Presentation_Jurczynska - Catalyzing Investments in RMNCAH at the Community Level
•Download as PPTX, PDF•
1 like•124 views
CORE Group Global Health Practitioner Conference 2019
Recommended
Recommended
More Related Content
What's hot
What's hot (20)
Similar to Presentation_Jurczynska - Catalyzing Investments in RMNCAH at the Community Level
Similar to Presentation_Jurczynska - Catalyzing Investments in RMNCAH at the Community Level (20)
More from CORE Group
More from CORE Group (20)
Recently uploaded
Recently uploaded (20)
Presentation_Jurczynska - Catalyzing Investments in RMNCAH at the Community Level
- 1. Catalyzing Investments in RMNCAH: The Family Planning – Sustainable Development Goals (FP-SDGs) Model Kaja Jurczynska, Demographer, Health Policy Plus (HP+)
- 2. The Sustainable Development Goals (SDGs) End poverty, protect the planet, and ensure prosperity for all 17 goals | 169 targets | 232 indicators Universal access to voluntary family planning services, information, education, and integration of reproductive health into national strategies and programs Indicator 3.7.1: proportion of women (ages 15–49) who have their family planning needs satisfied with modern methods
- 3. Family Planning: ACost-Effective Intervention Source: Health Policy Plus (HP+). 2018. “Health Policy Plus: Family Planning – Sustainable Development Goals Model.” Model Flyer. Available at: http://www.healthpolicyplus.com/ns/pubs/7170-10457_FPSDGsFlyerFINAL.pdf.
- 4. An evidence-based advocacy model that allows users to quantify the effects of contraceptive use on 13 SDG indicators • Users design three future scenarios for family planning and other socioeconomic variables • Impacts of scenarios on key SDG outcomes quantified for 2030 or 2050 Customizable to both national and subnational contexts Free and easy to use Available in both English and French Making the Investment Case: The Family Planning-Sustainable Development Goals Model
- 5. FP-SDGs Model Outputs 1.1.1 Proportion of the population below the international poverty line 2.1.2 Prevalence of moderate or severe food insecurity 3.1.1 Maternal mortality ratio 3.2.1 Under-5 mortality rate 3.7.2 Adolescent birth rate per 1,000 women in that age group 4.1.1 Proportion of children at the end of primary achieving at least a minimum proficiency level in reading 11.1.1 Proportion of urban population living in slums, informal settlements, or inadequate housing 8.1.1 Annual growth rate of real GDP per capita 8.2.1 Annual growth rate of real GDP per employed person 6.2.1 Proportion of the population using safely managed sanitation services 8.7.1 Proportion of children aged 5–17 years engaged in child labor 6.1.1 Proportion of the population using safely managed drinking water services 2.2.1 Prevalence of stunting among children under 5 years of age
- 6. FP-SDGs Model Results: SupportingAdvocacy Leverage results to make the case for: • Creating new, or updating existing, FP national and subnational strategies • Allocating an increasing share of the national and/or subnational budget for FP • Releasing (on-time, and fully) allocated funds for FP program components • Designing and implementing annual FP activities at national and subnational levels • Integrating FP program components within activities across other development sectors • Creating accountability structures (e.g., at community levels) for reaching the milestones articulated within FP strategies, financing commitments, and more
- 7. How does the FP-SDGs model work? Users enter or edit base year data Users create 3 scenarios Users generate population projections Future outputs generated Data in areas of: • Family planning • Demography • Health • Education • Economics • 3 future scenarios capturing various levels of ambition in FP alone and other policy variables • Users link model to Spectrum • Population projections are generated for each scenario, and automatically fed back into model • Population projections automatically combine with equations to produce future outputs • Equations are in the back-end of the model • Equations generated using statistical analysis
- 8. Applying the FP-SDGs Model 1. Questions to consider: • What are the main FP advocacy issues across decision-making levels? • Who are your decisionmakers? • Independent application or technical assistance? 2. Background research and data collection 3. Optional capacity building training on model 4. Model validation 5. Model finalization and development of advocacy materials 6. Results and advocacy dissemination event targeting decisionmakers
- 10. FP-SDGs ModelApplications OUAGADOUGOU PARTNERSHIP TANZANIA MALAWI Start year End year 2015 – 2018 2030 2015 2030 2015 2050 Family planning assumptions Socioeconomi assumptions Scenario 1 Extrapolate growth rate Scenario 2 Reach FP goal Scenario 1 No change in FP Scenario 2 Reach FP goal Scenario 3 Surpass FP goal Scenarios 1 & 2 Extrapolate historic growth rates Scenario 1,2, & 3 Gains equivalent to upper-middle income country status
- 11. Results for the Ouagadougou Partnership by 2030
- 12. Results for Tanzania by 2030 59.7 82.3 89.4 97.5 20.1 43.1 49.3 56.3 0 20 40 60 80 100 Tanzania today Development only FP Strategy & Development FP Strategy + & Development 6.1.1 and 6.2.1 Proportion Using Safely Managed Drinking Water and Sanitation Darker colours = safely managed drinking water Lighter colours = safely managed sanitation Compared to a scenario where Tanzania invests in traditional areas of development only, funding the FP strategy and beyond could boost use of safely managed water and sanitation by an additional 19% and 31%, respectively
- 13. Results for Malawi by 2050
- 14. Advocacy InAction: Using FP-SDGs Model Results in Noncontraceptavia Noncontraceptavia is highly decentralized; districts must plan, budget, and execute all FP activities. District governments do not adequately budget for FP activities, which are narrow in scope. FP is seen as a low priority, especially compared to improving access to safe water and increasing educational attainment. FP services are not integrated with maternal health or HIV care. FP service provision can only be carried out by the small fleet of medical doctors, despite WHO task-shifting guidance. Women, men, and adolescents do not know the benefits of smaller family sizes. As a result, women do not feel empowered to use contraception, and have little partner and community leader support to plan families. All Noncontraceptavia districts have low contraceptive use and high unmet need for FP.
- 15. Advocacy InAction: Using FP-SDGs Model Results in Contraceptavia Recently, an organization worked with local advocates in Noncontraceptavia’s Hope district to apply the FP-SDGs model by 2050. They created two scenarios: 1. Contraceptive use in Hope district remains constant, at just 15% of all women 2. Contraceptive use in Hope district increases to 48%, satisfying all current unmet need for FP How can advocates in Hope district use the FP-SDGs model results to improve FP policy, financing, and programs? Identify key result uses, for example: host a meeting for community/religious leaders, sensitizing them…
- 16. FP-SDGs Model Results for Hope District, Noncontraceptavia 30% decrease in the prevalence of stunting among children under 5 years of age 37% reduction in the maternal mortality ratio 33% reduction in adolescent fertility 5 million fewer people below the international poverty line 14% increase in the proportion of children achieving minimum reading proficiency at the end of primary school 22% increase in the proportion of the population using safely managed drinking water services 3 percentage point boost in the growth rate of GDP per capita
Editor's Notes
- As we know, the Sustainable Development Goals (SDGs) were officially adopted in September 2015, with the broad aims of ending poverty, protecting the planet, and ensuring prosperity for all. They consist of an ambitious set of 17 goals, 169 targets, and 232 associated indicators focused on global development aspirations, to which countries commit efforts through 2030. Ensuring healthy lives and promoting well-being for all is an essential element within the goals, and includes the target of achieving universal access to sexual and reproductive health-care services, including FP information, education, and services.
- It is encouraging that FP occupies space within the SDGs; the benefits of FP are vast: Over the last few decades, the development community has amassed extensive evidence about the cost-effectiveness of various interventions and programs. Health programs—specifically those focused on expanding access to and use of voluntary methods of contraception—are often at the top of the list, shown to be some of the most cost-effective interventions. One body linked to the SDGs found that making family planning available to everyone is one of the THREE most cost-effective SDGs targets (3rd out of 169!). For every dollar spent on contraception, a country can reap $120 in social, economic, and environmental benefits. What makes FP so beneficial to other sectors, as well as so cost-effective? Contraceptive use exerts both a direct and indirect effect on development outcomes, including those captured within the SDGs: Directly, contraception reduces the risk of maternal and newborn mortality by decreasing exposure to pregnancy, and high-risk births. Contraception also affects the total number of children in a family, and the total fertility rate at the country-level, which shapes demographic realities like the dependency ratio, population growth, and others. These population dynamics impact economic growth and prosperity, human capital, food and agriculture, health and education outcomes, the availability of social services, and more. Despite this evidence, the expansive nature of the SDGs poses a challenge for in-country prioritization and implementation of FP programs.
- In response to the lack of country-specific evidence on how family planning investments can impact broader development—specifically the SDGs—at the country level, the USAID-funded Health Policy Plus (HP+) project developed the Family Planning-Sustainable Development Goals (FP-SDGs) Model. The FP-SDG model is an evidence-based advocacy tool that enables users to quantify the effects of FP use—alone, or in combination with other socio-economic variables—on various SDG indicators through 2030 or 2050. Using the model, users create three different future scenarios for FP and other socioeconomic variables. We include these other variables because assuming nothing else changes in the future beyond contraceptive use would prove unrealistic. We want to see the additive benefit of family planning, and the only way to do so is to make assumptions about other aspects of development/growth The effects of these scenarios are automatically quantified for the user using a series of equations embedded in the model. The user can generate results for either 2030 or 2050 By comparing the future values/results of one scenario to another, users can observe the boost—or additional gains—that FP offers toward the SDGs The model can be applied at both the national level, as well as subnational units The model is housed in Excel, and available for free on the HP+ website It is also user-friendly, with easy navigation, default data for simple calibration, and an outputs page which compares results for the user from one scenario to the next Finally, the model is available in both English and French, accommodating applications across most low-income countries in sub-Saharan Africa
- To-date, we have quantified the impacts of FP, along with other variables, on 13 SDG indicators, cutting across 7 goal areas
- As mentioned, results from the model are intended to support in-country advocacy efforts. Specifically, results from the model can be used to make the case for the following: Creating new, or updating existing, FP national and subnational strategies Allocating an increasing share of the national and/or subnational budget for FP, including beyond just purchasing commodities to running demand generation programs and more Releasing (on-time, and fully) allocated funds for family planning program components Designing and implementing annual FP programs and activities in alignment with FP strategies at national and subnational levels (community health) Integrating FP program components within activities across other development sectors Creating accountability structures (e.g., at community levels) for reaching the milestones articulated within FP strategies, financing commitments, and more
- How does the model work? First, users select the country for analysis. This automatically populates the model with default data. Users have the option of editing these data to better reflect recent realities, or the subnational context. The data inputs required are in the areas of family planning, demography, health, education, and economics Next, users create the three scenarios we discussed in the previous slides. These scenarios capture various levels of ambition in FP in combination with other socioeconomic/development indicators Next, users link the model to DemProj – a population projection tool – from Spectrum. This tool creates population projections for each of the future scenarios on the basis of user inputs. For example, if a user created scenarios in which a) FP use doesn’t change over time; and b) FP use increases over time – the resulting total population would be larger for the first scenario, compared to the second, given the impact of family planning on childbearing, and broader demographic dynamics These projections are then fed back into the model, and combine with the built-in equations derived through statistical analysis, to produce model outputs.
- So far, we’ve applied the model in 2 countries and 1 region. We are disseminating these results, and working with advocates to use them in their interactions with decision-makers at various levels. The model can be applied in two general ways. The most recommended option is to apply the tool in close consultation with in-country stakeholders – specifically, advocates who will use the model results in the future. The other option is take a “desk application” approach – meaning the user sources data and creates assumptions without in-country partnerships. Generally though, the application process requires consideration of the following: First, its important to answer some key questions. These include understanding the main FP advocacy issues – who are the relevant decisionmakers for this issue, and who are the advocates? It’s also important to consider whether you are interested in undertaking an independent application, or whether you would like any technical assistance from the Health Policy Plus project The next step is to work with government stakeholders, advocates, and other partners to collect background information to inform model base year inputs Depending on who will be “owning” the model and its results, a training can be conducted on the model & its mechanics to enable those individuals to independently update the model in the future, if needed The next step is something we call a model validation meeting. During this workshop, in-country allies/partners validate or revises baseline data, determine model scenarios, & brainstorm advocacy messages/opportunities Next comes model finalization & development of advocacy materials. When everything is finalized, a results & advocacy dissemination event is organized, targeting decision-makers. Another approach is to embed the results in the advocacy activities of those already conducting visits/disseminations
- Now that we’ve discussed the model basics, we’re going to profile three recent applications and model results.
- We used this model to explore the implications of FP change across the 9 Francophone West African countries that form the Ouagadougou Partnership—Benin, Burkina Faso, Côte d’Ivoire, Guinea, Mali, Mauritania, Niger, Senegal, and Togo—Tanzania, and Malawi The shortest amount of time to quantify impact was about 12 years in the case of OP countries, whereas the longest time was in Malawi – 35 years For the FP part of the scenarios: We consistently created one scenario that represents either no increase in contraceptive use (constant FP), or incremental increase based on historic growth trends – these growth trends have often been very slow. This scenario represents a case in which there is low political will for FP in the future We’ve complemented this scenario with one or more that showcase growth in FP use over time, a rate that exceeds historic levels. Often, we’ve aligned future levels of FP use with the goals stated within country strategies. In the case of Tanzania and Malawi, we had a third scenario, which captured the most ambitious improvement in contraceptive use – this represents surpassing the FP strategy goal, meaning that there is an abundance of political will for FP. The socioeconomic assumptions are consistently the same across all scenarios. In some cases, the values of the socioeconomic indicators are extrapolated based on current growth trends. In other cases – like Tanzania and Malawi – future values are aligned with the indicator performance of countries that have achieved upper-middle income status. Why these countries? Because that is what both Tanzania and Malawi aspire to for their future. In short, by the end year of each model, the only thing that changes in FP use – this allows us to isolate the contribution of this component to achieving the SDGs over time
- Now let’s take a look at some of the results for the OP region. First, reduced food insecurity, and indicator under SDG2. Through its impact on pop dynamics, FP helps decrease food demands and alleviate strain around food supply and production. We found that greater contraceptive use across the region – aligned with countries’ FP ambitions – could lead to a 21% reduction in food insecurity by 2030. That translates to approximately 50 million fewer people who would be food insecurity Another result, this time for SDG goal 3. We found that realizing OP countries’ FP ambitions by 2030 could lead to a 27% reduction in the maternal mortality ratio