HP+ hosted an interactive, online policy forum on August 9, 2022, on how a stronger enabling environment for family planning can reduce contraceptive discontinuation. While much attention is given to reducing unmet need and the uptake of modern contraception, much less attention is given to helping women continue to use their methods once they start. Yet almost one in three new users of family planning discontinues within 12 months of starting for a variety of reasons. The event’s speakers, including Sara Stratton and Sandra Mapemba from HP+; Rahal Saeed from Palladium’s USAID-funded NPI EXPAND project; and Heidi Quinn from the International Planned Parenthood Federation, joined HP+’s Jay Gribble and 101 participants to discuss how program efforts can be strengthened to reduce discontinuation while helping women achieve their reproductive goals. Speakers offered examples from their work globally and in Kenya, Malawi, and Pakistan. The policy forum was the culmination of HP+’s blog series, “Rethinking Contraceptive Discontinuation: Are Solutions Being Overlooked?,” where a variety of authors detailed some of the emerging approaches, such as counseling and services, supply chain, self-care and digital solutions, financing, the development of new methods, and community norms, to address contraceptive discontinuation.
Health Policy Plus’s health financing lead, Eduardo Gonzalez-Pier, participated in the Annual Health Financing Forum (AHFF) on June 14–16 in Washington, DC. The annual event was co-hosted by the World Bank, USAID, and the Global Financing Facility. This year’s meeting, which assembled government officials, policy experts, and donor agencies from the health and financing sectors focused on mobilizing and pooling funds to pay for primary healthcare. Dr Gonzalez-Pier joined three deep-dive panels that explored how to protect primary healthcare resources through the frontline, building trust in health financing decisions for universal health coverage, and the role of taxes to promote health and increase funding. The meeting agenda was designed around the new “Lancet Global Health Commission on Financing Primary Health Care: Putting People at the Centre,” which promotes the vision that healthcare needs to be more effective, responsive, equitable, comprehensive, and primary healthcare-centered to be fully aligned with the objectives of universal health coverage. The forum discussions made evident that spending more and spending better on primary healthcare requires a balanced technical and political approach that needs to be supported by data-driven collaborative research, adoption of implementation science, and a deep understanding of political economy considerations. Promoting increased and open cross-country dialogue on lessons learned from locally relevant universal health coverage experiences is essential as countries emerge from the pandemic and set health systems back on track to meet the 2030 agenda.
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:
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.
The Global Digital Development Forum was held virtually on May 4 and 5, where select HP+ staff joined leaders from around the world to discuss the changing paradigm for implementing development in a digital world. The forum explored three key areas of digital development: climate change response, emerging technologies, and locally created technologies. HP+’s Meryn Robinson presented on “Digital Solutions for Family Planning Policy,” sharing how digital solutions can transform the development and implementation of health policies so they are more efficient, responsive, transparent, and effective. HP+’s Ida Kagone and Ryan Ubuntu Olson led a session alongside TechChange’s Allison Prell, where they shared recent work to build the policy advocacy capacity of rising youth leaders representing 23 countries in francophone West Africa. The session, “Reaching Youth Leaders in West Africa through Innovative Locally Led Approaches to Advance Health Policies,” showcased how they used a virtual platform to inspire and enlighten rising youth leaders to understand and take action on important policies that affect their health and the health of their local communities. Jointly, the two HP+ sessions gathered 167 attendees. Recordings of sessions are available for conference registrants on the GDDF website.
Three years in the making, HP+-supported work has been published in the February edition of Global Health: Science and Practice. Co-authored by HP+ partner staff and in collaboration with colleagues from USAID, Harvard, Johns Hopkins University, and Save the Children, the article focuses on a study of “Global Research Priorities for Understanding and Improving Respectful Care for Newborns.” The study developed, for the first time, a prioritized list of research questions focusing exclusively on respectful care for newborns. It highlighted the absence of agreed-upon terminology and tools needed to advance both theoretical and practical efforts. This list should guide researchers and other stakeholders in developing further research.
Leading up to UHC Day, a new piece on “The Elusive Goal of Universal Health Coverage” by HP+’s health financing lead, Eduardo Gonzalez-Pier, was published by New Security Beat on December 10, 2021. In the article, he argues that the COVID-19 “pandemic has been a stark reminder of the human and economic costs of not having made larger and smarter investments in health" and that "we should not let a health crisis of this magnitude go to waste." The article closes with important lessons learned, with a leading takeaway being the need to invest in health system strengthening, which not only saves lives but also delivers high rates of economic returns.
Effective advocacy to increase family planning budgets is an intricate and complex endeavor. A new brief introduces the HP+ budget advocacy approach and provides examples of the tools and approaches employed to support increased funding for family planning. The brief explains how HP+ and its predecessor projects have built on expertise in family planning advocacy to tackle budget advocacy using an approach that addresses underlying causes for budget shortfalls, advances systemic change, and strengthens the capacity of budget advocates to use evidence to make the case.
On November 30, 2021, HP+ hosted a thought-provoking webinar discussion on the challenges and opportunities in catalyzing the private sector’s investment in health, including for family planning commodities. The speakers, including Denise Harrison from USAID’s Commercial, Security and Logistics division of PRH and Monisha Ashok of the Center for Innovation and Impact joined with Palladium and Salient Advisory representatives and Caspian, an Indian venture debt company investing in health, to discuss findings of recent studies of commercial engagement in the family planning and health products space in India and four countries in Africa. The studies found challenges to attracting commercial sector investment in each region were similar and include financing, regulatory, and pricing constraints. However, discussions highlighted innovations that could be applied and supported by patient and risk tolerant capital provided by donors to mitigate risk for investors such as development impact bonds, credit funds, and multistakeholder grant-making mechanisms to support innovation and scale up. The speakers noted that rapid advances of digital innovations necessitated by the COVID-19 pandemic are demonstrating that capacity and opportunities exist. Speakers challenged listeners and one another to be bold and risk-averse in pursuing and financing innovations as this field of blended financing advances.
Family planning strategies, policies, programs, and advocacy can be more effective if they are grounded in a comprehensive understanding of the accountability ecosystem for family planning. To help stakeholders better understand the accountability ecosystem, HP+ has published a Legal and Policy Framework to Accountability Approach, which was applied in Zambia in 2020. The framework document provides an overview of a 10-step process that can be used to guide organizations aiming to understand the higher-level legal and policy frameworks within their country and how these influence accountability relationships, structures, and mechanisms for family planning. With a solid understanding of the accountability ecosystem for family planning, stakeholders can design more strategic advocacy campaigns, establish connections with new partners, and address underlying systemic challenges to achieving family planning objectives in strategies and policies.
In a new policy brief posted in October 2021, HP+ explores important donor considerations for evaluating potential blended finance opportunities. The brief describes blended finance as the strategic use of public and philanthropic resources to mobilize private capital for development outcomes, which can be used to jump-start and advance solutions to address challenges in family planning financing. Topics covered include types of investors to target for partnership, types of blended structures, and the donor financing required to catalyze private investment. The brief also weighs the pros and cons of investing in health funds and highlights several investment opportunities with potential to expand the use of family planning and primary healthcare in low- and middle-income countries, while generating a viable market return for investors.
HP+ has published key takeaways from an expert consultation to advance dialogue and find common ground for including a gender lens in family planning financing, recognizing that gender is one of multiple factors that inhibit many individuals’ access to family planning. The May 2021 consultation convened family planning financing and gender experts from USAID, nongovernmental organizations, and the private sector to discuss how to better integrate gender into family planning and health financing systems to make access to family planning information and services more gender-equitable for all clients. In addition to the key takeaways, the brief provides the group’s perspectives, recommendations, and practical next steps.
A review published in the October edition of the Bulletin of the World Health Organization by the partnership on High Impact Practices in Family Planning, with HP+ Senior Technical Advisor for Family Planning Sara Stratton as the lead author, looked at how equity is measured in family planning programs. The review of eight studies revealed variations in how equity is defined, with most addressing economic barriers to contraceptive use. Drawing on the findings, the authors propose a more comprehensive approach for examining and addressing inequities in family planning. The article recommends expanding how inequities are characterized and how they are measured and evaluated to go beyond wealth as the sole driver of inequity and contraceptive use as the primary outcome.
Following a request by the USAID Kenya Mission, HP+ conducted a high-level budget advocacy training for all USAID implementing partners (IPs) during the latest USAID Chief of Parties’ meeting. The training was aimed at sharing HP+ knowledge and expertise on identifying key opportunities and bottlenecks along the medium-term expenditure framework (MTEF) process to effectively influence budgetary allocations for priority health programs. It is expected that this engagement will enable collaboration between HP+ and IPs support resource mobilization efforts across national and county governments through the MTEF budget process, thereby facilitating efficient allocation and mobilization of domestic resources to sustainably finance key health programs.
Family planning is a key part of Liberia’s first private sector engagement strategy, advanced during a recent workshop in Monrovia supported by USAID and HP+. “The Ministry of Health has recognized the need to engage effectively with the private sector if we are to succeed in our mission,” Assistant Minister George Jacobs told the assembled Ministry of Health staff and representatives from professional associations, federation and regulatory bodies, nonprofit organizations, and the private health sector. The strategy for 2021–23 calls for private facilities offering family planning services to have regularly trained providers, consistent with the ministry’s family planning costed implementation plan. Government approval of the strategy is expected by fall 2021. Following that, the Ministry of Health will begin implementation with a multisectoral technical working group led by the ministry’s newly designated focal point for private for private sector engagement. The group will bring together public and private sector actors, begin rollout of the strategy at county level, and undertake a master training for key ministry focal persons.
Achieving improved health outcomes through multisectoral actions was the focus of an online policy forum convened by Health Policy Plus on June 22, 2021. The session—A Multisectoral Endeavor Called Health: Working Across Sectors for Quality and Sustainability—delved into the importance of designing cross-sectoral interventions and building strong collaborations, such as networks that focus on common goals and bring success to all their members. Clive Mutunga of USAID opened the discussion and provided insights on how multisectoral approaches strengthen health policy and sustainability. Building on his remarks, lead authors from the HP+ blog series “A Multisectoral Endeavor Called Health” shared some lessons learned around youth, nutrition, public and private sector collaboration, and governance. In a panel discussion led by Jay Gribble, deputy director for HP+, panelists addressed challenges faced when coordinating across silos, the importance of understanding context, the need to have good communications, and the role of stakeholder engagement. Speakers addressed audience questions around adapting strategies for sustainability in response to the COVID-19 pandemic and how to work with global organizations to support countries in undertaking multisectoral action.
HP+ is supporting FP2030, the next iteration of the FP2020 global effort to enable 120 million more women and girls to use contraceptives. Participating in the new family planning commitment-making process, HP+ health financing experts will provide feedback on country commitments and act as a one-on-one resource for country focal points. A number of reports and briefs developed under HP+ are included in FP2030’s Incorporating Domestic Financing in Commitments brief as part of the FP2030 Commitments Resource Kit developed for countries to use as they develop their family planning financing commitments. The kit includes HP+ documents on legal, regulatory, and financing considerations of universal health coverage, health insurance, catalytic investments for family planning, and the Family Planning Financing Roadmap.
As part of the global effort to equitably supply vaccines to countries in need, HP+ convened academic and program implementation experts to share best practices, lessons learned, and tools to support rollout in low-resource countries. Under an accelerated effort, developing countries will be supported by the COVAX mechanism to immunize 20 percent of the population in 2021. The target group, scale, and intensity of this immunization campaign is significantly different than those handled by health ministries and immunization programs in the past. Joining the discussion to explore this were Ramon Soto of HP+’s COVID-19 response team in Honduras, Dr. Laila Woc-Colburn from Emory University’s School of Medicine, Dr. Edwin Asturias from the University of Colorado Denver, and Danielle Darrow de Mora of FHI 360. Key issues emerging from the discussion include strategies to deliver vaccines to hard-to-reach populations including migrants and indigenous populations and the need to include communities in rollout planning (microplanning). Panelists proposed effective strategies on the prevention, identification, and management of rare adverse events.
In a recent blog post, HP+ deputy director Sara Bowsky argues that community healthcare workers and advocates for the marginalized need a seat at the table where governance decisions are being made. The call comes as the COVID-19 vaccination rollout has exposed inequities in access in both the United States and developing countries. She weighs the advantages and disadvantages of local and national responses to the pandemic. “But what’s needed is a balanced, adaptable approach—one that draws on the power and actions of communities in conjunction with federal and state agencies, and the collaboration needed to reinforce such a response,” she writes.
HP+ is exploring three new areas for implementing blended finance in family planning as the first step in developing financing models for USAID consideration. In December HP+ virtually convened 27 experts—USAID representatives, implementing partners in family planning, development finance experts, and impact investors—to explore how stakeholders can use blended finance to help expand modern contraceptive use. Three areas for opportunity came into focus: (1) market introduction/shaping and market access, (2) innovation in distribution channels and point-of-sale, and (3) new direct-to-consumer technologies. Blended finance is the strategic use of public and donor resources to mobilize private capital to achieve development outcomes, including addressing health. Such arrangements have been used to address climate change, access to clean water, and other economic development issues.
How best to improve maternal health access and quality in resource-constrained settings was the focus of an online policy forum convened by HP+ on March 23. The session—Quality v. Coverage: Is There a Trade-off in Financing Maternal Health?—highlighted the continued high level of maternal mortality despite increases in facility-based births. It explored the push and pull that policymakers must face when planning and allocating resources aimed at increasing access and quality. Led by Elena Ateva, HP+’s maternal health lead, the discussion featured Alison Morgan of the Global Financing Facility, Nana Twum-Danso of the Rockefeller Foundation, and Aparajita Gogoi of the White Ribbon Alliance/India. In addition, HP+’s Dorit Stein shared recommendations from a research study on strategic health purchasing reforms for maternal and neonatal health services and Aparajita Gogoi shared results from the What Women Want campaign and accompanying dashboard of women’s responses
While some patients with SARS-CoV-2 infection require hospitalization, most can be cared for at home. HP+ developed a new visual guide, COVID-19 Home-Based Quality Care: A Practical Guide for Healthcare Workers, to help healthcare workers educate patients, their families, and other household members on how to care for patients at home and prevent transmission of the virus. The guide also provides healthcare workers with information on caring for special conditions and identifying the need for timely referral to a hospital. The guide is equally useful for personal use or when caring for a household member with COVID-19. The guide is available for download in Spanish and English from the HP+ website and via the UCSF Open Critical Care Portal.
HP+ worked with the FP2020 Secretariat to develop new guidance on establishing strong “mutual accountability” approaches. The new guidance provides a “how-to” for governments to meaningfully engage civil society throughout the commitment process and how government and civil society can hold each other accountable for meeting 2030 commitments to family planning. The FP2020 Secretariat is rolling out the new guidance, and it will be officially launched in the coming weeks. The accountability guidance builds on HP+’s extensive experience supporting accountability for FP2020 commitments. It promotes including civil society throughout the commitment process—commitment-making, implementation, and tracking—and includes examples derived from an HP+ global review of existing social accountability mechanisms. FP2020 will disseminate this guidance through its country focal persons and other venues. Both the guidance and examples are available online.
Family planning stakeholders can find recommendations for how best to participate and influence the development and implementation of Global Financing Facility-financed projects in the recently published Opportunities for Financing Family Planning Through the Global Financing Facility. The report by Health Policy Plus provides 19 recommendations tailored to the stages of GFF funding: before or following the decision of country selection by the GFF Trust Fund Committee, during the development of the project appraisal document, at the start of the World Bank project implementation phase, and throughout implementation. The report also offers 15 family planning intervention ideas for stakeholders to consider. The GFF, housed at the World Bank, presents an opportunity for low- and middle-income countries to leverage additional funding for family planning. However, its grant mechanisms can be complex and the role of family planning programs within them not always clear. The report also describes how family planning has been included in GFF-funded programs and what family planning interventions are most often financed.
In the lead up to Universal Health Coverage (UHC) Day on December 12, HP+ published two new blogs in our series that highlight multisectoral actions critical to strengthening the health systems through which UHC is achieved. HP+ Nigeria Country Director Frances Ilika shows how multisectoral actions in Nigeria are prioritizing the health sector and removing obstacles to financing to increase enrollment in social health insurance at the state level. A second entry, co-authored by Sachi Jani, Daniel Cotlear, and Sayaka Koseki, discusses the need for the public sector to collaborate with the private sector as a key player in the health market to reach UHC. “The public sector can also improve access to services by leveraging existing private sector networks to expand or improve the efficiency of public health services,” they write. “For example, to improve commodity distribution in Kenya, Palladium used a total market approach to integrate the Kenyan government’s family planning program and contraception distribution with the private sector provider network.”
A new report from HP+ curates resources to estimate maternal health costs, outcomes, and inequities in low- and middle-income settings. The report, Models and Tools for Maternal Health Decision Making, Planning, and Strategy, summarizes seven tools to enable USAID Missions, governments, and implementing partners to better understand how modeling tools and analytic approaches can answer their policy and research questions regarding target setting, prioritization, budget development, and other program issues. The tools can be used to advocate for increased domestic funding for maternal health, inform policy development, and improve project design and performance—which, in turn, can lead to improved maternal health outcomes. This report, which builds on lessons learned in the 2012 Crosswalk of Family Planning Tools, broadens policymakers’ understanding about how models and tools can guide country-level planning and evaluation efforts aimed at reducing women’s morbidity and mortality during pregnancy, childbirth, and the postpartum period.
Quality family planning information and services have not yet reached those with the greatest need. To support progress toward equitable healthcare, HP+ developed an approach for diagnosing inequity in family planning programs. This approach identifies inequities: 1) for a diverse range of disadvantaged subgroups; 2) for various programmatic components of family planning; and 3) at national and subnational levels. Replicable across countries, this approach enables users to easily transform demographic and health survey data to better understand the profile of inequity. This information can be used to develop evidence for policy, financing, and programmatic decisions at national and subnational levels. The new methodology and replication guide describes the approach and provides step-by-step instructions for running the open source code independently. Results from the application of the approach to Uganda can be found in the brief and in this webinar.
A new blog published on the Wilson Center’s New Security Beat by HP+’s Dara Carr -- Reducing the Risk of Pandemic Disease Threats Through Multisectoral Action -- looks past our current “war time” footing on COVID-19 to the importance of sustaining and strengthening multisectoral collaboration to address future shocks. She discusses barriers to multisectoral collaboration and makes the case that existing policy assessment and advocacy approaches, including evidence-generating policy models, can be readily adapted to help address these barriers. The blog is part of a series edited by HP+’s deputy director for family planning, Jay Gribble, titled A Multisectoral Endeavor Called Health. The series examines the benefits of multisectoral actions in responding to the complex environment in which we live and explores the interrelationships between health and other sectors. Other topics in the series discuss the need for multisectoral collaboration to achieve health outcomes; the link between the health and nutrition sectors; the need for a creative and flexible policy and financing environment for effective planning across sectors.
A new blog by HP+ family planning/reproductive health deputy director Jay Gribble and monitoring and evaluation lead Nicole Judice—"Multisectoral Actions: Creative Thinking, Effective Planning, Power Sharing”—seeks to answer the question “Why do so many policies fail to improve the problem they are designed to address?” and offers approaches to collaborate across sectors to improve health outcomes. The blog is the third in the series “A Multisectoral Endeavor Called Health,” which examines the benefits of multisectoral actions in responding to the complex environment in which we live and explores the interrelationships between health and other sectors.
To take a closer look into women’s and girls’ self-articulated demands for their own healthcare, HP+ partner White Ribbon Alliance launched the Brave Voices, Bold Actions: Women’s Health, Rights & You podcast. Season one takes a deep dive into respectful maternity care through the lens of the Respectful Maternity Care Charter. Throughout 10 episodes, the podcast features the voices of brave women, girls, health professionals, and global leaders who discuss changes that should be made to improve sexual, reproductive, and maternal health outcomes, including during the COVID-19 pandemic.
HP+ recently launched revamped message boards in the Family Planning Financing Roadmap website’s Community of Practice to support the sharing of information and resources about family planning financing among decision-makers, policy-makers, and advocates. The Family Planning Financing Roadmap is an online resource, which enables stakeholders to explore specific family planning financing options based on country context. The message boards and other learning materials are expected to help stakeholders identify sustainable ways for countries to fund their family planning initiatives and underpin their long-term health and development goals.
HP+ and FP2020 co-hosted a webinar exploring ways to catalyze a shift in domestic financing for family planning. The webinar introduced a new framework that provides a structure for development partners and advocacy groups to work with country governments to identify and implement catalytic interventions for family planning in advocacy, capacity development, policy, and expansion of the family planning market. USAID’s Susanna Baker provided relevant HIV case studies from PEPFAR’s Sustainable Financing Initiative; Martyn Smith of FP2020 discussed the need for such investments; and Kojo Lokko of the “Challenge Initiative” shared experiences on matching funds and other means to raise domestic resources for family planning.
Following an HP+ analysis that showed the potential impacts on maternal and neonatal deaths and stillbirths that could occur as a result of declining maternal health services due to diverted services and reduced coverage indirectly caused by the COVID-19 pandemic, HP+ partner the White Ribbon Alliance (WRA) developed and launched the “Safer Together” Respectful Maternity Care advocacy and communications campaign. The campaign is being used by WRA National Alliances and other stakeholders in USAID priority countries—including Pakistan, India, Malawi, and Indonesia—to convene stakeholders, advocate for joint action, and disseminate joint messages to women, communities, and providers.
HP+ launches a new blog series today, A Multisectoral Endeavor Called Health: Working Across Sectors for Quality and Sustainability. The series will tackle a range of health development challenges and examine how multisectoral actions can help address complex, interrelated issues. Focusing on high-level objectives, such as achieving universal health coverage and reducing malnutrition, the blog series considers how multisectoral actions contribute to better health status of populations and play a role in achieving economic growth and other development goals. Read the first blog by Jay Gribble, Nicole Judice, and Suneeta Sharma, Unity is Strength: Improving Health is a Multisectoral Endeavor.
The New Security Beat, a Wilson Center blog, published a piece by Sara Stratton, HP+ technical director for family planning and maternal and child health. Pandemic Preparedness: Strengthening Family Planning Policies Today to Secure Essential Services for Tomorrow discusses the COVID-19 response and threats to contraceptive access for women in low- and middle-income countries. It sets out policy recommendations to ensure essential services for women and girls are maintained during this and future pandemic responses, including policies on task sharing with private sector suppliers such as pharmacies; policies on self-injection of contraceptives; and gender-informed policies for a female-dominated healthcare workforce.
A new HP+ blog post shares key lessons to advance universal access to family planning from 16 francophone countries. The lessons emerged from discussions among representatives from 15 francophone countries and Haiti—comprising government, civil society, development partners, and youth—convened by Family Planning 2020. Recommendations from the meeting included the establishment of a legal framework to include family planning in reforms aimed at achieving universal health coverage; using evidence and advocacy to make the case for including family planning in health insurance benefits packages; and strengthening stakeholder capacity to understand and manage health financing schemes.
A blog post co-authored by HP+’s Director for Family Planning and Reproductive Health, Jay Gribble, and gender adviser Beth Rottach discussing the importance of gender considerations amid the COVID-19 pandemic response was published by the Infectious Diseases Society of America’s ScienceSpeaks blog. The article was also cross-posted to the International Conference for Family Planning 2021’s COVID and Reproductive Health blog. These platforms reach a wide audience of infectious disease and family planning experts, offering recommendations to ensure that the ongoing health needs of women and the people who care for them are positioned at the forefront in the global response to the pandemic.
A blog published by Health Policy Plus in the lead up to Universal Health Coverage Day December 12th, considers a governance angle on Universal Health Coverage and identifies three areas that are particularly critical: 1) politically aware and savvy champions committed to inclusive processes; 2) leadership and management that fosters a culture of accountability; and 3) more data on the costs of effective management and administration of UHC programs. The authors, Jay Gribble, the deputy director for family planning and reproductive health and Alyson Lipsky, the project’s lead on governance and stewardship, draw on results from HP+ Nigeria and other case studies as they argue that these governance, stewardship, and accountability elements will be key to reaching UHC goals.
A new blog -- Integrating Services Means Thinking Outside Silos -- published on Science Speaks, the global health blog of the Infectious Disease Society of America, addresses the need for greater integration of family planning and HIV service delivery. The commentary, by Health Policy Plus deputy director for family planning and reproductive health, Jay Gribble, and the project’s technical lead on stewardship, RTI’s Alyson Lipsky, discusses the complexity of integration and explores three policy approaches to support it. They conclude that, “To move forward, health system actors must identify the problem that integration is trying to fix and which approach to integration best addresses that underlying problem. Often, the biggest challenge is breaking down the health system silos and being open to finding new ways to respond to people’s health needs.”
After many months of consultation with leading corporations and NGOs on boosting women’s health and empowerment in the workplace, the United Nations Foundation publicly released the Framework for Corporate Action on Workplace Women’s Health and Empowerment at a UN General Assembly side event on September 23. The framework, which offers a roadmap for gender-responsive policies, practices, and programs with health as the centerpiece of women’s empowerment, was developed by Meridian International—a non-profit, public diplomacy organization supported by HP+. In addition to providing concrete action steps for corporations and global supply chains to support these initiatives, the framework features publicly available tools and resources that can help companies to implement workplace interventions. At a consultation workshop during the Women Deliver conference in June, Meridian’s David Wofford presented the framework’s policy and systems change component that included information drawn from the HP+ Family Planning-Sustainable Development Goals (FP-SDGs) model. The final framework addresses workplace women’s health, gender-based violence, and professional advancement, with a priority placed on expanding access to services.
An event hosted by HP+ on June 4, 2019, showcased the synergies between stewardship of country health systems and the objectives of USAID’s journey to self-reliance in building countries' capacity to address their own development challenges. The event, which launched a special issue of the journal Public Administration and Development, “Stewardship and Health Systems Strengthening,” explored the concept of stewardship and its underlying six key functions, as outlined by WHO. The journal special issue was co-edited by HP+ colleagues, Derick Brinkerhoff of RTI and Harry Cross of Palladium. In addition to the co-editors and authors, who delivered their papers, speakers included David Jacobstein, a democracy specialist in USAID’s DRG office and HP+ AOR Linda Cahaelen. In a concluding discussion, moderated by Palladium’s Jay Gribble, Harry Cross summarized that “the road to self-reliance is dependent on the health system…it’s the road to sustainability. By improving stewardship functions, countries can achieve self-reliance.”
The fifth Global Symposium on Health Systems Research (HSR2018) was held recently in Liverpool, England. PEPFAR’s Sustainable Financing Initiative (SFI), supported HP+ to co-host an independent side session on October 10, with panelists from HP+, SHOPS Plus, UNAIDS, and USAID. The well-received session, “Beyond Vertical: Sustaining HIV Service Delivery Through Health Insurance,” was moderated by USAID’s Susanna Baker with HP+’s Arin Dutta. Also at HSR2018, HP+ presented two posters at the main conference: one on total market approach and another on women’s leadership and accountability. The latter poster, presented by HP+/RTI’s Christin Stewart, was awarded a “high scorer” prize and was featured on the conference website.
An event on July 10 co-hosted by the PACE Project and held the Wilson Center, A More Prosperous World: The Role of Population Dynamics and Family Planning for Economic Growth, Education, and Health featured Health Policy Plus Deputy Director for Family Planning and Reproductive Health, Jay Gribble. Jay joined a panel of experts who discussed how population dynamics drive development and how access to family planning services enables countries to meet their education, employment, and public health goals. The event also featured Peter McPherson, former USAID Administrator and Deputy Secretary of the Treasury, who is now President of the Association of Public and Land-Grant Universities.
The US President’s Emergency Plan for AIDS Relief (PEPFAR’s) Annual Report to Congress features the Gender and Sexual Diversity (GSD) blended learning package. The training package is designed to help PEPFAR improve its effectiveness at serving its most vulnerable populations with a focus on staff training. Health Policy Plus and PEPFAR built on the success of a series of in-country trainings to develop the GSD blended learning package, which includes online and in-person training components. All PEPFAR field and headquarters staff are required to spend 90 minutes participating in the online interactive curriculum. All staff must also join an in-person panel discussion with local gender and sexual minority representatives around HIV, human rights, and meaningful engagement of GSD in PEPFAR programming. Thus far, more than 400 PEPFAR field and headquarters staff have taken the online training.
The Reproductive Health Supplies Coalition Advocacy and Accountability working group hosted a webinar, Expanding Access: Estimating the Impact of DMPA-SC Introduction, in December 2017. The webinar, now featured on their website, was led by Erin McGinn, Jim Rosen, and Michelle Weinberger of the USAID-funded Health Policy Plus (HP+) project, provided an overview of the HP+ Microsoft Excel-based model to project the potential contribution of DMPA-SC (also referred to as Sayana Press) to a national family planning program. This model covers both hypothetical public health impact and potential cost savings and returns on investment. Results of recent country applications in Nigeria and Cameroon were shared during the webinar. Read our brief for more information.
USAID’s Health Evaluation and Applied Research Development (HEARD) project is shining a spotlight on HP+ partner the White Ribbon Alliance and their work under HP+ and its predecessor, the Health Policy Project, to build a movement for respectful maternity care. The White Ribbon Alliance—as an integral part of the Health Policy Project and now Health Policy Plus project—has grown the multi-sectoral Global Respectful Maternity Care Advisory Council and continues to support the role of midwives and women’s right to high-quality respectful maternity care by mobilizing civil society to advocate for accountability for respectful maternity care and advocating for the inclusion of women’s voices within global maternal health dialogues.
HP+ modelling experts provided technical guidance for a new publication by UNICEF called Generation 2030. The report makes a case for investment in children and young people to increase per capita income and improve economic prospects. Scott Moreland and Sayaka Koseki provided guidance to the authors who used DemDiv to run simulations for multiple African countries. According to the population projections in the report, by 2050, the continent will account for 42 percent of all global births and almost 40 per cent of all children under 18. DemDiv continues to be a popular tool being used by a range of players. Scott Moreland is currently reviewing a manuscript on a Mali application for a journal and is preparing a paper for Afrique Contemporaine, a publication of AFD, based on presentations he made last spring in Paris and recently in Cape Town at 2017 International Population Conference.
For World AIDS Day, HP+ participated in PEPFAR’s thunderclap and published an online #EndAIDS photo album, promoted via and e-postcard and on social media. The photos and accompanying quotes answered the question, “How does your work promote transparency, accountability, and partnerships to #EndAIDS?"
The USAID-funded Health Policy Plus project was represented at the Global Health Mini University on September 14, 2017. In Roadmaps and Mapping: Two Tools to Promote Governance and Accountability for Stronger Health Systems, Alyson Lipsky and Sue Richidei presented data on strengthening the capacity of women leaders in Africa and Asia to hold local health officials accountable. Breakout sessions provided attendees an opportunity to use presented data to brainstorm ways to create stronger health systems. In a separate session, In or Out? Adding Sayana Press to Your FP Methods Mix, Erin McGinn and Jim Rosen provided an in-depth look into the future prospects of accessible and effective family planning through self-injecting Sayana Press. Sayana Press has been referred to as a “game-changing” family planning method and attendees engaged in interactive exercises that evaluated its potential community-level impacts.
The Health Policy Project, the predecessor to HP+, with funding from PEPFAR provided Gender and Sexual Diversity trainings for 2,825 participants including PEPFAR staff and program implementers, U.S. government staff, and local stakeholders in 38 countries. Results from the first study to report on GSD attitude change among a global sample of almost 180 individuals from 33 countries were published in PLOS on September 19, 2017. The paper, Changing hearts and minds: Results from a multi-country gender and sexual diversity training, reports that attitudes toward gender and sexual minorities were more positive after the training compared to before the training. Additionally, positive attitudes toward gender and sexual minorities not only persisted 3 – 6 months after that training but improved even further. These changed attitudes were not only sustained for months after the training, but they were also associated with changes in the workplace and, to a lesser extent, HIV programming.
This World Population Day, the USAID-funded Health Policy Plus project produced an online slideshow featuring responses to the question, "How can family planning investments help your country achieve the Sustainable Development Goals?" Olive Mtema, HP+ Malawi, responds: “Results from HP+’s DemDiv model estimate that Malawi’s per capita gross domestic product could increase from US$397 (2014) to US$2,148 by 2054 when family planning is included, turning Malawi into a middle-income country around the year 2040.” Responses from Ms. Olive and others are captured in a photo show, and in a blog by HP+ country directors from Malawi, Nigeria, and Pakistan.
USAID and PEPFAR, through the Health Policy Project’s (HPP) follow-on, Health Policy Plus (HP+), shared best practices, resources, and the project’s current work to reduce HIV-related stigma in health facilities during a recent webinar. The HPP/HP+ stigma-reduction package is comprised of a series of tools (assess, train, and sustain); includes a total-facility approach to reducing stigma and discrimination; and is based on a globally validated measurement tool, participatory training materials, and experiences from Africa, the Caribbean, and South and Southeast Asia. The stigma-reduction package has been implemented globally, with work ongoing in Ghana, Tanzania, and Jamaica. During the webinar, Suzie Jacinthe of USAID/Ghana commented, “We’ve never been able to quantify [stigma-reduction activities] in a way to show that what we’re doing is measurable change. With this activity, the beauty about it is that we…do questionnaires for the health facility as well as questionnaires from the PLHIV perspective of their experiences with those facilities to: gauge both [perspectives], come up with interventions out of the findings of the assessment, pilot them…and measure that change.” Jacinthe went on to say that HP+’s current effort to also cost these interventions, a first, will help governments demonstrate the real costs, alongside the measurable benefits, of implementing and replicating stigma-reduction interventions.
Progress toward universal health coverage that reaches marginalized groups requires a multi-pronged approach that includes health insurance as well as demand-side interventions to improve service utilization; empowered communities demanding accountability; and, mechanisms to identify, reach, cover, and empower neglected or stigmatized populations. These recommendations were made at a USAID-hosted meeting - Extending Coverage to Marginalized Groups - at the Prince Mahidol Award Conference, in Bangkok, Thailand, on January 29th, which featured dynamic conversations among health economists and health reform experts. USAID representatives included Jennifer Adams, acting assistant administrator in the Bureau for Global Health; Margaret Reeves, senior family planning policy advisor; Jodi Charles, senior health systems advisor; and Josef Tayag, senior private sector financing advisor. The meeting was organized in collaboration with USAID-funded projects Health Policy Plus (HP+), Health Finance and Governance (HFG), and Sustaining Health Outcomes through the Private Sector Plus (SHOPS+).