USAID Family Planning and Contraceptive Security Programs

1. USAID Family Planning and Contraceptive Security Programs Kevin Pilz Commodity Security and Logistics Adviser February 25, 2010

2. GLOBAL HEALTH PRIORITIES • HIV/AIDS • Malaria • Family Planning • Maternal and Child Health • Other Infectious Diseases

3. GLOBAL HEALTH INITIATIVE • “I… recognize that we will not be successful in our efforts to end deaths from AIDS, malaria, and tuberculosis unless we do more to improve health systems around the world, focus our efforts on child and maternal health, and ensure that best practices drive the funding for these programs.” President Obama, May 5, 2009 • Increased focus on Maternal and Child Health, including FP/RH • Integrated approach with focus on strengthening health systems • Guiding Principles: • Implement a woman- and girl-centered approach • Increase impact through strategic coordination and integration • Leverage key multilateral organizations, global health partnerships and private sector engagement • Encourage country ownership and invest in country-led plans • Build sustainability through health systems strengthening • Improve metrics, monitoring and evaluation • Promote research and innovation • Proposed $1.2 billion in FY2010, total of $12 billion over 6 years for health priorities beyond HIV, Malaria and Tuberculosis

4. USAID Family Planning Programs

5. Family Planning:Responds to a panoply of problems • Enables couples to decide number/spacing of births • Reduces child mortality • Reduces maternal mortality/morbidity • Reduces abortion • Improves women’s opportunities • Key intervention in HIV settings • Essential component of health programs • Mitigates adverse effects of population dynamics on: • natural resources • economic growth • state stability

6. Unmet need for family planning among of 201 million people in developing countries translates to: 52 million unintended pregnancies, leading to: • 22 million abortions • 2 million miscarriages • 1.4 million infant deaths • 142,000 pregnancy-related deaths [1/2 in Africa] • 53,000 from abortion • 89,000 from other causes • 505,000 orphans Source: Guttmacher Policy Review, Summer 2008, Vol 11, Number 3

7. Technical & Programmatic Priorities for USAID FP Global Programs • Long-acting and permanent methods • Community-based FP • FP/HIV integration • Contraceptive security • Healthy timing and spacing of pregnancies • FP/MCH integration

8. Cross-Cutting Principles • Improve access for the poor • Enhance gender equity • Address the special needs of youth

9. How are we tracking FP/RH program performance? • MCPR goal: 1 percentage point per year • Equity goal: 1 point per year for poorest 2 quintiles • Performance indicators: • Reduction in % first births to mothers under age 18 • Increase in births spaced 3 or more years apart • Increase in share of total FP demand satisfied • Reduction in % of births of parity 5 or higher • In addition to MCPR increase

10. Responding to need • Strategic budgeting established in 2003 • Need assessed according to: • Population density relative to land/water resources • Modern contraceptive prevalence • Number of high-risk births • Number of women with unmet need • 17 Africa countries rank in the top 25 in need

11. Global perspective: Trends in CPR and TFR by region Source: DHS/RHS data

12. Percent of Married Women With an Unmet Need for Contraception, by Region, 1990-1995 and 2000-2005  Gilda Sedgh et al., Women With an Unmet Need for Contraception in Developing Countries and Their Reasons for Not Using a Method (New York: Guttmacher Institute, 2007).

13. FP/RH Funding Trends by Region: 2002-2008 ←Africa ←ANE ←Central ←LAC ←E&E $447m $457m

14. USAID Family Planning Program Countries * May be reviewed

15. Comparative FP Indicators by Country

16. Contraceptive Security Index Regional Comparison Source: USAID | DELIVER PROJECT

17. Family Planning Support in LAC Countries • Program design and strategies determined at local level (USAID mission and local partners) to fit country context • Special LAC regional initiative for Contraceptive Security • Graduation plans developed in consultation between Washington and country mission • Graduation plans typically focus on: • Developing country capacity to sustain and advance family planning programs: leadership, governance, commitment, community/civil society advocacy • Contraceptive security & logistics • Availability of long-acting and permanent methods • Continuity of data for program monitoring

18. No Product, No Program – Contraceptive Security

19. Commodity Security – Comprehensive approach to ensuring commodity availability • Contraceptive security exists when people are able to choose, obtain, and use high quality contraceptives and condoms whenever they want them for family planning and HIV/AIDS/STI prevention. • Components of USAID’s programs: • Commodity support (donations) • Country level technical assistance • Develop country tools, document global best practices • Institutional resources at global and regional levels • Coordination with donors and technical agencies

20. Contraceptive & Condom Shipment Values by Region, FY 2008 Total: $70.2 million

22. INSERT GRAPHIC TO ADD MAP MAP IS 6.17” TALL

23. In-Country Technical Assistance Areas • Policy • Financing • Strategic Planning • Coordination • Management • Leadership • Data for decision making • Procurement • Quantification and Forecasting • Warehousing • Distribution • Logistics Management Information Systems Implemented by many global and bilateral implementing partners. In LAC particularly the USAID | DELIVER Project (JSI) and the USAID | Health Policy Initiative (Futures Group)

24. Developing Country Tools • SPARHCS – Strategic Pathway to Reproductive Health Commodity Security • Make a Case for Supplies. Leading Voices in Securing Reproductive Health Supplies: An Advocacy Guide and Toolkit • National Health Account sub-analysis • Market Segmentation analysis • Procurement Planning and Monitoring Report

25. Documenting Global Best Practices • Contraceptive Security: Ready Lessons • Commodity Security Approaches • Practical Handbooks and Guides for Supply Chain Management • Online and CD-Rom Distance Learning on Logistics

26. Developing Institutional Resources at the Regional and Global Levels • Professional Networks: International Association of Public Health Logisticians (IAPHL) • Regional centers for health supplies training and technical assistance: • PRIMSA (Peru) • Eastern and Southern Africa Management Institute (ESAMI, Tanzania)

27. Coordinating with Donors and Technical Agencies • Reproductive Health Supplies Coalition • Countries At Risk Group • Reproductive Health Interchange • AccessRH • Pledge Guarantee for Health • UNFPA • World Health Organization • Other UN Agencies • Bilateral Donors • Foundations • NGOs, especially International Planned Parenthood Federation

28. Recent Accomplishments • Annual meetings on Contraceptive Security, convening Ministries of Health, Social Security Agencies, NGOs and donor partners • Strengthened supply chain systems in Paraguay lead to increased access to and use of FP • Contraceptive supply systems serve as model for supplies integration in Nicaragua and Paraguay • Improved donor coordination and inventory management, averting contraceptive stock outs • Leadership programs lead to strengthened commitment to CS and contraceptive budget line in El Salvador • Technical training opportunities for LAC countries on Supply Chain Management and RHCS expanded

29. Thank You !