Achieving Contraceptive Security in Jordan In this presentation I will provide an overview of the contraceptive security strategic planning process in Jordan. We initiated this process of developing a long-term strategy that will help move Jordan toward contraceptive security under the leadership of the government of Jordan and in collaboration with the CMS and DELIVER projects. Jordan is facing the challenge of increasing demand for contraceptives and declining donor support.

Approach Capacity building of a core group We have been using a number of approaches to help the government of Jordan achieve contraceptive security. Policy dialogue and awareness raising on how local authorities can address and promote local family planning needs in such a way as to move Jordan towards CS while remaining consistent with the RHAP; Capacity building for a core group of individuals in strategic planning , costing , and budgeting techniques; Participatory planning and related policy dialogue to develop and reach consensus on a 5-7-year strategy for contraceptive security (CS); Assisting the CS WG in drafting the strategic plan for CS with inputs from NGOs and other participants in the planning process; We are working in collaboration and cooperation with the ministries, CAs, donors, NGOs and commercial sectors. We are receiving the full supports from the MOH, MOP and MOF. Advocacy training for stakeholders involved in the planning process as well as other local NGOs; Advocacy by local NGOs and policy champions to lobby for the approval and adoption of the CS plan.

CS Activities Long-term funded CS Strategic plan Advocacy to get approval Strategic planning workshop CS Strategy Workshop Prioritizing Issues Policy analysis and mobilization of information The contraceptive security initiative is based on SPARHCS framework and involves a number of activities: Conducting key informant interviews Organizing Stakeholder meeting Forming CS working group Conducting policy analysis and mobilizing information for decision making Prioritizing issues Conducting strategic planning workshop And advocating for the approval of strategy The final product will be a funded long term strategic plan for achieving contraceptive security. Formation of CS working group Stakeholder meeting Key informant interviews

Stakeholder Meeting – November 2002 40 key stakeholders – government policy makers, donors, CAs, NGOs, Commercial Sector SPARHCS framework Government Leadership Awareness raising Information sharing November stakeholder meeting helped generate a common understanding of contraceptive security issues in Jordan. A wide range of stakeholders attended the workshop, including representatives from the Ministry of Health (MOH), MOP, MOF, MOE, JAFPP, PHCI, UNFPA, PHR Plus, UNRWA, USAID, WHO, and commercial sector. During this workshop POLICY staff, along with CMS and DELIVER staff, introduced SPARHCS (Strategic Pathway to Reproductive Health Commodity Security). The objective of applying the SPARHCS framework was to support countries in developing a strategic commitment and funded action plan for ensuring an adequate supply and choice of quality contraceptives and other reproductive health commodities that will meet every person’s needs.

Formation of Groups Formation of a CS working group Formation of a technical committee to support the working group 1-Information systems development 2- advocacy 3- policy 4-financial sustainability 5- coordination 6-service access 7-procurment and supply Contraceptive Security efforts are initiated in the government’s leadership. The stakeholders have demonstrated full commitment and strong cooperation in our efforts toward contraceptive security. Last, July we gathered to launch the Contraceptive Security Technical Committee and the CS Working Group. The committee has representatives from donors, MOH, MOP, MOF, different CAs, NGOs, the commercial sector and research institutions. This CS working group was appointed from that Committee and has representatives from government, NGOs, and the private sector. This committee provides guidance and support to the CS working group. The CS Working Group is responsible for leading the strategic planning process for contraceptive security. Based on that information and personal knowledge, they will develop a draft CS strategy to be presented to the larger Contraceptive Security Committee.

Analyses and Mobilization of Information FP market segmentation analysis Operational policies analysis Financial requirements for FP National Family Planning Accounts Procurement mechanisms POLICY undertook a number of background studies. We will present the findings of these studies in this workshop. Market segmentation analysis using 2002 DHS data. This analysis is critical to formulating a CS strategy that takes into consideration the different providers of contraceptives, the different socioeconomic characteristics of clients, and the current and potential match between the two. Operational policy assessment to further study and analyze operational barriers to achieving CS. The assessment identifies barriers in areas such as: availability of contraceptives, access to providers, and alternative financing mechanisms. Projected financial requirements for commodities is calculated using FAMPLAN model. Generating financing to fill these gaps is a critical component of any CS strategy that is developed. National Family Planning Accounts provides a comprehensive description of the flow of resources currently utilized for FP purposes. This information will be used to identify potential funding gaps and to better determine the true cost of CS. The assessment of strengths and weaknesses of procurement systems in public sector and NGOs including forecasting and distribution mechanisms is conducted.

Prioritizing Workshop Presentation of background studies Identification of CS issues Prioritization of identified issues During the next three days, we will hear about the results of these studies and discuss them to insure that the issues identification process is thoughtful and evidence-based. Based on these discussion we are being asked to list all relevant issues after which we will go through a prioritization process that will ultimately result in our identifying the 5-6 most important issues. These will form the basis of the strategic plan

Priority Issues identified In this part of the presentation, I will present the issues identified during priority setting meeting in March.

Top Priorities How do we fund the family planning program including contraceptives, IEC/BCC, training, and research beginning now? How to achieve effective procurement for all sectors? How to reduce unmet need, discontinuation and improve access to family planning? How to ensure sustained delivery of quality family planning services and contraceptives?

Top Priorities How to maintain/sustain effective logistics system? Raise awareness around contraceptive security among: parliamentarians, religious leaders, young adults, males, teachers, policy makers, medical syndicate and the legislature? How can we improve commercial and NGO sector contribution towards contraceptive security? How do we improve and maintain coordination among all partners (public, NGO, commercial sector, donors)?

Already implemented selected activities Assess pros and cons of a method by method phase out versus a phaseout of funding Develop feasible procurement models Review and revise logistics training Government to fund contraceptives costs for existing USAID funded program as a public health goal

C1: Information Systems A. Demand Creation CS Framework RHAP Components C1: Information Systems A. Demand Creation B. Finance C2: Financial Sustain. C3: Advocacy/Behav.Change C. Private Sector D. Policy C4: Policy E. Logistics C5: Coordination F. Service Delivery C6: Service Access Demand Creation, Finance, Private Sector, Policy, Logistics, Service Delivery

CS LINKAGES WITH THE RHAP Common focus on increased capacity related to: Data Collection and Analysis Advocating for public awareness Elimination of barriers Appropriate Use of resources RH/FP Sustainability Public/Private Sector Dialogue Agreement on Indicators Service Financing Procurement and Supply

Strong points Budget item line exists and the government has procured condoms, DMPA, and introduced the Implanon to the FP menu Effective logistics system Supply to other sectors like UNRWA, JAFPP, HIV and others are also under the same logistics system

Challenges Lack of private sector information Increased demand for contraceptives means increased budget required – ability of the government to meet these needs High quality products Family Planning and Health Insurance

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