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Stakeholder Engagement

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  • 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.

  • 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.  

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.  

  • The Sub-Saharan Africa MSM Engagement (SAME) Tool was developed based on literature reviews and expert/technical inputs from the USAID- and PEPFAR-funded Health Policy Project (HPP), the Johns Hopkins School of Public Health, amfAR, African Men for Sexual Health and Rights (AMSHeR), and USAID. In collaboration with eight leading MSM organizations—one each from Rwanda, Malawi, Togo, Mozambique, Zambia, Tanzania, Ghana, and Cameroon—HPP and AMSHeR piloted the tool from April to June 2013, in both English and French. This poster summarizes the pilot study, and was presented at the 20th International AIDS Conference in July 2014.

  • 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).

  • 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.

  • 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.

  • 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.

  • In June 2014, the government of Haiti passed a new anti-trafficking law to fill a legal gap in the protection of survivors and to increase prosecution of perpetrators of human trafficking. These new legal provisions are particularly important in a country known for being an origin, transit point, and destination for human trafficking. This brief, published by the USAID-funded Health Policy Project AKSE program, aims to explain the rationale, scope, and implications of this new law. It is aimed at international and local organizations working in the field of human rights. This tool is part of a collection of materials developed by HPP AKSE to enhance the environment addressing child protection, trafficking, gender-based rights, sexual and gender-based violence, and to reinforce the capacity of actors in the protection chain and reference networks. 

  • 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.

  • The 2015 Country Operational Plan (COP) Guidance includes specific guidelines for engagement of PEPFAR country teams with civil society organizations (CSOs) in the planning and development of the COP.  Following the finalization of the 2015 COP process, the USAID- and PEPFAR- funded Health Policy Project was requested by the Office of the Global AIDS Coordinator and Health Diplomacy to conduct an analysis on civil society’s perception of their engagement in the PEPFAR country team Country Operational Plan (COP) planning and to solicit recommendations for future PEPFAR country team engagement with civil society. This report documents responses received from an online survey and in depth interviews with representatives from civil society organizations located in PEPFAR countries.

  • 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.

  • 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. 

  • 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.

  • 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 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.

  • 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

  • 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.

  • 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.