1. 1 Repositioning Family Planning in West Africa Solutions for Addressing Unmet FP Need Leadership: Financing/Contraceptive Security Presente par Dr Antoine Ndiaye, Commodity Security Specialist, AWARE-RH Dana Aronovich, DELIVER PROJECT Margie Rowan, FUTURES GROUP

2. 2 Role of Leadership: The Financing Gap Assess and acknowledge the nature and dimensions of the financial gap Explore alternatives Review strategies

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4. 4 Financial Implications of Growth Growing population, high unmet need, & demand for services Growing need for services & commodities Increased financing for services & commodities

5. 5 Contraceptive Financing Gap: Togo

6. 6 Contraceptive Financing Gap: Burkina Faso

7. 7 Who Will Fill the Gap? Explore Alternatives What are current arrangements for financing reproductive health supplies from each potential source? What are the prospects for increasing each? What are the most reliable sources for commodity financing during the next five to ten years? What role do or could third parties play in financing commodities? –Employers –Insurer –Community-based financing

8. 8 Who Will Fill the Gap? Keys actors Governments must add/increase budget lines to buy contraceptives with general revenues or loan/credit funds (e.g., WB loans) FP program managers should mobilize medicine funds Donors may provide financing or donate products Households may pay for contraceptives Private sector has a social responsibility to provide

9. 9 Strategies to Address Financing Gap for Commodity Security Government financing Donor support Alternative financing mechanisms Rational segmentation of the market Develop funded contraceptive security (CS) strategies

10. 10 Government Financing Governments must add or increase budget lines especially for contraceptives Governments must work to improve resource allocation to eliminate the inefficient use of limited resources

11. 11 Donor Support: Forge Partnerships Donations of contraceptives, coordinated among donors and country governments Mobilize multi-national companies and large enterprises and interest them in Family planning Capacity building in budgeting, forecasting contraceptive requirements, procurement, distribution, service delivery, etc.

12. 12 Donor Support: Forge Partnerships (cont.) Regional strategy: a regional coalition under the leadership of WAHO on RHCS –Support WAHO to coordinate among donors/partners on RH Commodity Security in the region, including a regional strategy for RHCS. –Increase and sustain assistance to Member States for contraceptives and other RH Supplies. –Work with Member States to introduce line for RH Commodity in their budgets. –Strengthen WAHO leadership for RH Commodity Security, through co-ordination, advocacy, monitoring.

13. 13 Alternative Financing Mechanisms Social security/national health insurance plans Employment-based services Community health funds –E.g., Mutual Health Organization (MHO) managers to include contraceptives on their drug lists –E.g., Senegal: PF services offered by MHO

14. 14 Alternative Financing Mechanisms (cont.) Health savings and loan programs –Highly Indebted Poor Countries (HIPC) Vouchers for the poor Client fees: revolving drug fund for contraceptives –E.g., Cameroon under its strategic plan Diversification of resources via multi-sectoral efforts

15. 15 Rational Segmentation of the Market Assess clients’ willingness to pay Assess clients’ ability to pay Ensure access to highly subsidized or free public sector resources for those who can not afford to pay Ensure that wealthier clients have other options in the private/commercial sector Provide intermediate options such as subsidized social marketing programs

16. 16 Socioeconomic Profile of Public Sector Family Planning Users

17. 17 National Commodity Security Plans To Re-position Financing For Contraceptives SPARHCS framework Strategic planning examples: –Ghana, Mali, & Nigeria (completed) –Cameroon & Togo: ongoing –Benin, Guinea & Senegal: ongoing –Burkina (started 2004) –Gambia and Niger (interested 2005)

18. 18 Wrap Up / Conclusions Successful FP programs require strong management and contraceptive availability Contraceptive availability requires reliable financing and strong logistics management Reliable financing and logistics require strong leadership and multi-dimensional strategies to mobilize resources When resources are available, they must be used efficiently