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Development Partner Support to Comprehensive Condom Programming (CCP). UNFPA Consultants Patrick Friel, PhD and Grace Friel, MA 5 June 2009. Historical Background: Highlights. WHO condom programming Aide Memoire, 1995
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Development Partner Support to Comprehensive Condom Programming (CCP) UNFPA Consultants Patrick Friel, PhD and Grace Friel, MA 5 June 2009
Historical Background: Highlights • WHO condom programming Aide Memoire, 1995 • UNGASS 2001; High Level UN Meeting, 2006 (Stover’s papers in Lancet and Science 2002-06) • Scaling Up Towards Universal Access to HIV Prevention, Treatment, Care and Support, 2006 • UNAIDS/Interagency Task Team (IATT) Meeting on CCP, Chaired by UNFPA, Oct 2007
Inter-agency Task Team on CCP • UNFPA mandate: lead on comprehensive condom programming (CCP) • Scaling up “universal access” to male and female condoms requires a coordinated effort by allpartners: governments, donors, private sector and condom-related development agencies • Survey Objective: a recent “snapshot” of how CCP is supported by selected “development partners” (DP) • SRH/HIV-related DPs engaged with CCP “framework” components, e.g., research, demand creation, logistics or advocacy invited to share information on their activities
UNFPA Ten-Step Strategic Approach is “Rolling Out” in 55+ countries • Establish a national CCP support team • Conduct Situation Analysis • Develop a national M&F condom strategy • Develop a 5-year plan and budget • Link plan to essential drug/HIV/RHCS plans • Mobilize financial resources • Strengthen HR and institutional capacity • Create and sustain demand for condom use • Strengthen advocacy and engage media • Monitor implementation and evaluate outcomes
CCP Mini-Survey focus is “Programming” • UNFPA CCP survey, which examines types of programming, complements the UNFPA Donor Support Report (1996-2007) • UNAIDS IATT on CCP, led by UNFPA, is made up of diverse agencies—multi-bi donors, foundations, intergovernmental agencies, INGOs, contractors and the commercial sector • Advocacy and Resource Mobilization Working Group is gathering information from DPs to determine which agencies are providing which kinds of CCP support in which countries • Simple online Survey Monkey questionnaire • “who is doing what, when, where and how much”
Mini-Survey Facts • Contacted approximately 60 agencies thought to be supporting “significant” CCP work in 138 low- and middle-income countries • 39 development partners completed survey (65%) • 23 of the respondents are members of the RH Supplies Coalition • Non-responders include UNAIDS, WHO/HIV and several European INGOs • Multi-bi donors and foundations informed but not invited… why? Countdown Europe 2015 and likely double-counting
Internal Analysis: Findings • Development Partners • Agency Budgets re HFT, male and female condoms (N/A) • Key Populations • Prevention Interventions • CCP Programming Support by Country • CCP Programming Support by DP • Development Partners’ Suggestions
External analysis • External analysis compares support for the nine CCP components against: • Income levels • Epidemic status • Check out the annex tables in back of 2nd Evaluation of UNAIDS • The goal of the external analyses is to look for associations rather than imply causality
Future External analysis Future external analyses may compare possible associations of DP support for the nine CCP components against: • RHCS Working Groups • Social marketing programs • PEPFAR • Suggestions?
Implications for UNFPA and development partners • Gaps do exist… For example, social marketing programs not present in every developing country • Support is hard to quantify… Financial investment and programme data not fully available • More strategic planning and coordination is needed… No one alone can do all that needs to be done • UNFPA can improve leadership… and coordination amongst development partners, strengthen national programmes and help make them more strategic, coordinated and effective • DPs & countries must vet the data and engage
DPs’ Suggestions on how UNFPA can improve its global CCP leadership • IPPF: Integrate Condom Programming as a component of the different thematic areas of UNFPA's work such as Youth, HIV and Reproductive Health rather than to have it as a stand alone programme (in particular at HQ level). There can be CCP focal points within specific thematic areas. • RHSC: …there should be a dedicated (or half time) programme/technical officer whose job is to foster government buy in to CCP, help establish the Support team and assist the government in understanding the importance of the non-public sector in condom programming.
DPs’ Suggestions on how UNFPA can improve its global CCP leadership • GPST: UNFPA should take the lead in working more effectively with Global Fund to ensure all countries worldwide include both male and female condom procurement and programming funds in their GF applications. • World YWCA: UNFPA should strengthen relationships with UNAIDS at the country level-- very often this is where people are doing the most work and it is at the country level that demand for condoms needs to be created to put more pressure on the secretariat in Geneva.
Next Steps • Review and revise DP report—members of IATT/CCP Working Group on “Advocacy and Resource Mobilization” • Disseminate findings in peer review media • Mobilize CCP Champions via IATT’s members—activate donors and country stakeholders to promote comprehensive, strategic, integrated and coordinated efforts • Mobilize UNFPA Regional and Country Offices – working together with Government and national stakeholders develop CCP strategies as integrated parts of RHCS and SRH
Thank you! (P.S. “Road to Maternal Mortality”…)
Road to Maternal Mortality:The Story of Mrs. “X” Obstacles in the road… Correct responses! • Poor socio-economic development • Excessive fertility • High-risk pregnancy • Life-threatening complications DEATH • Raise women’s status • Quality FP services • Community-based maternal services • Accessible first-level referral services LIFE Narrated by Dr Mahmoud Fathalla
Comprehensive Condom Programming “FRAMEWORK” Framework contains 4 broad components that define CCP: • Leadership and Coordination (advocacy*, policy strengthening, links with other programmes and resource mobilization) • Demand, Access and Utilization (market research, TMA, social marketing, targeted distribution, IEC/BCC, social mobilization) • Supply and Commodity Security (forecasting, procurement, QA, storage, distribution, LM) • Support (advocacy, socio-behavioral & OR, capacity strengthening, training, M&E, documentation and dissemination of results *items highlighted in red are the nine CCP components included in the Mini-Survey
Commodities + Programming • UNFPA Donor Support Report, 1996-2007 • Tracks annual donor support to commodities, specifically contraceptives and condoms • Vital information: overall donor support for commodities is flat even as condom support, especially to Africa, is rising • Programming costs, needed for quality service delivery, are estimated to be at least four times the cost of the commodities themselves • UNFPA CCP survey, which describes the types of programming, aims to complement the report
DPs’ Suggestions on how UNFPA can improve its global CCP leadership • AVAC: Advocate more aggressively and at the highest levels for condom access and programming. • CHANGE: CCP is a place where reproductive health (including maternal health and family planning) merges with HIV/STI prevention, treatment and care, and can serve as a model for integrated services, dealing with women and all people, holistically, with a continuum of care, life cycle approach to meeting individual health needs.
DPs’ Suggestions on how UNFPA can improve its global CCP leadership • GCM: I think UNFPA needs to cultivate the resources to ASSURE that intensive female condom initiatives are included in every one of its in-country CCP campaigns! Inclusion of FC-based effort and supply as a substantial part of each country's program should be a mandatory part of CCP.
DPs’ Suggestions on how UNFPA can improve its global CCP leadership • UAFC: Female condom programming has to target the general female population and not specific target groups only. Supply chains for female condoms have to be improved and stock-outs have to be avoided.