Workshop on Financial Tracking and Advocacy for Contraceptive Security Month Year

1. Workshop on Financial Tracking and Advocacy for Contraceptive SecurityMonth Year

2. USAID | DELIVER PROJECT, Task Order 4 The USAID | DELIVER PROJECT, Task Order 4, is funded by the U.S. Agency for International Development (USAID) under contract number GPO-I-00-06-00007-00, order number AID-OAA-TO-10-00064, beginning September 30, 2010. Task Order 4 is implemented by John Snow, Inc., in collaboration with PATH; Crown Agents Consultancy, Inc.; Eastern and Southern African Management Institute; FHI360; Avenir Health; LLamasoft, Inc; The Manoff Group, Inc.; IMPERIAL Health Sciences; PRISMA; and VillageReach. The project improves essential health commodity supply chains by strengthening logistics management information systems, streamlining distribution systems, identifying financial resources for procurement and supply chain operation, and enhancing forecasting and procurement planning. The project encourages policymakers and donors to support logistics as a critical factor in the overall success of their healthcare mandates. USAID DISCLAIMER

3. Introductory Activity First: Find the partner whose card completes yours to make the phrase “contraceptive security” Introduce yourselves to each other Discuss what you each think “contraceptive security” means Describe your role in ensuring contraceptive security Then: Introduce your partner to the group

4. Definition of Contraceptive Security Contraceptive security exists when everyone is able to choose, obtain, and usequality, affordable contraceptives whenever they want or need them.

5. Global Picture: Financing for Contraceptives • Low- and middle-income countries need ~ $1 billion/year for contraceptives • Slightly more than ½ of funding is expected to come from government or donor sources (with the rest funded by individuals or private companies)

6. Current and Future Environment • Contraceptive funding needs will rise (with WRA and FP use) • Government spending for health has beenincreasing, but absolute levels remain low • Donor support for health is rising at a much slower rate than before • Spending on FP requires strong advocacy since needs are growing and FP competes with other priorities

7. Finance for Procurement Data from Contraceptive Security Indicators 2015 (FY 2014) Africa Blank = incomplete data

8. Finance for Procurement Data from Contraceptive Security Indicators 2015 (FY 2014) 18 countries indicated there was insufficient funding for contraceptive procurement for the public sector 13 countries covered 100% of the quantified need 12 countries covered more than 100% of the quantified need 6countries did not provide information to determine if there was a funding gap >100% Africa

9. Importance of Public and Private Sectors UPDATE FOR COUNTRIES OF INTEREST – Most Recent Source of Supply or Information Data from the DHS Program STATcompiler

10. Global Need for Tracking FP2020 is mobilizing commitments to add 120 million FP users by the year 2020 There is a need to track these and other commitments Given the global context, it is crucial to track contraceptive financing in each country to work toward contraceptive security

11. Challenges What do you think the main challenges to achieving contraceptive security are?

12. What Can You Do? List on a flip chart… • 3 things government can do • 3 things advocates and advocacy groups can do • 3 things technical experts can do • 3 things government, advocates and technical experts can do together …to address the financial, policy, and implementation challenges to contraceptive security.

13. Status and Plans for Financial Tracking Efforts Overall challenges with financial tracking: Overall successes with financial tracking:

14. Status and Plans for Financial Advocacy Efforts

15. Financing Schemes • Mechanism by which people get financial access to health care • Three general categories: • Government schemes and compulsory contributory healthcare financing schemes • MOH family planning program • Social health insurance • Voluntary healthcare payment schemes • Voluntary health insurance • Household out-of-pocket payment • Individual or household direct payment for contraceptives

16. Financing Schemes in Uganda

17. Funding Sources by Scheme in Uganda

18. Financing Agents • Institutions that manage and operate financing schemes • Collect revenues • Purchase contraceptives • May provide other services • May have one agent for collecting revenues and another for purchasing contraceptives • Ex: Ministry of Finance may collect revenue; government Procurement Unit may purchase contraceptives

19. Funding Sources and Financing Agents by Scheme in Uganda

20. Funding Sources and Financing Agents by Scheme in Uganda (cont.)

21. Financing Framework Diagram Funding Sources Scheme Agents

22. Day 1 Homework Assignment • Review the Financial Tracking Guide. • Write 3 questions on the content. • Be able to answer the questions.

23. End of Day 1 Homework Assignment • Complete the Scavenger Hunt handout, by consulting your guide • Write down the page number where the answer can be found in the guide • Feel free to work with another participant if you would like The Table of Contents is your friend! But then check within the guide to make sure you’re in the right place.

24. Categories of Financial Analyses • Procurement Requirements • Commitments • Spending • Comparisons • Comparison of commitment vs. need • Comparison of spending vs. commitment • Comparison of spending vs. need

25. Common Analyses for Financial Data • Procurement Requirements • Funding Commitments by Source • Commitment as Percentage of Procurement Requirements • Contraceptive Spending by Source and Financing Scheme • Amount of Internally Generated Funds Spent • Public and Foreign Share of Spending for the Government Scheme

26. Common Analyses for Financial Data (cont.) Spending by Scheme Spending by Commodity Comparison of Requirements, Commitments, and Spending Spending as a Percentage of Procurement Requirements Spending as a Percentage of Commitments Spending as a Percentage of Commitments, by Source

27. Procurement Requirements

28. Amount Committed for Contraceptives by Funding Source

29. Commitment as Percentage of Procurement Requirements

30. Spending by Scheme

31. Spending by Commodity Spending by Scheme

32. Amount of Internally Generated Funds Spent

33. Public and Foreign Share of Spending for the Government Scheme

34. Comparison of Requirements, Commitments, and Spending

35. Spending as a Percentage of Procurement Requirements Spending as a Percentage of Commitments

36. Results from Financing Analyses—Exercise • What general statements can you make about the status of commitments and spending on contraceptives? • How well is this country meeting its procurement requirements? • What are some possible areas that may require action to better ensure contraceptive security? • What are potential causes of the increase in public spending and other positive trends reflected in the graphs? • What are some of the potential causes of disparities between needs, commitments, and spending? • What are advocacy actions that can be used to address these issues?

37. Which Analyses Best Meet My Objectives In your small group, discuss the following questions: • Which objective(s) most closely matches what you need to achieve to address contraceptive security challenges in your country? • Which analysis (or analyses) will provide the best information to help you take action to improve contraceptive security?

38. Three Categories of Financial Data • Funds Needed (for Procurement Requirements) • The amount of funds needed for the quantity of contraceptives needed to be procured • Funds Committed • The amount of funds that various sources of revenue say they will spend on contraceptives • Funds Spent • The amount the program actually spent on contraceptives

39. Sources of Data – Small Group Activity Information on Commitment Information on Spending by Public Sources Secondary Sources of Information on Public Spending Information on Spending by Private Sources Information on Spending by Foreign Sources As a small group… Review the part of section 2.5 in Guide assigned to your group; be prepared to summarize your section Discuss any experiences you have had obtaining data from these sources

40. What was spent in fiscal year 2013? $1.5 million

41. What was spent in fiscal year 2013? $1.25 million

42. Considerations for Data Collection • What range of data to collect? • Subsidized contraceptives usually • What time period to use for funding needs, commitments, and expenditures? • What is the appropriate commodity price to use in spending calculations? (see page 26 in the guide) • What adjustment to make for exchange rates and inflation? • What do you do when data available is incomplete or inaccurate?

43. Example of Commodity Requirements from a Quantification Exercise

44. Funding Needs for Subsidized Contraceptives, Historical and Projected

45. Worksheet for Collecting Information on Commitments • Source of contraceptive financing commitment_______________________________

46. Worksheet for Collecting Information on Spending • Source of contraceptive spending_________________________

47. Country Specific Data Collection – Small Group Activity In your country team, spend 20 minutes discussing the following. Be as specific as possible. What sources of data do we have for contraceptive funds needed, committed, and spent? What additional data sources can we tap? Who should collect this data? How? What challenges might we have in collecting the data we need for financial analyses?

48. Typical Financing Process Steps

49. Day 2 Homework Assignment • Review the Status of Financial Tracking Efforts and the Status of Financial Advocacy Efforts templates for your country • Review any country specific work you have done in the workshop (notes from discussions, etc.) • Think about some of the next steps you will take after returning to your country.