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POLICY Issues in Planning and Finance

  • A key condition of contraceptive security is a policy environment that enables forecasting, financing, procuring, and delivering contraceptives in a fair and equitable way to all women and men who need them. Contraceptive security exists in a country when all women and men who need and want contraceptives can obtain them. Policies can either inhibit or enhance achievement of contractive security. There is a dynamic relationship between the policy environment, the logistics and management functions of delivering contraceptive supplies and services, and contraceptive security. More emphasis is typically given to logistics and management issues than to policy issues in efforts to promote contraceptive security. However, the importance of a favorable policy environment as a lynchpin to contraceptive security is becoming increasingly apparent. This brief focuses on the key policy aspects of contraceptive security, and describes how policy interventions are essential to achieving contraceptive security.
    French
    PI_Frch.pdf
  • A key condition of contraceptive security is a policy environment that enables forecasting, financing, procuring, and delivering contraceptives in a fair and equitable way to all women and men who need them. Contraceptive security exists in a country when all women and men who need and want contraceptives can obtain them. Policies can either inhibit or enhance achievement of contractive security. There is a dynamic relationship between the policy environment, the logistics and management functions of delivering contraceptive supplies and services, and contraceptive security. More emphasis is typically given to logistics and management issues than to policy issues in efforts to promote contraceptive security. However, the importance of a favorable policy environment as a lynchpin to contraceptive security is becoming increasingly apparent. This brief focuses on the key policy aspects of contraceptive security, and describes how policy interventions are essential to achieving contraceptive security.
    Spanish
    PI_Sph.pdf
  • A key condition of contraceptive security is a policy environment that enables forecasting, financing, procuring, and delivering contraceptives in a fair and equitable way to all women and men who need them. Contraceptive security exists in a country when all women and men who need and want contraceptives can obtain them. Policies can either inhibit or enhance achievement of contractive security. There is a dynamic relationship between the policy environment, the logistics and management functions of delivering contraceptive supplies and services, and contraceptive security. More emphasis is typically given to logistics and management issues than to policy issues in efforts to promote contraceptive security. However, the importance of a favorable policy environment as a linchpin to contraceptive security is becoming increasingly apparent. This brief focuses on the key policy aspects of contraceptive security, and describes how policy interventions are essential to achieving contraceptive security.
    English
    PI_Eng.pdf
  • Following the Platform of Action set forth at the 1994 ICPD in Cairo, nearly all countries place at least some policy emphasis on preventing and treating reproductive health problems. However, the necessary resources, both domestic and international, continue to be scarce. Nowhere in the developing world do reproductive health programs reach all the persons who would benefit. This means that policymakers and program managers must set priorities. This policy brief describes how to set priorities, various models and techniques available to set priorities and how priority setting works in practice.
    Spanish
    PI2Spanish.pdf
  • Following the Platform of Action set forth at the 1994 ICPD in Cairo, nearly all countries place at least some policy emphasis on preventing and treating reproductive health problems. However, the necessary resources, both domestic and international, continue to be scarce. Nowhere in the developing world do reproductive health programs reach all the persons who would benefit. This means that policymakers and program managers must set priorities. This policy brief describes how to set priorities, various models and techniques available to set priorities and how priority setting works in practice.
    French
    PI2French.pdf
  • Following the Platform of Action set forth at the 1994 ICPD in Cairo, nearly all countries place at least some policy emphasis on preventing and treating reproductive health problems. However, the necessary resources, both domestic and international, continue to be scarce. Nowhere in the developing world do reproductive health programs reach all the persons who would benefit. This means that policymakers and program managers must set priorities. This policy brief describes various models and techniques available to set priorities and how priority setting works in practice.
    English
    PI2English.pdf
  • Global demand for family planning services continues to increase rapidly. By 2015, the number of women using modern contraceptives is expected to nearly double (Ross and Bulatao, 2001). This dramatic growth is due in part to an increase in the number of women of reproductive age. It also stems from the fact that national family planning programs are doing a better job of both reaching out to women in need of family planning products and removing barriers to family planning services. Demand for condoms is rising even faster as a “dual-use” product, protecting against unwanted pregnancies as well as against sexually transmitted infections (STI), including HIV. New challenges for family planning programs have arisen from their success. In many family planning programs operated by the public sector, resources are falling short of growth in demand for services. At the same time, individuals with unmet need for family planning services are increasingly concentrated among hard-to-reach groups. Moreover, as low-cost public services come to dominate the family planning market, they compete with and crowd out the private sector. This brief explores one potential solution—targeting—to meet these challenges, alleviating barriers to the expansion and use of family planning services.
    Spanish
    PF3_Sp.pdf
  • Global demand for family planning services continues to increase rapidly. By 2015, the number of women using modern contraceptives is expected to nearly double (Ross and Bulatao, 2001). This dramatic growth is due in part to an increase in the number of women of reproductive age. It also stems from the fact that national family planning programs are doing a better job of both reaching out to women in need of family planning products and removing barriers to family planning services. Demand for condoms is rising even faster as a “dual-use” product, protecting against unwanted pregnancies as well as against sexually transmitted infections (STI), including HIV. New challenges for family planning programs have arisen from their success. In many family planning programs operated by the public sector, resources are falling short of growth in demand for services. At the same time, individuals with unmet need for family planning services are increasingly concentrated among hard-to-reach groups. Moreover, as low-cost public services come to dominate the family planning market, they compete with and crowd out the private sector. This brief explores one potential solution—targeting—to meet these challenges, alleviating barriers to the expansion and use of family planning services.
    French
    PF3_Fr.pdf
  • Global demand for family planning services continues to increase rapidly. By 2015, the number of women using modern contraceptives is expected to nearly double (Ross and Bulatao, 2001). This dramatic growth is due in part to an increase in the number of women of reproductive age. It also stems from the fact that national family planning programs are doing a better job of both reaching out to women in need of family planning products and removing barriers to family planning services. Demand for condoms is rising even faster as a “dual-use” product, protecting against unwanted pregnancies as well as against sexually transmitted infections (STI), including HIV. New challenges for family planning programs have arisen from their success. In many family planning programs operated by the public sector, resources are falling short of growth in demand for services. At the same time, individuals with unmet need for family planning services are increasingly concentrated among hard-to-reach groups. Moreover, as low-cost public services come to dominate the family planning market, they compete with and crowd out the private sector. This brief explores one potential solution—targeting—to meet these challenges, alleviating barriers to the expansion and use of family planning services.
    English
    PF3_Eng.pdf
  • Private sector involvement is crucial not only in helping respond to growing market demand but also in expanding consumer choices and ensuring equity in the contraceptive market. Evidence from many countries shows that the nonpoor benefit disproportionately from free and subsidized public sector services and commodities (Winfrey et al., 2000). A recent analysis of 10 donor-dependent countries reveals that 45 percent of pills and 56 percent of condoms supplied, respectively, by the public sector and social marketing initiatives went to those who could otherwise afford to pay for them (Sine, 2002). Redirecting wealthier/middle-income clients to the private sector will free up scarce donor and public resources for those most vulnerable and in need. A recent market segmentation study in the Philippines shows that shifting middle- and high-income users of government services to the private sector would reduce the burden on the public sector by more than 40 percent (Alano et al., 2002). It is important to recognize that more than one-third of all family planning users in the developing world already obtain contraceptives from the private sector (Rosen and Conly, 1999). In countries such as Cameroon, Colombia, the Dominican Republic, Ghana, and Jordan, more than 60 percent of users obtain their contraceptives from private rather than public sources (Ross et al., 1999). Given that the private sector in many countries is already a major player in the contraceptive market, any feasible contraceptive security plan needs to take into consideration the private sector’s current and potential role. This policy brief provides an overview of processes, strategies, and tools that developing countries can adopt to foster complementary public/private sector roles that enhance the private sector’s contribution to contraceptive security. Specifically, the brief examines the roles of the public and private sectors in the provision of contraceptives and condoms; and describes strategies/mechanisms used at both the policy and operational levels to mobilize the private sector.
    English
    PF4_Eng.pdf
  • Private sector involvement is critical not only in helping respond to growing market demand but also in expanding consumer choices and ensuring equity in the contraceptive market. Evidence from many countries shows that the nonpoor benefit disproportionately from free and subsidized public sector services and commodities (Winfrey et al., 2000). A recent analysis of 10 donor-dependent countries reveals that 45 percent of pills and 56 percent of condoms supplied, respectively, by the public sector and social marketing initiatives went to those who could otherwise afford to pay for them (Sine, 2002). Redirecting wealthier/middle-income clients to the private sector will free up scarce donor and public resources for those most vulnerable and in need. A recent market segmentation study in the Philippines shows that shifting middle- and high-income users of government services to the private sector would reduce the burden on the public sector by more than 40 percent (Alano et al., 2002). It is important to recognize that more than one-third of all family planning users in the developing world already obtain contraceptives from the private sector (Rosen and Conly, 1999). In countries such as Cameroon, Colombia, the Dominican Republic, Ghana, and Jordan, more than 60 percent of users obtain their contraceptives from private rather than public sources (Ross et al., 1999). Given that the private sector in many countries is already a major player in the contraceptive market, any feasible contraceptive security plan needs to take into consideration the private sector’s current and potential role. This policy brief provides an overview of processes, strategies, and tools that developing countries can adopt to foster complementary public/private sector roles that enhance the private sector’s contribution to contraceptive security. Specifically, the brief examines the roles of the public and private sectors in the provision of contraceptives and condoms; and describes strategies/mechanisms used at both the policy and operational levels to mobilize the private sector.
    Spanish
    PF4_Sp.pdf
  • Private sector involvement is critical not only in helping respond to growing market demand but also in expanding consumer choices and ensuring equity in the contraceptive market. Evidence from many countries shows that the nonpoor benefit disproportionately from free and subsidized public sector services and commodities (Winfrey et al., 2000). A recent analysis of 10 donor-dependent countries reveals that 45 percent of pills and 56 percent of condoms supplied, respectively, by the public sector and social marketing initiatives went to those who could otherwise afford to pay for them (Sine, 2002). Redirecting wealthier/middle-income clients to the private sector will free up scarce donor and public resources for those most vulnerable and in need. A recent market segmentation study in the Philippines shows that shifting middle- and high-income users of government services to the private sector would reduce the burden on the public sector by more than 40 percent (Alano et al., 2002). It is important to recognize that more than one-third of all family planning users in the developing world already obtain contraceptives from the private sector (Rosen and Conly, 1999). In countries such as Cameroon, Colombia, the Dominican Republic, Ghana, and Jordan, more than 60 percent of users obtain their contraceptives from private rather than public sources (Ross et al., 1999). Given that the private sector in many countries is already a major player in the contraceptive market, any feasible contraceptive security plan needs to take into consideration the private sector’s current and potential role. This policy brief provides an overview of processes, strategies, and tools that developing countries can adopt to foster complementary public/private sector roles that enhance the private sector’s contribution to contraceptive security. Specifically, the brief examines the roles of the public and private sectors in the provision of contraceptives and condoms; and describes strategies/mechanisms used at both the policy and operational levels to mobilize the private sector.
    French
    PF4_Fr.pdf
  • Contraceptive security (CS) is achieved when people are assured of access to an uninterrupted supply and adequate mix of contraceptive commodities and enjoy open access to information and services related to those commodities. As developing countries strive to achieve contraceptive security amid growing demand for contraceptives, they are increasingly cognizant of the impact of directing resources to vulnerable groups and their ability to ensure equitable access for all, including HIV-positive women. Providing for the family planning needs of HIV-positive women is a vital component in the fight against HIV/AIDS and the achievement of international development goals. However, CS programs often do not successfully accommodate the special needs of HIV-positive women. Challenges to reaching this marginalized group include a limited choice of accessible contraceptive methods, lack of informed counseling regarding appropriate contraceptive options, stigma and discrimination that hinder their ability to access information and healthcare services, and operational barriers that thwart providers effective delivery of medical care. Achieving access to family planning information, services, and commodities for this group can have a significant impact on the HIV/AIDS epidemic, and interventions that successfully overcome the challenges can help achieve this goal. The World Health Organization (WHO) identifies four stages of perinatal HIV prevention at which women need support: (1) prevention of HIV infection in women, especially young women of reproductive age; (2)prevention of unintended pregnancy in HIV-positive women; (3) prevention of mother-tochild transmission; and (4) support for the HIV-positive mother and family (WHO, 2003). A comprehensive CS plan is consistent with supporting women at all four stages and can directly affect success at stages two and three by reducing the barriers faced by HIV-positive women in accessing family planning (FP) goods, services, and information. This brief describes the importance of ensuring contraceptive security for HIV-positivewomen. It also reviews common barriers faced by HIV-positive women as they attempt to access FP services and illustrates interventions that can increase the likelihood of overcoming these barriers.
    English
    PF Issues_English.pdf
  • La sécurité contraceptive (SC) est atteinte lorsque les personnes disposent d'un accès assuré à un approvisionnement régulier et à une gamme adéquate de divers produits contraceptifs et qu'elles peuvent obtenir toutes les informations et les services nécessaires liés à ces produits. Alors que les pays en développement font de leur mieux pour assurer une sécurité contraceptive face à une demande contraceptive sans cesse croissante, ils deviennent de plus en plus conscients de l'impact si les ressources ciblent les groupes vulnérables et leur capacité à assurer un accès équitable à tous, notamment aux femmes séropositives. Il est impératif de répondre aux besoins en planification familiale des femmes séropositives pour lutter contre le VIH/SIDA et pour atteindre les objectifs internationaux de développement. Toutefois, les programmes de SC ont souvent du mal à répondre pleinement aux besoins spécifiques des femmes séropositives. Bien des obstacles se dressent sur leur chemin pour atteindre ce groupe marginalisé: choix limité des méthodes contraceptives accessibles, manque de services-conseils de qualité sur les options contraceptives adéquates, stigmatisation et discrimination empêchant souvent ces femmes davoir accès aux informations et aux services nécessaires et barrières opérationnelles auxquelles se heurte le personnel soignant et qui entravent sa prestation efficace de soins médicaux. Donner accès à l'information, aux services et aux produits de planification familiale pour ce groupe peut avoir un impact notable sur l'épidémie de VIH/SIDA et les interventions qui surmonteront ces obstacles peuvent aider à atteindre cet objectif. L'Organisation mondiale de la Santé, OMS, identifie quatre étapes de la prévention périnatale du VIH auxquelles les femmes ont besoin d'aide: 1) prévention de l'infection à VIH chez les femmes, surtout les jeunes femmes en âge de procréer, 2) prévention de la grossesse non souhaitée chez les femmes séropositives, 3) prévention de la transmission mère-enfant et 4) soutien pour la mère séropositive et sa famille (WHO, 2003).Un plan SC complet répond à ces besoins d'aide aux femmes aux quatre étapes et peut affecter directement les étapes deux et trois en réduisant les barrières rencontrées par les femmes séropositives qui souhaiteraient avoir accès à des produits, services et informations en planification familiale (PF). Ce résumé dorientation décrit limportance dasssurer la sécurité contraceptive pour les femmes séropositives. Il passe en revue les barrières usuelles que rencontrent ces femmes séropositives dans leur quête pour obtenir des services de PF et présente des interventions qui sont susceptibles de supprimer ces obstacles.
    English
    PF Issues_French.pdf
  • DAIA se alcanza cuando los individuos tienen acceso garantizado al suministro ininterrumpido y a la combinación adecuada de insumos anticonceptivos y tienen acceso irrestricto a la información y a los servicios relacionados con dichos insumos. A medida que los países en vías de desarrollo luchan por lograr la seguridad anticonceptiva en medio de una creciente demanda de anticonceptivos, son más concientes del impacto que implica dirigir los recursos hacia grupos vulnerables y de su capacidad de garantizar un acceso equitativo para todos, inclusive para las mujeres VIH-positivas. El hecho de satisfacer las necesidades de planificación familiar de las mujeres VIHpositivas es un componente fundamental de la lucha contra el VIH/SIDA y para alcanzar los objetivos de desarrollo internacional. Sin embargo, por lo general, los planes de la DAIA no se ajustan en forma satisfactoria a las necesidades especiales de las mujeres VIH positivas. Entre los desafíos para alcanzar a este grupo marginal se incluye: una selección limitada de métodos anticonceptivos accesibles, falta de asesoramiento informado con respecto a las opciones anticonceptivas adecuadas, estigma y discriminación que dificultan su capacidad de acceso a la información y a los servicios de atención médica y barreras operativas que evitan que los profesionales de la salud proporcionen una atención médica efectiva. Si se logra que este grupo pueda acceder a la información, servicios e insumos elacionados con la planificación familiar puede tener un impacto significativo sobre la epidemia del VIH/SIDA y las intervenciones que superen satisfactoriamente los desafíos pueden contribuir a alcanzar este objetivo. La Organización Mundial de la Salud, OMS, (WHO, por su sigla en inglés) identifica cuatro etapas de prevención de la transmisión perinatal del VIH en las que las mujeres necesitan apoyo: (1) prevención de la infección de VIH en mujeres, especialmente en mujeres jóvenes en edad reproductiva; (2) prevención de embarazos no planeados en mujeres VIH-positivas; (3) prevención de la transmisión de madre a hijo; y (4) apoyo a las madres VIH-positivas y a sus familiares (WHO, 2003). Un plan de la DAIA integral concuerda con el apoyo a las mujeres durante las cuatro etapas y puede tener un impacto directo sobre el éxito de las etapas dos y tres, disminuyendo las barreras a las que se enfrentan las mujeres VIH positivas para acceder a los insumos, servicios e información sobre planificación familiar (PF). En este informe se describe la importancia de garantizar la disponibilidad de insumos anticonceptivos para las mujeres VIH-positivas. Asimismo, revisa las barreras comunes a las que se enfrentan las mujeres VIH-positivas cuando intentan acceder a los servicios de PF1 e ilustra las intervenciones que pueden aumentar la posibilidad de superar dichas barreras.
    English
    PF Issues_Spanish.pdf
  • El objeto de este breve informe es ayudar a los gobiernos nacionales y subnacionales y directores de programas para que trabajen en forma conjunta para alcanzar sus objetivos de la DAIA. Aún cuando la autoridad y la responsabilidad se transfieran a niveles inferiores de gobierno, una iniciativa de la DAIA efectiva requerirá el liderazgo, compromiso y coordinación del gobierno central. Este breve informe incluye cinco temas que se deberian tratar al intentar de lograr la disponibilidad asegurada de insumos anticonceptivos en niveles inferiores de gobierno: (1) política; (2) planificación estratégica; (3) finanzas; (4) logística, adquisición y administración de recursos humanos; y (5) participación comunitaria. En cada tema, el informe propone estrategias para la capitalización de oportunidades al trabajar en un entorno descentralizado al mismo tiempo que se enfrentan los desafíos relacionados. Asimismo, se incluyen ejemplos de los países que han progresado con respecto a la disponibilidad asegurada de insumos anticonceptivos en entornos descentralizados.
    Spanish
    PF6_Spanish.pdf
  • Ce résumé est un guide ayant pour but d’aider les gouvernements nationaux et sous-nationaux2 et les responsables des programmes à travailler ensemble pour atteindre les buts de la SC de leur pays.Même lorsque les pouvoirs et les responsabilités sont délégués au niveau local, une initiative réussie de SC n’en demande pas moins la direction, l’engagement et la coordination du gouvernement central. Ce communiqué est organisé en cinq domaines d’activités essentielles dans cette quête vers la sécurité contraceptive aux niveaux inférieurs du gouvernement: 1) politiques, 2)planification stratégique, 3) financement, 4) logistique, achat et gestion des ressources humaines, et 5) participation communautaire. Pour chaque domaine, le communiqué propose des stratégies pour tirer profit des possibilités dont s’accompagne la décentralisation tout en cherchant à surmonter les obstacles et relever les défis qui se présentent. Des exemples sont également présentés de pays qui ont réussi à progresser vers la sécurité contraceptive dans un milieu décentralisé.
    French
    PF6_French.pdf
  • This brief is intended to help national and subnational governments and program managers to work together to achieve their countries' CS goals. Even when authority and responsibility are transferred to lower levels of government, a successful CS initiative still requires the central government's leadership, commitment, and coordination. This brief is organized into five areas that focus on issues to be addressed while aiming to achieve contraceptive security at lower levels of government: (1) policy; (2) strategic planning; (3) finance; (4) logistics, procurement, and management of human resources; and (5) community participation. In each area, the brief proposes strategies for capitalizing on the opportunities for working in a decentralized setting while addressing the associated challenges.
    English
    PF6_English.pdf