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2015

  • The 2013 Kenya Household Health Expenditure and Utilisation Survey (2013 KHHEUS), explores the health-seeking behavior, use of healthcare services, out-of-pocket health spending, and health insurance coverage of Kenyan households. The first health survey to take place since Kenya decentralized its government; the 2013 KHHEUS collects data from the country’s 47 newly-created counties. By interviewing members of 33,675 households and comparing results with those of previous years (2003 and 2007), the 2013 survey provides important insights into how healthcare utilization, spending, and insurance coverage have changed in Kenya over the past decade. The 2013 KHHEUS was conducted by the Kenya Ministry of Health with support from the USAID-funded Health Policy Project and in conjunction with the Kenya National Bureau of Statistics. The survey provides critical evidence to inform the development of Kenya’s latest health financing strategy and policy decisions related to the future universal health coverage and the National Hospital Insurance Fund, and will support the wider national health accounts estimation process.

  • 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.

  • The Gender & Sexual Diversity Training was developed by the USAID- and PEPFAR-funded Health Policy Project, in coordination with a U.S. Government interagency team made up of members of the PEPFAR Key Populations Working Group and the PEPFAR Gender Technical Working Group. This version of the curriculum was developed specifically for PEPFAR staff and their country-level implementing partners to help country programs understand and address the needs of gender and sexual minority communities in the context of HIV programming, U.S. workplace policy on non-discrimination, and through a human rights lens.

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

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

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

  • The presence of supportive FP/RH policies is considered an integral component to successful programs. However, much remains to be known about how policies are implemented, especially in a complex political, sociocultural and economic environment. Based on a review of academic and programmatic/applied literature, this paper outlines the various methodologies that can be used to study policy implementation, which include descriptive methodologies such as literature reviews and case studies; analytic methodologies such as stakeholder mapping and analysis, cross-sectional surveys and system dynamics; quasi-experimental and experimental studies; studies describing policy implementation within complex adaptive systems, such as, path dependence; and mixed methods as well including focus groups, document analysis and interviews. This USAID- and PEPFAR-funded Health Policy Project study further highlights the challenges of using rigorous research methods to determine the link between policy implementation and health systems and outcomes. Finally, the paper recommends that further research using rigorous methodologies is needed to study policy implementation.

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

  • This report summarizes the content and format of an advanced training on the OneHealth Tool (OHT) conducted by HPP for policymakers in Zambia. It also covers preliminary discussions on next steps for finalizing the reproductive, neonatal, maternal and child health projection in OHT, as well as solidifying the Ministry of Community Development and Mother and Child Health’s capacity to use OHT independently and analyze the results for program and policy decision making. 

  • In 2007, WHO recommended that voluntary medical male circumcision (VMMC) should be scaled up in priority countries with high HIV prevalence and low male circumcision (MC) prevalence. UNAIDS estimated that 3.2 million males had undergone VMMC by the end of 2012. Implementation experience has raised questions about the need to refocus VMMC programs on specific subpopulations for the greatest epidemiological impact and programmatic effectiveness. As Malawi prepared its National Operational Plan for VMMC, it sought to examine impacts of targeting subpopulations by age and subnational region. The Health Policy Project, with funding from PEPFAR through USAID, applied the new DMPPT 2.0 model (see this poster  for model description) to study the impact of scaling up VMMC to different target populations disaggregated by age group and geographical subregions of Malawi. This poster was presented at the 20th International AIDS Conference in Melbourne, Australia, in July 2014.

  • 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.

  • In 2011, the USAID-funded Health Policy Project (HPP) provided technical assistance to support gender integration in the Mali National Health and Social Development Program (PRODESS). As part of this effort, HPP conducted a gender and health analysis using available data to inform PRODESS working groups. To facilitate the analysis, HPP developed a systematic gender data analysis process and identified data sources, including the Demographic and Health Survey (DHS) and the National Multiple Indicator Cluster Survey (MICS), to elucidate gender-specific cultural attitudes and practices and gender-related barriers with the potential to impact health outcomes for women and girls in Mali.

    This document presents this secondary data analysis process, along with findings from Mali, to facilitate its possible application in other settings. We provide step-by-step procedures for using existing data sources to analyze key gender and health data and to illustrate the links between gender disparities and health outcomes. This process serves as a practical, easy-to-follow method for conducting a low-cost, data-informed gender analysis that can be used to provide concrete, quantifiable examples of the impact of gender on health and other development outcomes

  • This Health Policy Project case study methodology involves reviewing policy documents and plans, and conducting key informant interviews with the Ministry of Women’s Affairs (MOWA) to understand their role in monitoring NAPWA’s implementation, highlight challenges in gender mainstreaming and understand coordination efforts across other ministries’ gender units.

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

  • The Government of Kenya, through the National AIDS Control Council, is developing the Kenya AIDS Strategic Framework 2014/2015 to 2018/2019 to provide guidance on the country’s priorities in HIV programming and increase the effectiveness of the national response. The framework will build on and succeed the Kenya National AIDS Strategic Plan 2010–2013 (KNASP III). To inform work on the new framework, from April to October 2014, the council collaborated on a study with the Health Policy Project (funded by the U.S. Agency for International Development and the U.S. President’s Emergency Plan for AIDS Relief). The study team examined the social, cultural, and political barriers to and facilitators of policies intended to support the four pillars in HIV programming: HIV prevention, treatment, and care and multisectoral mainstreaming. The team also considered how these barriers and facilitators, in turn, affect clients’ experience of HIV programs under previous HIV strategic plans. This information made it possible to assess the social feasibility of Kenya’s HIV programs.

  • This annotated bibliography, prepared by the USAID-funded Health Policy Project, is a collection of hundreds of articles, reports, books, and tools to communicate the available knowledge, evidence, and best practices for health policy. Health-related policy is the critical first step along the way to strengthening health systems and improving health outcomes, so it is important for policymakers to understand the processes and complexities involved in health policy. This bibliography contains the necessary knowledge for effective policy development, implementation and evaluation.

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

  • In June 2014, government of Haiti passed a new law against human trafficking. The main purpose of the legislation was to minimize the incentives for people to become human traffickers. The act establishes penalties for trafficking-related crimes, including imprisonment for up to 15 years, and fines of more than US$30,000. Prior to the passage of this law, there were no provisions in the Haitian legal framework that criminalized trafficking in persons. The USAID-funded Health Policy Project AKSE program published this law to disseminate the content of this important legal instrument and help protect survivors of trafficking. It is intended for use by judges, lawyers, and human rights-focused NGOs, and is used by HPP AKSE to train judicial actors, in partnership with the Haitian governmen

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

  • 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.

  • Condom and lubricant (C/L) programming is a critical element of an evidence-based HIV prevention package for sex workers (SW), men who have sex with men (MSM) and transgender (TG) people, populations bearing a disproportionate burden of HIV in Africa. Policy impacts lubricant availability and access.The USAID- and PEPFAR-funded Health Policy Project adapted the Policy Assessment and Inventory Decision Model methodology in Burkina Faso, Togo, and Kenya to assess policies that impact SW/MSM/ TG access to services, including C/L, against international standards and best practices. This poster presents the methods and results of the study, and was prepared for the 20th International AIDS Conference in July 2014.

  • HPP worked with the Ministry of Women’s Affairs and Women’s Rights (MCFDF) to publish the White Paper on the status of women in Haiti, which presents findings and recommendations from county and national-level participatory fora on 5 key themes for women in Haiti: education, health, leadership and political participation, economy, and justice. The briefs present key findings and bring together data from a wide array of sources. They are intended to be a quick reference for a broad audience, including advocates, policymakers, health sector stakeholders, and development partners. 

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

  • Healthcare in many developing countries, including those in sub-Saharan Africa, is predominantly funded through out-of-pocket spending by households. Providing financial protection from exorbitant out-of-pocket expenses is an important tool for a country’s health system to ensure equitable access to care and ensure families are not unnecessarily faced with financial catastrophe and impoverishment. Using data from the Kenya Household Health Expenditure and Utilization Surveys and descriptive analysis, the Health Policy Project, with support from USAID and PEPFAR, estimated the incidence and intensity of catastrophic healthcare expenditure and impoverishment in Kenya in 2003 and 2007. Among other findings, the Catastrophic Health Expenditures and Impoverishment in Kenya analysis revealed that in 2007 an estimated 2.5 million people were pushed below the national poverty threshold as a result of paying for healthcare. Results from this analysis provide strong evidence for the need to implement policies that offer more financial protection to the poor and vulnerable in order to achieve the country’s overall goal of universal health coverage.

  • The USAID- and PEPFAR-funded Health Policy Project (HPP) has led a global effort to compile and refine a coordinated package of “best practice” tools for health facilities. HPP brought together a group of international experts to review, prioritize, adapt, and synthesize existing measures and programmatic tools for stigma reduction. The resulting intervention package supports an evidence-informed response in health facilities and offers the following advantages:

    • Synthesis of existing tools into a streamlined research-to-action approach
    • A “total facility” approach that involves all levels of health facility staff
    • A questionnaire, field-tested in six countries for broad applicability across diverse settings
    • A “best of” set of training exercises culled from field experiences in nine countries in Africa, the Caribbean, and South and Southeast Asia
    • Training menus for different types of facility staff and timeframes
    • Action planning and policy development to support a sustained, multilevel response.

    The tools in this package may be used or adapted to counter stigma and discrimination based on HIV status, gender identity, sexual orientation, and behaviors such as sex work or injecting drug use.

  • The USAID- and PEPFAR-funded Health Policy Project partnered with the government of Côte d’Ivoire and PEPFAR on a study to estimate the cost and impact of HIV treatment scale-up by calculating the cost of antiretroviral treatment (ART) for one person per year for adults, children, and pregnant women. This annual ART cost was analyzed as a function of regimen, stage of illness at treatment initiation, retention, and response to treatment. The average cost was used to project the total investment necessary to scale up ART between 2015 and 2020 and achieve the country’s 90-90-90 goal, in which 90 percent of people living with HIV know their status, 90 percent of those diagnosed with HIV are on treatment, and 90 percent of those on treatment are virally suppressed. Using the Spectrum suite of policy models, the study estimated the number of lives saved and pediatric infections averted if this treatment scaleup is achieved. This study fills the critical information gap on cost as it relates to outcome. The government of Côte d’Ivoire and its development partners will be able to understand the resource needs for treatment scale-up and have the necessary data to inform decision making to effectively target available resources for HIV treatment.

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

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

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

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

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

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

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

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

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

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

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

  • The Health Policy Project's final costing study entitled Estimating the Unit Cost of Providing a Minimum Package of HIV Services to Female Sex Workers and Men Who Have Sex with Men, provides useful information for national program planners, donors, and other stakeholders.It does now, however, include operational details on how these different stakeholders can use the study results for their individual planning, budgeting, and resource mobilization and/or allocation purposes. This companion guide provides details on how study results may be used to inform decision making at multiple levels.

  • The National AIDS Control Program (NACP) in the Ministry of Health and Social Welfare (MoHSW), with support from the USAID-funded Health Policy Project (HPP), engaged in a stakeholder-driven process to estimate the costs of the Third Health Sector HIV and AIDS Strategic Plan (HSHSP III) for the fiscal years 2013/2014-2017/2018. This report describes the HSHSP III costing process and shows the cost results by NACP program unit and HSHSP III impact area and strategic objective.

  • The Government of Tanzania (GoT) has recognized the need to stop gender-based violence and strengthen services for survivors of GBV. In 2011, the Ministry of Health and Social Welfare (MoHSW) developed management guidelines for GBV services delivered within the health care setting and began training service providers in accordance with these guidelines. In 2012, with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through its Gender-based Violence Initiative (GBVI), the MoHSW began a phased rollout of these guidelines through training and facility support. The GBVI was aimed at strengthening coordination of GBV prevention and response efforts and their integration within existing HIV interventions. As the MoHSW moves forward with scale-up of the national guidelines, policymakers and program managers have identified the need to better understand the costs associated with GBV service delivery – for the purposes of estimating resource requirements for scale-up and also for exploring factors that drive the costs of GBV service delivery. The purpose of this study was to estimate the cost of delivering GBV services per client encounter at public health facilities in Tanzania and to understand the cost drivers of GBV service delivery in order to inform scale-up policies and planning. 

  • The Health Policy Project (HPP) helped countries achieve their health goals by building capacity for policy, advocacy, governance, and finance at multiple levels. The project developed global tools and best practices for policy work, promoted South-South sharing and collaboration, and carried out regional and country-specific policy initiatives. The files included in this zip document provide brief program overviews for each country highlighting key accomplishments. Individual briefs are available from the country pages.

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

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

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

  • HPP received funding to work in three countries in the Central Asia Region (CAR)—Kazakhstan, Kyrgyz Republic, and Tajikistan—to support and strengthen collaboration and coordination between nongovernmental organizations (NGOs) and governments working together to identify linkages and referral protocols for HIV-related health and social services. This desk review and analysis is intended to provide a detailed review of recently published assessment reports (2007–2012) conducted in Kazakhstan, Kyrgyz Republic, and Tajikistan to serve as a resource for USAID (CAR) and other groups interested in identifying priority HIV policy areas.

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

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

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

  • In 2010, the new Kenyan constitution mandated the devolution of power to 47 counties. This process has had wide-ranging implications for the health sector in Kenya as stakeholders struggle to understand the impact of the new political structure on their programs and services. Starting in 2012, the Health Policy Project (HPP)/Kenya began working with various governmental and non-governmental stakeholders to guide public management and structural reform, in line with the devolution process. This brief gives an overview of HPP/Kenya’s role in the devolution of Kenya’s health system including supporting national level stakeholders to consider the implications of devolution; incorporating legislative guidance on decentralization into health sector planning; facilitating county-level institutional reform; and ensuring that county health management teams have the structures necessary to respond to the challenges of devolution. Finally, the brief highlights challenges to the devolution process and illustrates how the Government of Kenya, HPP/Kenya, and other key stakeholders are working together to overcome these challenges.

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

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

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

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

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

  • The government of Cote d'Ivoire is committed to the fight to gain control and turn the tide of the HIV epidemic. Striving to offer the best standard of HIV treatment, the country aims to adopt the new 90-90-90 target. The country also plans to roll out “test and offer” for the general population in the near future and begin piloting Option B+ for pregnant women in 2015. Such an intense scale-up of HIV treatment services will require intensified coordination to mobilize resources and effectively target those funds for treatment scale-up and sustainability.

    The aim of this cost-outcome analysis study was to estimate the cost of HIV treatment scale-up and the impact of such an expansion by estimating the cost of treatment for one person per year for adults, children, and pregnant women. Currently, limited data exist around the unit cost of HIV treatment in Cote d’Ivoire. To inform policy decisions on how best to finance scale-up of treatment with the limited resources available, understanding the outcome of HIV treatment—and the levers for improving the chances of successful treatment—is critical.

    The study found that the cost of the full year of treatment expected by following the national treatment guideline would be CFA142,431 (US$288) for adults, CFA217,603 (US$440) for children, CFA85,063 (US$172) for PMTCT Option B, and CFA 151,827 (US$207) for PMTCT Option B+. A total investment of approximately CFA147 billion (US$297 million) is required over the next five years, leading up to the year 2020, to achieve the 90-90-90 target and a 100 percent roll-out of the Option B+ approach for the prevention of mother-to-child transmission (PMTCT). This investment will save more than 35,000 lives and prevent more than 6,000 children from becoming infected via PMTCT compared to the status quo, in which treatment coverage increases at the historical pace.

  • The purpose of this guidance manual is to outline steps for estimating the cost of post-GBV services at the health-facility level. It provides the user with practical steps for conducting a costing study, including preparing for data collection, collecting and managing data, and analyzing and using the results. It provides detailed instructions on how to use the GBV Program Cost Calculator, an MS Excel-based tool developed under the Health Policy Project (HPP) that enables the use to generate unit cost estimates of providing health facility-based post-GBV interventions to a single client during one health facility visit. The cost data generated from these steps are meant to represent the cost of providing services and not on the cost to the client for seeking services. The results on the cost of post-GBV services generated from implementing these steps are to support program managers, policy makers, funding partners and government ministries to plan and scale-up GBV intervention services.

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

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

  • Compelling evidence of the effectiveness of voluntary medical male circumcision (VMMC) as an HIV prevention intervention emerged during three randomized control trials that concluded in 2007. In December 2011, the World Health Organization and UNAIDS established a global strategic target of scaling up VMMC to reach 80 percent male circumcision prevalence among priority countries by 2016. As programs have rolled out VMMC, questions have arisen about how programs can be focused on populations where they will achieve the greatest impact. The Health Policy Project, with funding from PEPFAR through USAID, constructed a new model, DMPPT 2.0, to examine the impact and cost of focusing circumcision services on different age groups and subnational regions. This poster, presented at the 20th International AIDS Conference in Melbourne, Australia, provides an overview of the model.

  • The USAID and PEPFAR-funded Health Policy Project team, at the request of and in collaboration with the National Department of Health, conducted a detailed study in 2015 of the costs of providing medical male circumcision in South Africa. The objectives of this study were to:

    • Derive the unit cost of delivering medical male circumcision in South Africa at the facility level

    • Assess costs from a client perspective

    • Identify the level of spending currently incurred for demand creation

    The study’s findings, presented in this report, provide a detailed investigation, through a comprehensive bottom-up approach, of the costs to providers in offering medical male circumcision, as well as the cost to clients in receiving medical male circumcision. Results from the study will assist the South African government to assess the actual unit costs of medical male circumcision delivery and scale-up and provide information about the financial barriers medical male circumcision clients might face. This analysis will also support the National Department of Health, development partners, and implementing partners to better project resources needed for medical male circumcision service delivery and to understand cost drivers and cost variances across provinces and different modes of medical male circumcision service delivery (e.g., circumcision provided at fixed sites vs. circumcision provided as part of outreach programs). The cost data from this report will also inform the second round of South Africa’s investment case analysis.

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

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

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

  • The 2013 Kenya Household Health Expenditure and Utilisation Survey (2013 KHHEUS), explores the health-seeking behavior, use of healthcare services, out-of-pocket health spending, and health insurance coverage of Kenyan households. The first health survey to take place since Kenya decentralized its government; the 2013 KHHEUS collects data from the country’s 47 newly-created counties. By interviewing members of 33,675 households and comparing results with those of previous years (2003 and 2007), the 2013 survey provides important insights into how healthcare utilization, spending, and insurance coverage have changed in Kenya over the past decade. This brief summary highlights the key findings from the survey which will be used to inform Kenya health and health financing policy and will support the national health accounts estimation process. The 2013 KHHEUS was conducted by the Kenya Ministry of Health with support from the USAID-funded Health Policy Project and in conjunction with the Kenya National Bureau of Statistics.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

  • Increasing eligibility for treatment necessitates reallocation of resources and strategic investment to prepare the healthcare system and ensure access to treatment. This policy will increase the number of patients needing treatment in the near term, which will put stress on human resources for health, facilities, and the supply chain. Recognizing these challenges, the USAID- and PEPFAR-funded Health Policy Project (HPP) provided technical assistance and programmatic support to the government of Botswana to address its ongoing efforts to restructure the health sector. Using the OneHealth Tool, HPP analyzed the costs of implementing the WHO 2013 recommendations and the test and treat model in 2016.

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

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

  • Among the many efforts of the Government of Malawi to prevent and respond to GBV, the Department of Gender Affairs from the Ministry of Gender, Children, Disability and Social Welfare currently is working to improve GBV data systems and data use. As a part of this effort, the USAID-funded Health Policy Project has conducted a literature review to help to contribute to a better-informed national GBV response through identification and synthesis of existing studies and key government documents on gender-based violence in Malawi.

    The literature review was conducted primarily using online search methods and then followed-up with collection of documents not available online by country partners as needed. The literature was conducted to help answer how, in Malawi: GBV is defined and measured and see whether or not definitions are comparable throughout the literature; look at the prevalence rates of the various forms of GBV and how they compare across data sources; find out what information is available on GBV among specific populations or in specific settings; what factors are associated with GBV; what the impact of GBV is; what information is available on interventions and effectiveness; and what the key government documents on GBV are and how they address the issue.

  • 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.

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

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

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

  • 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. 

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

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

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

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

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

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

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

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

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

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

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

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

  • In support of the Global Fund’s New Funding Model, the President’s Emergency Plan for AIDS Relief (PEPFAR) worked in coordination with the United States Agency for International Development (USAID) through the Health Policy Project (HPP) to provide technical assistance to select high-impact countries. HPP supported the South Africa National AIDS Council (SANAC) and provincial health authorities in KwaZulu-Natal (KZN) on a proposal to map estimated HIV prevalence using routinely collected facility-level data and other related data in KZN province and the metro municipality of eThekwini (formerly known as Durban). These efforts were intended to help inform the country’s Concept Note submission, scheduled for June 2015. In addition to providing technical assistance in support of the analysis, HPP documented the methodology (Judice and Datar, 2014)—adapted from Dr. Frank Tanser’s work in Mpumalanga Province—so that SANAC might include a request to replicate this analysis in multiple municipalities throughout the country as part of the funding application to the Global Fund.This report documents the methodology, data sources, and statistical methods used to map and analyze routine data to examine HIV variation at subnational levels.

  • The Harm Reduction Expenditure Tracking Tool assesses total and unit expenditure in-country over two fiscal years for needle and syringe exchange programs (NSPs) and opioid substitution therapy (OST). The user guide provides step-by-step instructions for using this Excel-based tool. 

    The USAID- and PEPFAR-funded Health Policy Project (HPP), in collaboration with the Eurasian Harm Reduction Network (EHRN), developed the Harm Reduction Expenditure Tracking Tool. The tool was created for use by civil society groups to advocate for increased funding for harm reduction as HIV prevention in Eastern Europe and Central Asia. The tool and user guide are available in English and Russian.

  • This Harm Reduction Funding Gap Tool shows the difference in financial resource needs and commitments by year for needle and syringe exchange programs (NSP) and opioid substitution therapy (OST) programs. The user guide provides step-by-step instructions for using this Excel-based tool.

    The USAID- and PEPFAR-funded Health Policy Project (HPP), in collaboration with the Eurasian Harm Reduction Network (EHRN), developed the harm reduction funding gap tool. The tool was created for use by civil society groups to advocate for increased funding for harm reduction as HIV prevention in Eastern Europe and Central Asia. The tool and user guide are available in English and Russian.

  • This Harm Reduction Unit Costing Tool estimates the in-country unit cost per client per year for opioid substitution therapy (OST) and needle and syringe exchange (NSP) services. The user guide provides step-by-step instructions for using this Excel-based tool.

    The USAID- and PEPFAR-funded Health Policy Project (HPP), in collaboration with the Eurasian Harm Reduction Network (EHRN), developed the harm reduction unit costing tool. The tool was created for use by civil society groups to advocate for increased funding for harm reduction as HIV prevention in Eastern Europe and Central Asia. The tool and user guide are available in English and Russian.

  • This guide is intended to inform civil society organisations (CSOs) in Malawi on health budget advocacy, serving as an introduction and easy reference guide. The guide describes how health budgets are developed in Malawi at both the national and district levels, and suggests entry points through which advocates can seek to influence government health budgets.

    Content in this guide was adapted from the budget advocacy guide for civil society organisations in Tanzania, developed under the Health Policy Project’s predecessor project, the Health Policy Initiative.

  • 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.

  • Households in Afghanistan contribute more than 70% of the country’s health care spending. These funds come directly from households through out of pocket (OOP) payments for health care services.  Such high costs of medical care can result in catastrophic expenditures where households may be forced to sell their land, sell their agricultural or animal livelihoods, or prevent children from obtaining education due to extra fees). Alternatively, poor households may choose not to seek care to avoid impoverishment, prolonging ill-health. These decisions may lead to further impoverishment for households. Yet, currently there are no risk protection mechanisms for households.  The Government of the Islamic Republic of Afghanistan (GIRoA) has the opportunity to protect all Afghans from catastrophic health payments; the opportunity to ensure that all Afghans have access to health care services; and the opportunity to ensure that all Afghans can use health care services. This opportunity is called health insurance.  This brief provides policy recommendations for introducing health insurance to Afghanistan.

  • The USAID- and PEPFAR-funded Health Policy Project (HPP) in Kenya helped the Ministry of Health (MOH) secure an allocation of KSh 2.9 billion (approximately US$30 million) in the 2015/16 national budget to purchase HIV commodities and other strategic health commodities. Of this, US$21 to 23 million will go to purchase antiretroviral drugs (ARVs) and HIV testing kits. The remainder will supplement the purchase of malaria and tuberculosis commodities. HPP also helped secure the reinstatement of a line item for an annual allocation for HIV commodities in future national budgets. HPP is also working with private sector pharmacies and hospitals to stock ARVs that can be accessed by those who can afford them. As part of this initiative, the Kenya Medical Supplies Authority has already earmarked ARVs for 10,000 patients to help trigger sales. Innovative efforts, like increasing ARV sales in the commercial sector, can further enhance the sustainability of Kenya’s HIV program and increase access to ARVs and HIV services for those who cannot afford private care.

  • In order to expand and ensure widespread access to healthcare services and protect households from what are termed "catastrophic" health expenditures, Kenya needs alternative and sustainable healthcare financing mechanisms. The Health Policy Project supported the government of Kenya to analyze the long-term health delivery costs and health financing options available to the country. Employing a number of economic and health financing tools, the analysis, Healthcare Financing Options for Kenya: FY 2013/14–2029/30, revealed a need to increase domestic financing and improve the efficiency of the service delivery and social health insurance systems. Results from the analysis will be used to support the country’s move toward universal health coverage.

  • 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.  

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

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

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

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

  • A new study released by the Health Policy Project, examines the experience of stigma and discrimination among male and female sex workers and how these experiences affect sex workers’ utilization of health services. Measuring the prevalence of four types of stigma: anticipated, witnessed/heard, experienced, and internalized; the study revealed that over 80 percent of male sex workers and over 70 percent of female sex workers avoided or delayed needed health services in the year preceding the survey. This and other findings provide critical evidence for the need to address stigma and discrimination to both improve health outcomes of and control the HIV among the key populations most affected by HIV.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

  • 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.

  • 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, marginalized and key populations including men who have sex with men (MSM) and sex workers experience high levels of HIV and gender based violence (GBV). Stigma and criminalization contribute to violence experienced by key populations, and it further undermines access to HIV prevention and health services. Integrated HIV/GBV services that are client-friendly would alleviate barriers to services yet services and referral networks are inconsistent and largely unavailable in Jamaica. In 2012, Woman, Inc., with support from the USAID- and PEPFAR-funded Health Policy Project (HPP), undertook a pilot intervention in Jamaica to examine the feasibility for integrating GBV and HIV services in health clinics through development of a screening and referral process. This poster summarizing the study was presented at the 20th International AIDS Conference in Melbourne, Australia, in July 2014.

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

  • The HIV epidemic in Ukraine is severe and concentrated: it is estimated that there were 211,800–237,000 HIV-positive individuals in the country in 2013. Once dominated by infections among people who inject drugs (PWID), the adult HIV incidence in Ukraine is increasing among other key populations and the national prevention strategy must adapt. These populations include female sex workers (FSWs), clients and casual partners of FSWs, and men who have sex with men (MSM), among others. In this context, the USAID- and PEPFAR-funded Health Policy Project partnered with the State Service of Ukraine on HIV/AIDS and the Institute for Economy and Forecasting to analyze the cost and effectiveness of HIV prevention from 2014–2018. Conducted in July 2013, the analysis aimed to inform the National AIDS Programme (NAP) 2014–2018. This poster was presented at the 20th International AIDS Conference in Melbourne, Australia.

  • Published by the Kenya Ministry of Health, the Kenya National Health Accounts 2012/13 (NHA 2012/13) details the flow of resources in the country’s health sector. The NHA 2012/13, which tracks who provides goods and services and how resources are distributed across the health system, presents data by total health expenditure and by major disease area. Findings from the NHA 2012/13 will help to inform policy processes and form the basis for policy dialogue in health financing.

  • Countries in West Africa (WA) have made significant progress in addressing the HIV epidemic. However, HIV prevalence among sex workers (SWs) and men who have sex with men (MSM) remains high, and data are unavailable for transgender (TG) populations. Services that meet the needs of SWs, MSM, and TG are often unavailable outside of major cities. Stigma and discrimination (S&D) against key populations impact service uptake and increase migration, making it harder to reach these populations. Policies—such as laws, national strategies, and operational procedures—impact service availability and uptake. To inform decisionmakers and improve access to HIV-related services for mobile SWs, MSM, and TG populations in West Africa, the USAID- and PEPFAR-funded Health Policy Project (HPP) conducted an analysis of key policies in countries along the Abidjan-Lagos corridor and Burkina Faso.

  • 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. 

  • In June 2014, the Government of Haiti passed a new anti-trafficking law in order to fill a fundamental legal vacuum for the protection of survivors and for prosecution of perpetrators of human trafficking. These new legal provisions particularly important in an island known for being a country of origin, transit, and destination for the trafficking of human beings. This brief, published by the HPP AKSE program, aims to explain the rationale, scope, and implications of this new law. It is especially intended to inform non-governmental organizations working in the field of human rights.

  • In October 2013, the Haitian government passed a law to regularize adoption. This new law focuses on children's best interests and aims to promote international adoption as a last-resort measure after reviewing all the national options. The USAID-funded Health Policy Project AKSE program reproduced the text of the law in this booklet to make it accessible to actors in the child protection chain and to promote its application through trainings for Haitian judicial actors and dissemination among human rights NGOs.

  • In June 2014, the government of Haiti passed a new law: the Responsible Paternity Act. With this law, Haiti sent a clear signal promoting the “protection of all children, without discrimination.” A significant implication of the act for parents is that children born within and outside of marriage must be afforded the same opportunities and rights (e.g., inheritance rights)—an important principle in a society with five forms of union. This booklet reproduces the text of the law, and was produced by the USAID-funded Health Policy Project AKSE program to educate parents and judicial actors about the new law and advocate for its concrete application. The law is not retroactive.

  • 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. 

  • The Saving Mothers, Giving Life partnership (SMGL) is a global partnership between governments, donors, and the private sector to accelerate reduction in maternal and neonatal mortality in sub-Saharan African countries.As part of the SMGL program, the USAID-funded Health Policy Project (HPP) has worked with Zambia’s Ministry of Community Development, Mother and Child Health (MCDMCH) and its Ministry of Health (MOH) to develop their capacity to use the OneHealth Tool (OHT) to model reproductive, maternal, neonatal, and child health (RMNCH) program scale-up and resource needs.In order to make further progress toward reducing maternal, neonatal, and child mortality, MCDMCH requested that HPP conduct a training on the Lives Saved Tool (LiST) (a component of OHT) with programmatic staff from the ministry’s maternal health, child health, and nutrition units. LiST is a computer-based modeling tool that uses input data such as demographic and service coverage levels to estimate the number of deaths that can be averted as a result of expanding effective maternal and child health interventions.

  • 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.

  • In June 2014, the government of Haiti published a paternity act that recognizes equal rights for children born within and outside of marriage. This act represents an important legal shift, enshrining the principle that all children are on an equal footing. The USAID-funded Health Policy Project AKSE documented the gaps that the law fills and why this achievement is so important for the Ministry of Women’s Affairs, the women’s organizations that fought for it, and for children in Haiti. In support of the Haitian Government HPP AKSE develops training curriculum to disseminate the content of this new law to judicial actors and Human rights NGO.

  • In June 2014, the government of Haiti published a paternity act that recognizes equal rights for children born within and outside of marriage. This act represents an important legal shift, enshrining the principle that all children are on an equal footing. The USAID-funded Health Policy Project AKSE program documented the gaps that the law fills and why this achievement is so important for the Ministry of Women’s Affairs, the women’s organizations that fought for it, and for children in Haiti. 

  • Afghanistan's Ministry of Public Health (MoPH) has prioritized the improvement of national hospitals in its Health and Nutrition Strategic Plan 2011-15 and in the Hospital Sector Strategy. Greater political and financial support is needed for the national hospitals to smoothly implement the hospital strategy and to ensure more efficient and effective delivery of tertiary services.  This policy brief provides recommendations to improve achieve greater hospital autonomy, which will contribute towards the efficient and effective delivery of tertiary services.

  • There have been remarkable improvements in the maternal health over the last 25 years but disparities remain. In June 2014, the U.S. Agency for International Development (USAID) documented its vision for maternal health in Ending Preventable Maternal Mortality: USAID Maternal Health Vision for Action, which lays out key strategic drivers that impact progress. Improving the health policy process has never been more important than in today’s increasingly complex, resource-constrained environment. Advocacy and accountability for the adoption of high-impact maternal health policies and interventions must be at the center of health systems and health service delivery improvements. Overcoming inequitable access to health services demands advocacy and social participation from local communities, as well as the meaningful engagement of global and national groups, including the private sector, who influence health policy decisions. This brief outlines how USAID investments in health policy, governance, finance, and advocacy contribute to ending preventable maternal mortality.

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

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

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

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

  • This poster was presented at the 20th International AIDS Conference in Melbourne, Australia, in July 2014. It summarizes a study of HIV-related stigma and discrimination, which pose barriers to accessing HIV testing and treatment services and, in healthcare settings, can be especially damaging for people living with HIV (PLHIV). This cross-sectional study is part of a collaboratively funded global effort led by the USAID- and PEPFAR-funded Health Policy Project to develop a brief stigma-measurement tool for health workers. This tool allows assessment and monitoring of stigma in healthcare settings. 

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

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

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

  • The number of new HIV infections in Eastern Europe and Central Asia (EECA) continues to grow, with people who inject drugs (PWID) and their sexual partners disproportionately affected by the epidemic. To address this challenge, the Eurasian Harm Reduction Network (EHRN), with support from the USAID- and PEPFAR-funded Health Policy Project (HPP), developed a suite of easy-to-use, Excel-based tools, available in Russian and English. Civil society organizations advocating harm reduction services can use them to estimate past expenditure levels, future resource needs, and potential funding gaps using local costs of services and products. This brief introduces these tools. 

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

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

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

  • Until recently, the primary focus of Botswana’s health agenda (as with many of its neighbors) has been on infectious disease control—particularly HIV, since the country has one of the highest prevalence rates in the world (22% of adults ages 15–49 are HIV positive). Noncommunicable diseases (NCDs) were not a priority on the global health spectrum, but rising affluence and urbanization have contributed to increases in NCDs in the last decade. In Botswana, NCDs are estimated to account for 31 percent of all deaths. The most common NCDs include cardiovascular disease, hypertension, cancer, chronic obstructive pulmonary diseases, and diabetes. 

    In recognition of these challenges, and with the overall emphasis shifting from care and treatment to prevention of these diseases, the USAID- and PEPFAR-funded Health Policy Project (HPP) provided technical assistance and programmatic support to the government of Botswana to analyze the resource implications of this shift for CVD, type II diabetes, and kidney disease.

  • 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.

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

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

  • 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.

  • In order to evaluate the distribution of health workers across Tanzania, relative to health needs, the USAIDfunded Health Policy Project (HPP) examined existing sources and conducted new analyses of human resources for health (HRH). Drawing on the results of these analyses, HPP proposes within this brief specific policy actions to improve 1) supply and retention of skilled health workers; 2) distribution of health workers; and 3) processes for hiring skilled health workers.

  • To improve understanding of political will for the devolution of Kenya’s health sector, the USAID- and PEPFAR-funded Health Policy Project (HPP) conducted a series of semi-structured interviews with key informants in January 2015—involving the national government, three county-level governments, and consultants—to explore what incentives are driving political will for the devolution of Kenya’s health sector. HPP found that the desire for improved health outcomes is one of many factors driving political will for health sector devolution. The need to meet constituents’ and political stakeholders’ expectations also influences political will. A greater understanding of the various factors that influence political will can help the national government take a leadership role to incentivize and encourage counties to make decisions for improving health outcomes, and move devolution forward.

  • 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.

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

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

  • Tanzania’s government recognizes that the country’s sustainable development and transition to middle-income status depends on the health of the Tanzanian people. To that end, the country has worked hard to achieve Millennium Development Goal (MDG) 4 to reduce child mortality and MDG 5 to improve maternal health. This USAID and PEPFAR-funded Health Policy Project brief explores the current policy framework for reproductive maternal, neonatal, child, and adolescent health (RMNCAH), and provides plans for intervention and strengthening of RMNCAH in the short, medium, and long term. 

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

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

  • A high proportion of Tanzania’s total health spending comes from foreign donors and households (out-of-pocket), rather than from sustainable sources such as government tax-based revenue or health insurance. While the country has made enormous strides in improving its population’s health, the Government of Tanzania and its development partners recognize that the current health financing structure is not sustainable. The government is now considering several crucial changes to how healthcare in Tanzania is financed; as part of this effort, the country is finalizing a health financing strategy and scaling up new programs to accelerate service delivery coverage and improve quality.

    In support of building a sustainable structure, the USAID- and PEPFAR-funded Health Policy Project reviewed the country’s healthcare financing situation to provide a baseline against which innovation and policy change can be gauged. This report provides a broad overview of the health financing landscape in Tanzania as of 2014 and aims to highlight those aspects suggesting a greater reliance on domestic and sustainable resources to accomplish Tanzania’s health goals. 

  • While Tanzania has made significant progress on priority health indicators, the limited effectiveness of health financing constrains its ability to achieve more.Despite challenges Tanzania is making progress toward sustainable financing. This USAID and PEPFAR-funded Health Policy Project brief explores the country's prospects for sustainable financing and explores the linkages between financing and universal health coverage. 

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

  • In close collaboration with IBESR, the USAID-funded HPP AKSE developed referral schematics and protocols will be developed for client service needs, safety, security, and confidentiality of existing child protection networks.

  • In close collaboration with MCFDF, the USAID-funded HPP AKSE conducted an assessment of the sexual and gender based violence (SGBV) referral monitoring and reporting system in Haiti. The following report includes results from the assessment and recommendation to strengthen the existing system.

  • The USAID-funded Health Policy Project (HPP) conducted a readiness assessment in Mozambique to see if would be possible and useful to conduct a costing study of post-GBV Care Services. Broadly the readiness assessment was designed to assess if there is a shared understanding about GBV and the need to scale up services. On a narrower level, the readiness assessment looked specifically at whether the data and information needed to apply HPP’s GBV Cost Calculator are available . The Calculator was initially developed and tested using the GBV management guidelines for the Ministry of Health and Social Welfare for the United Republic of Tanzania, which has invested heavily in standardized care protocols, training and data collection. The assessment highlights several important challenges to conducting a GBV costing study in Mozambique as well as some clear opportunities. The challenges include a lack of agreement about what constitutes GBV, a lack of protocols on what constitutes a GBV facility, and  a deficiency in national data collection protocols. The opportunities are reflected in a policy environment that offers a range of multisectoral and health sector policy documents and in the commitment by donors and the government of Mozambique to expand the quality and accessible of support for GBV survivors. 

  • This document is a report on the District Orientation meetings led by the Malawi Ministry of Gender, Children, Disability and Social Welfare (MoGCDSW) with support from the USAID-supported Health Policy Project. The orientation meetings were held to kick-start the implementation of the national Institutional Framework and the MoGCDSW Strategic Plan, in order to achieve the objectives of the Joint Sector Strategic Plan.

  • This report documents the process undertaken for the review and update of guidelines and standards for gender mainstreaming in Malawi, which was undertaken jointly by HPP and the Ministry of Gender, Children, Disability and Social Welfare. The report also documents the outcomes of this process.

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

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

  • The increasing demand for family planning (FP) services coupled with decreases resources highlights the need to develop and implement strategies to ensure access to FP services for all. One way for governments to do this is to enact policies that facilitate market segmentation for contraceptives to shift financial pressures on governments, donors, and non-profit organizations from the public to private, for-profit sector. This report highlights results from a desk review and key informant interviews in Burkina Faso which assess pricing policies for contraceptives and provide recommendations to ensure availability and sustainability of contraceptives.

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

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

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

  • The increasing demand for family planning (FP) services coupled with decreases resources highlights the need to develop and implement strategies to ensure access to FP services for all. One way for governments to do this is to enact policies that facilitate market segmentation for contraceptives to shift financial pressures on governments, donors, and non-profit organizations from the public to private, for-profit sector. This report highlights results from a desk review and key informant interviews in Togo which assess pricing policies for contraceptives and provide recommendations to ensure availability and sustainability of contraceptives.

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

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

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

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

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

  • This guide is designed to support communities and, specifically, healthcare providers in confronting D&A during facility-based childbirth and promoting dignity in evidence-based maternity care. This guide has been adapted from the generic guide produced by the Population Council to reflect the Nigerian context and the specific needs of healthcare workers at primary, state, and federal levels in the country.This toolkit was prepared by the White Ribbon Alliance with support from the USAID-funded Health Policy Project.

  • In 2013, each of Kenya’s 47 newly established county governments created a county department of health (CDOH) to oversee the delivery of health services, as outlined out in Schedule IV of the 2010 Constitution. To deliver health services and meet the challenge and promise of devolution, county governments require strong and accountable departments of health. As they strive to create effective governance and financing mechanisms, these departments can benefit from the experiences of other county governments. Counties have attempted to create new health management structures that provide strong organizational management.Unfortunately, many of these efforts have been weakened by political intransigence, entrenched interests, and bureaucracy. Mombasa County, however, overcame these hurdles to create a unified CDOH with defined staffing structures aimed at achieving a clear set of objectives. This brief reviews the factors that made this organizational restructuring possible.

  • Kenya's Health Sector Coordinating Committee, a joint forum of government and development partner representatives, commissioned a study in late 2012 to determine the implications of a lack of Global Fund resources for Kenya related to HIV, tuberculosis, and malaria. Conducted in 2012, and later revised in 2013, the assessment was carried out by Health Policy Project in partnership with the German technical support agency, GiZ. The study analyzes changes to the Global Fund, (e.g., the New Funding Model) and considers Kenya’s policy risks related to future Global Fund resources. The risk analysis also includes projected financial gaps for the three diseases and set of policy recommendations to the Government of Kenya to mitigate the risks of a decline in Global Fund resources and the potential challenges of implementing grants under the New Funding Mechanism.

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

  • 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.

  • Over the past decade, the performance of Tanzania’shealth system has been mixed. The country will achieve many of its 2015 targets for malaria, HIV and AIDS, tuberculosis, and child health, but progress in reproductive health is lagging. Currently, nearly half of the country’s health budget is covered by donor funding—the largest share in the world. This USAID and PEPFAR-funded Health Policy Project brief provides an overview of Tanzania's existing health system, including: human resources for health, health financing, commodities and supplies, and monitoring and evaluation and health management information systems.

  • 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 GIS Continuum and associated costing workbook and prioritization worksheet can be used to support a strategic planning and costing exercise to determine where investments are needed to strengthen GIS as part of a country's national spatial data infrastructure and health systems strengthening.

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

  • Stigma and discrimination (S&D) in health facilities undermines HIV prevention, care, and treatment and negatively impacts health. Reducing S&D requires understanding the prevalence of its drivers and manifestations to shape a tailored response. The St. Kitts and Nevis National AIDS Program (NAP), with support from the USAID- and PEPFAR-funded Health Policy Project (HPP) and the University of the West Indies (UWI), collected data as a first step in creating a comprehensive S&D-reduction program. This poster, presented at the 20th International AIDS Conference in Melbourne, Australia, in July 2014, summarizes the results of the data collection.

  • It is estimated that 80,000 infants born annually in Zambia are at risk of acquiring HIV from their mothers. In 2011, more than 415,000 Zambians were on antiretroviral therapy (ART), but the number of children accessing ART services lagged significantly behind that of adults. Ensuring universal access to ART requires more information about the costs of scaling up services to reach every child in need. To inform the resource investment required to increase coverage of pediatric ART, the USAID- and PEPFAR-funded Health Policy Project (HPP), along with the Ministry of Health of the Government of the Republic of Zambia (MOH), examined the average additional cost to infant and child health services at the health facility level (incremental cost) of providing clinical pediatric ART services for children living with HIV. HPP and the MOH also analyzed the cost drivers of treatment to identify opportunities for increasing efficiencies. This poster shows the results of this work and was presented at the 20th International AIDS Conference in July 2014.

  • At the end of 2013 an estimated 189,930–206,280 adults and 34,560–36,250 children were living with HIV in Ghana. There is strong evidence to suggest a disproportionately higher HIV prevalence among certain key population groups, such as men who have sex with men (MSM) and female sex workers (FSWs). Ghana’s epidemic continues to evolve. The USAID- and PEPFAR-supported Health Policy Project (HPP) partnered with the Ghana AIDS Commission (GAC) to conduct a focused analysis of the future effectiveness of HIV prevention in the country related to possible funding from external partners. This report offers information on the targets and highlights cost-effective decisions Ghana can make over the coming years. It comes at an opportune time as the country’s current National Strategic Plan (NSP) for HIV and AIDS comes to a close in 2015.

  • 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.

  • Since 2011, the International AIDS Society (IAS) has been seeking ways to improve the effectiveness and efficiency with which HIV services are planned and delivered. This investigation focused on a survey of IAS members, many of whom are frontline providers of care, and then turned to consultations with stakeholders across the spectrum of the HIV community: donors; local, regional and national governments; civil society organizations; the private sector; doctors and other caregivers; and people living with HIV. The results of these efforts are reported in this brief, produced with support from USAID and PEPFAR through the Health Policy Project.

  • The Expenditure Management Information System (EMIS) is an information system that collects contract, budget, and expenditure information on the health sector in a Microsoft Access database. The database produces financial reports for the Ministry of Public Health (MoPH) and donors, as necessary. This document will assist MoPH HEFD to advocate EMIS internally and at other ministries for buy-support and better understanding.

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

  • The Health Policy Project (HPP) offers user-friendly software, computer models, and tools to help in-country partners understand the magnitude of health challenges, explore policy and resource options, and set priorities as they develop strategies to improve the health of their citizens.  The project has recently completed a series of fliers on some of HPP’s useful tools and approaches. They provide excellent overviews of the following:

    • Costed Implementation Plans
    • DemDiv
    • ImpactNow
    • RAPID
    • OneHealth Tool
    • GeoHealth Mapping
    • DMPPT

    For your convenience we have also included our flier on all Software and Models. You can download the tools from our Software and Models page.

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

  • Classified as an upper-middle-income country in 2010, Jamaica is reorganizing its HIV response to heighten efficiency and financial sustainability. A key challenge involves sustaining the program, given declining external assistance and a government in fiscal crisis. Facing this challenge, the Jamaican Ministry of Health has integrated elements of its HIV program into its family planning program to create a new national Ministry of Health (MOH) agency for sexual health. In undertaking this reform, the MOH found a dearth of guidance about national-level integration. Thus, the MOH collaborated with the USAID- and PEPFAR-funded Health Policy Project to assess lessons to date and map next steps. This poster about the study was presented at the 20th International AIDS Conference in Melbourne, Australia, in July 2014.

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

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

  • 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.

  • 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.

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

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

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

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

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

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

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