning tasks from higher-level service providers to lower-level health staff to share the burden of family planning services within a health facility and increase access by providing family planning services through different service delivery points. As part of the action planning and budgeting process of the Ouagadougou Partnership/Call to Action (February 2011) to advance family planning in West Africa, Burkina Faso, Mauritania, Niger, and Togo committed to implementing one or more forms of task sharing. In 2014, the USAID-funded Health Policy Project conducted desk reviews and qualitative interviews in Burkina Faso, Mauritania, Niger, and Togo to assess the implementation of task sharing for family planning services and develop comprehensive recommendations to improve task sharing policies for family planning to contribute to the availability and sustainability of family planning services in West Africa.

  • In order to assess task sharing for family planning (FP) and possible policy implications that impact accessibility of FP services, the Health Policy Project (HPP) conducted a desk review and qualitative methods to assess task sharing for FP in Niger. This report shows results from this study and provides country-specific recommendations to improve task sharing policies for family planning in Niger.

  • The Health Policy Project (HPP) conducted a desk review and qualitative methods in Niger to assess pricing policies for contraceptives that impact accessibility of contraceptives. This report provides results from this study as well as recommendations to improve pricing policies for contraceptives in Niger.

  • The Health Policy Project (HPP) conducted a desk review and qualitative methods in Togo in order to assess task sharing for family planning (FP) in Togo. This report provides a summary of our findings an recommendation to improve task sharing for FP in Togo.

  • Family planning has long been recognized in sub-Saharan Africa as an essential way to maintain and improve the health and well-being of women and their families. Several international conferences, particularly the International Conference on Population and Development (ICPD) held in Cairo in 1994 highlighted the important role it plays in reducing maternal, newborn and child. However, the use of modern contraception is still very low in sub-Saharan Africa. This USAID-funded Health Policy Project report presents a situational analysis of repositioning family planning in West Africa. 

  • In order to assess task sharing for family planning (FP) in Mauritania, the Health Policy Project (HPP)  conducted a desk review and qualitative methods. This report shows findings from this study and provides country-specific recommendations to improve task sharing policies for FP in Mauritania to ensure availability and sustainability of FP services.

  • The increasing demand for family planning (FP) services, coupled with scarce resources highlights the need to develop and implement strategies that ensure access to FP services for all. One way governments more effectively target decreasing resources is to enact policies that shift FP users who can pay for services from the public to the the private, for-profit sector, thereby lessening financial pressures on governments, donors, and non-profit organizations. In order to assess pricing barriers for contraceptives in Mauritania, HPP conducted a desk review and key informant interviews to develop comprehensive recommendations to revised pricing policies for contraceptives to ensure availability and sustainability of contraceptives.

  • In order to assess task sharing policies for family planning (FP) in Burkina Faso, the Health Policy Project (HPP) conducted a desk review and qualitative methods. This report shows findings from this study and provides recommendadions to improve task sharing policies in Burkina Faso.

  • This policy brief  highlights (1) the advocacy process used to generate increased funding commitments for  family planning and reproductive health (FP/RH) commodities in Uganda, (2) the steps needed to ensure that the allocated funds fully translate into procurement of FP commodities, and (3) how advocates can sustain the momentum over the coming years. The information can be used to guide advocates in sub-Saharan Africa on addressing critical issues in the financing of FP/RH.

  • This policy brief is intended to guide Ugandan parliamentarians in addressing critical issues related to family planning and reproductive health (FP/RH) financing to ensure that increased budget commitments for RH commodities already realized are sustained over the coming years and that funds are disbursed and fully expended. Parliamentarians at the country level can fulfill three essential functions: (1) provide oversight to ensure that current allocations are maintained, (2) ensure that allocated funds from the World Bank RH Systems Strengthening Project are released and spent in FY 2013/14, and (3) track allocations to ensure the 100 percent expenditure of funds.

  • The OneHealth Model (OneHealth) is a tool for medium term (3 to 10 years) strategic planning in the health sector at the national level, ideally suited for public sector planners. It estimates the costs by disease program, as well as estimating the costs of utilizing the health system building blocks in delivering the targets involved in the disease programs. In Kenya, at the request of the Ministries of Health, HPP provided technical assistance in applying OneHealth to cost the Kenya Health Sector Strategic Plan III, 2012-2017, reflecting the interventions under the Kenya Essential PAckage of Health, as well as national disease strategies for programs that include HIV/AIDS, tuberculosis, malaria, non-communicable diseases, maternal, reproductive and child health, etc. The results include an assessment of the overall financial gap between resources needed and the government and donor resources available for all years of the analysis. This brief is intended for a policy audience in Kenya to support sustainable health sector planning, and may be of interest to other countries in the region who wish to apply OneHealth or similar approaches to assessing costs and financial gaps.

  • The United Nations Population Fund and the USAID-funded Health Policy Project used the Gather, Analyze, and Plan (GAP) Tool to analyze data on Zimbabwe’s demographic patterns and family planning (FP) costs. The analysis is intended to give decisionmakers in Zimbabwe a picture of the additional investment in FP that will be needed to achieve the country’s FP2020 goals.

  • This policy brief highlights the USAID-funded Health Policy Project's application of the RAPID model to forecast integrated data and evidence on population and socioeconomic projections for the Amhara region. The analysis can support experts and policymakers to engage in data-driven decision making, planning, budgeting, and monitoring and evaluation of regional population issues linked with related factors such as the economy, education, health, agriculture, and urbanization. The projections were made according to the Central Statistical Agency 2012 Intercensal Population Survey’s low and high variants for 2007 to 2037.

  • In every country and community worldwide, pregnancy and childbirth are momentous events in the lives of women and families and represent a time of intense vulnerability. As part of an overall effort to promote respectful maternity care, the Health Policy Project and White Ribbon Alliance have launched the Respectful Maternity Care Charter, based on the principle that respectful maternity care is every woman's right. A broad group of stakeholders representing research, clinical, human rights, and advocacy perspectives came together in a community of concern to develop this charter, which addresses the issue of disrespect and abuse among women seeking maternity care and provides a platform for improvement through seven distinct articles that clarify the rights of childbearing women. Improving the quality of care for women is an essential component in our work to improve maternal health worldwide.

    This brochure summarizes the key points and articles of the charter, titled Respectful Maternity Care: The Universal Rights of Childbearing Women, and is accompanied by a poster. Also available is A Guide for Advocating for Respectful Maternity Care, which provides national-level advocates with information, tools, and techniques to (1) raise awareness and demand for respectful maternity care (RMC), (2) hold local leaders and services providers accountable, and (3) secure commitments to institutionalize RMC as the standard of care.

  • In every country and community worldwide, pregnancy and childbirth are momentous events in the lives of women and families and represent a time of intense vulnerability. As part of an overall effort to promote respectful maternity care, the Health Policy Project and White Ribbon Alliance have launched the Respectful Maternity Care Charter, based on the principle that respectful maternity care is every woman's right. A broad group of stakeholders representing research, clinical, human rights, and advocacy perspectives came together in a community of concern to develop this charter, which addresses the issue of disrespect and abuse among women seeking maternity care and provides a platform for improvement through seven distinct articles that clarify the rights of childbearing women. Improving the quality of care for women is an essential component in our work to improve maternal health worldwide.

    This charter is accompanied by a summary brochure and poster and is supported by A Guide for Advocating for Respectful Maternity Care, which provides national-level advocates with information, tools, and techniques to (1) raise awareness and demand for respectful maternity care (RMC), (2) hold local leaders and service providers accountable, and (3) secure commitments to institutionalize RMC as the standard of care.

  • In every country and community worldwide, pregnancy and childbirth are momentous events in the lives of women and families and represent a time of intense vulnerability. As part of an overall effort to promote respectful maternity care, the Health Policy Project and White Ribbon Alliance have launched the Respectful Maternity Care Charter, based on the principle that respectful maternity care is every woman's right. A broad group of stakeholders representing research, clinical, human rights, and advocacy perspectives came together in a community of concern to develop this charter, which addresses the issue of disrespect and abuse among women seeking maternity care and provides a platform for improvement through seven distinct articles that clarify the rights of childbearing women. Improving the quality of care for women is an essential component in our work to improve maternal health worldwide.

    This poster presents the central articles of the charter, titled Respectful Maternity Care: The Universal Rights of Childbearing Women, and is accompanied by a summary brochure. Also available is A Guide for Advocating for Respectful Maternity Care, which provides national-level advocates with information, tools, and techniques to (1) raise awareness and demand for respectful maternity care (RMC), (2) hold local leaders and services providers accountable, and (3) secure commitments to institutionalize RMC as the standard of care.

  • About one-in-four Malawian women of reproductive age have an unmet need for family planning. The 2010 Demographic and Health Survey found that 26 percent of all births in the preceding five years had been unwanted and that an additional 19 percent were mistimed, indicating that nearly half of all women in Malawi are not adequately meeting their reproductive intentions. Unwanted and mistimed pregnancies contribute substantially to high maternal mortality and increase the strain on already limited resources for health, education, natural resources, and food security.

    With over 97 percent of Malawians belonging to an organized religion, faith leaders could be an important conduit of social change. In 2013, to support the Ministry of Economic Planning and Development’s strategy to raise awareness about population and development issues, HPP engaged  Malawi’s six major religious institutions (known locally as “mother bodies”)—the Episcopal Conference of Malawi, Evangelical Association of Malawi, Malawi Council of Churches, Muslim Association of Malawi, Seventh Day Adventists, and Quadria Muslim Association of Malawi—and their local faith leaders. HPP organized training and sensitization meetings with over 1000 faith leaders, to help them speak openly about population and family planning issues. After one year, Episcopal Conference of Malawi (ECM), the governing body of the Catholic Church in Malawi, decided they wanted to further institutionalize these activities and messages. They requested HPP’s assistance with drafting a booklet on family planning for use by Catholic marriage counselors. The booklet, which is available in both English and Chichewa, provides counselors with an introduction to population and development issues, as well as basic information on medical and natural family planning methods. 

  • This document sets out the strategy for monitoring and evaluation of scale-up of a gender-integrated health governance project in Nepal. The Gender, Policy, and Measurement (GPM) Program (jointly implemented by the Health Policy Project and MEASURE Evaluation) has partnered with the Suaahara Project, a community-focused program dedicated to improving the health of pregnant and lactating women and children under two years of age. The partnership aim is to design, implement, and evaluate a scalable capacity strengthening intervention for Health Facility Operation and Management Committees (HFOMCs) in Nepal to ensure issues related to gender and social inclusion (GESI) are addressed as part of the delivery of quality health services. As part of this endeavor, GPM and Suaahara have created a strategy to prospectively monitor and evaluate the scale-up of this intervention.

  • Expanding access to health insurance is an important part of an overall strategy to achieve universal health coverage (UHC). Since its launch in 1999, the National Health Insurance Scheme (NHIS) has been Nigeria’s major initiative to expand health insurance in the country. To support this endeavor, the Health Policy Project conducted case studies of the experience of three countries—Colombia, India, and Thailand—as they developed government policies as a strategy to achieve universal health coverage (UHC). The lessons learned should be useful for Nigerian stakeholders involved in expanding and improving the NHIS, as well as for stakeholders in any country facing similar challenges. How health insurance expansion features in a UHC strategy depends on the resources available to the government via general taxation; the growth and maturity of private voluntary health insurance markets; and, most important, the state of the health system across primary, secondary, and tertiary healthcare. Our case studies suggest that pragmatic choices made by lower-middle and middle-income governments—a group where Nigeria may be placed—have involved hybrid health financing models.

  • La investigación tiene como objetivo principal analizar mediante cuadros y gráficos, el perfil socio demográfico, actitudes de las mujeres en edad fértil en el Perú, frente a la planificación familiar de acuerdo a su quintil de bienestar, así como la segmentación económica de las fuentes de métodos anticonceptivos, que permita la evaluación del programa de salud familiar.

  • La graduación de USAID fue un proceso planificado que permitió enfocar acciones hacia cuestiones estratégicas, sin embargo también se constituyó en una oportunidad de mejora y crecimiento que fue identificada por el gobierno de Paraguay y sustentada por su voluntad y compromiso político hacia la planificación familiar. Este documento recopila la experiencia del Comité para la Disponibilidad Asegurada de Insumos Anticonceptivos (DAIA) en Paraguay para comprender cómo su desempeño desembocó en resultados exitosos y describe cuáles fueron los factores clave y su interacción, para obtener tales resultados. Los logros alcanzados reforzaron la confianza de los integrantes del Comité DAIA y naturalmente trascendieron el ámbito de trabajo del mismo. Obteniendo el reconocimiento de las autoridades e incluso traspasando las fronteras, puesto que hoy en día el caso de Paraguay está considerado como un modelo para los demás países que impulsan la DAIA en la región.

    Un sumario de este informe en ingles, está disponible en: Promoting Country Ownership through Latin American Contraceptive Security Committees: Paraguay Case Study.

  • The right to freely and responsibly decide if, when, and how many children to have has been enshrined in numerous international treaties, conventions, and political consensus documents. Governments are obligated to manifest their international commitments to family planning and reproductive health and rights through their policies and funded programs, at the national, state/province, and local level. Yet the reality on the ground is that for most countries worldwide, from the least to the most developed countries, governments fail in many respects to operationalize these international commitments.

    In recent years, the international development community has turned its attention to the role of accountability in achieving greater impact of development interventions.Social accountability is characterized primarily by the active involvement of citizens engaging with government decision-making processes to ensure government fulfills its commitments and implements policies and programs appropriately. While the FP/RH community has a long-standing commitment to advocacy and social mobilization to advance reproductive rights, some social accountability concepts and interventions are relatively new to the FP/RH community. This guidance document is a primer for CSOs working in health that are looking to initiate or expand activities aimed to hold government entities accountable for delivering on their national and international commitments related to family planning/reproductive health and rights.

    This document provides:

    • An overview of current concepts of social accountability.

    • A synopsis of common methodologies and tools used by civil society to engage in social accountability.

    • Ideas and examples on how social accountability can be used to further FP/RH within a country.

    • Suggestions on what elements CSOs might take into consideration when deciding to implement a particular methodology

    • A selection of documents and resources that may be helpful in implementing social accountability activities.

  • Ministries of health are largely responsible for achieving the commitments that their national governments have made as part of the FP2020 initiative. As stewards, ministries of health are responsible for fostering effective policy implementation. Yet, putting policies into practice is challenging, and all too often policy implementation is weak. This brief identifies three ways for ministries of health to address barriers to policy implementation and strengthen their role as stewards of national FP2020 efforts. It is part of a series of three briefs produced by the USAID-funded Health Policy Project to provide guidance to MOH officials and members of parliament (MPs) on three different approaches to strengthen MOHs’ stewardship functions for FP2020. The other briefs in the series are Stewardship for FP2020 Goals: The Role of Parliamentarians, and Stewardship for FP2020 Goals: Working with the Private Sector.

  • Ministries of health (MOHs) are largely responsible for achieving the commitments that their national governments have made as part of the FP2020 initiative, which aims to enable 120 million more women and girls to use contraceptives by 2020. However, MOHs’ ability to meet FP2020 goals depends on the strength of their stewardship functions, including the support they generate from and collaboration with other actors and sectors.This brief describes four skills that parliamentarians can develop and strengthen to become more effective at lobbying for, demanding, and securing additional funding for FP. It is part of a series of three briefs produced by the USAID-funded Health Policy Project to provide guidance to MOH officials and members of parliament (MPs) on three different approaches to strengthen MOHs’ stewardship functions for FP2020. The other briefs in the series are Stewardship for FP2020 Goals: Working with the Private Sector, and Stewardship for FP2020 Goals: MOH Role in Improving FP Policy Implementation.

  • At the Ouagadougou Partnership and Family Planning 2020 (FP2020) meetings, governments committed to improving access to family planning services and information. Costed Implementation Plans (CIPs) for family planning services and information provide a framework and tools for governments to achieve their international family planning commitments. This booklet, prepared by the Health Policy Project, highlights the methodology behind CIPs, walks through 10 steps for designing and implementing a national CIP for family planning, and shares experiences from seven African countries that have developed national CIPs for family planning to inform their decision making. It is estimated that implementation of the CIPs will accelerate each country's progress toward both achieving its target contraceptive prevalence rate and reducing maternal and child mortality.  

  • The USAID-funded Health Policy Project supports African women leaders through coaching, as part of a larger capacity development model. Too often knowledge and skills gained during training are eclipsed by the demands of returning to work—and to one's old habits. In order to nurture the seeds planted through the Empowering Women Leaders for Country-led Development program's three-week women's leadership workshop, HPP carefully matches each participant with a coach from her own country. Thus begins a year-long relationship that enables the participant to grow professionally and personally through prioritizing, networking, and learning. This brief describes workshop participants' experiences with their coaches, and includes guidance on the effective use of a coaching model for capacity development.

  • Tanzania's Ministry of Health and Social Welfare chose the OneHealth Tool, a model for medium- to long-term strategic planning in the health sector, to inform development and prioritization of the Fourth Health Sector Strategic Plan 2015/16–2019/20 (HSSP IV). Specifically, the OneHealth Tool was used to estimate the resource requirements and resources available for the health sector over the next five years, the impact on maternal and child health and HIV if HSSP IV service delivery targets are met, and the human resources constraints in scaling up health services. The results of Tanzania's OneHealth application are summarized in this report and provide an evidence base for strategic planning and resource allocation.

  • The 2013 general election in Kenya took place on March 4, 2013, giving citizens a chance to elect new leaders, including a new President, for a five-year term. To help maintain and further progress in the health area, the Health Policy Project documented the pledges, commitments, and promises made by the 2013 presidential candidates about the health sector in Kenya. This report outlines what the candidates and their parties promised to do about different health issues and how these promises align with current health sector aspirations described in the government’s existing short- and long-term policy and planning documents. The goal is to provide stakeholders in the health sector with a reference point from which to hold the incoming government accountable on its public promises and a tool for advocacy in pursuing further commitments that can improve the public health sector.

  • Health financing was the theme of a major national conference held in Calabar, Nigeria in November 2011. The specific focus of the three-day conference was “Improving Financial Access to Health Services for the Poor in Nigeria.” Participants shared information on a wide range of health financing strategies and mechanisms employed in Nigeria as well as other countries. The 255 participants represented a broad range of expertise; they included health managers and providers, insurance specialists, health economists, government officials, and media representatives from all 36 states and the national capital. State representatives met in regional groups to discuss the approaches most applicable to their area and formulate plans to apply these approaches at the state or community level. The conference generated many “actionable” policy and program initiatives that the states and federal government can adopt.

    This presentation is one of five presentations made by the Health Policy Project. The presenter gave an overview of a pilot project in Kenya, which found that the provision of subsidized vouchers for maternal health and family planning services were effective in reaching the poor at a reasonable cost; providers were paid for specific services (rather than supporting operating costs).

  • This presentation is one of five made by the Health Policy Project at a national health financing conference held in Calabar, Nigeria, in November 2011. Participants, including health managers and providers, insurance specialists, health economists, government officials, and media representatives, shared information on a wide range of health financing strategies and mechanisms employed in Nigeria and other countries.

    The Equity Framework is an approach that targets family planning and reproductive health resources to the poor—a segment of the population that is often overlooked in health program planning. The presentation examines a case study in Jharkhand, India—one of India’s poorest states—where health planners applied the Equity Framework to develop a voucher scheme to enable low-income women to access reproductive health services. Conference participants were able to learn from the success garnered in India and adopt similar policy and program initiatives to expand access to family planning and reproductive health services to the poor in Nigeria.

  • Health financing was the theme of a major national conference held in Calabar, Nigeria in November 2011. The specific focus of the three-day conference was “Improving Financial Access to Health Services for the Poor in Nigeria.” Participants shared information on a wide range of health financing strategies and mechanisms employed in Nigeria as well as other countries. The 255 participants represented a broad range of expertise; they included health managers and providers, insurance specialists, health economists, government officials, and media representatives from all 36 states and the national capital. State representatives met in regional groups to discuss the approaches most applicable to their area and formulate plans to apply these approaches at the state or community level. The conference generated many “actionable” policy and program initiatives that the states and federal government can adopt.

    This presentation is one of five presentations made by the Health Policy Project. The presenter gave an overview of an activity in Peru, where family planning advocates analyzed the needs of low-income women and successfully tapped into funding sources at the local, regional, and national level to increase access to FP services.

  • The Ethiopian Ministry of Health, in collaboration with the Health Policy Project (HPP), recently used the FamPlan model to measure the impact of increased family planning use on the number of infant and child deaths. The results showed that family planning uptake is associated with decreases in high-risk births and infant and child mortality and that faster gains in the contraceptive prevalence rate lead to more dramatic health improvements. This poster—presented at the 2013 International Conference on Family Planning in Addis Ababa, Ethiopia—describes the methodology and results of the model application.

  • This presentation of the demographic dividend and implications for Nigeria and other sub-Saharan African countries was given at the 2nd Nigeria National Family Planning Conference in  Abuja, November 27-December 1, 2012. The demographic dividend is an opportunity for higher economic growth rates that occurs due to changes in the structure of a country’s population. In order for the dividend to be achieved, countries first have to open the “window of opportunity” by promoting demographic change. At the same time, they have to capitalize on the demographic opportunity through socioeconomic policies. The presentation reviews current demographic indicators for Nigeria, highlighting comparisons with other countries that have opened the window of opportunity and achieved the dividend, as well as presents some of the policy investments required now and in the future.

  • Decentralization of family planning is a critical concern for policymakers as international family planning commitments and the expansion of decentralization reforms become more common. Building on the latest research, this paper presents a family planning and decentralization analytical framework that was developed by the USAID-funded Health Policy Project to help key stakeholders better understand family planning decentralization processes, identify potential challenges and opportunities, and guide decentralization reforms. 

  • To support gender integration efforts in the Philippines, the Gender, Policy, and Measurement (GPM) program of the USAID-funded Health Policy Project (HPP) conducted a gender assessment of health-related laws, policies, and programs, in collaboration with USAID/Philippines staff and stakeholders. The analysis was designed to help the health office of USAID/Philippines determine how the government, donors, and nongovernmental organizations are responding to gender inequality, norms, and barriers. This report presents the gender assessment’s results. It analyzes the country’s resources and capacity to develop and implement gender-responsive health programs, suggesting entry points and opportunities for investing in gender equality for improved family planning and maternal, neonatal, and child health outcomes. The report also recommends ways to incorporate gender-integrated interventions in the country’s health portfolio: for example, adapting or developing tools and training materials and adopting strategies for monitoring and evaluating gender-integrated programs.

  • The GAP Tool (Gather, Analyze, and Plan) is a simple Excel-based tool designed to help policymakers, ministry officials, health officials, and advocates understand and plan for the costs associated with expanding family planning (FP) to achieve their country's contraceptive prevalence or fertility goals. This PowerPoint presentation provides a brief overview of the benefits of and major steps for applying the GAP Tool and includes highlights from a pilot application of the tool in Ethiopia and Nigeria.  

  • The GAP Tool (Gather, Analyze, and Plan) is a simple Excel-based tool designed to help policymakers, ministry officials, health officials, and advocates understand and plan for the costs associated with expanding family planning (FP) to achieve their country's contraceptive prevalence or fertility goals. This brief provides a brief overview of the benefits of and major steps for applying the GAP Tool and includes highlights from a pilot application of the tool in Ethiopia and Nigeria.  

  • This manual provides the user with step-by-step instructions to apply the GAP Tool (Gather, Analyze, and Plan). The GAP Tool is a simple Excel-based tool to help policymakers, ministry officials, health officials, and advocates understand and plan for the costs associated with expanding family planning to achieve their country's contraceptive prevalence or fertility goals. The two main outputs produced by the tool are the country’s funding gaps for a national family planning program and for family planning commodities. 

    The U.S. Agency for International Development (USAID) supported development of the GAP Tool through the USAID | Health Policy Initiative, Task Order 1, and continues to support work on the tool, as well as this manual, through the Health Policy Project. 

  • The Health Policy Project (HPP) in Jordan focuses on supporting national-level awareness raising, resource mobilization, and policy reform to improve the quality of and access to family planning and reproductive health (FP/RH) services. HPP supports the Higher Population Council (HPC), Ministry of Health (MOH), and other key stakeholders to create an enabling environment for FP/RH through improved multisectoral engagement and coordination, data use, and policy reform. A particular area of focus is healthy birth spacing. Nearly one third of all births in Jordan are spaced less than two years apart, and more than half are spaced less than three years apart. Statistics show that an interval between births shorter than 33 months lowers the chance of survival for the mother and child. The higher rates of maternal and child mortality and morbidity associated with short birth intervals create burdens for families and society as a whole. The practice of healthy birth spacing is increasing in Jordan, but not fast enough. Wide adoption of healthy birth spacing in Jordan will reduce neonatal, infant, child and maternal mortality; improve the health of mothers and their offspring; enhance the ability of fathers to care for their families; and make communities healthier and stronger. This package of materials present the research evidence for healthy birth spacing and suggest what Jordan can do in the spheres of policy, education, and health services to promote the practice.

  • Using the ImpactNow model, the USAID-funded Health Policy Project collaborated with the Amhara Regional Health Bureau (RHB) to estimate the near-term benefits of achieving Ethiopia’s ambitious family planning goals in the region. This brief summarizes key health and economic benefits associated with achieving these goals and offers recommendations for the Regional Health Bureau to increase investment in and improve family planning services. The analysis found that if the contraceptive prevalence rate (CPR) in the Amhara Region increases from 46 percent in 2014 to 73 percent in 2020 and if women adopt more long-acting and permanent methods (LAPMs), family planning would save the lives of 13,000 mothers and 112,000 children over that time period. Moreover, compared to current trends in the CPR, the Amhara Region would save an additional US$19 million in maternal and child healthcare costs. Using these results, the RHB promotes data-driven FP policy development and can advocate for increased access to family planning and LAPMs to achieve national FP goals in the region. 

  • The USAID-funded Health Policy Project applied its new ImpactNow model to estimate the near-term benefits of achieving the FP2020 goals in Zimbabwe. This brief describes some key benefits associated with achieving these goals, and offers recommendations for the government of Zimbabwe and development partners to increase investment in and improve family planning services in the country.

  • Adopting new practices in health on a large scale requires systematic approaches to planning, implementation, and follow-up, and often calls for profound and lasting changes in health systems. Without attention to the policies that underlie health systems and health services, the scale-up of promising pilot projects is not likely to succeed and be sustained. Because of the urgency to rapidly expand effective interventions to improve the health of mothers, children, and families, particularly the poor and underserved, there exists a growing interest in scale-up among the international public health community and others involved in health policy and programs.

    To explore best practices and guide the scale-up of these practices, the Health Policy Project (HPP) reviewed the literature on scale-up, interviewed key experts involved in scaling up initiatives, and hosted a meeting on relevant policy and gender issues. This paper focuses on efforts to scale up interventions in family planning (FP) and reproductive health, and maternal, neonatal, and child health (MNCH) in developing countries. It defines “scale-up” and describes some of the frameworks and approaches to scale-up found in recent health literature and how such approaches address policy. The paper, developed with support from the U.S. Agency for International Development, also reviews the experience of selected organizations in scaling up best practices and how they have addressed policy issues. It identifies a number of lessons learned from scale-up initiatives and lists six recommendations for ensuring supportive policies to strengthen scale-up.

    Related resources:

    Expert Meeting on Policy Implementation and Gender Integration in the Scale-Up of Family Planning and Maternal, Neonatal, and Child Health Best Practices

    Integrating Gender into the Scale-Up of Family Planning and Maternal, Neonatal, and Child Health Programs

  • A literature review was conducted to identify and collect existing frameworks and other analytical tools for assessing gender factors within the health policy environment and health programs. Gender tools for family planning/reproductive health (FP/RH), HIV, and maternal and child health were the primary focus. The review, however, also included a search for relevant gender analysis tools outside these health domains and relevant areas outside the health sector. The results of the literature review are intended for use by Health Policy Project (HPP) staff to assist in strengthening gender approaches across HPP core and field support programs.

  • In developing countries, governments are increasingly turning to innovative policy measures to improve access to basic health services. In Guatemala, policies were introduced to protect the financing and provision of family planning and reproductive health (FP/RH) services. Follow-on legislation earmarked 30 percent of the alcohol tax revenue for the Ministry of Health (MOH) to purchase contraceptives. To determine the impact of the revenue on the FP/RH budget, the Health and Education Policy Project (HEPP) evaluated whether the funds were available and used as legislated. HEPP gathered data on MOH funds and alcohol tax funds retrospectively to see if the policy was working as intended. Budget tracking constitutes a practical, sustainable tool for non-experts to assess transparency.

  • The USAID-funded Health Policy Project (HPP) in Ethiopia builds the capacity of leaders to increase demand for and use of evidence for family planning and reproductive health (FP/RH) services in support of the strategic planning, monitoring, and evaluation of programs, nationally and in selected regions.To strengthen the capacity of national planning bodies, professional associations, training institutions, and research partners in this area, HPP collaborated with the Ethiopian Public Health Association (EPHA) to provide trainings and technical updates on key FP/RH models, including the GAP (Gather, Analyze, and Plan) Tool and a selection from the Spectrum System of Policy Models.

    To ensure that participants would apply the skills learned, HPP and EPHA designed and implemented a pilot mentorship program that paired selected trainees and master trainers as mentees and mentors, respectively.To document the lessons learned and obtain participant feedback on the training and mentorship program, an assessment, including in-depth interviews, was conducted.

  • The Gender, Policy and Measurement program, funded by the Asia bureau of the U.S. Agency for International Development and implemented by the Health Policy Project (HPP) and MEASURE Evaluation, undertook a comprehensive, systematic review of the impact of gender-integrated programs on health outcomes. The findings are primarily intended to inform the work of government officials, donors, nongovernmental organizations, and other key stakeholders involved in health programming in India, as well as other low- and middle-income countries around the world.

    This review presents evidence showing how gender-integrated programming influences health outcomes in low- and middle-income countries: in particular, reproductive, maternal, neonatal, child, and adolescent health; HIV prevention and AIDS response; gender-based violence; tuberculosis; and universal health coverage.

    To read the full report—Transforming Gender Norms, Roles, and Power Dynamics for Better Health: Findings from a Systematic Review of Gender-integrated Health Programs in Low- and Middle-Income Countries—please visit www.healthpolicyproject.com?zp=381.

  • The Gender, Policy and Measurement program, funded by the Asia bureau of the U.S. Agency for International Development and implemented by the Health Policy Project (HPP) and MEASURE Evaluation, undertook a comprehensive, systematic review of the impact of gender-integrated programs on health outcomes. The findings are primarily intended to inform the work of government officials, donors, nongovernmental organizations, and other key stakeholders involved in health programming in India, as well as other low- and middle-income countries around the world.

    This review presents evidence showing how gender-integrated programming influences health outcomes in low- and middle-income countries: in particular, reproductive, maternal, neonatal, child, and adolescent health; HIV prevention and AIDS response; gender-based violence; tuberculosis; and universal health coverage.

    This report was authored by Arundati Muralidharan, Jessica Fehringer, Sara Pappa, Elisabeth Rottach, Madhumita Das, and Mahua Mandal.

    To read the subject briefs associated with this report, please visit: http://www.healthpolicyproject.com/index.cfm?id=publications&get=pubID&pubId=382. 

  • According to the 2011 census, India’s population is 121 crore (1.21 billion), an increase of 18.1 crore (181 million) since 2001. United Nations estimates indicate that India will be the most populous country in the world by 2030, surpassing China. The Empowered Action Group (EAG) states constitute 45.9 percent of the country’s population, so the future of India’s population will largely be governed by the socio-demographic status of these states. This brief, developed by the Policy Unit of the National Institute of Health and Family Welfare and the USAID-funded Health Policy Project, presents a situational analysis of fertility and family planning indicators of the EAG states in India, focusing on the levels of and trends in certain crucial indicators, such as the total fertility rate, contraceptive prevalence rate, current scenario of method mix, and unmet need for contraception. This analysis could be used as a ready reckoner for stakeholders at different stages of planning and implementing family welfare programs across the EAG states.

  • This presentation,  "Why Does How Policy Is implemented Matter for Health Outcomes?" and poster, "How Do Health Policies Affect Health Systems and Outcomes," were given during a satellite session on policy implemenation hosted by the Health Policy Project at the Second Symposium on Health Systems Research, in Beijing, China, October 31, 2012.   

    Note: The conceptual framework presented during the session has since been updated; for the current version and more details on the framework, see the recently published paper, Linking Health Policy with Health Systems and Health Outcomes: A Conceptual Framework.

  • The Empowering Women Leaders for Country-Led Development program fostered yearly cadres of women champions from Ethiopia, Ghana, Kenya, Malawi, Tanzania, and Uganda to engage in family planning and reproductive health decision making and to advocate for policy change. The 70 alumnae represent civil society organizations, government ministries, faith-based organizations, and elected bodies at local and national levels and comprise a wide range of backgrounds and experience. The program included a three-week intensive skills-building workshop focused on personal leadership, advocacy, and networking skills; seed funds to implement local advocacy; one year of south-to-south coaching by a Plan USA-trained coach; and ongoing technical assistance and networking support. This brief explores the program's methods, approach, and results. 

  • The  Malawi government  introduced  the  Youth  Friendly  Health  Services (YFHS) program in  2000 and  in  2007  the  Ministry of Health-Reproductive Health Directorate (MOH-RHD)  developed  Youth  Friendly  Health  Services Standards  with  the aim of providing  quality services  to young  people. In 2014, the MOH-RHD and the Centre for Social Research, University of Malawi, with assistance from the USAID-supported Evidence to Action project, conducted its first comprehensive evaluation of the YFHS program. The evaluation assessed the quality of YFHS compared to the existing national standards, in the context of the current sexual and reproductive health (SRH) needs of Malawian youth.  

    This brief summarizes the implementation of YFHS standards in Malawi and suggests key questions for policy makers and program managers to consider in order to improve YFHS in Malawi.

  • The  Malawi government  introduced  the  Youth  Friendly  Health  Services (YFHS) program in  2000 and  in  2007  the  Ministry of Health-Reproductive Health Directorate (MOH-RHD)  developed  Youth  Friendly  Health  Services Standards  with  the aim of providing  quality services  to young  people. In 2014, the MOH-RHD and the Centre for Social Research, University of Malawi, with assistance from the USAID-supported Evidence to Action project, conducted its first comprehensive evaluation of the YFHS program. The evaluation assessed the quality of YFHS compared to the existing national standards, in the context of the current sexual and reproductive health (SRH) needs of Malawian youth.  

    This brief summarizes data collected in 2013 by the E2A project, and lays out key questions for policy consideration.

  • The  Malawi government  introduced  the  Youth  Friendly  Health  Services (YFHS) program in  2000 and  in  2007  the  Ministry of Health-Reproductive Health Directorate (MOH-RHD)  developed  Youth  Friendly  Health  Services Standards  with  the aim of providing  quality services  to young  people. In 2014, the MOH-RHD and the Centre for Social Research, University of Malawi, with assistance from the USAID-supported Evidence to Action project, conducted its first comprehensive evaluation of the YFHS program. The evaluation assessed the quality of YFHS compared to the existing national standards, in the context of the current sexual and reproductive health (SRH) needs of Malawian youth.  

    This brief summarizes the sexual knowledge and behaviour of youth in Malawi and suggests key questions for policy makers and program managers to consider in order to improve YFHS in Malawi.

  • This booklet presents an analysis of family planning (FP) in Zimbabwe and explains how FP saves the lives of women and children, promotes economic development, and saves money in other areas of development. It also examines the funding gap that Zimbabwe must address to achieve its FP2020 objectives.

    The analysis was conducted by a group of partners from the Zimbabwe Ministry of Health and Child Care, the Zimbabwe National Family Planning Council, the United Nations Population Fund Zimbabwe (with pooled funding from the United Kingdom Department for International Development, the Government of Sweden, and Irish Aid), and the Health Policy Project (funded by the United States Agency for International Development).