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Non-Government/Community Service Org.

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  • 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.

  • 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

  • When it was established, Kenya’s Inter-Agency Coordinating Committee on Health Care Financing (ICC-HCF) was intended to provide a forum for health financing stakeholders to share knowledge, deliberate, and reach consensus on contentious issues. Yet the ICC-HCF became stalled in 2011. Shortly after, the Kenya government requested assistance from the Health Policy Project (HPP) to revitalize the forum. This brief provides an assessment on the impact of HPP’s support to the ICC-HCF, the constraints that affected Kenya finalizing its healthcare financing strategy, and offers a series of recommendations for how best to support the work of the ICC-HCF going forward.   

  • Based on the UTETEZI Project curriculum, Advocacy for Improved Access to Services for MSM: A Workshop Curriculum for a Multi-Stakeholder Policy Advocacy Project, this advocacy for policy change guide is designed for use by MSM (men who have sex with men) groups, community-based organizations (CBOs), civil society organizations (CSOs), and individuals working in HIV and MSM health to help them advocate regionally, nationally, and locally for improved HIV and health-related MSM policies. In particular, this guide can serve as an important tool for CSOs working on MSM issues in hostile legal environments.

  • Community-based models for HIV treatment and care have shown promise in some sub-Saharan countries, especially for improving patient outcomes and increasing the sustainability of the overall program. The Health Policy Project, in collaboration with the National AIDS and STI Control Programme, reviewed the state of evidence for implementing community-based approaches to care and treatment in Kenya. While some of the evidence suggests that such models can be applicable and beneficial, more data and Kenya-specific evaluations are required before concrete recommendations can be made. This brief serves a research agenda for Kenya in this regard.

  • The Blueprint for the Provision of Comprehensive Care for Trans People and Trans Communities in Asia and the Pacific (the Blueprint) is a document with far-reaching potential and applications in trans health and human rights in the region. The purpose of the Blueprint is to strengthen and enhance the policy-related, clinical, and public health responses for trans people in Asia and the Pacific. The primary audience for the Blueprint is health providers, policymakers and governments. The information within the Blueprint could also serve donors, bi- and multilateral organizations and trans and other civil society organizations.

    The Asia Pacific Transgender Network (APTN), the United Nations Development Programme (UNDP), and the USAID-funded Health Policy Project (HPP) collaboratively developed the Blueprint. This document is the third in a series of regional trans health Blueprints, and builds on what was produced in Latin America and the Caribbean by the Pan American Health Organization, the Regional Office of the World Health Organization for the Americas.

  • 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.

  • 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.

  • This brochure provides an overview of a web-based platform that civil society organizations in Ghana can use to report cases of discrimination to the country's Commission on Human Rights and Administrative Justice (CHRAJ). The system, developed with support from the USAID- and PEPFAR-funded Health Policy Project, links civil society to CHRAJ through case tracking, follow-up, and data reporting. The brochure provides information on why someone would submit a complaint, how to submit a complaint, and how to follow up on a complaint. It is meant solely for informational purposes. Step-by-step guidance on how to use the system is provided by the Discrimination Reporting System User Guide.

  • The Discrimination Reporting System User Guide outlines how civil society organizations in Ghana can use a web-based platform to report cases of discrimination to the country's Commission on Human Rights and Administrative Justice (CHRAJ). The system, developed with the support of the USAID- and PEPFAR-funded Health Policy Project, links civil society to CHRAJ through case tracking, follow-up, and data reporting. The user guide provides civil society organizations with a visual description of how to navigate the online system, submit complaints on behalf of clients, track the progress of complaints, and generate reports. It will be distributed to civil society organizations in Ghana that support people living with HIV and key populations.

  • In June 2013, President Uhuru Kenyatta of Kenya announced policies to remove user fees in dispensaries and health centers and to provide free maternal health services in all public health facilities. This report presents the findings of a study conducted in Kenya by the USAID-funded Health Policy Project (HPP) to establish baseline measures for evaluating the impact of these policies. The Kenya Ministry of Health, with support from HPP, identified the need to monitor and evaluate the impact of the policies on utilization, service provision, and revenue collection, among other indicators.

  • 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.  

  • Survey results in Dominica illustrated that key drivers of Stigma and Discrimination in health facilities (fear of HIV infection, negative attitudes and facility environment, including policy) are present across all levels of health facility staff, both medical and non-medical. HPP organized participatory analysis of the evidence and dissemination among health facility staff in order to promote reflection and to propel a sense of urgency to reduce stigma in the health setting. Baseline evidence provided a tool to motivate staff and policy makers to measurable improve services. Recommendations developed by the health care workers focus on a range of training suggestions including who, when, and how to strengthen capacity through training of health and auxiliary staff; and policy development strategies. They urged a call to action based on human rights and a professional obligation to provide equitable, quality services to all. The discussion and recommendations highlight the effectiveness of a participatory approach to data analysis to inform action. 

  • St. Kitts and Nevis is implementing an intervention package to achieve “stigma-free” HIV services. This brief summarizes the results from a survey of health facility staff to inform the intervention, and review of these data in a participatory workshop with health sector stakeholders. The National AIDS Programme is leading the implementation effort with technical support from the University of the West Indies (UWI) and the USAID- and PEPFAR-funded Health Policy Project (HPP). The package includes: a comprehensive survey of all health facility staff; training for health staff and NGO leaders on stigma reduction in health facilities; development of policies and facility Codes of Conduct to reduce HIV stigma; routine monitoring of stigma and discrimination; and where possible, tracking progress on treatment adherence and uptake of testing, treatment, and prevention. The package is part of a regional initiative led by the Pan Caribbean Partnership Against HIV/AIDS (PANCAP) and facilitated by HPP and UWI to apply a jointly agreed framework for effective stigma reduction in health facilities.

  • Discrimination against people living with HIV and key populations is a common and challenging problem. A year ago, the Commission on Human Rights and Administrative Justice (CHRAJ) in Ghana launched a web-based system to provide a simple way for reporting HIV- and key population–related discrimination with help from the USAID and PEPFAR-supported Health Policy Project (HPP). This brief describes the outcomes of the discrimination reporting system after one year and ways forward. 

    Click here to read a blog on HPP's work on the CHRAJ stigma and discrimination reporting portal.  

  • 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.

  • PEPFAR’s Gender-Based Violence Initiative (GBVI) is implementing comprehensive gender-based violence (GBV) programming in three countries: Mozambique, Tanzania, and the Democratic Republic of Congo. As part of this initiative, the USAID- and PEPFAR-funded Health Policy Project (HPP)  collaborated with 12 grassroots organizations in Mozambique to integrate GBV prevention activities into existing HIV programs as a way to reduce GBV and prevent the spread of HIV—particularly among women, orphans, and vulnerable children. As HPP’s support to the NGOs ended the project systematically assessed the outcomes of the capacity development efforts at the community level. HPP documented the extent to which local program staff responded to GBV trainings, implemented gender- and GBV-integrated program design, and executed prevention and response mechanisms. The project also documented the community members’ attitudes toward and knowledge of gender equality and GBV. This report presents the findings of the assessment and documents the project’s successes, challenges, and lessons learned in its efforts to build GBV capacity in Mozambique.

  • In Jamaica, Woman Inc., with support from the Health Policy Project (HPP), implemented a pilot project to assess the feasibility of integrating screenings and referrals for gender-based violence (GBV) with clinical services for HIV and other sexually transmitted infections. The links between GBV and HIV are widely acknowledged, but relatively few people access services for GBV, especially women and key populations with high HIV burdens such as men who have sex with men and sex workers. The pilot project involved gender training for healthcare providers and community agencies, adaptation and implementation of a GBV screening tool, and mapping and strengthening of GBV referral systems. The findings, summarized in this brief, indicate that the pilot enhanced the capacity of HIV healthcare providers to improve access to GBV support services and better meet the needs of their patients, especially women and key populations.

  • 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.

  • Jordan’s continued economic development and concomitant population growth is putting increased pressure on natural resources and the environment. Over the past 40+ years, the gap between the ecological footprint and the local capacity has grown, and this deficit has largely been made up for by importing goods, especially food and energy, from abroad.

    Productive land in Jordan is limited. Only 11 percent of the total land area can be considered agricultural land---of which less than 2 percent is arable; the rest is ranges and forests. As population size increases, so does the need for more land to produce food and build houses, businesses, recreation areas, schools and health facilities, roads, and mosques, as well as other supporting uses.

    This RAPID presentation, developed by the Health Policy Project in collaboration with Jordan's Higher Population Council, demonstrates that future population growth will directly affect the use of land in Jordan. While reducing population growth will not be sufficient in eliminating all the pressures being placed on the land, it is a necessary step that needs to be taken in combination with many others if Jordan is to successfully resolve its pressing land use 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. 

  • Local Capacity Initiative Facilitated Discussion and Capacity Assessment Tool: Facilitator's Manual The purpose of this manual, prepared by Advancing Partners & Communities with support from the Health Policy Project, is to help determine technical assistance needs and to conduct an assessment of an organization’s policy, advocacy, and organizational systems capacity. The assessment consists of a facilitated self-assessment as well as optional stakeholder interviews. The tool is divided into five major sections (LCI outcome areas); four of these areas focus on critical elements for advocacy and one focuses on overall organizational capacity. Additionally, there are in-depth domains associated with each larger outcome, which can be used to further review capacity.

    Policy Advocacy Rapid Assessment Tool for CSOs This tool is used to facilitate an overarching conversation with small to medium sized CSO regarding policy advocacy capacity and priorities. The tool addresses six major topics and seven cross cutting themes related to policy advocacy. Findings identified by this conversation can be used to design capacity development strategies.

  • Through this case study, the USAID- and PEPFAR-funded Health Policy Project (HPP) seeks to share Thailand’s experience implementing the AIDS Zero Portal (AZP) and its initial impact at the national and provincial levels. The AZP offers a potential model for other countries looking to institutionalize and leverage information systems as part of their routine monitoring and evaluation, strategic planning, and resource allocation efforts.

  • 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.

  • The PANCAP Stigma Framework was developed with assistance from the USAID- and PEPFAR-supported Health Policy Project in response to regional and national requests made to PANCAP for direction on responding to stigma and discrimination in the Caribbean. Stigma and discrimination continue to be key drivers of the Caribbean HIV epidemic and are major obstacles to effective responses. Their impact on Caribbean health and development is wide ranging. HPP provided technical and financial support for PANCAP partners with experience in reducing stigma and discrimination to review existing frameworks and Caribbean tools to inform the drafting of a comprehensive approach. A small group of technical experts from HPP drafted the initial framework to meet the needs of small countries, island states, and emerging nations. This framework has initially engaged and will serve to strengthen the capacity of national HIV programs to develop, implement, and monitor effective policies and programs, and to address HIV in a sustainable manner at the national level. The PANCAP Stigma Framework is built on three components, health and development, collective empowerment, and social justice and gender equality, which are crucial in addressing the Caribbean response to HIV-related stigma and discrimination. 

  • Males who have sex with males (MSM), transgender (TG) people, and sex workers (SWs) are at higher risk for HIV transmission than other individuals, even in generalized epidemics. Structural and policy issues have created barriers for MSM/TG/SW in seeking services and adopting individual and community harm reduction strategies. The Policy Analysis and Advocacy Decision Model for HIV-Related Services: Males Who Have Sex with Males, Transgender People, and Sex Workers, published by the Health Policy Project and AMSHeR (African Men for Sexual Health and Rights) with support from USAID and PEPFAR, is a collection of tools that helps users assess and address policy barriers that restrict access to HIV-related services for MSM/TG/SW. In 2012 and 2013, the Decision Model was applied in Burkina Faso and Togo. This brief presents the Decision Model and key policy findings.

  • This USAID-funded assessment, conducted in Togo, is the second country application of the Health Policy Project (HPP) and African Men for Sexual Health and Rights (AMSHeR) Policy Analysis and Advocacy Decision Model for HIV-Related Services: Males Who Have Sex with Males, Transgender People, and Sex Workers (Beardsley et al., 2013). The current application of the Decision Model in Togo complements the pilot application conducted in 2012 in Burkina Faso. It was designed as an in-depth policy analysis of the legal, regulatory, and policy environment related to sex workers (SW), men who have sex with men (MSM), and prison populations in Togo to uncover gaps in policy and practical challenges to policy implementation. Beginning in June 2013, the HPP principal investigator, a legal expert from AMSHeR, and a team of local consultants conducted a document review and assessment. The team collected an inventory of 116 source policy and program documents and previous policy and program research related to HIV and/or key populations. Upon completion of the inventory, the team conducted 21 key informant interviews to examine the policy environment and assess dissemination and implementation of current policies, particularly gaps in dissemination and implementation that pose barriers to service access for key populations. The HPP policy analysis and key informant interviews confirmed that positive changes related to HIV prevention, care, and treatment are occurring in Togo. Initial steps are being taken to develop policies that recognize key populations and aim to improve access to services for them. Significant opportunities exist to further progress, including the USAID-funded Regional Project for the Prevention and Care of HIV/AIDS in West Africa (PACTE-VIH) and open support from the president of Togo and the permanent secretary for the National AIDS Council. However, critical gaps in policy, dissemination, and implementation remain and are highlighted in this report.

    Read the brief on this topic.

  • This handout provides an overview of the Positive Health, Dignity and Prevention (PHDP) Curriculum created by the Jamaican Network of Seropositives (JN+)—with support from the Jamaican Ministry of Health’s National HIV/STI Program (GIPA Unit) and the USAID- and PEPFAR-funded Health Policy Project. The curriculum aims to promote personal health and advocate for high-quality health services for people living with HIV (PLHIV). Although it was developed in Jamaica, the curriculum offers a promising, practical tool to help strengthen PLHIV leadership and advocacy to advance PHDP in the region and globally, and to enhance health systems and health outcomes across prevention, care, and treatment.

  • The Health Policy Project designed this training manual for civil society organizations implementing HIV prevention and orphan and vulnerable children (OVC) care and support programs in Mozambique. The manual aims to raise awareness and sensitize participants on the concepts and interlinkages between gender inequality, HIV, and gender-based violence (GBV). By doing so, the organizations will better understand and appreciate the influence of gender and violence on HIV- and OVC–related issues and will be in a better position to develop and implement program strategies and interventions that will promote gender equality and help prevent GBV. The manual contains eight sessions covering a range of topics from a basic introduction to gender to developing a multisectoral response to gender-based violence.

  • 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.

  • 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.

  • The USAID- and PEPFAR-funded Health Policy Project (HPP) supports health systems strengthening (HSS) by bringing together different actors and disciplines within the health system to improve policy and ultimately achieve more equitable and sustainable access to health services. The importance of HSS for HIV and AIDS, tuberculosis, and malaria programs is recognized in Tanzania’s national strategic plans.

    In May 2014, USAID/Tanzania approached HPP to assist the Ministry of Health and Social Welfare’s Directorate of Policy and Planning in conducting a rapid HSS assessment with two main objectives: to build initial consensus around priority HSS actions that will inform a new national HSS strategy, and to provide information for the ministry to advocate for additional HSS funding. The latter includes presenting HSS priorities, activities, and actions to the Global Fund’s Tanzania National Coordinating Mechanism to be considered for inclusion in the upcoming grant application process.

  • The United States Agency for International Development (USAID) supports the implementation of the United States President’s Emergency Plan for AIDS Relief (PEPFAR), a United States government (USG) initiative to save the lives of people around the world who are suffering from HIV and AIDS, in almost 100 countries. Since 2003, PEPFAR has worked with these countries to create systems that have stabilized the HIV epidemic by preventing new infections and providing care, support, and treatment to those infected and affected by HIV. Due to the progress that has been made in Guyana, the PEPFAR program will transition from a service delivery model to one that provides targeted technical assistance over the next five years (2013–2017). This will also result in a shift in USG funding, inclusive of USAID.

    Within this context, there is an identified need to clearly define roles and responsibilities for all key stakeholders and delineate next steps in the transition to ensure long-term sustainability of HIV prevention, care, and support services and the continuum of care for people infected and affected by HIV and AIDS.  Toward this effort, the USAID- and PEPFAR-funded Health Policy Project (HPP) supported PEPFAR Guyana by conducting a high-level assessment of HIV and AIDS NGOs, relevant private sector entities, the Ministry of Health (MOH), the National AIDS Program Secretariat (NAPS), and other relevant line ministries in Guyana. The aim of this assessment was to document the country’s capacity gaps and needs to support the transition of HIV services from donors to the country, and suggest approaches for ensuring an ethical transition and sustainability of these services over time.

  • The United States Agency for International Development (USAID) supports the implementation of the United States President’s Emergency Plan for AIDS Relief (PEPFAR), a United States government (USG) initiative to save the lives of people around the world who are suffering from HIV and AIDS, in almost 100 countries. Since 2003, PEPFAR has worked with these countries to create systems that have stabilized the HIV epidemic by preventing new infections and providing care, support, and treatment to those infected and affected by HIV. Due to the progress that has been made in Guyana, the PEPFAR program will transition from a service delivery model to one that provides targeted technical assistance over the next five years (2013–2017). This will also result in a shift in USG funding, inclusive of USAID.

    Within this context, there is an identified need to clearly define roles and responsibilities for all key stakeholders and delineate next steps in the transition to ensure long-term sustainability of HIV prevention, care, and support services and the continuum of care for people infected and affected by HIV and AIDS.  Toward this effort, the USAID- and PEPFAR-funded Health Policy Project (HPP) supported PEPFAR Guyana by conducting a high-level assessment of HIV and AIDS NGOs, relevant private sector entities, the Ministry of Health (MOH), the National AIDS Program Secretariat (NAPS), and other relevant line ministries in Guyana. The aim of this assessment was to document the country’s capacity gaps and needs to support the transition of HIV services from donors to the country, and suggest approaches for ensuring an ethical transition and sustainability of these services over time.

  • In 2012, the Government of Haiti worked in collaboration with the U.S. Centers for Disease Control (CDC) and Prevention to conduct the Violence Against Children Survey (VACS). The objective of the study was to measure the prevalence and consequences of physical, emotional, and sexual violence against children. The results would inform the design, implementation, and evaluation of a violence prevention program for children, and the building of systems for child protection. The USAID-funded HPP AKSE developed this brief to provide context and information to guide the Government of Haiti's strategies to respond VACS survey results and identify ways to strengthen child protection.

  • This study, conducted by the USAID- and PEPFAR-funded Health Policy Project (HPP), assessed the costs and benefits of different prevention of mother-to-child transmission of HIV (PMTCT) treatment options (baseline treatment as currently offered, Option B, and Option B+). It is intended to inform the scale-up of PMTCT services in Nigeria’s 13 high-burden states, which account for 70 percent of the mother-to-child transmission burden.

  • 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. 

  • 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.

  • In the Caribbean, transgender persons are disproportionately affected by HIV. Moreover, high levels of stigma and discrimination create significant barriers and make it difficult for them to access the health care services they need. Most clinicians in this region also do not receive any training on transgender health or broader issues of sexuality and diversity, further limiting availability of transgender-friendly services.

    In response, HPP has developed a training manual for healthcare workers in Jamaica, Barbados, and the Dominican Republic to strengthen their capacity to provide high-quality, stigma-free health services for transgender persons. This brief highlights key content from each of the chapters contained in the manual.

  • Developed by the USAID- and PEPFAR-funded Health Policy Project, this guide is a training tool that provides a standard for stigma reduction. It is a resource for facilitators seeking to train participants to reduce HIV and key population stigma and discrimination, and for leaders of community dialogue and policy development in this area. The guide has been piloted in the Caribbean and other settings and can be readily adapted for other contexts.

  • The response to HIV and AIDS is an integral component of efforts to improve social and economic conditions in Ghana and Côte d’Ivoire. Available data suggest that HIV prevalence rates among key populations, particularly female sex workers (FSWs) and men who have sex with men (MSM), are several times higher than the national averages for both countries. These groups also face additional barriers to social acceptance and access to services, compared with the general population. Accordingly, Ghana and Côte d’Ivoire each completed a Strategic Framework to guide interventions and service delivery specifically for key populations. The frameworks propose a package of services that includes HIV prevention; HIV treatment, care, and support; and psychosocial support and legal services. This brief describes the costing analysis conducted by HPP and in-country stakeholders to provide country-specific costing data on key populations to provide an evidence base for policy-making processes.

  • Universities and research centers have traditionally been places of knowledge generation rather than knowledge translation. Though they produce important research findings, these institutions have not traditionally played a strong role in disseminating this information to key decisionmakers. In many cases, this paradigm is changing. Advances in information technology and globalization have eased the flow of technical information between researchers and policymakers, amplifying their voices in important policy discussions. However, there are currently no clear guidelines on how universities can ensure their research findings are utilized in health decision making. Documenting the ways in which universities have sought to bridge the research-to-policy divide can provide useful guidance to institutions looking to do the same. This white paper, prepared by the Health Policy Project with support from USAID and PEPFAR, provides an overview of three models of university engagement in advocacy and examples of each approach. It also describes practices from non-educational institutions whose frameworks could be useful for linking research to policy or opportunities for partnerships. Finally, it identifies key points for universities to consider when designing an approach to health advocacy.