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Better Policy for Better Health

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West Africa

map with West Africa highlighted

Overview

This is a time of dynamic policy advancement in West Africa. Commitments made by policymakers coincide with West Africa having the highest unmet need for family planning across all regions of Africa and some of the lowest contraceptive prevalence rates for modern methods in the world. Political support for expanded access to family planning and reproductive services is strong. Regional and global conferences have served to galvanize national, regional, and international stakeholders to join efforts in developing prioritized plans and budgets to advance family planning and task-shifting goals.

Since 2018, the number of people living with HIV in the region who are on treatment has improved, as have rates of HIV detection. Burkina Faso, Senegal, and Togo are making progress toward epidemic control—but persistent challenges exist. Ensuring that people get tested and on treatment—particularly key populations, who are at a considerably higher risk of contracting HIV—remains difficult. In addition, user fees for consultative health facility visits are commonplace across the region and may be a barrier to accessing HIV services for people who cannot afford to pay them.

Publications

Costs of COVID-19 Testing and Treatment in Burkina Faso
Costs of COVID-19 Testing and Treatment in Burkina Faso
Estimating the Economic Impact of COVID-19 on Gold Export, Cotton Production, and Food Security in Burkina Faso
Estimating the Economic Impact of COVID-19 on Gold Export, Cotton Production, and Food Security in Burkina Faso
Indirect Health Impacts of COVID-19 in Burkina Faso: Potential Impact of Declines in Utilization of Key Health Services
Indirect Health Impacts of COVID-19 in Burkina Faso: Potential Impact of Declines in Utilization of Key Health Services
View all West Africa Publications

What We Do

Health Policy Plus supports national governments in West Africa—namely, ministries of health and national AIDS commissions—to achieve national and regional family planning and HIV goals in support of health systems strengthening efforts. Specifically, Health Policy Plus is:

  • Identifying, supporting, and building capacity for priority policy and advocacy interventions and policy implementation to remove barriers to family planning and HIV programming
  • Collaborating with local stakeholders to support policy, governance, and community engagement work to improve family planning and HIV services
  • Supporting and building capacity for strategic planning, including financial forecasting, to improve domestic resource mobilization for health
  • Strengthening the understanding of and the conditions and actions required for countries to benefit from a potential demographic dividend. This work is being done in close collaboration with regional and local stakeholders—including the private sector—who are addressing service delivery, commodity security, capacity development, learning and evaluation, and scale-up

Featured Activity

two women at a training with the WAHIT team
West Africa Health Informatics Team

HP+ is supporting the West African Health Organization (WAHO) to develop and train the West Africa Health Informatics Team (WAHIT). WAHIT, a team of local health informatics experts, will provide technical leadership and support to ministries of health across the Economic Community of West African States (ECOWAS) to strengthen health information systems through local capacity building.

News

In Niger, a Local Leader Makes Family Planning a Priority
In Niger, a Local Leader Makes Family Planning a Priority
Joining Forces for Better Health in Liberia
Joining Forces for Better Health in Liberia
Recognizing and Responding to COVID-19
Recognizing and Responding to COVID-19
View all West Africa News

Project Impacts

Senegal Increases Government Budget for Health, Including Family Planning

January 2021 — 

Senegal’s Ministry of Health and Social Action used HP+ supported resources to raise the visibility of and consensus around the need for domestic resources for family planning, helping lead to an increase in the government’s budget allocation to contraceptives. In 2019, HP+ worked with the MSAS and other family planning stakeholders to identify and evaluate opportunities to catalyze domestic resources for family planning, based on an HP+ framework. HP+ also led a budget advocacy training, supporting stakeholders to develop an action plan to influence the next budget cycle. In a recent news article, MSAS Cabinet Director Alphonse Ousmane Thiaw discusses a consultation on mobilizing domestic resources for family planning. He quotes a report supported by HP+ that suggested a focus on national and subnational government advocacy and strengthening support for family planning under Senegal’s Agency for Universal Health Coverage. Thiaw reaffirms the government’s commitment to financing family planning and announces an increased allocation for contraceptives in 2021. This allocation of CFA 500 million (US$926,000) aligns with the country’s FP2020 commitment, reverses the trend of decline in this allocation between 2016 (CFA 300 million) and 2019 and 2020 (CFA 117 million) and will support the annual contraceptive needs of approximately 160,000 family planning users.

Family Planning Stakeholders in Togo Use Data to Track Progress

November 2020 — 

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.

Webinar Features Liberia’s Journey to Private Sector Engagement

July 2020 — 

An HP+ webinar on July 8 featured a discussion on Liberia's private sector response to COVID-19 and the Healthcare Federation of Liberia’s efforts to stimulate coordinated private sector engagement in health following a private sector assessment undertaken by HP+ in 2019. Dr. Cuallau Jabbeh-Howe of Liberia’s Ministry of Health, Dr. Nicole Cooper of the Healthcare Federation of Liberia, and Dr. Amit Thakker of Africa Health Business shared reflections on opportunities and challenges of private sector engagement in health and discussed possibilities for collaboration between the public and private health sectors in Liberia. Listen to the webinar here.

In Niger, a Local Leader Makes Family Planning a Priority

July 2020 — 

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.

HP+ Analysis Spurs Private Sector Donation of Supplies to Fight COVID-19 in Niger

June 2020 — 

HP+ recently conducted an analysis of available equipment and supplies required to fight COVID-19 in Niger’s capital, Niamey. The analysis pointed to the need for an increase in hygiene supplies to effectively combat the pandemic. As a result, the Bank of Africa Foundation provided handwashing kits to 20 health facilities in the city. The handwashing kits, which are valued at more than one million CFA (approximately US$1,700), are in addition to the 373 million CFA (approximately US$640,000) already granted by the Association of Banks and other financial establishments to the Nigerien government to aid in its pandemic response.

Training Private Sector Providers to Respond to COVID-19 in Liberia

March 2020 — 

The HP+-supported Healthcare Federation of Liberia is working alongside the Ministry of Health and the National Public Health Institute of Liberia (NPHIL) to scale-up trainings to private sector providers across Montserrado County to address COVID-19. The three-hour rapid training, conducted by NPHIL with social distancing measures in place, will cover infection prevention and control, case management, and emergency response protocols. Up to 250 private providers (from 150 facilities) will be trained in two weeks, covering over 50 percent of Liberia’s health facilities.

Healthcare Federation of Liberia Launches

March 2020 — 

In February, the newly launched Healthcare Federation of Liberia (HFL) elected its inaugural board of directors, who also participated in their first Ministerial Stakeholder Forum. The association was launched following an HP+ assessment of the private health sector that identified the need for a unifying body as well as opportunities to improve the private health system, create a framework for collaboration with the government, and better leverage private sector actors for improved health outcomes. With HP+ support, the HFL will offer financial management skills-building courses to health small- and medium-sized enterprises and partner with Access Bank to support the development of loan products tailored to the health sector.

Gambia Meets with Health Assessment Team After Lifting of Aid Suspension

December 2019 — 

After a decade of aid suspension, Gambia’s newly-elected President met with US government officials and a health assessment team to discuss the lifting of the country’s suspension and what it could mean for Gambia. Modibo Maiga and Pascal Saint-Firmin, representing the USAID-funded Health Policy Plus project’s West Africa program, attended the meeting, which also included the United States Ambassador, Eleonore Rabelahasa, and Rachel Cintron from USAID.

West Africa Country Director Briefs Congressional Delegation to Burkina Faso

October 2019 — 

Members of the U.S. House of Representatives Foreign Affairs committee were briefed on US-funded health programs in Burkina Faso on October 4, 2019, during the delegation’s visit to Ouagadougou. The delegation of Karen Bass and Representative Sheila Jackson-Lee joined U.S. Ambassador Andrew Young, staff of the Centers for Disease Control and Prevention and USAID partners to share successes in health support and discuss challenges related to the ongoing strike of health professionals, security, and support for internally displaced people. Modibo Maiga, HP+ country director, and other implementing partners highlighted the strong collaboration between the US and Burkina Faso and the important role that community leaders, including religious leaders and youth, have played in mobilizing domestic resources for health and catalyzing policy change in support of family planning, adolescent reproductive health, and HIV/AIDS. Maiga also briefed the delegation on efforts by the Ministry of Health to integrate community health workers into its health workforce and stressed that the formalization of this cadre of workers at the community level will reduce the impact of the striking health professionals and will help defuse security tensions in communities.

West Africa Meeting Advances Move for Community Health Worker Formalization in System

September 2019 — 

Government and civil society health leaders from nine Francophone countries of West Africa called for the integration of community health workers into their nations’ health systems at a ground-breaking meeting in Lomé, Togo. The three-day workshop, held from September 16 – 19, gathered health officials and implementing partners, and local community health workers, who shared their perspectives. Senior officials from Togo’s Ministry of Health, WAHO and WHO’s West Africa office, along with U.S. Ambassador, Eric Stromayer joined a high-level opening ceremony. Eleonore Rabelahasa, the Senior Health Systems Strengthening and Policy Advisor in USAID’s regional health office, also participated in the three-day workshop. Five Togolese CHWs, who deliver a range of family planning, malaria and health consultations interventions, discussed the challenges and opportunities they face as front-line health workers and their perspectives to improve their capacity to improve equitable access to health services. The delegates developed action plans for each country with a goal to convene key stakeholders and put in place a plan of action by June 30, 2020.

Niger Triples Budget for Contraceptives

January 2019 — 

The Ministry of Public Health has announced it will more than triple its budget to procure contraceptives in 2019. The budget item jump, from 62 million FCFA in 2018 to 200 million FCFA in 2019 comes as result of USAID-supported advocacy by family planning groups and support from Health Policy Plus (HP+), and promises to vastly increase the country’s capacity to provide voluntary family planning to meet demand. HP+ assisted Nigeren family planning advocates in forming The Network of Champions in Advocacy for Adequate Health Financing (RCPFAS) and, with the Directorate of Maternal and Child Health, provided guidance to its members to make the case for the increase, which meets a pledge made by the government at the Family Planning Summit in London in 2017. HP+ also helped organized a series of meetings with civil society and key Ministry of Health and Ministry of Finance decision makers to secure the commitment and the sign off by the Secretary General Ranaou Abache on November 22, 2018. Read more in our news story.

Private Sector Group IMG Commits Funds for Family Planning in West Africa

January 2019 — 

Under the leadership of Senegal’s Ministry of Health and Social Action, HP+ West Africa organized an unprecedented family planning advocacy workshop in Dakar in August to secure support and financial commitments from the private sector. The workshop resulted in more than US$630,000 pledged for family planning funding. The International Management Group (IMG), a private company from Cote d'Ivoire that took part in the Dakar meeting disbursed funds for family planning advocacy and clinic services in December 2018. Their contribution provided access to contraceptive pills, injectables, implants and IUDs to 121 additional women on voluntary contraception. This is just a start. IMG expressed a commitment to sustain its engagement moving forward.

Private Sector Leaders Show Support for Family Planning Efforts in West Africa

September 2018 — 

Under the leadership of the Senegal’s Ministry of Health and Social Action, USAID-funded HP + West Africa organized an unprecedented reproductive health and family planning advocacy workshop August 30 and 31, 2018, in Dakar to secure support and financial commitments from the private sector resulting in more than approximately USD 630,000 pledged for family planning funding. Participants, including representatives of Banque of Africa, Nantou Mining SA, Mata Holding and other private sector groups, signed a collective declaration in support of reproductive health and family planning policies and programs in their respective countries. USAID Senegal representative, Omar Sanga, the senior government-to-government financing advisor, said of the workshop: "It is exceptional what I saw, such a success with the Private Sector of the sub-region. It is thanks to the expertise of HP+." Follow-up will be done by HP+ at the country level to ensure that the commitments made by the private sector will be implemented.  

Traditional and Religious Leaders in West Africa Renew Commitments to Harness the Demographic Dividend

August 2018 — 

In late July, close to 100 traditional and religious leaders hailing from 10 West African nations gathered in Burkina Faso to share experiences and renew commitments in implementing innovative strategies to take advantage of the region’s demographic dividend—the accelerated economic growth that can result from changes in the age structure of a population.  Among the nine-point pledge announced by the religious leaders is a commitment to advocate with their peers for the acceptance of family planning through use of methods that conform with their values and a commitment to fostering dialogue between couples on reproductive health issues. The forum, organized with support from the USAID-funded Health Policy Plus (HP+) project, “Reaping the Demographic Dividend: Religious and Traditional Leaders Get Committed,” held July 24-26 in Ouagadougou, was attended by the President of Burkina Faso, Roch Marc Christian Kaboré; the Mossi Emperor, Moogho Naaba Baongho; and the U.S. Ambassador to Burkina Faso, Andrew Young. HP+ plans to support the implementation and monitoring of action plans developed during the regional meeting.  

Moving from Planning to Action in West Africa to Meet FP2020 Goals

June 2018 — 

Ministries of Health across West Africa are taking action to meet ambitious family planning commitments made in the past several years in support of FP2020 goals. In Burkina Faso, where the use of reproductive health services is only 22.5 percent, the government has issued its 2017-2020 Family Planning Acceleration National Plan (PNAF 2017-2020). The action plan is part of the nation’s strategic vision for improving modern contraceptive prevalence to 32 percent by 2020. In Niger, with a goal of 50 percent contraceptive prevalence by 2020, the Ministry of Health has issued a new operational plan that focuses on identifying and mobilizing resources for contraceptive products. Mauritania is repositioning family planning to focus on birth spacing as an appropriate strategy to improve the supply of family planning and other health services. There, the Ministry of Health has issued a National Action Plan on Birth Spacing with the goal of increasing the modern contraceptive prevalence rate for women in union from 11 percent in 2013 to 18.5 percent in 2018. The USAID-funded Health Policy Plus project provided technical assistance to each of the ministries and key partners, conducted reviews and analyses, and provided recommendations in support of implementing these crucial plans. 

Mauritanian Reproductive Health Law Moves to Implementation

March 2018 — 

The government of Mauritania, on International Women’s Day (March 8, 2018), signed a regulatory decree to implement a new reproductive health law in focus counties. The law was originally passed in January 2017. With the signing of this new regulatory guidance, there is now approval for community health workers to provide birth control pills and injectables. Nurses are now allowed to provide IUDs and implants. This policy advance, which promises to bring efficiency and scale to contraceptive use, comes as a result of advocacy efforts led by USAID and supported by the HP+, FP2020, AgirPF, Stop Sida, UNFPA, and local partners.

Social Contracting for Key HIV Services Moving Forward in Guyana

December 2017 — 

USAID and PEPFAR, through HP+ is providing technical support to Guyana’s national AIDS program secretariat to plan for the country’s transition from external to domestic financing of HIV programs and services. This support includes the development mechanisms the government can use to directly support civil society through new “social contracting” measures. A meeting held in mid-November resulted in consensus among nearly 50 civil society, private sector, and government stakeholders and donors to move forward with a social contracting model. In addition to implementation of the model, HP+ will provide additional support to Guyana’s mobilization of domestic resources for HIV programs, including developing costing of civil society-led services and programs and technical assistance to Guyana’s high-level HIV Transition and Sustainability Steering Committee.   

Burkina Faso Increases Budget for Family Planning Commodities

November 2017 — 

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

Côte d'Ivoire scales up postpartum family planning in public and private health centers

August 2017 — 

Côte d'Ivoire’s Ministry of Health and Public Hygiene in April 2017 issue new guidance scaling up post-partum family planning to increase women's access to family planning services.  The new guidance directs health facilities and qualified service providers to inform new mothers of the full range of family planning methods to ensure free and informed choice of options immediately following delivery. This comes as a result of advocacy efforts by a range of stakeholders. The USAID-funded Health Policy Plus (HP+) provided guidance and capacity development for advocates using the AFP SMART advocacy tool. 

Sierra Leone Embraces Use of CIP Data in Budget Planning

June 2017 — 

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.   

HP+ West Africa Leadership Plays Leading Role on ECOWAS Task Shifting/Sharing Resolution

June 2017 — 

The regional director of the USAID-funded Health Policy Plus West Africa region, Modibo Maiga, participated in the annual ECOWAS Health Ministers meeting with WAHO and WHO in Abuja this month. WAHO and WHO selected Mr. Maiga from among all the partner representatives to draft the Partners’ Resolution. Mr. Maiga led a small committee to draft the resolution on task shifting/sharing in the ECOWAS region, which will help advance the sustainable development goals.  The resolution was presented during the June 15 plenary session to the delegates. The same resolution was presented by WHO to the Ministers of Health on June 16. 

Mauritania Reproductive Health Law Advances – Language Guarantees Reproductive Health as Universal Right

November 2016 — 

Mauritania’s Council of Ministers, on October 6, 2016, approved the text of a new Reproductive Health Law, which explicitly states that the right to reproductive health care is a universal right guaranteed to all throughout the course of their lives and prohibits forms of violence against women, including female genital mutilation.  The law, submitted by the Minister of Health, brings Mauritania’s national policies into alignment with those of other countries of the Ouagadougou Partnership pursuing commitments on family planning outlined in FP2020 goals.  This comes as a result of nearly a decade of unceasing effort by USAID and its policy advocacy partners, including UNFPA, Health Policy Plus and its predecessor projects, which helped draft an early version of the law for FP2020 advocacy efforts across West Africa.  The bill will be presented to Parliament for passage in the coming months.  

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CONTACT US

Health Policy Plus
1331 Pennsylvania Ave NW, Suite 600
Washington, DC 20004
policyinfo@thepalladiumgroup.com

Health Policy Plus (HP+) is a seven-year cooperative agreement funded by the U.S. Agency for International Development under Agreement No. AID-OAA-A-15-00051, beginning August 28, 2015. HP+ is implemented by Palladium, in collaboration with Avenir Health, Futures Group Global Outreach, Plan International USA, Population Reference Bureau, RTI International, ThinkWell, and the White Ribbon Alliance for Safe Motherhood.

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