strategic budgeting process for scale-up of family … · strategic budgeting process for scale-up...

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Strategic Budgeting Process for Scale-Up of

Family Planning Costed Implementation Plans

(CIPs) for Family PlanningAnnie Chen

Nichole ZlatunichModibo Maiga

Donald Dickerson

November 2013

polic

y

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Donors who have supported the Costed Implementation Plan (CIP) process include:n Ouagadougou Partnership

n Bill & Melinda Gates Foundation

n United States Agency for International Development (USAID)

Technical partners who have supported the process include:n Health Policy Project (HPP), Futures Group

n Futures Institute

n FHI 360

n Clinton Health Access Initiative (CHAI)n Advance Family Planning (AFP)

This booklet was prepared by the Health Policy Project. The Health Policy Project is a five-year cooperative agreement funded by the United States Agency for International Development (USAID) under Cooperative Agreement No. AID-OAA-A-10-00067, beginning September 30, 2010. It is implemented by Futures Group, in collaboration with CEDPA (part of Plan International USA), Futures Institute, Partners in Population and Development Africa Regional Office (PPD ARO), Population Refer-ence Bureau (PRB), RTI International, and the White Ribbon Alliance for Safe Motherhood (WRA).

Ack

now

ledg

men

ts

Fore

wor

dAt the Ouagadougou Partnership and Family Planning 2020 (FP2020) meetings, governments committed to improving access to family planning (FP) services and information.

National Costed Implementation Plans (CIPs) for family planning provide a framework and tools for governments to achieve these international family planning commitments.

This booklet:n Introduces the methodology and tools behind national Costed

Implementation Plans for family planning

n Walks through ten steps for designing and implementing a national CIP for family planning

n Shares experiences from African countries that have developed a national CIP for family planning to inform their decision making

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Con

text

n The Ouagadougou Partnership and FP2020 meetings generated global commitments from countries to make high-quality, voluntary family planning services, information, and supplies more available, acceptable, and affordable

n Core goals of these commitments are country-driven planning and accountability for national family planning programs

n Donors committed to support funding, technical assistance for implementation, and monitoring

Countries that are part of:

� Ouagadougou Partnership� FP2020� Both

The Ouagadougou Partnership & FP2020 Countries

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Con

text

Issue: Meeting Ouagadougou Partnership and FP2020 commitments without a systematic, national action plan for family planning is challenging.

Solution: Countries analyze family planning needs, develop national strategies, and determine approaches to attain the ambitious commitments made in the Ouagadougou process and at the London FP Summit to be implemented through FP2020.

Using CIP tools and methodologies, countries can develop a targeted national plan to address priority family planning needs.

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Con

text

Benefits of Costed Implementation Plans for family planning include that they:

n Clarify country strategies—CIPs articulate the country’s consensus-driven priorities for family planning

n Detail activities and an implementation roadmap—Ensure that all necessary activities are included with defined targets

n Determine impact—Develop estimates of the demographic, health, and economic impacts of the national family planning program

n Define a budget—Determine detailed costs associated with the national family planning program

n Secure commitment—Determine and secure current donor and national government commitments, identify funding gaps, and develop an advocacy plan to ensure adequate funding is raised

n Monitor progress—Measure activity implementation to help ensure country objectives are met

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Con

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Building in country ownership from the start is essential to the development of CIPs

n Good coordination among the ministries, civil society, and implementing partners is critical

n The CIP process ensures that existing coordinating mechanisms, ongoing efforts, and technical and financial partners in the specific country are involved

n Each CIP is unique because it addresses the specific country context and strategic priorities for family planning, and leverages existing local resources and expertise

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Met

hodo

logy 10-step methodology to develop country-owned national Costed

Implementation Plans for family planning

Government requests a Costed Implementation Plan

Develop a Technical Support Team

Conduct a landscape analysis for FP

Prioritize key FP interventions

Refine the National Action Plan for FP

Estimate the demographic, health, and economic impacts

Finalize the National Action Plan for family planning

Estimate costs and financing gaps

Performance management

National Advocacy Day

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3

4

5

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8

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Tool

s

Costed Implementation Plans include:1

n A National Action Plan for family planning

n A detailed list of activities to be implemented with a corresponding timeline

n Detailed activity-based budgets

n An estimate of costs for the National Action Plan with financial gap analysis

Optional elements that countries may select include:

n Impact estimates of demographic, health, and economic impacts

n A national landscape analysis for family planning

n Monitoring and evaluation (M&E) tools

n Regionalization of activities and budgets

n Marketing and communications materials

1 Zlatunich, N. 2013. Costed Implementation Plans for Family Planning, Washington, DC: Futures Group, Health Policy Project.

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Lessons Learned from African Countries

Lessons learned from implementing CIPs for family planning in the following countries:

� Burkina Faso� Guinea� Mauritania� Niger� Togo� Senegal� Zambia

Less

ons

Lear

ned

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At the Ouagadougou Partnership meeting, Burkina Faso set an ambitious target to increase its contraceptive prevalence rate (CPR) to 25 percent by 2015, which will require an additional 332,000 new modern contraceptive users.

Burk

ina

Faso

2012 Target 2015

869,000

537,000

+332,000

Modern Contraceptive Usage Married women 15–49 years old

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Burk

ina

Faso

To achieve its international commitments, Burkina Faso decided to develop a Costed Implementation Plan for family planning.

The CIP process in Burkina Faso included:

n Convening the government of Burkina Faso, donors, civil society, and representatives from the community to prioritize key family planning needs

n Using data and interviews on family planning policies, programs, and financing to inform the National Action Plan on family planning and impact measures

n Projecting future family planning needs based on existing demography and FP services

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As a result of implementing a CIP for family planning, by 2015 an additional 399,000 women will have access to modern contraceptive methods in Burkina Faso.

Burk

ina

Faso

140 20 40 60 80 100 120

CentreBoucle du MouhounHauts BassinsCentre-OuestCentre-EstEstNordCentre-NordSahelCentre-SudPlateau CentralCascadesSud-Ouest

101 46 56 49 25 25 23 25 9 10 19 74

Total 399,000

RegionsAdditional women using modern contraceptives 2013−2015(in thousands)

,

Gui

nea

At the Ouagadougou Partnership meeting, Guinea set the ambitious target of increasing its contraceptive prevalence rate to 22.1 percent by 2018, requiring an additional 521,000 new users of modern contraceptives for a total of 772,000.

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2012 2013 2015 2018

CPR 7% 8% 13.6% 22.1%

� Women not using modern contraception� Women using modern contraception

Modern Contraceptive Usage • Married women 15−49 years old

Thou

sand

s

2,665 2,707 2,691 2,642

0

750

1500

2250

3000

Gui

nea

To achieve the international commitments it made at FP2020, Guinea developed a national CIP for family planning. Imple-menting Guinea’s national CIP for family planning would avert 16,500 infant deaths and 2,000 maternal deaths by 2018.

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50

51

53

55

56

58

60

2013 2014 2015 2016 2017 2018

Infant Mortality Rate • Implementation of CIPs, 2013–2018

� Without action plan� With action plan

Thou

sand

s

56.8

57.6

56.7

57.9

55.9

58.2

55.0

58.5

54.0

58.5

52.6

Mau

ritan

ia

Mauritania set the ambitious goal of increasing its contraceptive prevalence rate to 18.5 percent by 2018, requiring 55,000 new users and a total of 115,000 women using modern contraceptives.

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0

200

400

600

800



2011 2013 2015 2018

697,289

CPR 10% 11% 14.6% 18.5%

725,353 741,683 764,606

Thou

sand

s

To achieve the international commitments it made at FP2020, Mau-ritania decided to develop a Costed Implementation Plan for family planning. Implementation of the CIP from 2014–2018 would give 55,000 more women in Mauritania access to modern contraceptives.

The CIP process in Mauritania included:

n Convening the government of Mauritania, donors, civil society, and representatives from the community to develop a detailed plan that addresses family planning holistically by focusing on increasing the demand and supply of family planning services and commodities, creating an enabling environment for family planning, and improving monitoring and coordination

n Using data on family planning policies, programs, and financing to inform the National Action Plan on family planning and to project future financial gaps

n Launching an Advocacy Day to disseminate the CIP and advocate for international donors to partner with Mauritania to implement its National Action Plan

Mau

ritan

ia

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Nig

er

Niger set the ambitious target of increasing its contraceptive prevalence rate to 25 percent by 2015, and to 50 percent by 2020, requiring 450,000 new modern contraceptive users by 2015.

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0

1000

2000

3000

4000

2012 2013 2014 2015 2016 2017 2018 2019 2020

407

2,701

852

2,555

1,954

1,954

3,108 3,207 3,307 3,407 3,507 3,607 3,708 3,808 3,908



Thou

sand

s

CPR 25% 50%

Niamey +6.0% +76,000

Agadez +3.3% +14,000

Dosso +4.0% +59,000

Tahoua +4.0% +78,000

Tillabéri +5.0% +85,000

Zinder +5.0% +96,000

Maradi +3.0% +85,000

Diffa +1.5% +5,000

Total +4.5% +499,000

Region Annual target CPRAdditional women who have access to modern contraceptives

Nig

er

To achieve its international commitments, the government of Niger developed a CIP for family planning. Implementation of the CIP would give 499,000 more women access to modern contraceptives by 2015.

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Sene

gal

At the Ouagadougou Partnership and FP2020 meetings, Senegal set an ambitious goal of increasing its contraceptive prevalence rate to 27 percent by 2015 and to 45 percent by 2020, requiring the addition of 360,000 new modern contraceptive users by 2015.

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2011 Target 2015

578,000

228,000

+350,000

Modern Contraceptive UsageMarried women 15–49 years old

CPR 12% 27%

Sene

gal

To achieve the international commitments it made at the Ouagadougou Partnership and FP2020 meetings, the Republic of Senegal developed a CIP for family planning.

The CIP process in Senegal included:

n Three Technical Committee meetings and workshops to ensure the process was country-owned and country-driven from inception

n A landscape analysis of family planning policies, programs, and financing

n Meetings with Chief Medical Officers in two regions, the Minister of Health and Social Welfare, and the Cabinet to approve the National Action Plan for family planning

n Establishment of working groups to define strategic actions in Senegal

n A calendar for implementation

n Development of performance measures

n A national Advocacy Day

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Implementation of Senegal’s CIP includes plans to increase investment in communication and advocacy, and in the availability of FP services and commodities. The real impact of implementing the CIP in Senegal would mean an additional 360,000 women will have access to modern family planning methods by 2015. Se

nega

l

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Togo

At the Ouagadougou Partnership meeting, Togo set the ambitious target of increasing its contraceptive prevalence rate to 20.6 percent by 2015, requiring an additional 211,683 new modern contraceptive users.

0

300

600

900

1200

15001,343,301 1,375,119 1,389,164 1,404,739

Thou

sand

s

CPR 13.2% 15.2% 20.6% 24.3% 2010 2012 2015 2017



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To achieve the international commitments it made at the Ouagadougou Partnership meeting, Togo decided to develop a Costed Implementation Plan for family planning.

The CIP process in Togo included:

n Developing a landscape analysis of family planning in Togo which guided the development of national strategies that build on existing community-based efforts to improve family planning

n Using data and interviews on family planning policies, programs, and financing to identify finance gaps and opportunities

n Developing seven mechanisms to monitor, evaluate, and coordinate family planning efforts at all levels

Togo

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Togo

The real impact of implementing Togo’s Costed Implementation Plan for family planning would avert 369,000 infant deaths and 17,500 maternal deaths by 2050. By 2050, the CIP would also save a total of USD$185 million (90 billion F CFA).

0

50

100

150

200

250

300

350

400

2010 2020 2030 2040 2050

F C

FA (

in b

illio

ns)

90 billion F CFA saved

19 19

93

154

91

144

244

211

375

285

� Without Action Plan� With Action Plan

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At the FP2020 meeting, the government of Zambia pledged to increase the contraceptive prevalence rate from 33 percent in 2007 to 58 percent by 2020. The government decided to develop a CIP to ensure that current gaps in family planning in Zambia will be adequately addressed.

Strategic priorities in Zambia include:

n FP demand generation and behavior change communication

n Adolescents and youth

n Staff and training

n Access to FP services for rural and underserved populations

n Stockouts at service delivery points

n FP governance structure and FP policy monitoring and coordination

Zam

bia

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Implementation of Zambia’s CIP from 2013–2020 would:

n Avert 3.5 million unintended pregnancies

n Avert 104,177 child deaths and 9,926 maternal deaths

n Save 1,492 million Zambian kwacha (ZMW) Zam

bia

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0

50

100

150

200

250

300

2013 2014 2015 2016 2017 2018 2019 2020

Savings due to implementation of the CIP

ZMW

(in

mill

ions

)

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Front cover photo: Pierre Holtz, UNICEF, Humanitarian and Development Partnership Team Page 1 photo: Andre Thiel Page 3 photo: United NationsPage 21 photo: ©Ami Vitale, The World BankBack cover photo: Pierre Holtz, UNICEF, Humanitarian and Development Partnership Team

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“The MCDMCH would like to encourage all stakeholders to commit to this important scale-up plan to reach our family planning goal for 2020, so that we can continue to save lives, and women and families can continue to fully enjoy the benefits of family planning.” Hon. Dr. Joseph Katema, MP, Zambia

Health Policy Project (HPP)Futures GroupOne Thomas Circle, NW, Suite 200Washington, DC 20005Tel: (202) 775-9680Fax: (202) 775-9694Email: [email protected]

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