Malawi Matching Funds Activity Yields Family Planning Results

Two HP+ activities in Machinga, Malawi increased knowledge and demand for family planning services through a matching funds scheme that HP+ devised to encourage multiple districts to boost local investment in family planning while strengthening capacity to fulfill costed implementation plan priorities. HP+ provided funds to match domestic resources allocated by the District Health Office (DHO) for key family planning activities. One of the activities, a community mobilization campaign that raised awareness of available family planning services, led to women in the community opting for modern contraceptive methods rather than natural methods, which they found ineffective in delaying pregnancy. Also through the matching funds activity, the Machinga DHO trained providers from five health facilities on the Family Planning Reference Manual developed by Ministry of Health, with support from the HP+ and OPTIONS Wish projects. Through the training, providers learned that some of their approaches were outdated, such as offering family planning methods to women six weeks after delivery. Now, the providers, who will further train other providers, know they should discuss family planning method choice even before delivery. These approaches will be integrated within antenatal care services. Overall, these efforts reflect a “learning by doing” approach to capacity strengthening in policy implementation. To secure matching funds, HP+ coached actors in Machinga (and other districts) to review the costed implementation plan, identify the highest priority activities for domestic and HP+ support, finalize their matching funds application and detailed budget, and implement and report on activities. 

HP+ Supports Launch of FP2030 Updated Costed Implementation Plan (CIP) Resource Kit

On May 26, 2022, HP+ participated in FP2030’s CIP Toolkit launch webinar, presenting key findings from an HP+ analysis of lessons learned through the CIP process in 30 countries. Both quantitative and qualitative data were collected, providing a wide range of detailed insights into strengths and weaknesses of existing CIP processes. HP+ developed four new tools for the updated toolkit:  

1. Deciding to Develop a Costed Implementation Plan: Seven Considerations to Inform Country Decision Making
2. Stewardship for the Execution of Costed Implementation Plans: Considerations for Stakeholders
3. Conducting a Costed Implementation Plan End-Line Review: A Guide for Stakeholders
4. Approaches for Mobilizing Resources for Family Planning Costed Implementation Plans: Examples of Success

HP+ also revised three existing tools on team roles and responsibilities for CIP development and execution; the 10-step process for CIP planning, development, and execution; and an illustrative CIP development timeline. These efforts have focused on making the CIP planning, development, and execution processes more user-friendly, effective, and efficient for stakeholders on a global scale. The new tools were created to fill gaps identified in the previous resource kit and enable stronger CIP management and implementation. 

Niger Ministry of Health Adopts Second Costed Implementation Plan for Family Planning

Under the leadership of the Ministry of Health, HP+ West Africa supported the development of a new costed implementation plan for 2021–2025. The operational plan details the program activities and costs associated with achieving national objectives, providing clear information at the program level on the resources needed to promote voluntary, safe, and affordable family planning and provide better access to family planning services for all. Adopted by family planning stakeholders in Niger in August 2021 and now being disseminated, the plan details targets, actions, and indicators for success and suggests redirecting funding to priority needs. The adoption of the plan translates Ouagadougou Partnership and FP2030 commitments into concrete actions and constitutes a genuine advocacy tool for the mobilization of resources for family planning. 

Madagascar’s President Commits to FP2030 Objectives

At a roundtable event held on September 28, 2021, the president of the Republic of Madagascar, ministry officials, and technical and financial partners signed the country's official FP2030 commitment. HP+ supported the Ministry of Public Health to organize and facilitate the event to renew the country’s commitment to family planning, including a pledge to increase family planning resources. HP+ also supported efforts to define the country's objectives for 2030 and presented the economic incentives and investment case for family planning at the roundtable. The gathering brought together 200 participants, including senators, parliamentarians, government ministry officials, technical and financial partners, and leaders from civil society. The next step is for the Family Planning Committee, led by the Directorate of Family Health, to develop a 2022–2023 national costed implementation plan to achieve Madagascar’s FP2030 commitments through improved communication, domestic resource mobilization, service delivery and access, and monitoring and evaluation. 

Youth Advocates Provide Input into Madagascar’s Costed Implementation Plan for Family Planning

Youth in Madagascar have provided valuable input during a review of Madagascar’s 2016–2020 Costed Implementation Plan (CIP) for Family Planning and provided insight to be considered for the next CIP. The participatory and multisectoral CIP review, for which HP+ provided technical support, included the perspectives of youth stakeholders as members of the family planning committee. Their insight was particularly valuable as Madagascar’s CIP addresses the unique needs of young people in a country where nearly 60 percent of the population are under the age of 25. The CIP review revealed that the modern contraceptive prevalence rate among young people increased by 4 percentage points from the CIP’s introduction in 2016 to its end in 2020. Furthermore, recommendations from a May 2021 virtual consultation, led by the Youth Advocacy Association as part of the CIP gap analysis, will be factored into the next CIP (2021–2025). Their proposals include improving contraceptive supply chains, continuing to strengthen implementation of the 2018 law on reproductive health and family planning, bolstering government commitment to family planning, and improving service offerings that meet the specific needs of young people. They requested specific strategies targeting youth and recommended greater engagement of youth networks, nongovernmental organizations, and associations in family planning demand creation.    

Final Review Report Details Madagascar CIP Achievements

Madagascar’s Ministry of Public Health has published a final review of its 2016-2020 Costed Implementation Plan (CIP) in a new report available through HP+. The CIP is a five-year roadmap that identifies evidence-based strategies and approaches for improving family planning programs and estimates the costs of implementing those strategies. The final review report examines and details the CIP achievements using Organisation for Economic Co-operation and Development (OECD) criteria of effectiveness, efficiency, coherence, relevance, impact, and sustainability. The effort was part of the project’s commitment to help strengthen Malagasy capacity to develop, implement, and monitor health sector policies and strategies to improve equity and sustainability of health services. Information from the review report, which also includes perspectives of family planning stakeholders in-country and a literature review, will be used by Madagascar stakeholders as they develop the country’s next CIP and to improve the nation’s family planning program. HP+ had previously supported the government of Madagascar’s efforts to develop and implement the national costed implementation plan (CIP) for family planning (2016-2020).  

Madagascar Finalizes Its 2016-2020 Costed Implementation Plan for Family Planning Final Report

Madagascar’s Ministry of Public Health has finalized its final review of the 2016-2020 Costed Implementation Plan for Family Planning. HP+ provided updated gap analysis results and costed implementation plan (CIP) dashboard data, as well as a CIP execution checklist (part of the CIP Resource Kit). The final review report was validated in April by Madagascar’s Family Planning Committee, technical and financial partners, representatives from regional and district health directorates, civil society organizations, and youth networks.  Key successes identified in the review include an increase in the modern contraceptive prevalence rate from 33 percent in 2012 to 41 percent in 2020, representing an estimated 959,000 more contraceptive users. Further, the political environment was improved through passage of the law regulating reproductive health and family planning, ensuring access to reproductive health and family planning services to vulnerable populations, youth, and individuals with disabilities without discrimination. HP+ contributed significant technical and financial support to the development of this law. The Madagascar Ministry of Public Health Family Health Directorate demonstrated strong country ownership and staff capacity throughout the final review process, including through its assessment and validation of all tools and materials used during the review.  

Mali Develops Financial Gap Analysis for Family Planning Costed Implementation Plan

HP+ has completed a financial gap analysis to accompany the Mali Costed Implementation Plan for Family Planning (2019–2023). The analysis was prepared to help Mali’s Sub-directorate of Reproductive Health better implement its costed implementation plan, understand the extent to which activities and strategic areas have been allotted funding, and advocate for future funding to drive achievement of Mali's family planning objectives and larger development goals. The costed implementation plan, completed in July 2019, is a five-year roadmap designed to help the Malian government achieve its family planning goals.

HP+ Develops a Guide on Integrating Family Planning Interventions into District Implementation Plans in Malawi

HP+ has developed a guide on how to incorporate the priorities of Malawi’s national costed implementation plan for family planning into local district-level plans. The guide calls for a three-step approach to helping councils increase their awareness of national objectives and develop district-level plans based on the Costed Implementation Plan (CIP) for Family Planning (2016–2020). HP+ collaborated with the Ministry of Health’s Reproductive Health Directorate to facilitate implementation in several districts by establishing multisectoral task forces to facilitate the integration of priority plan activities into district implementation plans. One district, Machinga, allocated its own resources to implement family planning activities for two years in a row, while other district task forces directed available donor resources to family planning activities. The guide is intended to enable others to replicate and refine this approach beyond the life of the project. While the guide was developed for Malawi's health context, it could be adapted and used in other decentralized settings.

Family Planning Stakeholders in Togo Use Data to Track Progress

In Togo, HP+ West Africa recently convened a gathering of national and regional stakeholders to collect, review, and validate data to update the costed implementation plan (CIP) for family planning performance dashboard. Updating the dashboard—a critical first step in the CIP execution process—supports the country to monitor progress toward achieving its family planning goals, which include reaching a contraceptive prevalence rate of 22 percent by 2022 (from 17 percent in 2017). Training stakeholders on use of the CIP tool and dashboard supports family planning decision making and helps to focus family planning activities and implementation on meeting CIP goals.

Madagascar Uses Performance Data to Review CIP and Generate Recommendations

On August 25, HP+ supported Madagascar’s Family Health Directorate (DSFA) within the Ministry of Public Health to conduct a virtual semi-annual review and performance monitoring meeting of the country’s costed implementation plan (CIP) for family planning. Using data generated by an online CIP dashboard developed by HP+, meeting participants were able to monitor progress of CIP activities and indicators, identify bottlenecks and solutions, and provide recommendations for the next iteration of the plan. Since adoption of the CIP in 2016, the country’s contraceptive prevalence rate has improved from 33 to 44 percent and maternal deaths averted by family planning have increased from 500 to 2,600.

Tanzania Stakeholders Reflect on Traction Gained Executing the Family Planning Costed Implementation Plan

This month, HP+ and Tanzania’s Reproductive and Child Health Section of the Ministry of Health, Community Development, Gender, Elderly, and Children worked together to convene the first semi-annual family planning implementers meeting. The meeting, which was held virtually, focused on review and discussion of current progress in implementing the country’s family planning costed implementation plan (CIP) related to subnational roll-out, program and funding coverage, and achievement of results. According to performance data collected for the first year of CIP, Tanzania is on track or gaining traction to meet performance targets for six of ten results; progress has been delayed for the remaining four results.      

In Niger, a Local Leader Makes Family Planning a Priority

A local leader in Niger has invested FCFA 57 million (US$97,500) in the purchase of family planning products and the financing of income-generating activities for women in his municipality—about 2.7 million individuals—as a result of HP+ advocacy. Following an HP+-supported regional workshop aimed at engaging communities in advocacy to support costed implementation plans for family planning, Dosso Mayor Issoufou Idrissa mobilized the funds for the rehabilitation of health centers, purchase of family planning commodities, and financing of income-generating activities. Since January 2020, 966 new users have accessed health services in the municipality are a result of this investment.

Webinar Introduces CIP Performance Dashboard as Performance Monitoring Tool

An HP+ webinar delivered by Christine Lasway and Laura Hurley on May 14 – What’s Measured Matters: Monitoring Family Planning Costed Implementation Plans – presented an overview of the CIP Performance Dashboard, a data management tool to track CIP performance targets. The discussion included case studies from Madagascar and Ghana, countries using it to monitor execution of their CIPs. The CIP Performance Dashboard, available in Excel and now as an online tool, was developed based on DHIS2. This webinar is ideal for stakeholders looking for a strategic planning performance monitoring tool. 

Burkina Faso's Stewardship of Family Planning Access is Model for the Region

In December 2019, Burkina Faso’s Ministry of Health launched a monitoring and evaluation (M&E) plan to measure its progress on increasing contraceptive access. The finalization and implementation of the Costed Implementation Plan M&E plan is an important milestone showcasing the country’s commitment to increasing modern contraceptive prevalence, which at 30.7 percent, is the highest in the West Africa region. The M&E plan was developed following the formation of a multisectoral steering committee and thematic groups comprised of public, private sector and civil society representatives who advocated for a tool to track progress, a model for the region. Read our news story for more details.

Institutionalization of New Web-Based CIP Dashboard in Madagascar

In Madagascar, the Ministry of Public Health’s Family Health Directorate (DFSa) is using a web-based dashboard tool to facilitate data analysis and visualization as part of its semi-annual costed implementation plan (CIP) execution review meetings. HP+ developed the dashboard and trained the DSFa and CIP committee on its use. The dashboard, which is owned by CIP committee members, allows for strategy adaptation and orientation for improved family planning programming and CIP implementation in the country. The dashboard encourages country ownership of the CIP process and progress toward achieving its goals, including increasing the contraceptive prevalence rate to 50 percent.

Ghana on Track to Meet Family Planning Costed Implementation Plan Performance Milestones

Recent data indicates that Ghana is on track to meet the milestones in its costed implementation plan for family planning, including achieving the goal of increasing modern contraceptive prevalence among currently married women from 22.2% (2014) to 29.7% (2020). HP+ has supported the development of performance indicators to monitor execution of key results and established and rolled out a web-based performance monitoring dashboard to government stakeholders and implementing partners. Ghana is estimated to have added 590,000 contraceptive users since 2012, bringing coverage to a total of 1,676,000 users and averting 213,000 unsafe abortions and 1,100 maternal deaths.

Tanzania Scales Up Execution of its National Family Planning Costed Implementation Plan

In Tanzania, 90% of district councils (167) have been oriented to the country’s national family planning costed implementation plan (CIP) and supported to develop action plans for inclusion in councils’ 2020/21 budget requests. In 2019, HP+ supported the Ministry of Health, Community Development, Gender, Elderly, and Children in national dissemination of the CIP. These efforts involved supporting the facilitation of dissemination workshops to enable local government authorities to understand and buy into the plan—important steps toward increasing budget allocation for family planning at the local level.

Mali Minister of Health Launches New Costed Implementation Plan

Mali’s new Minister of Health Michel Hamala Sidibe launched the country’s costed implementation plan (CIP) in Bamako on July 16th, at an event featuring the USAID family planning advisor Patrick Coulibaly and the UNFPA country representative Josiane Yaguibou. Capitalizing on the growth in modern contraceptive prevalence rate between 2012/13 and 2018 (9.9%-18%), the CIP goal is to reach 30 percent by 2023. The CIP was developed with support by USAID through the Health Policy Project, which worked closely with Technical Advisor of the Minister, Dr. Mohamed Berthé, who is also the FP2020 focal point, and who ensured Ministry of Health and Social Affairs leadership throughout the process. Local news coverage of the event featured HP+ policy and advocacy advisor, Rokia Sissoko, who emphasized the collective effort of many stakeholders. Shanda Steimer, the USAID Mali health team lead, also attended the event.

Ouagadougou Partnership Donors Applaud HP+ Family Planning Efforts

On April 29 and 30, a caravan of Ouagadougou Partnership donors visited Mali to view progress that has been made in achieving family planning objectives and to understand existing challenges to these efforts. Since February, HP+ Mali has led the process of finalizing the country’s second generation costed implementation plan for family planning (CIP) that includes plans to accelerate modern contraceptive prevalence in the country from 16 percent in 2019 to 30 percent by 2023. The donor caravan deemed the CIP process to be “inclusive” of all necessary actors, highlighting the success of HP+ Mali in convening and executing the planning process. The project is in the process of finalizing the CIP in line with final recommendations from the pilot committee and aims to launch the plan in June 2019.

15th Annual National Campaign for the Promotion of Family Planning Launches in Mali

This year’s annual national campaign for the promotion of family planning in Mali, "Multisectoral commitment to achieving the objectives of sustainable development through family planning," was launched on December 17 under sponsorship of the First Lady of Mali, Keita Aminata Maiga. For the second year in a row, HP+ was recognized by the Minister of Health and Social Affairs as the recipient of a Certificate of Acknowledgement of Family Planning Champions for its technical assistance efforts to provide the country with a consensus-driven costed implementation plan. This campaign is one of the key priorities of the Ministry of Health and Social Affairs aimed at reducing maternal and infant mortality nationwide.

HP+ Recognized as Family Planning Champion by Mali’s First Lady

 On May 15, during the official launch of Mali’s 2018 National Family Planning Campaign, the USAID-funded Health Policy Plus (HP+) project was awarded a certificate of recognition as a family planning champion by First Lady of Mali, Mrs. Keita Aminata Maiga. The certificate serves as a recognition of HP+’s valuable contribution to the Division of Reproductive Health over the past two years, particularly in capacity strengthening, improving coordination of family planning stakeholders, and in support of the country’s costed implementation plan. At the event, Dr. Boré Saran Diakité, Head of the Division of Reproductive Health said, “HP+ stands out for the relevance of their support, the quality of the products produced with their support, and their partnership with all the [family planning] stakeholders in Mali.” Rokia Sissoko, who accepted the certificate on behalf of HP+, thanked the First Lady for her collaboration in improving the lives of women and children in Mali. The launch—which took place as part of Mali’s annual event to provide family planning outreach and services—attracted approximately 2,500 people, including representatives from USAID, WHO, UNFPA, and various implementing partners. 

Burkina Faso Increases Budget for Family Planning Commodities

Burkina Faso’s Ministry of Finance's 2018 general budget includes a line item for purchase of contraceptives, which represents 68% of the total estimated cost of contraceptives the country requires for 2018. The Ministry is recommending an increase from CFA 500 million to CFA 1.300 billion to purchase contraceptives. With this recommendation, Burkina Faso is demonstrating political will and prioritizing family planning for investment.  No other Francophone West African country has committed this level of domestic resources for contraceptives to date.  

The decision to increase domestic resources for family planning commodities is based on the activities outlined in Burkina Faso’s new Costed Implementation Plan (CIP 2017-2020) for family planning. The costed implementation plan’s stated objective is to attain a modern contraceptive prevalence rate (mCPR) of 32% by 2020. Burkina Faso’s current mCPR is estimated at 22.5%, so given that objective Burkina Faso’s contraceptive need for 2018 will cost about CFA 1.900 billion. USAID/West Africa’s Health Policy Plus activity supported Burkina Faso’s multi-sectorial reproductive health steering committee to develop the costed implementation plan. 

This  story originally published by USAID WA in its newsletter, written by Eleonore Rabelahasa, USAID/West Africa

Sierra Leone Embraces Use of CIP Data in Budget Planning

To fulfil national family planning commitments, countries must be strategic in how they invest limited resources. A costed-implementation plan (CIP) is a multi-year roadmap designed to help governments achieve their family planning goals by the most effective, efficient means possible. In May 2017, Sierra Leone’s Ministry of Health Services and its partner the UNFPA incorporated contraceptive commodity forecast data into their procurement planning.  The data, based on the anticipated method mix and growth in contraceptive use generated by increased support for family planning, was drawn from Sierra Leone’s CIP, which is currently being developed with support of the USAID-funded Health Policy Plus (HP+).  Evidence-based decisions using the CIP are already helping the ministry to calculate its budget requirements and will help ensure a sustainable supply of family planning commodities throughout Sierra Leone.   

Pakistan’s Women Leaders Advocate for Youth Family Planning Services

Participants in the USAID-funded Health Policy Plus (HP+) project’s Women's Leadership initiative in Pakistan have had tremendous success, directly contributing to policy and other efforts aimed at expanding outreach and access to family planning services for youth. Collectively, the women successfully advocated for the inclusion of youth-specific indicators to monitor the country's costed implementation plan and developed youth-specific guidelines for Pakistan's Manual of Standards for Family Planning Services. They provided recommendations to Sindh province's FP2020 working group and to the government—the latter of which ensured the funding and operationalizing of critical youth-friendly activities. 

These wins come on the heels of three HP+ Women's Leadership for Family Planning workshops focused on increasing the women's confidence, capacity, and connections to achieve health policy and governance outcomes. HP+ initiated the Women's Leadership program in Pakistan late last year. The last of the three workshops was held in April. 

Now, HP+ is continuing to support the women in their advocacy efforts and tracking their successes in our unfolding story on their progress. 

Evidence of the Impact of Contraceptive Prevalence Supports Official Statements

Appearing at Madagascar’s First National Family Planning Conference (September 13–16), the head of the Ministry of Health (MOH) family planning division presented on findings from an application of ImpactNow, a USAID-supported model available through HP+. The division head highlighted that Madagascar could prevent over 4 million unintended pregnancies and 12,000 maternal deaths by 2020 if modern contraceptive prevalence increases to 50 percent among married women. The presentation material is also available as a brief. 

At the conference conclusion, the MOH director of family health presented and highlighted the importance of key elements of the Costed Implementation Plan (CIP) for family planning. The CIP development process has been guided by HP+ and is close to completion in Madagascar. The country will join other FP2020 countries with a comprehensive roadmap to achieve its FP2020 goals by late 2016.