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Best Practices

HP+ More recent Best Practices publications are available.

  • 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.

  • 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

  • To successfully lead a strategic, effective and sustainable response to AIDS, individuals must be equipped with a diverse set of skills. However, many individuals rise to leadership positions with purely medical backgrounds and lack essential skills in management, finance, advocacy and policy, and governance. For over a decade the National Institute of Public Health (Instituto Nacional de Salud Pública – INSP), part of the National Health Institutes of the Health Ministry in Mexico, has designed and conducted training courses to augment HIV leaders’ skills in these critical areas and to strengthen the regional AIDS response, particularly in Mexico, Central America, and the Caribbean.

    The USAID-funded Health Policy Project commissioned a case study of INSP’s educational programs to better understand what elements are critical for such programs to be successful, what challenges they face, and to identify opportunities to strengthen and expand regional capacity-building efforts in the future.

    The results indicated that the students surveyed felt INSP’s multidisciplinary training approach for leaders in the region’s HIV and AIDS response fostered a more harmonized response to the epidemic. Further, the lessons and tools learned through INSP modules and courses become a principal resource for former students who go on to play strategic roles in national and state AIDS programs, as well as civil society. INSP course alumni feel better equipped to make decisions based on available evidence, to design and implement strategic prevention and care strategies, and to contribute to policy development. However, challenges remain and to sustain and expand, the INSP and other training initiatives must find ways to reduce course costs and required time commitments without sacrificing the quality and comprehensiveness that has made them so effective.

    Opportunities for continued education and virtual support through networking will also provide critical ongoing support. To maximize impact, curricula should take into account the unique economic, political, social, and cultural characteristics of individual countries; differences in infrastructure and human resources; and the diverse ways the AIDS epidemic manifests across the region. Those interviewed indicated that comprehensive training programs such as those developed by INSP play an essential role in equipping national and regional leaders to improve and expand HIV and AIDS services. The INSP programs fill a critical gap in human resource training and efforts should be made to mobilize the resources and support needed to expand and duplicate these kinds of training opportunities.

  • This brief describes the Health Policy Project’s perspective on systems change, the expertise needed for effective engagement in the policy process, implementation steps for capacity initiatives, and evaluation. It will be of particular use for those interested in capacity-strengthening approaches specific to policy, advocacy, governance, and finance. For sustained change, HPP encourages its partners to take a systems approach that addresses capacity needs at interrelated levels: individual, organizational, and systems.

    For information on the project's implementation of this approach, see the Capacity Development Topics page, which also includes practical resources such as HPP's recently developed Organizational Capacity Assessment (OCA) Suite of Tools. The tools are specifically designed to assist organizations with building their capacity related to health policy by 

    • Establishing a baseline of the organization’s capacity in key areas
    • Promoting organizational dialogue, learning, and standard setting
    • Informing the development of a capacity-strengthening plan for addressing organizational priorities

  • 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.

  • 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

  • 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.

  • Stigma and discrimination (S&D) confronting people living with HIV and key populations violate people’s rights and can adversely affect HIV prevention, care, and treatment. However, standardized approaches for quantifying and responding to health facility S&D have been unavailable. The USAID- and PEPFAR-funded Health Policy Project led a collaborative global effort to review, prioritize, adapt, and synthesize existing measures and programmatic tools. This effort involved researchers, trainers, other experts, and stakeholders. The resulting stigma-reduction package supports a comprehensive, research-to-action response in health facilities. This poster, presented at the 20th International AIDS Conference in Melbourne, Australia, in July 2014, describes the development of the stigma-reduction package and framework.

  • 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

  • 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.

  • 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. 

  • The USAID- and PEPFAR-funded Health Policy Project assisted the Ghana AIDS Commission with updating the country's National HIV/AIDS and STI Policy. The updated policy reflects the state-of-the-art and best practices in HIV and AIDS prevention and treatment, especially in the areas of human rights and key populations. The new policy provides the overarching vision for the national HIV and AIDS program in Ghana and will ensure that all new strategies and guidelines are in line with the best practices in HIV implementation incorporated into the new policy. 

  • 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 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. 

  • 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—created a capacity-building curriculum led by people living with HIV (PLHIV). The curriculum aims to implement and advocate for Positive Health, Dignity, and Prevention (PHDP) and promote community leadership at the country level.

    PHDP—a global policy framework authored by the Global Network of People Living with HIV (GNP+) and UNAIDS in 2011—advances a holistic framework for PLHIV to manage their health, advocate for high-quality HIV services, and prevent onward HIV transmission. PHDP provides a concrete framework and road map that is especially relevant to meeting current global and national care and treatment goals for HIV—and to making “combination prevention” a reality.

  • 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. 

  • Over the past five years, the USAID- and PEPFAR-funded Health Policy Project (HPP) has worked in collaboration with global and country-level institutions to advance understanding and approaches to measuring and addressing HIV-related stigma. At the global level, HPP led efforts to review, prioritize, adapt, test, and synthesize existing measures and programmatic tools for stigma reduction in health facilities. This resulted in the development of a comprehensive package for “stigma free” health facilities (HPP, 2015). The package was piloted in several Caribbean countries,2 and offers a complete response to S&D in health facilities—from research to action. Its total facility approach targets all health facility staff, from doctors to cleaning staff.

    In an effort to facilitate further scale-up and refinement of these successful approaches, HPP convened an expert meeting in Washington, DC on June 3, 2015 to discuss and strategize a way forward to scale up S&D reduction efforts in health facilities. These discussions yielded valuable insights and recommendations, which are presented in this brief.

  • 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.

  • 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.

  • 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

  • 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.