In many countries, global donor and development trends are increasingly helping to foster health policies based on international best practices. Despite this progress, a number of issues still need to be addressed. Health systems in these countries remain weak in many cases, often due to insufficient political will to translate policies into meaningful action. In addition, policy barriers, conflicts, and gaps in healthcare services are common in many settings; these may impact sustainability, equity, affordability, and human rights.
HP+ works to improve global health policies using a variety of strategies. These include various forms of training with individuals, institutions, and civil society groups to strengthen their capacity to
Use available data for evidence-based decision making
Monitor and evaluate the effectiveness of policies
Develop solutions to operational barriers
Engage in essential dialogue with non-health sectors
HP+ also advances policies that are equitable, sustainable, affordable, and rights-based by expanding advocacy using evidence-based approaches and including vulnerable populations in the policy process. Ideally, our efforts improve the success with which individuals, institutions, and organizations conduct their own advocacy, monitor policies, and work cooperatively with each other across multiple sectors.
Why Policy Matters
In 2020, HP+ launched its “Why Policy Matters” storytelling series. Using visual media, these stories give voice to the impact of policy action and convey how innovative policy approaches drive impact and sustained local leadership.
We see our policy work as successful when governments institute or improve health policies that result in greater equity, access, availability, affordability, and accessibility of high-quality health services, supplies, and information. Using proven indicators, we track new policies as they are developed, adopted, and implemented, and subsequently assist in monitoring their effectiveness. Successful policy work results in improved individual and institutional capacity to create, monitor, and evaluate policies and frameworks at all levels of governance.
Success also results in policies that are sustainable and address health equity, nondiscrimination, and human rights for poor, marginalized, and vulnerable populations. Increasingly, gender-responsive policies are becoming another measure of success. Because the success of robust and sustainable policies is tied to effective advocacy, HP+ tracks the frequency with which advocacy efforts contribute to policy actions or improve partnerships and collaboration across sectors. We also look for and assess opportunities to recommend new policies, structures, and strategies that are capable of working across sectors to expand health services and support to broader development goals. Finally, workshops, training sessions, and advocacy events are held regularly with our partners to reinforce HP+ policy work.
Project Impacts
HP+ Malawi Hosts its End-of-Project Event
April 2022 —
The Health Policy Plus (HP+) project in Malawi celebrated almost seven years of accomplishments with an in-person and live-streamed event in Lilongwe April 28, showcasing three major pillars of achievement in improved policy implementation and monitoring, health governance and sustainable health systems, and multisectoral engagement to improve the lives and health of Malawians. Featured at the session was HP+ Malawi’s purposeful collaborative approach with the Malawian government and civil society. As Gerald Manthalo, deputy director of planning for the Ministry of Health, said: “The project was implemented government’s way. Supporting us to support ourselves was running throughout, and now we have strengthened ability to raise resources, better governance across all levels, and a holistic approach to health development.” Project Director, Suneeta Sharma, attended the event led by Country Director Olive Mtema. The more than 100 participants included the deputy speaker of Parliament and the chair of the Parliamentary Health Committee, development partners, faith leaders, youth, the media, and health ministry representatives from the planning unit, the Reproductive Health Directorate, the Family Health and Health Systems Strengthening Division, and USAID Malawi.
Advocacy Secures Financing and Commemoration Day for Traditional Midwives in Guatemala
March 2022 —
Following years of advocacy by the National Alliance of Indigenous Women’s Organizations for Reproductive Health, Nutrition, and Education (ALIANMISAR) through letters and petitions to congressional committees, the Guatemalan Congress approved Law Initiative 6026 in March 2022. The law declares May 19 “National Day for the Dignity of Comadronas” (midwives) and allocates an annual payment of GTQ 3,000 (approximately USD 380) to each of the 23,000 nationally registered traditional midwives in the country. Approval of the law is a major step in symbolically and financially recognizing the important and demanding work of midwives, who provide maternal and neonatal health services in Guatemala. This law will be enacted as a part of the 2022 budget and is a result of the capacity strengthening HEP+ provides its civil society partners in the areas of political dialogue and advocacy.
Malawi’s Youth Participate in Policy Review and Development
October 2021 —
In late August 2021, HP+ and partners organized a meeting in Malawi focused on youth, education, gender, and health, which provided a platform for stakeholders—including youth themselves—to strategize on positive youth development, share evidence-based interventions, and propose policy and programmatic recommendations. Youth participants used the meeting as an opportunity to effectively engage officials from various ministries working on youth issues. They suggested innovative and youth-tailored solutions that covered topics such as mental health, sexual and reproductive health and rights, accountability platforms, capacity strengthening, and collaboration among youth and government ministries. In addition, youth participants advocated for greater representation in each sector and ministry, a greater focus on cyberbullying, and stronger mechanisms to curb and report on sexual and gender-based violence. These recommendations will inform the follow-on youth-friendly health services strategy, updating the 2015–2020 strategy.
Madagascar Public Financial Protection Law to Improve Health Sector Funding Championed by Parliament
October 2021 —
A significant policy win was achieved as HP+ Madagascar supported the development of the Public Financial Protection Law, which is intended to create a more favorable legal environment in support of universal health coverage. At a meeting with parliamentarians that HP+ helped organize in May 2021—a rare collaboration between the Ministry of Health and parliamentarians—the parliamentarians accepted the importance of the law and proposed to be part of the process of carrying it forward to advance equitable healthcare access. The president of the National Assembly’s Public Health Commission was particularly engaged and volunteered to personally carry forward the Public Financial Protection Law. The law includes the creation of a new National Health Solidarity Fund, which will be financed through direct transfers from the national budget, private donations, and external funding and will cover contributions for poor and vulnerable populations. Now that the parliament has bought in, they are developing both the law and the national strategy for health financing alongside partners such as the Ministry of Finance and Budget and Ministry of Decentralization. Next steps include establishing a coordination mechanism between the National Assembly and the Ministry of Health and conducting further advocacy in favor of increasing the state budget for the health sector.
Tanzania Helps Local Leaders’ Implement and Fund Family Planning Programs
August 2021 —
HP+ recently helped planners in Tanzania ensure that local family planning services systems reflect national-level guidance. HP+ provided technical support to update the National Package of Essential Family Planning Interventions for Comprehensive Council Plans and ensure that both it and the National Family Planning Costed Implementation Plan (NFPCIP) 2019-2023, are incorporated into revised guidelines for the local level decisionmakers and used as the key reference documents for subnational budgeting and planning for family planning. Integrating these family planning guidelines within council level plans—which previously contained no FP planning guidance—is expected to increase domestic resource mobilization for family planning and further support efforts to encourage sustainable family planning budget allocation and disbursement among local government areas. It is also anticipated to increase the effectiveness and speed of NFPCIP 2019-2023 implementation at all levels and increase uptake of modern contraceptives.
Indonesia Adopts Policy to Boost Public-Private Partnerships
June 2021 —
Indonesia’s public and private sectors have come together to endorse a policy that will provide a legal framework, institutional arrangements, and reporting requirements to catalyze health public-private partnerships. Representatives from both sectors endorsed the Public-Private Partnership Policy for Health Services in early May, following a series of HP+-supported workshops on the topic. The policy is now considered final, and the Ministry of Health is charged with its administration and implementation. In a preliminary example of how the partnerships can play out, a new partnership was created to address early-childhood immunization. It involves a vaccine manufacturer, a health technology provider, a consumer goods company, and district-level government. The new policy is expected to open up similar opportunities for partnerships between public and private actors to expand access to healthcare. For additional background, listen to our webinar covering this topic.
Report Urges Improvement in Nepal’s Male Engagement in Family Planning
April 2021 —
In a recent report, HP+ examined the policy environment for male engagement in family planning in Nepal, focusing on men and boys 15–24 years of age. The report presents findings on how policies engage men and boys in family planning, how implementation of those policies influences male engagement, and priority policy actions to strengthen a supportive environment for engaging men and boys in family planning programs and services. Recommendations include a call for more evidence around what works for engaging young men and boys in family planning in Nepal, strengthening family planning policies to explicitly engage men and boys in family planning, and increased capacity to develop and implement male engagement policies across all levels of the health system.
HP+ Hosts Second Watch Party Featuring Maternal Healthcare in Kenya
November 2020 —
HP+ hosted the second watch party in its Why Policy Matters series on November 10. “Free Maternal Healthcare in Kenya Saves Lives” features health officials, clinical staff, and patients in Port Reitz, where maternal deaths fell by 64 percent and newborn deaths by 87 percent just two years after the country’s free maternal healthcare policy, Linda Mama, was launched under the National Health Insurance Fund, with HP+ costing and data analysis support. Along with HP+ Kenya leadership, the watch party featured Dr. Isabel Maina, division head for health financing at the Ministry of Health and representatives from the Mombasa county government, Dr. Mercy Bruba and Emily Mwaringa.
HP+ Hosts First “Why Policy Matters” Virtual Watch Party
October 2020 —
On October 23, 75 participants joined a virtual watch party and panel discussion organized by HP+ to screen the short film “Why Policy Matters: Reforms Lead to a Healthy Outlook for Nigerians.” The most successful social media post promoting the event resulted in 83 video views and, due to successful outreach to partners, had a potential reach of over 28,000. The Commissioner for Health from Osun State, Nigeria, who joined the watch party and discussion, recognized the work of HP+ and USAID in his state to successfully implement national health reforms and expand access to care.
Catalyzing Domestic Resources for Family Planning Webinar
September 2020 —
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.
Supporting Revision of Honduras’s COVID-19 Isolation Guidelines
August 2020 —
HP+ supported the Honduran Ministry of Health to revise COVID-19 isolation criteria using a symptoms-based strategy in place of laboratory results-based processes. The new criteria, which align with international guidance, shorten required isolation time for improving non-severe and non-immunocompromised cases and asymptomatic cases and no longer require a negative real-time PCR test. HP+ supported local professional medical networks and the Pan American Health Organization to facilitate clinical discussions, update the guidance, and implement the guidelines. The revised criteria will allow facility staff who meet the revised criteria to safely leave isolation earlier and return home to their families.
Webinar Highlights How Health Policy Is Essential to Enabling Service Provision in a Pandemic
August 2020 —
On July 30, an HP+ webinar, “Pivoting During COVID-19: How Health Policy Enables Service Provision in a Pandemic,” showcased the COVID-19 public health response underway in several countries, featuring ongoing service delivery activities in Brazil, El Salvador, and Honduras. Among the speakers were Mariella Ruiz-Rodriguez, an education development officer from USAID/Honduras. Evidence-based health policies allow countries to quickly and effectively pivot from business as usual to full-scale pandemic response. Longer-term strategies that ensure a continuum of care are likewise essential to support. The webinar considered what a holistic COVID-19 response looks like: focused on service delivery and informed by local realities.
Malawi Youth Trained by HP+ Successfully Advocate for Policy Changes at the District Level
April 2020 —
In Malawi, youth trained in policy communication have successfully advocated for policy changes at the district level. The training, facilitated by HP+ in coordination with partner Population Reference Bureau (PRB) in July 2019, resulted in the creation of policy advocacy plans by youth advocates. Recent follow-up by PRB revealed multiple successes in the implementation of these plans, including implementation of a differentiated care model for antiretroviral therapy service delivery, expanded clinic hours to target youth, and inclusion of youth leaders in local decision-making committees and district structures. These policy changes improve youth access to health services and family planning information, contributing to improved health outcomes across Malawi.
Nepal: New Law Enshrines Right to Health and RMC
January 2019 —
In October, 2018, the government of Nepal passed the Safe Motherhood and Reproductive Health Rights Act. The act ensures that important aspects of respectful maternity care such as privacy, confidentiality, and consent are well defined and protected in public as well as private healthcare facilities. This comes as the result of decades of advocacy work by Health Policy Plus partner, White Ribbon Alliance Nepal, supported by USAID under successive health policy projects, to ensure high-quality, respectful care for women and babies in Nepal. Read the WRA news story.
HP+ Kenya/East Africa supports proposed East Africa Community Health Policy
September 2016 —
HP+ Kenya/East Africa provided technical assistance to an East Africa Community (EAC) workshop, held in Kampala, Uganda, to review and validate the proposed EAC Health Policy. For the past two years, the EAC secretariat has worked with its five member states and various stakeholders to develop a regional health policy to enhance collaboration in all areas of health, including disease surveillance and epidemic prevention and control. With USAID support provided through HP+, the secretariat convened representatives from member states’ ministries of health to review and validate the draft policy, so that it can be tabled for endorsement and adoption by the East African Community Council of Ministers later in the year.
