Fp2020 pARTNERSHIp IN ACTION 2012-2013 - Family Planning 2020
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fp2020 PARTNERSHIP IN ACTION 2012-2013 www.familyplanning2020.org
fp2020
@FP2020Global
#FP2020Progress
PARTNERSHIP
IN ACTION
2012-2013
ISSUED NOVEMBER 2013
WWW.FAMILYPLANNING2020.ORG AMENDED DECEMBER 2013TABLE OF Executive Summary 5
CONTENTS Foreword 7
When women have the
FP2020 PROGRESS 9
FP2020: Commitments and Accountability 11
tools they need to plan
FP2020: Innovation and partnership 37
FP2020: Measuring Progress 57
their families—information,
Annexes
FP2020 Reference Group & Working Group Members 95
access to contraceptives,
FP2020 Commitment Makers 99
69 Focus Countries 101
and high-quality health
acronyms 102
care—they are much more
likely to finish their
education. That gives them
the opportunity to do what
they do best: build thriving
families, communities,
and nations.
Melinda Gates
Co-Chair, Bill & Melinda Gates Foundation
Partnership in Action 3 4 Partnership in ActionEXECUTIVE At the 2012 London Summit on
Family Planning, the leaders of
initiated a number of activities to
establish the systems and infra-
SUMMARY 150 countries, international agen-
cies, civil society organizations,
structure necessary to monitor the
impact of family planning programs
foundations, the research and and to strengthen accountability for
development community, and the implementing financial, policy, and
Our goal is to private sector endorsed the goal
of expanding access to family
programming commitments. This
undertaking included the selection
expand access planning information, services, of core indicators, collating corre-
to contraceptives and supplies to an additional 120
million women and girls in the
sponding baseline data, improving
the way in which family planning
to an additional world’s poorest countries by 2020. expenditures are tracked, and
launching electronic data collection
120 million women Family Planning 2020 (FP2020)
carries forward this momentum.
in select countries.
and girls in the Since its launch, more than 25,000
individuals and organizations
Importantly, FP2020 also laid the
groundwork to develop a transfor-
world’s poorest have expressed interest in joining mative framework to measure and
countries by 2020. FP2020, and the constellation
of stakeholders who are vested
report on the autonomy, equity, and
human rights–based dimensions of
in improving women’s and girls’ family planning programs.
lives continues to grow.
Countries have made progress
One-quarter of FP2020 commitment- in addressing supply and demand
making countries have launched barriers to accessing family planning.
detailed, costed national fam-
ily planning plans. One-third of This report describes significant
commitment-making countries have actions taken in the past year,
increased their national budget including price reduction agree-
allocations for family planning ments, innovations in contraceptive
services or supplies. Half of com- technology, improvements in ser-
mitment-making countries have held vice delivery and commodities
national family planning conferences distribution models, and outreach
to emphasize high-level political to vulnerable and marginalized
support and to accelerate progress groups, in the global effort to con-
on family planning strategies. tinue to expand access and choice
for millions of women and girls.
Preliminary data on international
donor expenditures indicate an The progress documented in this
increased level of disbursements report demonstrates that we
on family planning programs. are moving forward—program by
Concrete examples of progress program, clinic by clinic, and com-
on the local, national, and regional munity by community—toward a
levels are detailed throughout future in which all women, no
this report. matter what their circumstances,
will have the information, services,
A rigorous measurement and evalu- and supplies they need to decide
ation agenda has been established freely and for themselves whether,
as a means of guiding progress in when, and how many children they
delivering on the promise set forth in want to have.
London. Over the past year, FP2020
Stephanie Freid-Perenchio
photography/SFP STUDIO
Partnership in Action 5 6 Partnership in ActionFOREWORD It may defy the rules of mathematics,
but there is truth to the observation
that harnessed market incentives to
solve formerly intractable problems.
tion, and a lack of appreciation for
cultural sensitivities and personal
preferences are all formidable barri-
that a whole can be greater than Millions of women in the world’s
the sum of its parts. This insight lies poorest countries will now have ers. Family planning strategies will
Under the right at the heart of the Family Planning
2020 (FP2020) initiative. We believe
access to long-acting, reversible
contraceptive methods thanks to the
not succeed unless they are embed-
ded in a continuum of care, protect
conditions,bringing that, under the right conditions,
bringing together a broad, diverse
vision and dedication of colleagues
representing governments, NGOs,
human rights, and promote gender
equality. No plan can be said to
together a broad, group can yield results far greater pharmaceutical companies, donors, serve the needs of women and girls
diverse group can than the participants would achieve
on their own.
and multilateral organizations. if it does not respect their agency.
yield results far Last year, leaders from govern-
Accurate, timely, accessible informa-
tion is the lifeblood of this initiative.
As we present FP2020’s first annual
progress report, we look forward
greater than the ments, civil society, multilateral
organizations, donors, the private
That’s why FP2020 is committed
to expanding participation in the
to the year ahead. We are inspired
by the power and promise of infor-
participants sector, and the research and
development community converged
practices of measurement, evalu-
ation, and adjustment, which for
mation, the dynamic intelligence
and creativity of our colleagues in
would achieve at the London Summit on Family many countries are in their infancy. all sectors, and our shared dedica-
on their own. Planning to agree upon one extraor-
dinary—but absolutely vital—goal:
For the first time, this report docu-
ments the results of our collective
tion to achieving our common goal.
Reaching 120 million additional
women and girls with life-saving
expand access to family planning effort to establish a measurement
information, contraceptives, and framework for the initiative. The contraceptives in just eight short
services to an additional 120 indicators, methodologies, and years is an ambitious goal, but
million women and girls in the data presented here will serve as together we will succeed.
world’s 69 poorest countries by the the baseline to gauge our progress
year 2020. Seventy commitments in future years. This is especially
were made, and donors and the important because, though the
private sector pledged US$2.6 world is spending more on family
billion in new funding. planning, funding is still inadequate.
Budgets for international assistance
FP2020 carries forward the momen- have been cut and programs are Dr. Chris Elias
tum of the Summit. It is not a under greater pressure than ever President, Global Development
new NGO, nor is it a vertical fund. before. Through careful analysis we BilL & Melinda Gates Foundation
Instead, it is a different way of work- will diminish inefficiencies, leverage
ing together: a creative network of economies of scale, and focus on
cooperation that revolves around plans that work.
a hub to promote knowledge
sharing and emergent thinking. Expanding access to contracep-
Rather than duplicating efforts or tives for an additional 120 million
pushing organizations into a new women and girls will require the
hierarchy, FP2020’s structure equivalent of US$4.3 billion over Dr. Babatunde Osotimehin
encourages partners to align their the next eight years, over and
Executive Director
agendas, pool their talents, and above the US$10 billion necessary
utilize existing structures in new to sustain current use. FP2020 will United Nations Population Fund
and complementary ways. One actively seek new funding, policy,
year after the Summit, we have and service delivery commitments.
successfully formed new alliances We will promote accountability for
among a broad range of partners those commitments by tracking
from all sectors. We must now hold and reporting progress, linking with
ourselves accountable. the UN Secretary General's Global
Strategy for Women's and Children's
We believe that the family planning Health, Every Woman, Every Child.
community’s greatest resource is
the human energy of our diverse Insufficient funding is just one
leaders, experts, advocates, and reason family planning programs
implementers. Some of the most may fail to reach women and girls.
exciting progress of the past year Social and cultural factors such
came from innovative partnerships as gender inequality, discrimina-
Partnership in Action 7 8 Partnership in ActionFP2020 07.12 • London Summit on Family 02.13 • Niger launches costed national 08.13 • FP2020 Rights & Empowerment
Progress Planning. 70 commitments made
toward increasing access to
family planning plan
• FP2020 Stakeholders meet
Working Group convenes for first
full meeting, Washington, D.C.
family planning for additional 120 • Agreement to reduce price of • Burkina Faso launches
million women and girls, including Jadelle® contraceptive implant Consolidated Action Plan
2012-2013 pledges amounting to US$2.6
billion and commitments by more
for Family Planning
than 20 governments 03.13 • FP2020 Reference Group
• Announcement to expand access
to Sayana® Press injectable
meets for the second time,
Washington, D.C.
09.13 • Indonesia holds National Family
Planning Summit, Jakarta
contraceptive • Senegal launches nationwide
scale-up of Informed Push Model
05.13 • FP2020 commitment makers of distribution for contraceptive
10.12 • Kenya launches costed national
family planning plan
at Women Deliver Third Global
Conference, Kuala Lumpur
commodities
• Zambia launches Costed Eight-
• Ghana holds national family • PMA 2020 and Track 20 Year Integrated Family Planning
planning conference, Kumasi projects launch Scale-up Plan
• Agreement to reduce price of • FP2020 Reference Group
IMPLANON® and IMPLANON NXT® Meeting, New York
11.12 • Ethiopia holds National Family contraceptive implants • Family Planning Association
Planning Symposium, Bahir Dar • FP2020 Reference Group meets of Pakistan holds Towards
• India holds National Review for the third time, Kuala Lumpur Realizing Family Planning Vision
Meeting on Family Planning, 2020 seminar
New Delhi
• Nigeria holds National Family 06.13 • Burkina Faso launches national
Planning Conference, Abuja
• Senegal launches National
family planning plan
• Memberships of FP2020 Country
10.13 • Tanzania holds national
family planning conference,
Strategic Plan for Family Engagement, Performance Dar-es-Salaam
Planning Promotion Monitoring & Accountability, and • FP2020 Market Dynamics
• Kenya amends National Family Rights & Empowerment Working Working Group membership
Planning Service Provision Groups announced announced
Guidelines, allowing trained
community health workers to
offer injectable contraceptives
at community level
07.13 • Uganda’s Parliament approves the
National Population Council Bill
11.13 • Third International Conference
on Family Planning, Addis Ababa.
• One-year anniversary of the New FP2020 commitments
London Summit on Family announced
12.12 • Responsible Parenthood and
Reproductive Health Act signed,
Planning
• FP2020 Country Engagement
Philippines
• Malawi approves National
Working Group convenes for first
full meeting, Washington, D.C.
12.13 • Uganda to hold national family
planning conference
Population Policy • FP2020 Performance Monitoring
• FP2020 Reference Group meets & Accountability Working Group
for the first time, New York convenes for first full meeting,
Geneva
Partnership in Action 9 10 Partnership in Action01
Family planning programs have had a many decision makers, funding and
SECTION 01 profound impact in a relatively short
period of time. In the developing
implementing these programs were
no longer priorities.
world, the contraceptive prevalence
Commitments rate (modern methods) rose from
negligible levels in the 1960s to
Today, this work remains far from
finished. There are more than 220
and Accountability 55% in 2000.1 Although many
groups were underserved, steady
million women in developing countries
who don’t want to get pregnant but
progress was manifest. lack access to the family planning
information, services, and supplies
But the gains stopped, and the they need. Nothing short of our full
contraceptive prevalence rate dedication is required to surmount
leveled off. Support for family the logistical, financial, geographical,
planning and reproductive health and other barriers they face. It is
remained high, but the sense of to these women that FP2020 is
urgency had waned. For far too ultimately accountable.
1
Singh S and Darroch JE,
Adding It Up: Costs and
Benefits of Contraceptive
Services, Estimates for 2012,
New York: Guttmacher Institute
and United Nations Population
Fund (UNFPA), 2012, http://
www.guttmacher.org/pubs/
AIU-2012-estimates.pdf
Partnership in Action 11 12 Partnership in ActionWomen and FAMILY
Girls at PLANNING
the Heart 2020
of FP2020
Bridget Anyafulu is the was caught taking a pill, his wrath, She went from village to village and The 2012 London Summit on countries to adhere to a new
founder and executive director and the wrath of his family, could home to home, talking with leaders Family Planning was intended to reporting regime. FP2020 does not
of the International Centre for be formidable. and individual husbands about reenergize the global family planning divert attention from its constituent
Women’s Empowerment and Child the benefits of family planning. community, but the enthusiasm it stakeholders, but rather magnifies
Development (ICWECD). She is The women devised a plan. They She persuaded them that having unleashed far exceeded expecta- their ability to mobilize resources
based in Delta District, Nigeria. bundled up their contraceptives fewer children, who are healthy and tions. Leaders from 150 donor and and deliver life-saving services.
She is a member of the FP2020 and hid them in a tree near the educated, is a better legacy than developing countries, international
Rights & Empowerment Working river. Every day, on their way to having many children whose pros- agencies, civil society organizations, FP2020 structure
Group, with whom she shared fetch water, they could take their pects are dim. She helped them foundations, and the private sector
this story. pills out of sight of the men. understand that when a mother joined together to endorse the goal FP2020 is governed by a Reference
dies in childbirth, the whole family of expanding access to contracep- Group that sets the overall strategic
A project that brings fresh running Then the pipes came. Now, with and the community suffer. tives to an additional 120 million direction and drives coordination
water to a remote, impoverished running water not 200 meters from women and girls in the world’s among the partnership’s stakehold-
village — how could it be anything their doorsteps, the women had It took many years of hard work, poorest countries. ers. The Reference Group has 18
other than a blessing? no excuse to visit the tree by the but today, attitudes in Delta District members representing govern-
river. They didn’t want to get caught have changed. Family size is smaller, FP2020 carries forward this momen- ments, multilateral organizations,
The local women didn’t see it by their husbands, but no woman and there are fewer maternal and tum. Since its launch, more than civil society, and the private sector.
that way. wants to die in childbirth or lose newborn deaths. There is still a 25,000 individuals and organiza-
her newborn. long road ahead, but the lessons tions have expressed interest in join- The current Co-Chairs of the Refer-
In a small village in the Delta are clear. Services should never ing FP2020, and the constellation ence Group are Dr. Babatunde
District of Nigeria, women would So they came up with a new be implemented without a deep of stakeholders continues to grow. Osotimehin, Executive Director
walk up to four kilometers every day plan. The women vandalized the understanding of the needs of all of UNFPA, and Dr. Chris Elias,
to get water from the nearest river. water pipes. members of a community. Building FP2020 has developed a platform President of the Global Develop-
These women had a secret. a pipeline is not enough. For that recognizes change must occur ment Program at the Bill & Melinda
When Bridget saw what had change to take root, we must place on multiple levels, across multiple Gates Foundation. To date, the
Many were desperate to delay happened, she knew the problem women’s empowerment at the sectors, by enabling a broad range Reference Group has met four
getting pregnant. Local people was neither the pipes nor the center of the development agenda. of allies to participate in their times: in December 2012 and in
believed husbands should decide women. She understood that area of expertise. The structure of March, May, and September 2013.
how many children to have, and the root of the trouble was the FP2020 fosters the cross-pollina-
men preferred big families. It was husbands’ attitude toward family tion of ideas and creates a space FP2020 has a Task Team respon-
not unusual for women to give birth planning, and the cultural norms to reach consensus, especially on sible for the implementation of day-
eight, nine, or 10 times. Motherhood that kept women disempowered. crucial matters such as indicators to-day activities. It is led by Valerie
started early; one assessment She also knew that if this was a to monitor progress. DeFillipo, reports to the Reference
found that approximately 50% of the problem in one village, it was likely Group, and is hosted by the UN
village’s girls already had a child. a problem in other Delta District Equally important are the things Foundation. The Task Team moni-
Tragically, maternal and child deaths communities. FP2020 does not do. It does not tors overall progress for reporting
were common. create bottlenecks by funneling all to countries and to the Reference
Bridget’s strategy was to convince participants into one-size-fits-all Group, coordinates across other
If a woman could get to a hospital, husbands that women have the right strategies. In recognition that entities and external groups, and
she could get access to contracep- to live and to see their children grow duplicative reporting structures supports Working Group strategies
tives. But getting there was only and thrive. To do that, women need create significant administrative and implementation.
part of the problem. By taking to space their pregnancies and have burdens, FP2020 does not require
contraceptives, a wife was usurping fewer children.
her husband’s authority. If she
Partnership in Action 13 14 Partnership in ActionThe imperatives of human rights guidance, best practices, and tools
and public health are not merely to ensure that a rights-based
compatible; they are indivisible. approach underpins the design,
FP2020 has four Working Groups implementation, monitoring, and
that mirror the lateral, organic
interrelation of the forces that
evaluation of family planning
programs. RE WG will collaborate The London Summit on Family
contribute to rights-based family
planning programs.
with other Working Groups and
partners to address the full range Planning last year was a starting point
• Countries vary in the type of
of barriers that limit or prevent
many women from using family for determined global action on family
support they need to develop,
implement, and monitor transfor-
planning information, services,
and supplies, and to prioritize planning. Public, private and civil society
partners from around the world agreed
mational national family planning human rights principles such as
strategies. The Country Engage- participation, accountability, non-
ment Working Group (CE WG) works discrimination, empowerment,
with partners to provide support
to accelerate the implementation
transparency, and sustainability in
all FP2020 activities. to a goal of giving an additional
of country plans within the context
of their reproductive, maternal, • FP2020’s Market Dynamics 120 million girls and women in the world’s
newborn, and children’s health
strategies. CE WG facilitates
Working Group (MD WG) will
improve global and national poorest countries access to voluntary
access to technical, funding, and
other assistance, and coordinates
information sharing and peer-
markets to sustainably ensure
choice and equitable access to
a broad range of high-quality,
family planning by 2020.
to-peer support. CE WG works affordable contraceptive methods.
with the Performance Monitoring
& Accountability Working Group
MD WG is driven by the need
to ensure that family planning Investing in girls and women in this way is also
the smart thing to do. It is about giving women
(PMA WG) to measure the impact commodities are available for an
of family planning programs and additional 120 million women
to strengthen countries’ efforts and that the market is healthy
to collect and utilize data on an
ongoing basis to inform decision
enough to sustain this demand
after 2020. A well-coordinated, in developing countries the choice over when
making. expert working group focused on
addressing tensions and infor- to get married and how many children to have,
• Substantial and consistent moni-
toring and evaluation efforts are
mation gaps in the market can
unlock new and important oppor- control over their lives and their job prospects,
central to FP2020’s efforts to track
advances, identify gaps and chal-
lenges, and promote accountability.
tunities to ensure that access
to contraceptive supplies and
services is expanded. That is the
and a voice in their communities.
The PMA WG strives to improve the aim of market shaping, whether
I welcome the progress the FP2020 movement
quality and availability of informa- it is achieved by making products
tion for use at the community, more affordable, ensuring appro-
country, and global levels and to priate product design, securing
further explore methodologies to
measure service quality, encour-
adequate and sustained supplies,
improving product quality, or has made so far and the UK will continue to
age the use of data in program
management and policy develop-
increasing product availability.
play its part. Our goal must be for all girls
ment, and embed human-rights
approaches recommended by the
Each Working Group has an
affiliated Consultative Network of and women to have the opportunity to
Rights & Empowerment Working
Group (RE WG).
stakeholders who will be engaged
periodically for input on Working
Group activities. The Consulta-
shape their own future.
• FP2020 envisions a world where tive Networks provide additional
the right of women and girls, expertise and are instrumental in
no matter where they live, to identifying critical resources and The Right Honourable Justine Greening
decide whether and when to have materials that highlight success MP, Secretary of State for International
children is respected, protected, stories, high-impact practices, and Development, United Kingdom
and fulfilled. The RE WG acts innovations to share with decision
as a resource for expertise, makers at the country level.
Partnership in Action 15 16 Partnership in ActionProgress on
Commitments
to FP2020
The enthusiasm that emerged FP2020 Commitment Makers
at the London Summit on Family
Planning is yielding tangible results,
and it is clear that countries2 are
leading the way. As of July 2013,
countries comprised one-third of the
70 commitment makers to FP2020.
The FP2020 commitment-
making countries are:
34%
Bangladesh Pakistan
Burkina Faso Philippines 6%
Côte d’Ivoire Rwanda
Ethiopia Senegal
Ghana Sierra Leone
India Solomon Islands
Indonesia South Africa3
Kenya Tanzania
Liberia Uganda
Malawi Zambia
Mozambique Zimbabwe
Niger 27%
Nigeria
33%
2 3
Low- and Middle Income Donor Countries,
FP2020's goal is to enable South Africa's GNI does not Countries (24): 34% Foundations, Private
an additional 120 million qualify as one of the world’s
women in the world's poorest poorest based on the World Sector (19): 27%
countries (FP2020 focus Bank 2010 classification
countries) to use modern using the Atlas Method.
contraception by 2020. These Civil Society Multilaterals and
countries—69 in total—are
defined as those with a Organizations (23): 33% Partnerships (4): 6%
gross national income (GNI)
of $2,500 per year or less
(based on the World Bank
2010 classification using the
Atlas Method).
Stephanie Freid-Perenchio
photography/SFP STUDIO
Partnership in Action 17 18 Partnership in ActionProgress is driven by the govern-
ments of these countries, in
Snapshot of Country-Led Progress
collaboration with civil society
organizations, service providers,
Burkina Faso Pakistan
advocates, industry leaders, and
National family planning plan launched National budget for family planning increased for fiscal years 2012-2013
experts. Multilateral organizations,
Introduction plan for Sayana® Press approved Provinces currently developing budget frameworks for financing of family planning
foundations, and other members
of the global family planning
community provide support and ethiopia SENEGAL
technical assistance. National Family Planning Symposium National Strategic Plan for Family Planning Promotion launched
National budget for family planning increased Informed Push Model of distribution scaled up nationwide
One-quarter of FP2020 commit- Community Health Extension program expansion continued Introduction plan for Sayana® Press approved
ment-making countries have
launched detailed, costed national
GHAna Sierra Leone
family planning plans. One-third
National Family Planning Conference National budget for family planning increased
of commitment-making countries
have increased their national Voucher system implemented for family planning services for the poor
budget allocations for family plan- india School for Husbands initiative launched
ning services or supplies. Half National Review Meeting on Family Planning Civil society organizations supported to monitor distribution of
reproductive health commodities
of commitment-making countries
have held national family plan-
indonesia
ning conferences to emphasize South Africa
high-level political support and to National Family Planning Summit
Revised policy to require public health facilities to offer all contraceptive methods
accelerate progress on family plan- National budget for family planning increased
ning strategies. Preliminary data on Family planning services and supplies available free of charge in national insurance
program, commencing January 2014 Tanzania
international donor expenditures
National resources redirected to smaller islands and areas with greatest unmet need National family planning conference
indicate an increased level of
disbursements for family planning National budget for family planning increased
programs. Concrete examples of Framework contract for procurement of contraceptives endorsed by government
kenya
progress on the local, national, and Guidelines approved to allow NGOs direct access to Medical Stores Department
Costed national family planning plan launched
regional levels are detailed through- National budget for family planning services and commodities both increased
out this report. Guidelines changed to allow community health workers to provide injectables Uganda
Increased access to family planning services for the impoverished and youth Stakeholders meeting to develop FP2020 action plan
National budget for family planning supplies increased
Reproductive health subaccount established to track resource flows
malawi
Unified, costed, national family planning plan under development
National Population Policy approved
Policy changed to allow health worker task sharing and administration of injectables
Introduction plan for Sayana® Press approved
Niger Vouchers for postpartum IUDs
Costed national family planning plan launched Planning under way for first national family planning conference (December 2013)
Introduction plan for Sayana® Press approved Parliament passed bill to establish National Population Council
Meeting of 80 traditional chiefs convened by government and UNFPA to
discuss family planning
School for Husbands initiative expanded Zambia
Costed Eight-Year Integrated FP Scale-up Plan 2013-2020 launched
Pilot study on allowing community health workers to provide contraceptive injections
NigerIA
Implementing scale-up of mobile health services
National Family Planning Conference organized
National budget for family planning commodities and services increased
Gombe State plan to expand access to family planning launched
Policy change to allow community health workers to provide injectable contraceptives
Cluster model of integrated services implemented by Nigeria Planned Parenthood
President launched Saving One Million Lives initiative
Family planning trainings scaled up
Trainings of community health workers on injectable contraceptives begin
Distribution of contraceptives to the last mile using review-resupply meeting model
BCC and media campaign to increase knowledge and awareness of female condoms
Detailed implementation plan to expand use of modern contraception developed
Partnership in Action 19 20 Partnership in ActionA CLOSER LOOK:
GHANA
Family planning is
not a privilege, but a
Ghana’s Commitment Ghana has a diverse and inspiring As the delegation toured the facility,
to FP2020 range of family planning and they happened to notice one person
maternal health programs. The who wasn’t taking part in the excite-
Ghana is committed to making city of Tamale, for example, has ment. Her name was Afia, pictured
basic human right.
family planning free in the a brand-new Marie Stopes clinic here, and she sat very quietly in a
public sector and to supporting situated in the middle of an corner, on a hard, wooden bench.
the private sector in providing enormous open-air market. Fully A midwife was by her side.
services. Services will be available stocked with a range of family
By enabling women,
for young people through youth planning information and modern Afia’s face was etched in pain, but
promoters and adolescent-friendly contraceptive options, it makes her cries were muted. With quiet
services. Improved counseling and access easy for the women who dignity, and few of the trappings that
customer care will be prioritized. work in the crowded midday market. attend births in wealthier countries,
particularly the most
Contraceptive choices are being they found out she was in labor
expanded to include a wider range Worlds away from the bustle of to deliver her first child. She had
of longer-acting and permanent the city, there are clinics such as reason to be scared.
disadvantaged and
methods, along with task shifting the one Planned Parenthood of
options and improvement of post- Ghana, built in an isolated village In Ghana, for every 100,000
partum and post abortion family north of Bolgatanga. It offers an women who go into labor, 350 die
planning services. The government integrated mix of family plan- while giving birth or because of
hardest to reach, to make
has put in place a comprehensive ning and other health education pregnancy-related complications.
multisector program to increase services. The local people are
demand for family planning as a proud of their clinic. It is their The following day, the delegation
priority intervention in the MDG 5 only source of medical care. learned that Afia had had a lovely
informed choices about
Acceleration Framework, including baby girl, and both mother and
advocacy and communications to Not long ago, UNFPA Ghana child were happy and, most impor-
improve male involvement, such welcomed a delegation of leaders at tantly, healthy.
as the “Real Man” campaign. the isolated clinic. To get there, they
the number, timing
rode by bus from the nearest city In the coming months and years,
for three hours on unpaved roads. the Planned Parenthood of Ghana
clinic will help Afia keep herself and
The delegation was greeted with her baby healthy, and will give her
and spacing of their
enthusiasm and excitement. About the information and contraceptives
200 people —village elders, moth- she needs to plan her family and
ers and fathers, grandmothers and her future.
children, we help them
grandfathers, children—had come
out to show support for their clinic.
They talked about the difference the
clinic was making in their lives.
exercise this right.
Dr. Babatunde Osotimehin The Planned Parenthood of
Executive Director, UNFPA Ghana clinic will help Afia keep
herself and her baby healthy.
Stephanie Freid-Perenchio
photography/SFP STUDIO
Partnership in Action 21 22 Partnership in ActionA CLOSER LOOK:
INDONESIA
The London Summit
on Family Planning was Indonesia’s commitment
to FP2020
on the FP2020 Reference Group.
BKKBN’s Dr. Siti Fathonah serves
One highlight of the summit was
a panel of young people who
a defining event for
on FP2020’s CE WG, and Dr. Roy discussed the needs of youth
Starting January 1, 2014, family Tjiong of the Indonesian Planned in Indonesia and challenged the
planning services and supplies will Parenthood Association serves on government to increase the legal
be available free of charge through PMA WG. All three played an active age for marriage from 16 to 18
Indonesia's family planning
Indonesia’s universal health role in designing and executing the years old. They asked for more
coverage system, and efforts are Indonesia summit. attention and resources for sexuality
underway to improve 23,500 clinics education and greater support for
and strengthen human resources in Historically, Indonesia had one young people, especially the poor
program. Our commitment
order to meet increased demand. of the world’s most successful and most vulnerable. The Minister
Resources are being reallocated family planning programs. However, of Health, Dr. Nafsiah Mboi, spoke
to focus on the most densely progress has decelerated over the of the critical importance of family
populated areas, and efforts will last decade, and the contraceptive planning in reducing maternal and
there crystallized actions we
be concentrated on reaching choices available for women have infant mortality, and underlined the
populations in rural areas and on diminished. Today, fewer women need to collaborate across govern-
smaller islands. The government are using IUDs and implants than ment programs to support the
is committed to working with
were considering for
15 years ago. Responding to this needs of women and girls. Attend-
national and international partners stagnation, Indonesia committed ees applauded midwives for their
to provide the technical support to improving the quality of its family heroic efforts to improve maternal
needed to provide gender-sensitive, planning program at the London health and for the pivotal roles
revitalizing our program.
high-quality family planning infor- Summit on Family Planning. they play in improving access to
mation and services to all people, family planning and expanding
including unmarried women, youth, Responding to this commitment, contraceptive options.
and the poor. BKKBN convened four FP2020
FP2020 continues to be a
country meetings. The meetings, Another high point was the
Indonesia’s Family Planning which were co-chaired by USAID and announcement that BKKBN and
Summit and Commemoration of UNFPA, had a catalytic impact on the the Population Commission of the
World Contraception Day, held on reproductive health community and Philippines had signed a memoran-
catalyst, as was evident
September 26, 2013, in Jakarta, reframed and reinforced the govern- dum of understanding to support
was a resounding success. More ment’s revitalization efforts. south-to-south collaboration, with a
than 1,700 participants were in focus on Mindanao Island, a conflict
attendance. The Vice President of BKKBN’s new chair, Dr. Fasli Jalal, area in the Philippines that has a
during Indonesia's Summit
Indonesia, Dr. Boediono, opened told the Indonesia Family Planning majority-Muslim population. Areas of
the meeting by reiterating the Summit attendees that family collaboration include strengthening
government’s strong commitment planning must be prioritized as a the role of faith-based organizations,
on Family Planning.
to family planning and by person- long-term, multisector development sharing lessons on decentralization
ally pledging his full support. Five issue. To do so, it is essential to and local advocacy, and sharing
government ministers presided build support in the local govern- best practices.
over the opening and high-level ments of more than 500 districts.
panel discussions. Some significant actions discussed
during the summit include increas-
Dr. Julianto Witjaksono, Deputy ing access to long-acting methods
of Family Planning and Repro- of contraception, improving and
Dr. Julianto Witjaksono ductive Health of Indonesia’s increasing midwifery services,
Deputy of Family Planning and Reproductive National Population and Family and mounting a communications
Health of Indonesia’s National Population Planning Board (BKKBN), serves campaign to raise awareness of
and Family Planning Board (BKKBN) family planning choices.
Partnership in Action 23 24 Partnership in ActionAllocated
A CLOSER LOOK: Government of Uganda Funding for FP/RH Commodities:
Allocation Versus Expenditures, 2005/06 – 2013/14 Spent
UGANDA (US$ Millions)
Uganda’s Commitment private providers of contraceptive policy. These innovations include
EXPENDITURES
to FP2020 services and supplies in the country, task sharing for contraceptive
US$ MILLIONS
PROJECTED
strategized a total market approach procedures and provision of contra-
At the London Summit on Family to coordinate service delivery and ceptive injectables by village health
Planning, Uganda committed to increase access to a full range of teams, and postpartum availability
9
reduce unmet need for family contraceptive methods. Donors, of IUDs through voucher programs.
planning from 40% to 10% by government, and others assessed PPDARO will lead efforts to track the
8
2022. Uganda will increase the the realities of speeding delivery of continued fulfillment of the commit-
annual government allocation services and supplies to ensure ment. The first-ever Ugandan family
6.8
6.8
7
for family planning supplies from universal access to quality, voluntary planning conference will take place
US$3.3 million to $5 million for family planning services. in December 2013, coordinated by
6
the next five years and improve the Ministry of Health, UFPC, and
accountability for procurement Within a year, the three main pillars others, with support from UNFPA.
5
and distribution. The government of the commitment—increased
will develop and implement a national government investment in Though Uganda’s family planning
4
campaign for integration of family family planning, more donor support, needs are acute, there is renewed
3.3
3.3
3.3
3.3
planning into other services. This and systems strengthening—had optimism that progress is possible
2.7
3
will include partnerships with been accomplished. Specifically, and that health and development
the private sector and scaling the allocation for family planning prospects will be significantly
1.9
2
up of innovative approaches, supplies increased from US$3.3 improved. With gains made toward
0.78
0.75
0.65
0.73
such as community-based
0.74
million to $5 million in the current fulfillment of the FP2020 commitment,
1
0.28
0.29
distribution, social marketing, budget. UNFPA, USAID, and DFID universal access to family planning
0.17
social franchising, and youth- exceeded the additional $5 million is within reach.
0
friendly service provision. Uganda called for from donors. Finally, a
will strengthen the institutional reproductive health subaccount was 2005/ 2006/ 2007/ 2008/ 2009/ 2010/ 2011/ 2012/ 2013/
capacity of public and community- established to track reproductive 2006 2007 2008 2009 2010 2011 2012 2013 2014
based service delivery points to health resource flows and improve
increase choice and quality of the National Medical Stores’
care at all levels. capability to distribute reproductive
health supplies and commodities.
In September 2012, the Ugandan
Ministry of Health brought The government and its partners
stakeholders together to begin are now working to create a unified
an intensive, collaborative effort and costed national plan for family
to capitalize on President Yoweri planning using the FP2020 commit-
Museveni’s commitment to ment as a guide and to firmly ground
FP2020. Partners in Population the plan in Uganda’s development
and Development Africa Regional priorities. The plan is expected to
Office (PPDARO) convened be completed and implementation
members of parliament to share underway by the end of 2013.
the President’s commitment and
devise an action plan to hold the The UFPC and Advance Family Plan-
government accountable. The ning have already begun expanding
Uganda Family Planning Consortium access to family planning through
(UFPC), comprising of all major innovations supported by government
SOURCE
Reproductive Health Financing
for Uganda: Commitment to
SOURCE Action. Partners in Population
Advance Family Planning, and Development Africa
September 2013. Regional Office, June 2013.
Partnership in Action 25 26 Partnership in ActionHIGHLIGHT Accountability:
from Commitments
to Progress
UNFPA Disbursements Accountability is an aspect of ning expenditures, consistent data
justice: it invokes the expectation sources, and common reporting
Uganda’s FP2020
At the London Summit that institutions will understand and periods (see page 90).
on Family Planning, UNFPA respect the needs of all the people
committed to increasing who are affected by their actions, Tracking Donor Expenditures
the proportion of its and will operate in a way that
commitment presents resources focused on
family planning from
25% to 40%, based on
promotes equity and inclusion.
FP2020 will promote accountability
Tracking donor expenditures is
critical to accountability, yet current
financial tracking mechanisms are
a great opportunity to move
funding levels at that by tracking progress on existing limited in their ability to provide real-
time. It calculates that and new commitments. There has time information specific to family
this will bring new funding been a surge of investment as planning assistance and do not fully
for family planning of at a result of FP2020 to establish account for all resource flows.
forward on family planning.
least US$174 million per mechanisms to monitor the
year from 2013 to 2019. implementation of commitments Beginning in 2014, the Kaiser
In 2012, UNFPA spent and elevate civil society voices in Family Foundation (KFF) will report
approximately 40% of its debates to shape country-level annually on global family planning
We have already met the
total resources on family policies and programs. disbursements from all public and
planning (~US$272 million) private sources. KFF will adapt
and approximately 70% on While it did not have the infra- the comprehensive methodology it
sexual and reproductive structure in place to do so this uses to monitor global spending on
main first-year components
health (~US$470 million).4 year, FP2020 does intend to HIV/AIDS to measure family plan-
track financial, policy, and service ning financing. This year, KFF began
delivery commitments going to track donor government disburse-
forward. FP2020’s methodology ments for family planning in an effort
of the commitment and now will be informed by feedback from
countries, lessons learned from the
Partnership for Maternal, Newborn
to establish the baselines necessary
to monitor progress toward meeting
FP2020 financial commitments.
we must work together to
and Child Health’s monitoring
of commitments to the Global While support from all sectors is
Strategy, and expertise from the critical to meeting our goal, donor
Commission on Information and governments provide a significant
see them bear fruit.
Accountability and the independent share of global funding for family
Expert Review Group. planning services. Preliminary data
from KFF’s research indicate donor
This report includes preliminary government disbursements for
data on donor expenditures. Early family planning increased in 2013.
results demonstrate that many
donor governments have already
Dr. Collins Tusingwire budgeted increased levels of funding
Assistant Commissioner For for family planning in 2013, and
indicate progress toward fulfilling
Reproductive Health, financial commitments made at the
Uganda Ministry of Health London Summit on Family Planning.
These figures (see chart on page 31)
are provisional and for indicative 4
purposes only. The FP2020 track- Internal UNFPA analysis from
interim FP expense tracking.
ing methodology will be improved SRH overall estimates from
to include, as far as possible, UNFPA Country Programme
Documents approved by
standard definition of family plan- UNFPA Executive Board
Partnership in Action 27 28 Partnership in ActionDonor Government Family Planning Disbursements, 2012 Kaiser Family Foundation Preliminary
Analysis: Donor Government
mulTilateral – unfpa
Assistance for Family Planning
core contributions
(us$ millions) *
(us$ millions)
(us$ Millions)
commitments
bilateral
country
summit
notes
total
Australia Plans to spend an additional AU$58 million over five $42.7 $14.9 $57.5 Australia identified US$44.6 in FY11/12 using This analysis establishes a base- Findings
years on family planning, doubling annual contributions the FP2020-agreed methodology, which includes a line level of disbursements5 in 2012
to AU$53 million by 2016. This commitment will form percentage of a donor’s core contribution to UNFPA.
a part of Australia's broader investments in maternal, Australian bilateral funding was determined by that can be used to track total inter- • In 2012, donor governments
reproductive, and child health (at least AU$1.6 billion adjusting its total funding level to take into account national assistance funding levels for provided US$900 million for
over five years to 2015). its UNFPA contribution. family planning6 over time, as well as bilateral family planning programs
specific donor government progress and an additional US$432 million
Canada $41.5 $17.4 $58.9 Bilateral funding is for family planning and reproductive in meeting London Summit on Family in core contributions to UNFPA.
health activities (including life skills education) in FY12. Planning commitments.
• The U.S. was the largest bilateral
It includes an analysis of funding donor, providing US$485 million
Denmark An additional US$13 million over eight years $13.0 $44.0 $57.0 Bilateral funding is family planning–specific in FY11, provided by the 24 governments and accounting for more than half
the most recent year available, and includes a specific
contribution (in addition to its core contribution) to
that were members of the Organisa- (54%) of total bilateral funding in
UNFPA’s Reproductive Health Commodities Fund. tion for Economic Co-operation and 2012. The UK was the second-
Development (OECD) and Develop- largest bilateral donor (US$99.4
An additional €100 million on family planning within $49.6 $0.5 $50.1 Bilateral funding is for a mix of family planning,
ment Assistance Committee (DAC) million, 11%), followed by the
France
the context of reproductive health through 2015, reproductive health, and maternal/child health in 2012.7 Netherlands (US$65.5 million,
in nine countries in francophone Africa activities in FY12. 7%), France (US$49.6 million,
Of these, 11 made specific commit- 6%), and Germany (US$47.6
Germany €400 million to reproductive health and family planning $47.6 $20.7 $68.3 Bilateral funding is family planning–specific in FY11, ments at the Summit to increase million, 5%).
over four years, of which 25% (€100 million) is likely to the most recent year available.
be dedicated directly to family planning, depending on funding for family planning: Australia,
partner countries’ priorities Denmark, the European Commission, • Sweden was the largest donor to
* All UNFPA core
France, Germany, Japan, Korea, the UNFPA (US$66.3 million), followed
€370 million in 2012 for sexual and reproductive $65.5 $49.0 $114.5 The Netherlands provided a total of US$484.8 million
contributions are for Netherlands, Norway, Sweden, and by Norway (US$59.4 million), the
Nether- FY2012.
lands health and rights, including HIV and health, and [plans] in FY12 for “Sexual and Reproductive Health & Rights, ** Austria, Belgium, European the United Kingdom. In addition, Netherlands (US$49.0 million), and
to extend this amount from €381 million in 2013 to including HIV/AIDS” of which an estimated US$65.5 Union, Finland, Greece,
Ireland, Italy, Japan,
there are several other donor Denmark (US$44.0 million).
€413 million in 2015 million was for family planning–specific activities. In
FY13, the Netherlands increased funding for “Sexual
Korea, Luxembourg, New governments, particularly the United
Zealand, Portugal, Spain,
and Reproductive Health & Rights, including HIV/AIDS” and Switzerland. Czech States and Canada, which, while not • While complete funding data for
to US$504.1 million. Republic, Iceland, and
Slovak Republic became
making specific commitments at the 2013 is not yet available, two
DAC members in 2013 Summit, also provide funding for donor governments (Norway and
and therefore not included
in analysis. family planning activities. the UK) have already budgeted
Norway Doubling investment from US$25 million to US$50 $3.3 $59.4 $62.7 Bilateral funding is family planning–specific in FY12.
million over eight years For FY13, the Norwegian budget provides an estimated
increased levels of funding for
US$25 million in “new” (additional) family planning 5 family planning in 2013.
A disbursement is the actual
funding as well as a slight increase in its UNFPA release of funds to, or the
contributions. purchase of goods or services
for, a recipient. Disbursements
• In addition, while family planning
in any given year may include –specific funding is not yet avail-
disbursements of funds
Sweden Increasing spending on contraceptives from 2010 level $41.2 $66.3 $107.5 Bilateral funding is for family planning and reproductive committed in prior years, able, the Netherlands increased
of US$32 million per year to US$40 million per year, health in FY12. and in some cases, not all
funds committed during a
funding in 2013 for “Sexual and
totaling an additional US$40 million between 2011
and 2015
government fiscal year are Reproductive Health & Rights,
disbursed in that year.
including HIV/AIDS” to US$504.1
Committing £516 million (US$800 million) $99.4 $31.8 $131.2 Bilateral funding is family planning–specific in FY12/13. 6
million, fulfilling its summit
UK
over eight years Family planning–specific funding is estimated to Family planning services commitment.
including counseling;
increase in FY13/14. information, education, and
communication (IEC) activities;
delivery of contraceptives;
$485.0 $30.2 $515.2 USAID stipulates that specified bilateral subtotal is capacity building; and training.
U.S.
family planning–specific in FY12.
7
Since 2012, three other
Other DAC $11.0 $98.0 $109.1 Bilateral funding was obtained from the Organisation governments have become
Countries** for Economic Co-operation and Development (OECD) DAC members: Czech
Credit Reporting System (CRS) database and represents Republic, Iceland, and
Slovak Republic.
funding provided in 2011, the most recent year available.
Total $899.8 $432.3 $1,332.1
Partnership in Action 29 30 Partnership in ActionDonor Government Disbursements for Family Methodological Note assistance sectors (e.g., education,
01. OTHER DAC COUNTRIES* $11.0 1%
02. australia $42.7 5%
03. canada $41.5 5%
04. denmark $13.0 1%
06. GErmany $47.6 5%
05. france $49.6 6%
07. netherlands $65.5 7%
civil society) have remained largely
Planning in 2013 (Totals in US$ Millions) The financial data presented in this unidentified. For purposes of this
analysis represent disbursements analysis, we worked closely with the
and are a significant step forward, largest donors to family planning
in terms both of currency and to identify such family planning–
07
substance. However, in the wake specific funding where possible
01
of the London Summit on Family (see Table notes). Going forward,
Planning, tracking financing for it will be important to efforts to
$11 $66 family planning in the developing
world should be considered a work
track donor government support
for family planning if such funding
Other DAC Netherlands in progress. The data presented was more systematically identified
Countries were obtained through direct within other activity categories
communication with donor govern- by primary financial systems.
02 08 ments, analysis of raw primary
data, and from the OECD Creditor Additional Note
$43 $3 Reporting System (CRS). UNFPA
core contributions were obtained In advance of the London Summit
Australia Norway from United Nations Executive on Family Planning, a number of
Board documents; however, we donors, including the United Kingdom,
03 09 were unable to determine what agreed to use an adapted version of
share of these core contributions the G8 Muskoka methodology8 for
$42 $41 are attributable to family planning
specifically (since such funding is
tracking donor support to maternal,
newborn, and children’s health–which
Canada Sweden also used to support broader repro-
ductive health and related efforts).
takes into account the fact that
reproductive health often includes
04 10 significant spending on family
Similarly, it is also difficult in some planning as an integrated service–
cases to disaggregate bilateral as well as a small percentage of
$13 $99 family planning funding from broader
reproductive and maternal health
other health codes. The total family
planning disbursements reported by
Denmark UK totals, and the two are sometimes donors using this methodology will
05
TOTAL = represented as integrated totals. likely be higher than the figures given
11
$899.8 MILLION In addition, family planning–related here, which are mainly for funds
activities funded in the context coded to family planning alone.
$50 $485 of other official development Please see reference on page 30.
France U.S.
06
*Includes the other 14 donor
$48 members of the OECD
Development Assistance
Committee in 2012.
Germany
09. sweden $41.2 5%
08. NORWAY $3.3Bloomberg Philanthropies Establishing health
is pleased to have recently services that
rolled out our first promote women's choices
grant from our FP2020 and the delivery of
commitment. This high-quality care means
grant builds on a maternal fewer maternal
health program we have complications, fewer
supported in Tanzania maternal deaths and
since 2006 and will allow ultimately, healthier
for the integration of households and
comprehensive family communities.
planning services in some Dr. Kelly Henning
of the country's most Director, Public Health Programs,
Bloomberg Philanthropies
remote health facilities.
Partnership in Action 33 34 Partnership in ActionAlignment with Number of Commitments to the Global
Strategy for Women’s and Children’s Health
Every Woman
Every Child
FAMILY
117
PLANNING
ANTENATAL
Launched by UN Secretary-General the Commission on Information & 74
CARE
Ban Ki-moon during the Millennium Accountability framework for global
Development Goals Summit in reporting, oversight, and account- SKILLED ATTENDANT 89
September 2010, Every Woman ability on women’s and children’s AT BIRTH
Every Child aims to save the lives health and the independent Expert
of 16 million women and children Review Group. Collaboration with POSTNATAL CARE 95
by 2015. It is an unprecedented Every Woman Every Child, and the FOR MOTHER
global movement of more than 250 Partnership for Maternal, Newborn POSTNATAL CARE
partners that mobilizes and intensi- and Child Health (PMNCH) and 67
FOR NEWBORN
fies international and national alignment with relevant UN mecha-
action by governments, multilater- nisms are fundamental to the EXCLUSIVE 67
als, the private sector, and civil success of FP2020. BREASTFEEDING
society to address the major health
challenges facing women and Promoting Accountability DTP3
57
VACCINES
children. The effort puts into action
the Global Strategy for Women’s All political leaders have multiple, ANTIBIOTICS FOR
and Children’s Health (Global Strat- urgent responsibilities. Despite 61
PNEUMONIA
egy), which presents a road map their best intentions, and regard-
on how to save these lives through less of the merits of an issue, if IMPROVED
47
the achievement of MDG 4 (Reduce stakeholders do not persistently, SANITATION FACILITIES
Child Poverty) and MDG 5 (Improve visibly, and persuasively hold
IMPROVED DRINKING
Maternal Health). leaders accountable, the promises WATER SOURCES
42
they make may never be fulfilled.
FP2020 is proud to be included in Commitments serve to inspire; 0 20 40 60 80 100 120 140
this global effort. In the past two accountability brings results.
years, family planning has gone
from being a neglected intervention Pending ministerial approval, DFID
to receiving the largest number will support an NGO consortium
of commitments to the Global to serve as an accountability
Strategy. The London Summit on secretariat for country-led efforts to
Family Planning was a major driver hold leaders accountable for their
of recent gains. Analysis shows that FP2020 commitments. The consor-
disbursements of both new and tium will coordinate with FP2020’s
additional funds have increased PMA WG and Task Team to comple-
substantially over the past year and ment existing accountability efforts,
that many stakeholders have made such as Advance Family Planning.
significant progress in implementing
their commitments. Further, data With support from the Bill &
are emerging that demonstrate Melinda Gates Foundation, a
that FP2020 is bolstering progress consortium of European NGOs will
toward the Global Strategy goals advocate funding for family plan-
of preventing 33 million unintended ning as a key element of Official
pregnancies and reaching 43 million Development Assistance for health.
new users in 49 countries in 2015. Working in at least eight European
(Source: PMNCH) countries and at the EU level, it will
focus on sustaining and increasing SOURCE
FP2020’s monitoring and account- support for family planning above PMNCH
ability efforts will complement and 2012-2013 levels and on honoring
contribute to Every Woman Every FP2020 commitments. Stephanie Freid-Perenchio
photography/SFP STUDIO
Child accountability efforts, through
Partnership in Action 35 36 Partnership in ActionYou can also read
