PO 5555: DFID RHFS
PO 5555: Reproductive Health Services Framework Part A: Executive Summary & Part B: Technical and General Tender
19 July 2011
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Contents
Letter and Declaration to Accompany Tenders
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Part A - Executive Summary
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Part B - General and Technical Tender
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Section 2 - Technical Response
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Section 3 - Names and Curriculum Vitaes
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Annexe 1 - Declaration of Non-Canvassing and Non-Collusive Tendering
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Annexe 2 - Conflict of Interest and Disclosure Letters
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Annexe 3 - Letters of Intent to form a Joint Venture
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Annexe 4 - Capability Statements
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Annexe 5 - Service Delivery Matrix
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Annexe 6 - Logical Framework Analysis
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Annexe 7 - Nigeria Workplan
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Part A - Executive Summary IPPF responds to DFID’s Reproductive Health Services Framework (RHSF) tender with a team comprised of EngenderHealth, Management Sciences for Health, Liverpool School of Tropical Medicine and MannionDaniels. This IPPF-led team (The Team) presents its No Opportunity Wasted approach (NOW!) that will significantly increase uptake of family planning (FP), reproductive health (RH) and maternal, newborn health (MNH). NOW! meets the needs of women and girls, particularly poor, young and displaced.
Technical Capability
ICON, IPPF’s procurement arm, will purchase and distribute commodities. ICON works in line with WHO pre-qualification and Good Manufacturing Practice. Similarly, forecasting, procurement and distribution is supported through IPPF’s Standardised Procurement Handbook and Medical Services Delivery Guidelines. Service quality will be assured by: IPPF’s Handbook of Medical Services Delivery Guidelines; Quality of Care (later Continuous Quality Improvement System); EngenderHealth’s Supply-Enabling Environment-Demand programming model; etc.
Methodology and Innovation
The Team has operational capacity in all DFID RHSF countries and service delivery areas. IPPF’s key personnel are responsive to the skills in the DFID RHSF Terms of Reference (TOR). They are part of IPPF’s staff, enabling rapid response and cost effectiveness. Ms Ilka Rondinelli will oversee technical implementation, with support on management and coordination from IPPF’s business development team. Ilka is a nurse recognised for her skills in increasing access, through task-shifting/ sharing, quality-improvement and strengthening health sector responses, particularly to the poor at community level.
NOW! combines innovative approaches into one comprehensive package that significantly increases the uptake of FP, RH and MNH, including linking communities to robust referral and follow-up systems. NOW! is based on the premise that no opportunity is wasted in stimulating, identifying and comprehensively fulfilling client needs. NOW! establishes a qualityassured FP service as part of an integrated package of essential services (IPES) to simulate and meet demand for sexual and reproductive health and rights (SRHR). The NOW! critical path is presented below.
Quality of commodities and service delivery will be assured using existing effective tools.
NOW! provides a framework for strengthening service delivery across
all sectors, representing a total market approach. Value for money will be assured by implementing a standardised costing and results-driven financing methodology. The latter will use a balanced scorecard of performance metrics to help track delivery.
Monitoring and Evaluation IPPF has a robust Clinic Management Information System (CMIS) through which is connected the web-based portal, the Electronic Information Management System (eIMS). By connecting these systems we will compile quality-assured data on impact, outcomes, results, milestones, price and cost levels. Nine RHSF countries have these systems to implement NOW! today. This will be supplemented through client monitoring using a variety of innovative tools including Do They Match, PEER and community mirror. We will track equity through disaggregated data on whether clients are poor, vulnerable, young or displaced. This work will be supplemented by applying an innovative “Poverty Scorecard”. NOW! will make a significant contribution to delivering the objectives of DFID’s Framework for Results.
Figure 1 - The NOW! Approach
NOW! Meet needs, increase uptake of FP/RH/MCNH services
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Expand Supply
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Expand supply of high Impact, comprehensive, integrated package of services
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Increase Demand Increase demand among women and girls
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Improve Performance
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Improve performance, delivery and value for money
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Part B - General and Technical Tender Section 1 Qualifications to Terms of Reference (TOR)
1.
We have taken ‘long acting contraception‘ to mean either long acting reversible contraception (implants and intra-uterine devices (IUDs)) or long-acting permanent contraception (male or female sterilization). We will abbreviate this to LAPM (long acting and permanent methods), though not all facilities equipped to provide long-acting reversible contraception can provide permanent sterilization.
2.
We will use the following definitions of ‘poor’, ‘marginalised‘, and ‘vulnerable’: •
Poor: people living on less than US$2 per day
•
Marginalised: people who for reasons of poverty, geographical inaccessibility, culture, language, religion, gender, migrant status, or other disadvantage, have not benefitted from health, education and employment opportunities, and whose sexual and reproductive health needs remain largely unsatisfied
•
Socially-excluded: people who are wholly or partially excluded from full participation in the society in which they live
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Under-served: people who are not normally or well-served by established sexual and reproductive health service delivery programmes due to a lack of capacity and/or political will; for example, people living in rural/remote areas, young people, people with a low socio-economic status, unmarried people, etc.
3.
IPPF’s definition of a ‘young person’ is someone between the ages of 10 and 24. In terms of collection of data, IPPF MAs are able to further segregate data into the following age brackets: 0–10; 10–14; 15–19 and 20–24. IPPF may also segregate ‘young people’ into sub groups by definition and not age. These may be young people who are at particularly high risk and require special attention, for example: •
pregnant adolescent girls; particularly those under 16
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marginalised adolescents
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very young adolescents (10-14 years)
4.
In Part A, General and Technical Tender, IPPF has a combined section on methodology and innovation. The Team’s approach, called NOW!, has three output areas - expand supply, increase demand and improve performance. Innovation is an integral component of each output area. Innovation in this tender will highlight areas of promising practice in terms of a) increased reproductive health choices for the client and/or b) improving value for money in the reproductive health sector.
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Section 2 Technical Response Section 2.1 - Overview of Technical Capability IPPF’s NOW! approach offers an integrated package of WHO-recognised1 high-impact services that means no opportunity is wasted in meeting women and girls unmet need for reproductive health (RH). The NOW! approach builds on the extensive experience and expertise of IPPF: •
IPPF provides FP and RH services in 25 of 27 of DFID’s RHSF countries.
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In 2010, in DFID’s RHSF countries IPPF provided 2,319,004 CYPs and attracted 3,008,465 clients for FP/RH.
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In 2010, in DFID RHSF countries, 76.7 per cent of IPPF’s family planning and reproductive health services were provided to poor people and 43.6 per cent to young people
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IPPF provides services through public and private clinics including 3,631 private physicians and other agencies, 561 outreach services, 2,726 direct provision and social franchising, 13,115 through community-based distribution including social marketing.
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IPPF delivers value for money through our connected management information systems3 which enables it to track the integration of services and cost their effectiveness at the input, milestone, output and outcome levels.
IPPF works in 11 fragile states2 of DFID’s RHSF countries in Asia and Africa.
•
IPPF’s integrated package of services (IPES) ensures quality services – including a range of short-term, long-acting permanent family planning methods – and respective commodities are available for clients at every consultation.
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IPPF’s CMIS, as part of our overall Monitoring and Evaluation system, means we track increases in access to services and adapt to market conditions. IPPF will introduce CMIS in key DFID RHSF countries by the end of 2011.
MannionDaniels
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Capacity to analyse and respond to the current RH market structure
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Capacity to work in partnership with the private and public sectors
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Capacity to develop networks and capacity with formal and informal commercial providers
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Capacity to provide behaviour change communication management
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Compliance with Quality Assurance standards and processes for services and commodity procurement
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Ensuring value for money and delivery of health outcomes
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Monitoring development effectiveness of intervention through ‘before and after’ evaluations
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Capability to measure/report regularly on service use; disaggregate to target poor; use shared performance indicators
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Provision of data on service costs (disaggregated by inputs)
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LSTM
MSH
Key Skills
IPPF
Figure 1.11 - Key Skills: DFID RHSF TOR
Engender Health
The IPPF-led team brings a range of complementary skills and expertise that inform our overall ability to deliver a comprehensive skill set to DFID:
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1 Jamison DT et al (2006) Priorities in Health. Disease Control Priorities Project (DCPP), World Bank 2 Chapman, N & Vallant, C. Synthesis of Programme Evaluations conducted in Fragile States. DFID Febuary 2010, p10. 3 IPPF’s Management Systems include electronic Integrated Management System (eIMS) and client management information system (CMIS), an open-source clinic management package.
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Section 2.11 - Quality of Key Personnel of Lead Organization IPPF will achieve the best value for money by developing and delivering an effective programme of work at a low unit cost. Key IPPF personnel have been recruited from a pool of recognised FP/RH experts with the skills-sets identified in the DFID RHSF TOR.
medical and surgical abortions and postabortion contraception. Her programme has identified integration strategies to counselling and service provision that significantly increase post-abortion family planning.
Key personnel will provide short-term technical assistance on both country competitions and projects. IPPF is confident using this approach it will quickly mobilise the staff required to commence immediate implementation.
Nguyen-Toan Tran:
Ilka Rondinelli: Spearheaded successful efforts to dramatically increase the proportion of IPPF’s clients that are poor and vulnerable in middle-income countries (eg. in Brazil, where in 2010 97% of IPPF’s clients were classified poor and vulnerable). Developing techniques that have become industry norms, she has a track record of significantly increasing access through task-shifting/ sharing, quality improvement and by integrated community-based service delivery.
Dora Lind Braeken: Leads IPPF’s approach to delivering services for and by young people. She has recently commissioned multi-country research to support the expansion of youth services, identifying improvements in quality and cost.
Kevin Osborne: Has been at the forefront of international efforts to demonstrate the ‘how’ of effectively integrating services to optimise reduced unintended pregnancies and HIV transmission results. He is currently working with the London School of Hygiene and Tropical Medicine and the Population Council to determine the costs and benefits of using different models for delivering integrating HIV and SRH services in medium and high HIV-prevalence settings.
Kelly Culwell: Is the technical lead in IPPF’s efforts to increase the Federation’s provision of abortion related services, including
Developed, devised and implemented a programme that is increasing the effectiveness of humanitarian assistance in meeting the family planning and other reproductive/sexual health needs of displaced and refugee women, girls and men. His work has laid out a blueprint for meeting the specific needs of displaced people, the vast majority of whom do not live in specifically designed camps.
John Good: Has been championing results-driven financing and the service costing methodology, which enable us to continuously improve value for money.
Daniel Messer: Has been leading the development and implementation of the CMIS and eIMS to gather and digest quality data. He is also a member of NPOKI, a multi-organisational initiative to develop a web-based indicator tracking system, which has the potential to access shared data thus improving cost and knowledge-management.
The skills matrix overleaf demonstrates our personnel’s skill set; they ensure that we can develop responsive country-level competitive bids, and secure country-level contracts that deliver on results, performance and value-for-money. Section 3 provides detailed curriculum vitae of all key personnel.
South Asia Region (SARO)
Capacity to work in partnership with private and public sector
Nutritional Supplements
Ante-Natal, Safe Childbirth & Newborn Care
Safe Abortion Related Services
Prevention of HIV/Other STIs
Community Based Distribution and Outreach
Direct Provision
Capacity Building/Quality Management
Social Franchising
Social Marketing
Asia & Middle East Regional Experience
Africa Regional Experience
IPPF Region
KEY PERSONNEL
REGION & SKILLS
East and South East Asia and Oceana Region (ESEAOR)
Capacity to analyse and respond to the current RH market structure
Western Hemisphere Region (WHR)
Monitoring development effectiveness of interventions through ‘before and after’ evaluations
European Network (EN)
Capacity to provide BCC Management
Arab World Region (AWRO)
Capacity to develop networks and capacity with formal & informal commercial providers
Africa Regional Office (ARO)
Ensuring VFM and delivery of health outcomes
Central Office (CO)
Compliance with Quality Assurance standards, and processes for services/commodity procurement
REGION KEY:
Provision of data on service costs (disaggregated by inputs)
Figure 1.21 - IPPF Personnel Skills
Capability to measure/report regularly on service use; disaggregate to target poor; use shared performance indicators
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COORDINATION: Matthew Lindley, Senior Advisor - Resource Mobilization Ilka Rondinelli, Senior Advisor - Access
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STTA: John Worley - Global Advisor: Public Policy and acting Director of Operations
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Dr Heidi Marriott, Head - Organizational Learning and Evaluation
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Abdul Muniem Abu Nuwar, Senior Associate
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Dora Lind Braeken Van Schaik, Senior Advisor - Adolescents/Young People
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Susmita Das, Director - Programmes
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Dr. Ibrahim Ibrahim, Director General. Planned Parenthood Federation of Nigeria
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Daniel Messer - Organizational Learning and Evaluation John Good, Finance Director David Smith, General Manager - ICON
Elizabeth Bennour, Director - Programmes and Advocacy Dr. Kelly Cullwell, Senior Advisor - Abortion
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Teong Seow Kin, Evaluation Manager
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Lucien Kouakou, Team Leader - Western and Central Sub Region
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Elly Mugumya, Team Leader - Eastern and Southern Africa Sub Region
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Kevin Osborne, Senior Advisor - HIV/AIDS Dr. Nguyen Toan Tran, Global Medical Advisor Alejandra Trossero, Director, Integrated SRHR Programmes Dr. Jameel Zamir, Programme Officer - Access
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Section 2.12 - Quality Assurance of Commodities IPPF will assure the quality of commodities and products at all stages of the supply chain.
Quality monitoring
Quality monitoring
Serving clients
Distribution: Storage Transport
Logistics Management Information System People Policies Funding
Quality monitoring
Forecasting Procurement
Product selection
Quality monitoring
Figure 1.31 - IPPF’s Approach to Commodity Quality Assurance
Logistics Management and Information Systems IPPF’s approach to ensuring the quality of commodities encompasses its policies, people and the funding available for their purchase. IPPF’s policy on the purchase of contraceptives, condoms and RH medicines was recently updated (May 2011). It notes that we will only offer supplies that are reviewed and recommended by IPPF’s International Medical Advisory Panel; they must be assured under the WHO prequalification programme4 or manufactured in accordance with current Good Manufacturing Practice from stringent regulatory authorities. IPPF’s regional offices provide regular training for staff in forecasting and procurement. This includes working in partnership with USAID-funded projects (e.g. DELIVER). To reduce the incidence of stock-outs, IPPF aims to have three months’ buffer FP/RH supply
stocks at all clinics and at the Member Association level. While Member Associations purchase through ICON (IPPF’s wholly-owned procurement company), many also purchase or accept commodities from a wide range of manufacturers, donors or third-party agents. Orders made to ICON are tracked via the Reproductive Health Interchange5. IPPF’s Standardised Procurement Handbook is used to assist in forecasting demand and planning the delivery of supplies for this project. ICON will also be responsible for the pre-qualification of suppliers, preparation of supplier contracts, receiving shipments, and conducting quality testing. ICON will work to register any projects that require local registration. IPPF’s Handbook of Medical Service Delivery Guidelines includes guidance on storage of contraceptives and stock management.
4 Policy 3.4, IPPF Policy Handbook 2011 5 http://rhi.rhsupplies.org/rhi/index.do?locale=en_US 5 http://rhi.rhsupplies.org/rhi/index.do?locale=en_US 6 The Guidelines are consistently the most downloaded publication from IPPF’s website. In addition to translations by IPPF, it has been translated by other organizations, including professional medical bodies, into local languages.
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The IPPF-led team will benefit from the ground breaking work of EngenderHealth on the Supply-Enabling Environment-Demand (SEED) programming model. SEED comprehensively addresses the multifaceted determinants of health and builds capacity for scaling up FP/RH/MCNH services. By responding to the challenges of delivering quality services (supply); strengthening health policy, governance and resourcing (enabling environment); and removing client barriers to using health services and adopting health behaviours (demand), SEED supports mutually reinforcing interventions.
Section 2.13 Quality Assurance of Service Delivery An enabling and total-quality environment for service delivery is a continuous process that requires strong management, governance, quality assurance and supervision systems. Underpinning these are information systems that provide pertinent, accurate and timely data for effective decision making. IPPF’s Handbook of Medical Service Delivery Guidelines is an “industry norm” in the provision of high quality FP/RH services.6 During 2011 our Quality of Care Programme is being revised and updated to become a Continuous Quality Improvement (CQI) system, which will place quality within the context of VFM economy, efficiency and effectiveness. All country competitions won by this IPPF-led team will benefit from this innovative approach to quality assurance.
IPPF recognises the application of SEED as a programming model that works in synergy with the IPES to increase client choice, particularly with regards to access to longer-acting methods of contraception through a range of community level services delivery outlets (e.g. mobile clinics). MSH’s Fully Functioning Service Delivery Point and the LSTM Standardised Quality Improvement Package similarly provide high levels of quality assurance in the fields of expanding services in resource-poor settings, and for maternal newborn and child health respectively.
Figure 1.41 - Supply-Enabling Environment-Demand (SEED)
Quality client-provider interaction
Supply
Demand
Increased availability
Increased knowledge + acceptability
Service sites readied Staff performance improved Training, supervision, referral increased Logistics systems strengthened
Meeting reproductive intentions
Accurate information disseminated Image of services enhanced Communities engaged and supportive of family planning
Enabling Environment Improved policy + program environment
Fundamentals of care
Data for decision making
Gender Equity
Stakeholder participation
6 The Guidelines are the basis for a total-quality service environment and are used by many organisations. IPPF’s Quality of Care Programme provides the resources for training, strengthening supportive supervision and upgrading of facilities to realise the Guidelines.
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Section 2.2 Methodology and Innovation
A unique strength of the NOW! approach is the ability to track the comprehensive service pathway and uses this information to respond to needs and drive increases in service delivery and uptake.. Our innovative Clinical Management Information System (CMIS) helps ensure and monitor integration with - and referral to – other key services. Understanding and using the information critically to further refine services including the cost of each component of the services and adapting them to the local context means that we can better respond to the needs of the local population whilst identifying ways to be more efficient. The IPPF-led team will provide a total market approach to reach all market segments particularly the poor and vulnerable, adolescents and displaced populations. The NOW! approach draws on IPPF and the rest of the Team’s essential role in the health system, and will strengthen our ability to work across the market to strengthen all
Our approach will include new technologies to the supply chain: Sino–Implant7: effective long-acting and reversible contraceptive that costs only a third of the price of its competitors. Uniject: injectable contraceptive that will be available in the next two years as home-based self-administrated injectable. Uniject has the potential to improve the safety and acceptability of injectable contraceptives given by service providers, and in particular by community-based distributors.
7 Once qualified by WHO
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Antenatal care
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Family Planning
Sexually tr
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The IPES diagram overleaf (Figure 2.22) illustrates the three levels of services provided through a client’s lifecycle. For every client, there is a tailored package of high impact services that ensures their comprehensive needs as women and girls - whatever their entry point.
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Community Based Distribution and Social Marketing Outreach Direct Service Provision and Social Franchising
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NOW! tracks the path a client takes at a service delivery point, creating a family planning “pathway” (See Figure 2.21). NOW! offers an integrated package of essential services (IPES) to every client that arrives at a service delivery point. It delivers through three strands of service provision:
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No Opportunity Wasted (NOW!) is the Team’s critical path that delivers outputs and performance with a clear link to costing. It will increase reproductive health choices and improve value-formoney (VFM) in the RH sector. Now! places the client at the very centre of everything we do, and ensures that we deliver quality comprehensive services to every client, no matter what their point of entry into the health system.
G e nd erb
NOW! Approach: A Critical Path
fri en
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Expand Supply
Increase Demand Figure 2.21 - NOW!: A Family Planning Pathway actors in the public and the private sector. To reduce barriers to access, services and commodities will be subsidised or provided free of charge, making use of demand side financing mechanisms where feasible and useful. NOW! offers an approach amenable to demand-side mechanisms (such as vouchers) supported by the necessary systems to help manage effectively (CMIS).
The NOW! Approach: Delivering Health Outcomes The IPPF-led team recognises the need to address risks and assumptions from the outset and ensure that we continue to accelerate performance. We have outlined risk management strategies and mitigation plans that are essential to delivering results: •
CMIS – captures information and ensures we are responsive to women and girls’ comprehensive needs;
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Quality Assurance/Quality Improvement – ensures that we deliver a high impact quality comprehensive and integrated package of services;
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Ensuring client satisfaction – responding to client needs and delivering services that match expectations;
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Results-driven financing – payment on delivery of key performance metrics.
14 PO 5555: DFID RHFS Figure 2.22 - IPES: A client-centered continuum ADOLESCENT AND BEFORE PREGNANCY
PREGNANCY
BIRTH
POSTNATAL
COMMUNITY BASED DISTRIBUTION AND SOCIAL MARKETING
OUTREACH
DIRECT SERVICE PROVISION AND SOCIAL FRANCHISING
NEWBORN
MATERNAL HEALTH INFANT
FP/RH
SAFE CHILDBIRTH
NEWBORN CARE
- contraceptive services (LAPMs) - case management for STIs - safe abortion services - post-abortion contraception (LAPMs) - sexuality counselling - GBV supporting services for survivors
- skilled obstetric care and essential care for neonates - PMTCT - emergency obstetric care - emergency care for newborn babies
- emergency care - case management for neonatal illness - care for children with HIV
FP/RH
ANTENATAL CARE
POSTNATAL CARE
CHILDCARE
- contraceptives services (OCs, injectables, LAPMs, condoms) - STI?HIV counselling diagnosis/testing - sexuality counselling - safe aortic services - GBV screening/referral
- four visit focused package - condoms - integrated with HIV testing, TB, malaria prevention (insecticides/bed nets) - immunizations - PMTCT
- Healthy behaviours/ hygiene/nutrition - contraceptives services (condoms, COs, injectables, LAPMs) - PMTCT (feeding) - TB
- immunizations - malaria prevention - care of children with HIV - trimoxazole
CHILD
COMMUNITY BASED CARE - contraceptive, STI/HIV - prevention, safe abortion, information/referral - contraceptive distribution (OCs, condoms, injectables)
- ANC (nutrition, recognition of complications/risk signs) - emergency preparedness - community support-referral - emergency transport and funding schemes
DIRECT SERVICE PROVISION AND SOCIAL FRANCHISING
OUTREACH
COMMUNITY BASED DISTRIBUTION AND SOCIAL MARKETING
NOW! will also be supported by a communication strategy that builds on IPPF’s existing community-based outreach and commitment to rights. IPPF’s commitment to a rights-based approach places clients needs at centre, including in the design, monitoring and evaluation of services. We will deploy tools to clients have a satisfactory experience from all FP/RH services at all project service delivery points. Maintaining regular reporting on results is essential to good project management. We will ensure regular quarterly reporting and teleconferences with DFID. Our
- clean delivery - early care for neonates - breastfeeding - PP/contrception
- health home behaviour (nutrition, hygiene care, water) - demand for quality skilled care - diarrheoa - information on immunization
Now! Advisory Group (chair: John Worley, Global Advisor, Public Policy) will comprise senior representatives of The Team and stakeholders. Meeting quarterly, it will strengthen collaboration towards achieving key results To ensure that we deliver value for money, we will use a cost methodology that links payments to the achievement of results. Detailed costing information will be compiled using a costing tool for both input-based budgeting and benchmarking. This will enable us to provide a detailed indication of costs of results and impact indicators. Each tender at the country-level will clearly identify the costs of inputs and outputs either in terms of milestone or individual services, depending on the nature of the activity. During the inception phase of each project, a payment schedule will be provided based on the achievement of key milestones. For the duration of the project, the payment schedule will be directly linked to the achievement of key performance targets. Planned Parenthood Federation of Nigeria (PPFN) currently provides approximately 10 per cent of family planning in Nigeria, and is well placed to deliver health outcomes for the poor and vulnerable, young people and displaced populations. Nigeria has been selected for use as an illustrative example of a NOW! workplan for use at the country level.8 (see Annex 7)
8 It is important to note that the work plan demonstrated for Nigeria is for illustrative purposes only, and would be refined at the country-level competition and inception phase should IPPF be shortlisted.
PO 5555: DFID RHFS 15 Figure 2.23 - NOW!: a total market approach
QA/QI Training Supportive supervision Data quality assurance
NOW! Total market approach: Determine supply
Clear definition of the population, gateway to the territory the system covered, and the health needs
Entry Point
First level of care
FP/RH/MNH continuum of care
Network of integrated services
BCC/social participation/ community: Generate demand
The next section will demonstrate how our Methodology will deliver key RHSF outputs. Output 1 Expand supply of high impact comprehensive, integrated package of services The NOW! approach provides a high impact, comprehensive, integrated package of services to those most in need. Our range means that we offer high quality services to hard-to-reach market segments – poor, adolescents and displaced people – with least access. We ensure that we provide choice through IPES, and seek to extend reach through our networks of service delivery points, training (including to public and private providers), service quality improvement and development and tools and standards. We will scale up services and quality of care provided to each client through three stands of provision to support a total market approach: 1) Community-Based Distribution 2) Other Outreach Services 3) Social Franchising & Direct Service Provision
Clinical management Commodities + logistical support Integrated information system: - eIMS - CMIS - poverty scorecard Innovative financial schemes: - franchising/voucher/PPP Results based financing: - service statistics - key performance indicators
Integrated package of essential FP/RH/MNH services Single clinical record Appropriate referral and follow-up task-sharing Intersectoral coordination
1) Community Based Distribution and Social Marketing: In 2010, IPPF provided services through 13,094 community-based delivery points in DFID RHSF countries. NOW! will be implemented in these most remote and hard-to-reach areas by working with our existing network of volunteers who act as community-based distributors (CBDs).9 Recent evidence from WHO found the provision of injectable contraceptives through community-based health workers to be safe and effective.10 Scale up of the delivery of injectables, along with expanded and informed contraceptive choices, through community-based health workers, will be a key part of our response. In 2010, IPPF Member Associations in DFID RHSF countries operated approximately 900 social marketing service delivery points. Building on our experience, NOW! will adapt social marketing strategies including commercial advertising and marketing techniques to influence health behaviour change. Branding, responsive packaging, and clear information improve consumer acceptance and uptake of products, so are essential to meeting the unmet need for family planning. By harnessing all of the social marketing strategies currently being implemented by the Team, we will ensure increased demand for and use of services and contraceptive methods using already established distribution channels.
9 Community-based distributors (CBDs) deliver contraceptives and other sexual and reproductive health services which do not require a clinic setting. Community members are trained to provide health education, advice and supplies, and to make referrals. 10 WHO Conclusions from a technical consultation: Community-based health workers can safely and effectively administer injectable contraceptives, 2009.
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NOW! builds on proven areas of social marketing: •
IPPF-branded condoms are socially marketed through both the public and private sectors.
•
In 1999, IPPF’s Brazilian MA BEMFAM launched its PROSEX condom brand. Over 43 million PROSEX condoms have been distributed through both the public and private sectors using targeted socially marketed campaigns.
Case Study - MSH Afghanistan MSH’s Rural Expansion of Afghanistan’s Communitybased Healthcare (REACH) programme adapted a social marketing campaign to stimulate demand for and supply of contraceptives, oral rehydration salts, safe water systems, and insecticidetreated bed nets in rural areas. Through a wide variety of distribution channels, the capacity of NGO suppliers, Private Pharmacy Network and health extension workers in the public sector were strengthened to reach the poor and vulnerable.
2) Other Outreach Services: NOW! will foster innovative delivery channels and approaches to increase access to ensure all market segments - particularly poor – have the opportunity to access services regardless of their geographic location. In 2010, IPPF operated 561 mobile service delivery points which provided critical outreach services directly to clients who otherwise would not have access to healthcare. Some salient examples include: providing injectables through communitybased health workers, long-acting and permanent methods through mobile clinics (including implants), and reaching
Case Study - Innovation for Access Working in collaboration with the Abdul Latif Jameel Poverty Action Lab11, IPPF Nigeria is investigating how task-sharing with community-health workers can increase access to LAPMs. This innovative investigation will influence future programming at PPFN, potentially the Ministry of Health’s own workforce and NOW!
11 http://www.povertyactionlab.org/ at the Massachusetts Institute of Technology
the poor by providing services free-of-charge through incentives, such as voucher schemes. We have the quality-assured protocols to offer our clients a larger mix of contraceptives, and in particular long-acting and reversible contraceptives (LARC), such as IUDs and implants, through mobile clinics. Under NOW!, the Team will establish a functional network of services linked through an effective referral and cross referral system ensuring that clients are referred on and that no client is missed through the system. CMIS will track the referral process, ensuring client referral to services not currently offered through the NOW! approach where needed.
IPPF referral networks encompass the following providers: •
Private clinics
•
Private hospitals
•
Pharmacies
•
Public health centres and hospitals including NGO and government
•
Public financed community health workers
•
Small retail shops
The Team will continue to work closely with government partners to support the delivery of health services, to help fill gaps in the market. IPPF actively advocates for governments to increase their commitment to sexual and reproductive health and rights. Where governments successfully introduce services, we strategically reallocate our resources to target other parts of the population who are in need and under-served. At country level, the Team will build capacity across all sectors including the public sector not only to ensure that clients have access to sustainable network of service providers through referrals but also ensure quality. Depending on the needs of the public sector, the Team will enhance collaboration with government health workers through the interchange of information and experience including training or sharing service delivery protocols and other best practices. These initiatives help build the overall health system in the countries where we are working. Sometimes, this means supporting the government’s delivery of SRHR services through capacity-building; in other instances, it involves working closely with the government on advocacy; elsewhere it may mean complementing the government system by delivering services where they cannot or will not go. Even in the most difficult circumstances, IPPF and its partners work on the slow and gradual process of building government
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capacity. In Somalia, MannionDaniels is building up government capacity to manage and provide services in an important move from humanitarian to more long-term and sustainable developmental approaches. MannionDaniels has recently started working with WHO and UNICEF in Somaliland and Puntland to collaborate with the Ministry of Health and Regional Health Authorities. MannionDaniels is working to strengthen leadership and management within the government. The work involves: assessment of current development partner support; assessment of human resources (including analysis of core competencies, and the current definitions of roles and responsibilities); and establishing a framework for capacity building. The Somalia framework will include a detailed approach to supporting more effective coordination, policy development, and ultimately defining sector support and key government health reforms, adopting the principles of the Paris Declaration. We recognise these as key issues that need to be addressed if effective delivery of public services will take place. By continuing to lead the way through our global advocacy initiatives, the IPPF led team will also focus on holding governments to account for existing political and financial commitments to reproductive health.
Case Study - LSTM MAKING IT HAPPEN, how we work closely to strengthen the public sector The Liverpool School of Tropical Medicine’s programme ‘Making it Happen’ works closely with the Ministries of Health in Bangladesh, Kenya, India, Sierre Leone, and Zimbabwe to increase the availability and quality of essential obstetric care and newborn care (EOC & NC). LSTM works closely with governments to deliver a country-adapted competency-based training package to improve health care providers’ capacity to delivery EOC and early NC. This model is sustained by training in country Master Trainers of Facilitators, and then followedup through strengthening of Supportive Supervision in the workplace. Furthermore, LSTM has introduced a common monitoring & evaluation framework across all the countries that can measure project performance and impact. Initial results have indicated a mean overall reduction of 49 per cent in obstetric care fatality measures, and 15 per cent overall reduction in stillbirth rates in target facilities in Bangladesh and Sierra Leone that received the training.
We will build on Engender Health’s experience in supporting development of successful franchises in Nepal for reproductive health and child survival, and in the Philippines where they are working with a network of midwife franchisees on quality RH/FP/ MH services. 3) Social Franchising & Direct Service Provision: NOW! will work closely with IPPF Member Associations, as well as other partner service delivery providers, in a form of franchising agreement to maintain quality and standards, and be able to track services and costs as noted at the PPQ stage. IPPF’s current business model has many of the characteristics of social franchising. Many IPPF Member Associations are the largest non-state providers of SRHR in DFID’s RHSF countries and operate through a model of social franchising12. The Team is well-versed in social franchising: MSH is credited for the creation and success of innovative franchises that market pharmaceuticals and related services. For example, MSH introduced a franchise business model to improve access to and use of drugs and health commodities in Tanzania where the establishment of accredited drug dispensing outlets (ADDOs) resulted in a reduction of unregistered products for sale from 26 per cent to 2 per cent. The NOW! approach will scale up and adapt innovative approaches to provide reproductive health choices of the population. We will provide access to LAPM, in particular in the period following childbirth, to enable women to achieve their fertility desires. For women with limited access to medical care, the time of delivery offers a unique opportunity to address their need for contraception if the delivery takes place in a health –care centre. Long acting methods afford numerous benefits to both individuals and service delivery sites. These methods are highly effective and safe; they are suitable for use by all categories of clients, including adolescents. The Team will ensure scaling up of LAPM through training to service providers in post-partum and post-abortion LAPM from the outset of the programme. Training and technical assistance to strengthen core clinical areas, while expanding access through community and outreach services and task shifting that allows nurses, auxiliary and lay volunteers to deliver more services. The Team will benefit from the considerable experience of Engender Health, most recently through the USAID RESPOND project, in integrating LAPM of contraception into public and private sector clinical and non-clinical service delivery points.
12 As a Federation, the relationship between the IPPF Secretariat and Member Associations has many of the attributes of a social franchising arrangement, insofar as: (i) MAs must comply with minimum standards of governance as well as quality of care; (ii) MAs standard are actively monitored through an accreditation system; and (iii) IPPF offers a corporate identity and provides key tools, resources and support to enable MAs to operate. Unlike a franchise arrangement however, each Member Association also has its own unique name and brand which it maintains and displays in addition to the IPPF brand. This arrangement allows MAs to continue to benefit from their well earned national and local status.
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Output 2 - Increase demand and reduce barriers for women and girls to access quality services – serving the underserved.
working closely with communities using its NOW! will encourage and 1. Implementing financing extensive network of volunteers and peer mechanisms to reach the poor. motivate women and girls to educators who not only provide critical information about RH/FP information at demand better and more services. NOW! will follow the same model that the community level but who also maintain IPPF Member Associations currently use to Increasing awareness and use referral linkages to the rural outreach ensure access for the poor. All of the 25 services. Under NOW! the existing network Member Associations in the DFID priority of services and contraceptives community-based providers will be countries provide free services to those forms the backbone of the NOW! who cannot afford to pay. IPPF is currently of utilised to strengthen and expand services to the targeted communities by taking implementing a number of financial approach. The Team will draw integrated services to the most remote exemption mechanisms at country level to on strong behaviour-change communities. target services to particular groups. These include LAPM, and reversible contraceptives communication strategies which (IUDs, Implants) and surgical methods. 3. Understanding and Meeting the have already been developed Needs of the Client. and implemented in a number of In countries where health services are not free at the point of care, we will explore various The Team will draw on the successful countries. health financing schemes to promote experiences in total market analysis to uptake of services by the community, in particular the poor. This funding will allow selected service delivery points to subsidise contraceptive services that have a high onetime cost that poor clients cannot afford at the point of care. These include longacting and reversible contraceptives (IUDs, implants) and surgical methods. These vouchers can take the form of certificates that clients can redeem with our trained providers. Voucher schemes for poor clients can be effective in improving access for the poor to services they cannot afford.13 We will ensure that clients are fully informed about their rights and contraceptive choices, and are not biased toward a particular method because it is subsidised.
2. Addressing geographical barriers. We will implement NOW! even in the most rural areas. Our experiences of providing services in Afghanistan, Bangladesh and Nigeria and other largely rural countries have demonstrated the importance of the rural provider – be it a pharmacist or midwife – as the sole information source for the client. The capabilities of the rural providers to convey accurate and useful information to consumers are therefore crucial to the success of behaviour change14. The Team has a proven track record of
assess specific needs of the different segments of the territory to cover, determine the gaps that prevent women and girls from putting behaviour change into action using tools such as Reality √ Model15. This model maps the different segments of the population, providing key information about potential clients and most importantly how services can be tailored to meet their most urgent specific needs. Addressing the needs of the most vulnerable including young people and displaced populations can make a significant contribution to national health, well being and development as well as to poverty reduction strategies.
i. Young People IPPF has long been in the vanguard of defining and providing youth-friendly services that are non-judgmental, confidential, and innovative in engaging young people. IPPF bridges the gap where the public sector does not and/or cannot provide adolescent reproductive health services appropriately or sensitively. An IPPF supported operations research project ‘Do They Match’16, in Bangladesh and Malawi, helped identify valuable lessons for provision of services for young people.
13 See for example, “Vouchers for health: using voucher schemes for output-based aid”, Sandiford et al, World Bank, 2002. 14 See for example: Smith, et al. “Working with Private Sector Providers for Better Health Care: An Introductory Guide” (WHO) 15 See for example, “Using the challenge model”, Management Sciences for Health, 2008 16 “Do They Match”, IPPF, 2010.
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IPPF has undertaken a peer review study in Nepal on services and sexuality education of young people.
Sudan have extensive experience in meeting the needs of displaced populations.
The results and lessons from this work show that young people place a premium on being treated with confidentiality, in a youthfriendly environment, and being involved in the monitoring and evaluation of the services themselves. NOW! will integrate these findings into its package of services, ensuring that the services we provide are tailored for youth. Combating stigma among health care workers (using the Stigma Index17) is also a proven technique that we will use under NOW! to address any inequities that may occur in health care provision. Trained peer leaders will also play an important role in ensuring that young people feel comfortable and empowered to seek services.
In those areas where we are working with displaced populations and/or in fragile states, we will integrate NOW! into our approach, thus demonstrating that NOW! can be applied to any setting to ensure that integrated services can be provided to all displaced populations. By further enhancing the Minimum Initial Service Package (MISP) for Reproductive Health to include the full continuum of care package we will ensure delivery of the complete service package to those most in need. In 2010, IPPF increased the capacity of more than 4,300 humanitarian workers in 81 countries in providing SRH services in humanitarian settings through its SPRINT initiative.
The Vulnerability of Young People Despite the challenges of working in a fragile state, IPPF’s Member association in Sierra Leone, Planning Parenthood Association of Sierra Leone (PPASL), is currently the only organisation providing youth friendly SRH services and making positive changes in the SRH environment for young people. Girls and women have a high unmet need, and are vulnerable to various SRHR challenges such as gender based violence, teenage pregnancies, unsafe abortion and high prevalence of STIs including HIV. In 2008 – 2010, PPASL dramatically increased youth friendly services, through providing sexual and reproductive health counselling and treatment services to 12,000 young people, and issuing approximately 130,000 contraceptives to young people by trained peer educators and service providers. Young girls are empowered to overcome unequal gender relations and discrimination.
ii. Meeting the needs of displaced populations, and those in fragile states. The IPPF-led team currently provides services in conflict and natural disaster areas in a number of the RHSF countries. Women and girls in humanitarian settings are at increased risk for rape, HIV transmission, unwanted pregnancies, and maternal death due to unassisted delivery and unsafe abortion. Given that women and children make up 75 to 80 percent of populations displaced by crises, IPPF views this work as essential and an increasingly integral part of its operations. IPPF’s Member Associations in Afghanistan, Kenya, Liberia, Pakistan, Palestine, Sierra Leone and
17 See http://www.stigmaindex.org
SPRINT ‘Responding to the Full Needs of Displaced Populations’ The SPRINT Initiative is the humanitarian stream of IPPF. It aims at increasing access to the Minimum Initial Service Package (MISP) for Reproductive Health, a set of priority life-saving SRH services to be put in place for forcibly displaced populations in humanitarian settings. SPRINT takes an innovative approach by empowering multisectoral country coordination teams to take the lead in mainstreaming the MISP into the country’s emergency management cycle. This encompasses the phases of emergency preparedness and disaster risk reduction, emergency response, recovery and redevelopment. This holistic approach ensures continuity and sustainability of access to services throughout the different phases of an emergency in disaster-prone and fragile States.
4. Innovative communication initiatives. The Team will adapt proven campaigns and messages designed to convey information about a wide variety of issues that influence barriers to access. Such issues might include: stigma and discrimination; the benefits of smaller families; debunking the myths about family planning; encouraging self-determined choice; promoting the life-cycle approach to MCH/FP/RH. The package will aim to bring about a change in mind-set of the community that will slowly start to see them seek out health services themselves, support the continuation of existing services, reduce barriers that women face to accessing services.
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A behaviour change communication (BCC) package will be an evolving entity that can be shaped to fit the particular demographics of the community or geographical location it serves. MannionDaniels’ work in Nigeria demonstrates how BCC can go beyond just promoting key health messages, to actually providing a more supportive environment for people to initiate and sustain positive health behaviours. The Nigeria work under the DFIDfunded PATHS2 project promotes personal responsibility and public accountability, and is particularly effective in reaching the socially excluded. Using innovative mobile technology to reach the poor. IPPF has developed a model to expand use of mobile technology to increase
Case Study - ‘Ask Nigeria’ ‘Ask Nigeria’ is an innovative series of dialogues between government officials and the general public, currently run in 4 districts (including the more conservative Northern districts of Kano, Kaduna and Jigawa). ‘Ask Nigeria’ presents people’s authentic narratives on a public platform. This increases individuals’ demand for services because it boosts their knowledge about priority health issues, and increases their confidence and motivation to access services due to this new form of inclusion and consultation, this awakening their sense of personal responsibility. On the service side, the live debates encourage government officials and health providers to respond to citizens’ expressed needs. In particular, the timing of the debates immediately before the recent 2010-11 State and Presidential elections helped to establish the issue of health entitlements and health care provision firmly onto the political agenda, and have resulted in increased staff allocations to service delivery points and financial allocations to the state health budgets ‘Ask Nigeria’ thus strengthens the linkages between demand and supply components of health work.
access to services for the world’s poorest women and girls. The technology provides educational and preventive messages to help achieve the development of a healthy pregnancy; the timely identification of warning signs to avoid complications; and usefulness as prenatal care appointment reminder. The model, first applied in the USA, has since been successfully replicated in Mexico, and will be expanded in selected RHSF countries including Nigeria.18
Output 3 Improve performance, delivery and value for money The IPPF-led team will achieve value for money through NOW! through the use of robust management tools and processes. We define value for money as: •
a measure of economy, in that we measure how our financial inputs are in connection with the actual expenditures;
•
a measure of efficiency, in that we measure how NOW! delivers services (outputs) that are targeted and at a good cost;
•
a measure of effectiveness, in that NOW! services contribute to fulfilling overall objectives as well as to achieving internationally agreed targets for improving SRHR.
In order to assess the costs and the returns of all our actions, both internally and through delivery of our programmes, NOW! will use evidence-based design, integrate strong indicators to measure results, and establish systems to learn lessons and maintain continuous improvement. We also recognise the nuanced complexity of the term ‘value for money’. Sometimes, working in remote areas or with the most vulnerable people has a higher unit cost but also a greater impact. Results-driven financing: IPPF has developed an innovative results-driven financing system to strengthen the connection between funding and the delivery of outputs and to increase accountability of funded programmes and services and efficient use of limited funds. This incentivises NOW! implementers to focus on timely completion of targets and results, and to prioritise the improvement of programme implementation and the use of evidence for decision-making. Standardised service costing methodology: By tracking accurate costing information, IPPF and partner service delivery points implementing NOW! will be able to identify and act upon cost improvements more systematically and over time. The Team expects that the cost-per-CYP delivered will decrease as services and contraceptives uptake rise and efficiencies increase. In order to support this implementation, IPPF is providing detailed costing tools with guidance notes on measurement and standardised costing categories to ensure that the reported unit costs are comparable among countries and across services. One of the unique benefits of
18 Given key factors such as strengths of existing partnership and provider network coverage; the opportunity to reach particularly stigmatised youth populations and technological factors, including high mobile penetration, Nigeria will be considered for the next roll out phase.
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IPPF’s standard costing model is that it can be applied any setting (including fragile states or in remote geographical areas). Driving Performance: IPPF will drive performance through directly linking payment to results and impact. Each tender will clearly identify the costs of inputs and outputs either in terms of milestone or individual services, depending on the nature of the activity. Following a short inception phase when possible the payment schedule will be directly linked to the results and impact. It should be noted that in some circumstances where operating conditions are particularly difficult or delivery is through a third party, payment may need to be input based- where this is considered necessary, this will be clearly identified and justified as part of the tender proposal. Demonstrating Value for money over the life of the project: A key output from each project will be the demonstration of the linkages between the project inputs, its results and final impact. The outputs of each contract will be linked to impact measures to provide information of the cost of impact. At the end of each year a report will be prepared comparing the actual cost of delivery to that proposed in the original budget highlighting the cost of activities and the outputs and impacts to which they are linked.
How will results-based financing work? The Team will report on the 29 performance metrics (performance indicators as listed in the Logical Framework Analysis at Annex 6) on an annual quarterly basis. These results will be verified by staff in regional offices and performance scores will be calculated for each indicator. The overall scores will then be used to set performance -based funding. Many of the results that the Team will produce for this system will also be used to estimate outcome-level impact. The new financing system is intended to transparently, consistently, and fairly reward funding on the basis of accurate and verifiable performance.
Leveraging existing resources including the Public and Private Sectors: Wherever possible, NOW! will capitalise on opportunities to use existing resources and to leverage support within the design of activities. This includes projects funded by DFID. One strategy is to leverage resources through all partners, thus achieving greater results for the inputs provided, or reduced inputs for the same result. Another strategy is to cost-share with other existing projects, using existing materials / offices / staff to achieve economies of scale.
Harnessing the strengths of the private sector NOW! will be implemented through private sector providers including nonprofit IPPF Service Delivery Points, partner Service Delivery Points, and private providers where appropriate. By undergoing rigorous training and orientation, and establishing and monitoring care through the CMIS, we will ensure that independent private providers maintain NOW! standards. The IPPF-led team has experience of working with the private sector. For example, in Afghanistan, MSH is a consortium partner of the Expanding Access to Private Sector Health Products and Services in Afghanistan (COMPRI-A) project. MSH is helping the Afghan Ministry of Public Health (Office of Private Sector Coordination) articulate a National Private Sector Policy and Strategy; negotiate a Private Hospitals Regulation Act; arrive at a private hospital accreditation framework; and acquire skills to negotiate PPP arrangements independently. COMPRI-A also has provided technical and financial support to the Afghan Private Hospitals Association and the Afghan MedicineServices Union (commercial pharmaceutical businesses). Other alliances with the private sector will also be made that strengthen the delivery of NOW! to the most vulnerable populations. For example, during the last decade, IPPF’s Member Association PPFN has collaborated with eight Nigerian banks to implement an HIV work-place programme. Since 2005, PPFN has worked with Shell Petroleum Development Company to provide HIV prevention and care services to local communities in the Niger Delta Region of Nigeria. PPFN has also worked with Nigeria Breweries, Mobil Nigeria Limited, the Central Bank of Nigeria, and the Nigerian Army in various areas of training of their private health workers to provide RH service provision (including specific family planning methodology).
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Section 2.3 Monitoring and Evaluation NOW! mobilises a number of existing IPPF monitoring systems. These systems are flexible such that they can be rapidly deployed to individual country work programme while enabling synthesis of data for quarterly reporting to DFID. The IPPF-led team is supportive of the use of these standardised metrics and monitoring and evaluation systems. Section 2.31 Systems to measure results and impact NOW! will deploy a robust monitoring system that: •
Promotes quality and equity of service delivery
•
Attributes performance (both results and impact) against investments
•
Supports continual improvements in value for money
•
Facilitates analysis of market structures and their evolution
The systems deployed for NOW! are IPPF’s client-centred CMIS and its integration with its web-based portal the electronic Management Information System (eMIS), which collates qualitative and quantitative data on service delivery. The evolution of these complementary systems over the last decade means that IPPF is unique in its ability to track the integration of services at the service delivery point towards delivering agreed results by cost. NOW! will collate these data on project results on a quarterly basis. The eIMS system will offer a detailed picture of the range of clinical services provided by the IPPF-led team, including those relating to IPES. Where the connection between CMIS/eIMS is fully operational we will also be able to develop a stronger understanding of the number of clients and type of receiving services, the services they accept and their chronological order - i.e. tracking clients’ pathways within the integrated FP/RH continuum of care.
CMIS: INSTITUTIONALISING CONTINUAL IMPROVEMENT IMPROVEMENT AREA
BETTER QUALITY OF CARE
BETTER CONTROL
IMPLEMENTATION PROCESS
SPECIFIC IMPROVEMENTS
Implementation of best practices
- Improvement of manual filing systems - Revision of Service Statistics / Price Lists - Standardised clinic forms/Moving to digital forms - Revision of client flow - Locally customised (language, local terminology, etc.)
Clients being served at reception
- Optimised client flow - More efficient and complete collection of key data - Appointment management
Clients receiving quality services
Faster/better access to clinic history data Service provision based on comprehensive clinic data Comprehensive clinic data collection Referral and counter-referral management Standard information protocols (SOAP, ICD, etc.)
Controlling clinic supplies
Enables inventory management better practices (First expired/ first out (FEFO), expiration dates, rotation) Prescription management
Controlling financial resources
End of day (EOD) sales reporting Strict service/product income control Donations / Credit control
Controlling specialised areas
Laboratory services Quality of care of procedures, Diagnosis, Treatment
Making informed management decisions
Improved Service Statistics Better reports on clients, finance, supplies Analysis of appropriate application of protocols
Institutionalise clinic system
Local staff in charge of training and rolling out the system
BETTER MANAGEMENT
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This connected information system has already demonstrated its ability to support efforts such as technical assistance to accelerate task-sharing, commodity security through automated ordering, improving service delivery mix to meet client needs, the result of client referrals, etc. All such data is used without ever compromising the confidentiality of the client. This system will also drive the results-driven financing mechanisms included in NOW! through its ability to calculate unit costs, user fees and service subsidies for each service. The CMIS is currently being rolled out across the Federation. It is already functional in service delivery points in the following DFID RHSF countries: Bangladesh, Ghana, India and Nepal, and in 2011 work is underway to introduce the system in Afghanistan, Ethiopia, Kyrgyzstan, Nigeria and Pakistan. IPPF is accelerating the manual and electronic roll out of the CMIS to DFID RHSF countries. In all countries where DFID awards the IPPF-led Team a country contract, manual and electronic versions of the CMIS will be operational before the end of the inception phase. Those directly in need of FP/RH services must lead, monitoring and shape the response to maximise access, quality and sustainability. NOW! will engage the clients, using a variety of techniques such as the widely documented PEER approach19 and the community mirror20 (a visual methodology which enables communities to track the work their elected health representatives are doing). The programme’s indicators and targets form a monitoring and evaluation framework against which we will measure results and impact. The Logical Framework (annex 7) illustrates the different indicators relevant to various levels of reporting:
Development impact: NOW! will contribute to key development impact indicators set out in the DFID Framework for Results. The IPPF-led team will calculate the number of women and children’s lives saved, women (and men)
using modern methods of family planning (including new users and disaggregated by age group), and unintended pregnancies prevented.
Outcome indicators: Quantitative indicators, such as the number of unintended pregnancies averted and couple years of protection, will illustrate the overall outcome of NOW! on the lives of our clients.
Results indicators: The combined CMIS/eIMS is designed to capture each service and the chronological order of their delivery to each client.
Key milestones: Indicators will help us monitor the achievement of results and the overall dayto-day management of NOW!.
Price and cost data: these indicators will enable the Team to provide unit costs at the input, result and impact levels. It further offers data on user fees and service subsidies by client. Systems to calculate impact: NOW! will also use the data collected to examine the impact of its interventions. In 2010, IPPF initiated work with the Guttmacher Institute to develop models to calculate the impact of IPPF’s contraceptive, abortion and obstetric services, and to review the applicability of models for a number of other SRH services that IPPF provides. These models are already providing information on a range of impact values, including unintended pregnancies averted, unsafe abortions averted and DALYS (disability adjusted life years). This work, combined with that of the Futures Group on CYP conversions, should become industry norms to allow for benchmarking across the sector. In addition to IPPF, NOW! will draw on the experience of other Team members in developing web-based performance monitoring systems both at clinic and at country level. For example, MannionDaniels developed and implemented a web-based
performance-monitoring system for use in seven Asian countries for UNFPA. The system involved an on-line tracking and reporting structure that allowed input of data at project source by implementing NGOs across seven Asian countries including Bangladesh, Nepal and Pakistan. UNFPA subsequently extended the system’s use to tracking work on an African regional health programme. Similarly, the Team has demonstrated expertise in strengthening national health management information systems. For example, MSH’s Technical Support to the Central and Provincial Ministry of Public Health (Tech-Serve) Project in Afghanistan is strengthening the health management information system (HMIS) for community and hospital services through use of community Lot Quality Assurance Sampling (LQAS)21and a national monitoring checklist for facilities. Tech-Serve works with the Ministry of Public Health (MOPH) at the central and provincial level to build its capacity to perform its primary function of guiding the health system. It does this by establishing national health objectives that address national health priorities while ensuring equity and fostering sustainability. Tech-Serve provides ongoing technical assistance in key public health technical areas and engages both central and provincial managers in developing their management and leadership skills to focus on health results and accountability. Evidence and data from CMIS, eIMS and LQAS systems will be reviewed quarterly in consultation with the local partners, including public and private sectors, and key stakeholders. Similarly, the Team is experienced in working with donors to commission before and after evaluations, through external assessments. It is also anticipated that through the data collected by the systems used, it will strengthen institutional learning and stimulate further innovation within the IPPF-led team, donor, government and stakeholder agencies.
19 For example please visit Options Consultancy’s website on Participatory Ethnographic Evaluation and Research: http://www.options.co.uk/monitoring 20 For example please visit the Knowledge for Health website: http://www.k4health.org/system/files/MSH%20eHandbook%20ch09.pdf 21 For example please visit the Knowledge for Health website: http://www.k4health.org/system/files/MSH%20eHandbook%20ch09.pdf
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Section 2.32 Systems to Track Equity of Access Equity definition According to the International Society for Equity in Health, equity in health is “is an ethical value, inherently normative, based on the principle of distributive justice and in line with the principles of human rights.”22 NOW! will directly address health inequality by systematically overcoming barriers to access, particularly for people who are in the bottom two income quintiles, young or displaced. NOW! offers the client an IPES, regardless of their point of entry into the health system. This is because it will be implemented across a wide network of centres/clinics, outreach and communitybased facilities (including social marketing), whichever is best-placed to meet their needs.
Disaggregating data IPPF’s eIMS currently provides estimates of the number of clients who are poor and/ or vulnerable, and the number of clients who are younger than 25. For example, in 2010, 76.7 per cent of IPPF clients from the 25 RHSF countries were classified as poor and/or vulnerable. In 2010, 43.6 per cent of IPPF clients from the 25 RHSF countries reached people under the age of 25. The connection of the CMIS/eIMS will able NOW! to collect data on actual numbers of clients, including disaggregation by key market segments including clients who are
in the bottom two income quintiles, young or displaced. This innovation enables IPPF to use its Results-Driven Financing system to reallocate resources to drive increases in equity based on client type as well as by service.
Bottom two income quintiles Under Output 2 in the Logical Framework (see Annex 7), we will use the standard and established IPPF terminology and service statistics system to measure the percentage of clients who are poor, marginalised, socially-excluded and underserved, as well as the proportion of clients receiving modern contraceptives who are classified as such.
Young people The IPPF Service Statistics can disaggregate by age. As can be seen in the Logical Framework (see Annex 7), most of the indicators can be disaggregated to see what proportion was received by clients under the age of 25 (number of FP/RH services, number of contraceptive services, number of unintended pregnancies averted, couple years of protection, number of HIV and STI related services etc).
Displaced people The NOW! Approach will work in concert with IPPF’s SPRINT Initiative. IPPF is the lead partner in the SPRINT initiative, which works through intergovernmental and government systems to build national capacity and preparedness to deliver a basic package of FP/RH/MNH services through the national disaster contingency plans. The Team will work through national disaster planning and programming committees to ensure that before and during a disaster the needs of displaced populations to access FP/RH are recognised. The specifics of working in such complex and rapidly evolving situations makes it more difficult to predict and track the exact needs or their fulfilment. However, IPPF has a broad experience of working through such national systems to directly target displaced
22 International Society for Equity in Health website: Accessed 14 July 2011: http://www.iseqh.org/
populations, even when they live alongside host communities. Recent examples in DFID RHSF countries include: Afghanistan, Liberia, Palestine, Pakistan, Sierra Leone, Sudan, and Uganda.
Vulnerability measurement tool In 2007 IPPF developed an Entitlement Index to enable it to track and target increased access for poor and vulnerable populations. The index uses proxy indicators relating to financial, social and cultural wealth alongside individual freedoms (such as ability to leave the home). Through the Index IPPF has strengthened the design and implementation of its programmes to meet the needs of those most at risk. In 2011 IPPF is working with MEASURE Evaluation PRH Associate (Futures Group) to allow a greater level of sophistication such that a more precise quantification of the proportion of clients who are poor and/ or vulnerable, including young people. The assessment applies a specific tool that uses a poverty scorecard. The Bolivian Member Association is now using this tool on an annual basis to collect data with which it is making programmatic decisions on how to increase service provision to the poorest and most vulnerable clients. Poverty is assessed using the 10 question ‘Poverty Scorecard’ using data from the Household Survey. The scale estimates the likelihood that a household has income below a given poverty line. Household survey data is already available in the following DFID RHSF countries: Bangladesh, Ethiopia, Nepal, Nigeria, Occupied Palestinian Territories and Pakistan. IPPF is currently working on how the poverty scorecard can be readily tailored to meet the specific needs of countries and market segments. Once completed, this innovation will be incorporated into the NOW! Approach.
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Section 3 Names and Curriculum Vitaes
Information Sytems Market Analysis
-Daniel Messer
-Dr Heidi Marriott
Finance & Value for Money -John Good
Short Term Technical Assistance
Supply Chain Management
-Regional Office, MA and Central Office Senior Advisers
-David Smith
Mini Competition Coordination: Matthew Lindley
Access & Systems Improvement -Ilka Rondinelli
Partner Technical Expertise -Mannion Daniels, EH, MSH, and LATH
Technical Implementation Coordinator: Ilka Rondinelli
Implementation -Country Teams
Partner Technical Expertise -Mannion Daniels, EH, MSH, and LATH
Short Term Technical Assistance
Supply Chain Management
-Regional Office, MA and Central Office Senior Advisers
-David Smith
Market Analysis -Heidi Gagnebe Marriott
Information Sytems -Daniel Messer
Finance & Value for Money -John Good
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CV - Abdul Muniem H.Abu-nuwar Abdul Muniem Abu-Nuwar is a demographer and a leading expert on population surveys and statistical analysis. He has experience of population data, sampling and mathematical statistics. He has undertaken a wide range of census and survey design projects including a genderbased violence survey programme, and is the author of a technical paper on ‘Total Quality in Censuses.’ Prior to joining IPPF he has worked for the Ministry of National Economy in Jordan as a Census Adviser
and in the past UNFPA and EC. He has core skills in statistical causality analysis and development planning, population strategy formulation, computer modeling and use of scientific and mathematical software. He has a very broad range of international experience and has provided oversight functions for UNFPA-funded Censuses and Surveys in Latin America, Asia, Europe, Africa and Arab States. He also assisted DTCD in the Design and follow-up of the Population Censuses, including analysis
and dissemination in China, Vietnam, Namibia, Brazil, Argentina, Mexico, Turkey, Indonesia, Somalia, Mauritania, Sudan, Lebanon, Syria, Oman and Egypt. In the past he has provided training to Arab Countries on Modern Integrated Population Information Systems, including Census, Vital Registration and Administrative Records. He was the technical backstop for the World Health survey programme.
EDUCATION UNFPA-Harvard University Online Training Courses Maternal Health, RH/RR, Gender, Rights-based programming; Evidence-based policy dialogue and advocacy; Resultsbased programming; Coaching and staff assessment management.
2009
PhD Candidate Actuarial Sciences Part-time External Researcher, City University, London
Present
MSc Mathematical Statistics West Virginia University
1978
Special Masters, Sampling/Censuses and Surveys Georgetown University
1973-1974
BSc Genetics, School of Agriculture Alexandria University
1970
EMPLOYMENT International Planned Parenthood Federation, Arab World Region Senior Associate
2011-Present
Ministry of National Economy, Sultanate of Oman Resident Census Adviser Responsibilities: Adviser on all aspects of Census data collection and analysis.
2009-2011
European Commission Consultant Responsibilities: Design of Gender-based violence survey programme.
2009
United Nations Population Fund – UNFPA Director, Country Technical Services Team for Arab States Representative for Egypt Representative for Syria and Country Director For Lebanon & Cyprus UN Resident Coordinator for Syria
2001-2008 1997-2001 1995-1997 1996-1997
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United Nations Population Fund Country Director, Syria/Lebanon and Cyprus Deputy-Chief, Division for Arab States and Europe Senior Technical Officer, Technical and Evaluation Division International Programme Officer, Middle East and Mediterranean Branch
1993-1994 1991-1993 1985-1990 1981-1985
Government of Jordan Director General, Censuses and Surveys Director, Population Studies Director, Agriculture Statistics Deputy Director, Agriculture Statistics Staff Member, Agriculture Statistics
1978-1981 1975-1978 1973-1975 1972-1973 1970-1971
LANGUAGES Arabic, English.
SELECTED PUBLICATIONS Authored the Chapter on: “Population Data” in UNFPA Review & Assessment, 20 Years of Experience. Authored the World Economic Forum’s Paper “The Arab Population,” presented and discussed in Dafos 2003. Co-authored the guidelines for UNFPA’s “Programme Review and Strategy development-PRSD,” 1988. Participated in the book “Legacy of Family Planning in Islam.” Authored a technical paper on: “Total Quality in Censuses.”
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CV - Olufunmilayo Balogun-Alexander Over 20 years experience as a Gender Rights and Sexuality Specialist in Africa. Experience spans rights and gender advocacy, evidence based research and gender mainstreaming. Provides ongoing technical capacity building for integrating gender, rights and sexuality within SRHR service provision with particular focus on sexual and gender based violence, abortion rights and provision of services to diverse
groups. Superior skills in developing advocacy strategies and programmes with governments and the facilitation of processes for women’s engagement with the constitutional reform and macroeconomic rights processes Nigeria and Kenya. Developed a Gender, Rights and Sexuality Strategy and comprehensive gender and rights training manual on Sexual and Reproductive Health Rights
provision focusing on the 5 priority areas of Adolescent Sexuality; HIV/AIDS, Abortion, Comprehensive access to SRHR and Advocacy. Excellent Monitoring and Evaluation experience, with strong skills in developing result based management indicators.
EDUCATION MA Gender & Development Institute of Development Studies, University of Sussex, UK
1994
BA (Hons.) English University of Lagos, Akoka, Nigeria
1988
EMPLOYMENT International Planned Parenthood Federation, Africa Regional Office, Nairobi, Kenya Gender, Rights and Sexuality Technical Adviser Responsibilities: Capacity building for the integration of gender, rights and sexuality within the activities of IPPF’s 41 Member Associations working in 41 countries in Africa to provide rights and gender based sexual and reproductive health services. Supporting the integration of SGBV within sexual and reproductive health provisions a strategy of strengthening national responses and laws to SGBV, and very importantly, providing key statistics on the incidences and types of SGBV in Africa through existing access to over 5m people, most of them women, that IPPF serves annually. Management of pilot projects to demonstrate the use of sexuality framework and adoption of sexual rights within SRHR in 4 countries providing SRHR services to sexual diverse groups
2008-Present
UNIFEM Regional Office for East and Horn of Africa, Nairobi, Kenya Kenya Country Manager Responsibilities: Country Program manager/Grants manager of an US$6m Basket Fund on Gender, Rights and Governance. Monitoring and evaluation for delivery of results of Basket Fund.
2006-2008
2000-2006 UNIFEM Anglophone West Africa Office, Abuja, Nigeria Program Manager Responsibilities: Program Manager for the program on increasing women’s human & economic rights in Anglophone West Africa sub-region (Ghana, Liberia, Nigeria and Sierra Leone). Developed and managed UNIFEM’s pilot Gender Budget Initiative Program in Nigeria. Supported the mainstreaming of gender within the Secretariat of the Economic Community of West African States (ECOWAS). Provided gender technical support for gender mainstreaming to the UN Development System in Anglophone West Africa through the UN Development Assistance Framework and MDGs. United Nations Development Programme (UNDP) Lilongwe, Malawi Gender Specialist & Program Officer Responsibilities: Implemented the UNDP/Government of Malawi’s joint Advancement of Women Programme worth US$1.3m. Built capacities of government to manage the programme and provided gender analysis expertise within the UN Country Office and within UNDP
1997-2000
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Federal Ministry of Women & Social Development, Abuja, Nigeria Planning Officer Responsibilities: Management and successful implementation of the UNDP/Federal Government of Nigeria’s Women Economic Empowerment Programme. Secretary to the NGO Selection Committee to assess national civil society organisations to access grants/loans.
1991-1997
SELECTED PUBLICATIONS Integrating Gender, Rights and Sexuality within 5 Critical Areas of Sexual and Reproductive Health (Adolescents Sexuality, Access, HIV/ AIDS, Safe Abortion and Advocacy). ‘Between Culture and Dignity: Women’s Reproductive Rights in Africa’ – African Women Leadership Institute, Kampala, Uganda. ‘Adolescent Sexuality & Gender Equality – Presentation at National Youth Forum in preparation for Beijing Conference on Women, Abuja
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CV - Elizabeth Bennour Elizabeth Bennour has longstanding experience of evaluating sexual and reproductive health projects. She also has extensive experience of developing and managing a range of RH and rights-based programmes in challenging settings. Her current role at IPPF involves advocacy work for SRHR donor support and programmes (including adolescent RH and safe
abortion) in Europe. Her skills lie in building partnerships and alliances, and working with partners at multiple levels – European, regional and local. Before joining IPPF European Network in 2004 she worked in international development settings in the Arab World, Africa and Asia. A particular area of expertise is management and technical capacity building for NGOs. She is
committed to stakeholder participation, and has provided assistance to governments in developing sector-wide programmes with the active involvement of NGOs and other relevant non-governmental actors.
EDUCATION Postgraduate Diploma in Development Management Open University
2002-2004
Diploma in Modern Arabic Bourguiba Institute of Modern Languages, Tunis
1981
BA Hons, Politics and Social Administration University of Newcastle Upon Tyne
1970
EMPLOYMENT IPPF European Network Director of Programmes and Advocacy Responsibilities: Lead a team of 11 professionals to achieve the IPPF European Network’s strategic objectives within the framework of the IPPF global strategic plan. This includes: programme development and implementation; advocacy for SRHR in Europe; advocacy for European donor support to SRHR; capacity building and support for Member Associations; performance analysis; and resource mobilization. Supervision of major donor-funded projects (adolescent SRHR; governance and transparency; advocacy for donor support to SRHR; safe abortion) and accountability to donors. Development and implementation of capacity building plans, building and maintaining partnerships and working alliances, work with partners at various levels (within IPPF, European partners, other regional offices, technical agencies, donors). Budget responsibility for programme and advocacy. IPPF Arab World Regional Office (AWRO), Tunis, Tunisia Director Planning, Evaluation, External Affairs, Communication Director of Programme Support and Development Responsibilities: Responsible for the design, planning and implementation of AWRO strategies and technical activities through regional activities/initiatives and technical support to 14 member associations (MAs). Assessed MA annual work programmes and monitored their implementation. Monitored the implementation of MA restricted projects, determined MA technical assistance (TA) requirements and developed TA plans. Developed regional and countrylevel projects for submission to international donors, foundations and IPPF funds. Monitored the implementation of these projects and reported to donors. Lead AWRO resource mobilization and supported that of MAs. Represented AWRO at IPPF and other international meetings. Advocated for the adoption of a rights-based approach to sexual and reproductive health. Developed new strategic directions for the region, with a focus on institutional, programme and financial sustainability. Resource mobilization (approx $10 million) through the successful development of regional and country-level projects submitted to international donors as well as IPPF funds. These include projects of over 1 million dollars in Sudan, Palestine, Mauritania and Yemen. Introduction of management capacity building as a key element in all new initiatives, including management capacity assessments, development of capacity building plans, and planning and coordination of TA.
2004-Present
2003 1999-2002
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1994-1999 Planning Assistance, Washington, D.C. USA (based in Tunis) Senior Programme Advisor Responsibilities: Provided technical and management assistance in population and health for improved program design, implementation and resource management. Assistance was provided through several channels including working with major international donors, including the World Bank, on the request of national governments (particularly in Africa). Worked directly with local organizations using donor funds mobilized internationally or locally. The position required ongoing communication and negotiation with potential donors to secure project funding, as well as the development of project proposals. Also managed Egypt and Tunisia country programmes. Participated as a member of the World Bank team in the development of health sector plans in The Gambia and Niger as part of the health sector reform. This included the definition of minimum packages of services at each level of the health pyramid (The Gambia and Niger) and the development of district health plans (in Niger). Designed and facilitated the project launch workshop in Niger. Also led a research/action process in Tunisia with a team of area leaders, community representatives and health personnel to understand problems associated with women’s health. Independent Consultant, based in Tunisia Responsibilities: Consulting assignments with a range of international agencies including the World Bank, USAID, UNFPA and US-based organizations. Major assignments included:
1990-1994
Egypt: Headed team responsible for evaluating IEC component of USAID/Egypt’s FP/Pop. II project. (1993). Niger: Team member for design of five-year, $25 million, Niger World Bank Population Project. Oman: Needs assessment and design of program to introduce family planning service delivery through government MCH facilities. Tunisia: Analysis of management training institutions in Tunisia. Turkey: Design and implementation of action-research in Istanbul to assess community health behaviour in relation to different service providers. Yemen: Development of a population strategy and population project concept paper for USAID/Yemen, with special focus on training and gender. Other work in Mali, Pakistan, Tunisia, Yemen and The Gambia. 1987-1989 PAC II Project, RONCO, Washington, USA Field Operations Officer, Tunis, Tunisia PAC II was a USAID project for training health and community workers in family planning. Responsible for the overall design and monitoring of training program, from needs assessment to implementation and evaluation. Emphasis on Jordan, Egypt and Tunisia. Programs developed FP service delivery skills of midwives, nurses and social workers through the establishment of decentralised training systems. Faculty of Economics, University of Tunis Lecturer in English, Economic Planning and Development
1981-1987
IPPF, Middle East & North Africa Regional Office, Tunisia Programme Advisor, for women and policy issues
1976-1981
LANGUAGES English, French, Arabic, Tunisian dialect of Arabic.
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CV - Kelly Culwell Dr Kelly Culwell is an expert in Family Planning, Maternal and Child Health. She currently works for IPPF as a Senior Advisor on Abortion. Her key skills include post abortion care, Family Planning, Reproductive Health, and contraceptive methods for women with medical conditions. She previously worked as a research assistant for the World Health
Organisation in the Promoting Family Planning Team. She has extensive research experience on contraceptive methods and medical trials, and has published several papers on the subject. She has worked on a strategic assessment of unsafe abortion in Zambia as part of a multi-disciplinary team. Dr Culwell has coordinated and led a training workshop for health care workers
in Family Planning and HIV integration in Maseru, Lesotho. She is a qualified doctor of medicine, with an MPH from Northwestern University in Chicago USA.
EDUCATION Master of Public Health Northwestern University, Chicago IL, USA Thesis: Lack of health insurance as a barrier to prescription contraceptive use
2007
Doctor of Medicine University of California at Davis, Davis, CA, USA
2000
Bachelor of Science, Biological Sciences California Lutheran University, Thousand Oaks, CA, USA
1995
EMPLOYMENT International Planned Parenthood Federation (IPPF) Senior Advisor, Abortion Responsibilities: Represent IPPF in key international meetings including the Technical Consultation to update the World Health Organization Safe Abortion Guidance. Provision of intellectual leadership in the area of abortion for the Federation – including provision of technical updates based on the latest evidence to Regional Offices and Member Associations. Work with Regional Offices to increase capacity of Member Associations to conduct clinical and advocacy work in abortion, including on-site provision of training and clinic assessment when requested. Oversee the Global Comprehensive Abortion Care Project, including project implementation, monitoring and quality assurance/ quality improvement activities for safe abortion and family planning services. Oversee IPPF administration of the Safe Abortion Action Fund and serve as Board Member of the Fund.
2009-Present
World Health Organization, Geneva Switzerland Medical Officer/Research Assistant Professor School of Public Health, Department of Maternal and Child Health University of North Carolina, Chapel Hill Responsibilities: Two-year assignment to the Promoting Family Planning Team, Department of Reproductive Health and Research at WHO. Project Manager for the ongoing international multicentre randomized controlled trial on implantable contraceptives. Conducted systematic reviews of the literature on use of contraceptive methods by women with medical conditions in support of the Medical Eligibility Criteria and Selected Practice Recommendations for Contraceptive Use. Team member on a Strategic Assessment of unsafe abortion in Zambia, with fieldwork undertaken in Lusaka, Mansa and Nchelenge, as part of a multi-disciplinary team.
2007-2009
Physicians for Reproductive Choice and Health, New York Leadership Training Initiative Fellow Responsibilities: Media and legislative advocacy training in women’s health.
2006-2007
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World Health Organization Geneva, Switzerland Internship: Team for Promoting Family Planning, Department of Reproductive Health and Research Responsibilities: Co-coordinated and lead a training workshop for health care workers in Family Planning and HIV integration in Maseru, Lesotho.
2006
Northwestern University Chicago, IL Fellow in Family Planning and Contraception Department of Obstetrics and Gynecology Responsibilities: Research into Family planning and contraception around the lack of health insurance as a barrier to prescription contraceptives.
2005-2007
Vista Way - Ob/Gyn, Oceanside, CA Responsibilities: Obstetrician/Gynaecologist.
2004-2005
University of California at San Diego Residency and Internship, Department of Reproductive Medicine Responsibilities: Elected Administrative Chief Resident June 2003-June 2004.
2000-2004
SELECTED PUBLICATIONS Gaffield ME, Culwell KR, Lee CR. The use of hormonal contraception among women taking anticonvulsant therapy. Contraception. 2011. 83(1):16-29. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion; Centers for Disease Control and Prevention (CDC), Farr S, Folger SG, Paulen M, Tepper N, Whiteman M, Zapata L, Culwell K, Kapp N, Cansino C. US Medical Eligibility Criteria for Contraceptive Use, 2010: adapted from the World Health Organization Medical Eligibility Criteria for Contraceptive Use, 4th edition. MMWR Recomm Rep. 2010. 59(RR-4):1-86. Culwell KR, Vekemans M, de Silva U, Hurwitz M, Crane B. Critical gaps in universal access to reproductive health: contraception and prevention of unsafe abortion. International Journal of Gynecology and Obstetrics. 2010. 110(Suppl):S13-16. Culwell KR, Curtis KM. Use of contraceptive methods by women with current venous thrombosis on anti-coagulant therapy: A Systematic Review. Contraception. 2009. 80(4):337-45 Gaffield ME, Culwell KR, Ravi A. Oral contraceptives and family history of breast cancer. Contraception. 2009. 80(4):372-80. Culwell KR, Curtis KM, del Carmen Cravioto M. Safety of contraceptive method use among women with systemic lupus erythematosus: a systematic review. Obstetrics and Gynecology. 2009. 114 (2, Part 1): 341-353. Culwell KR. Immediate start of hormonal contraceptives for contraception (last revised: 1 February 2008). The WHO Reproductive Health Library; Geneva: World Health Organization. Culwell KR, Adams Hillard P. Patient education and contraceptive compliance. Global library of women’s medicine. (ISSN: 1756-2228) 2008; DOI 10.3843/GLOWM.10378. Culwell KR, Feinglass J. Changes in prescription contraceptive use, 1995-2002: the effect of insurance status. Obstetrics and Gynecology. 2007. 110(6):1371-1378. Culwell KR, Feinglass J. Lack of health insurance as a barrier to prescription contraceptives. Perspectives in Sexual and Reproductive Health. 39(4): 226-230. Culwell KR, Shulman LP. Non-daily, non-oral and non-coital reversible contraception: increasing options for women. Expert Review of Obstetrics and Gynecology. 2007. 2(1), 51-60. Scientific Presentation: Lack of health insurance as a barrier to prescription contraceptives. Oral poster presentation at the American College of Obstetrics and Gynecology Annual Meeting, San Diego, CA. May 2007.
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CV - Susmita Das Susmita Das has over eleven years experience of working on sexual reproductive health and rights (SRHR) programmes, with a focus on safe abortion, HIV/AIDS, access and adolescents, youth issues and communications. She is currently Director of Programmes for the South Asia Regional Office of the IPPF. She has experience in designing and managing Family Planning programmes, HIV prevention, care and support programs for
adolescents. She has worked extensively on targeted interventions for most-at-risk populations (sex workers, IDUs and MSMs) in India. She has managed projects with children affected and infected by HIV/AIDS, and on care and support issues focusing on counseling and testing services, prevention of parent-to-child transmission of HIV and treatment adherence. She is a Family Health International (FHI) certified trainer on Research Ethics, and has conducted
training programs on HIV treatment adherence, home-based care and positive living. Core areas of competence include program management and financial planning, advocacy and behaviour change communication and technical report writing. She has worked with national and international NGOs, bilateral agencies and government bodies.
EDUCATION Master of Public Health (MPH) Gates Scholar, Johns Hopkins Bloomberg School of Public Health, USA
2000
Master of Arts (MA), Sociology Delhi School of Economics, University of Delhi, India
1999
Bachelor of Arts (BA), Sociology Presidency College, Calcutta, India
1997
EMPLOYMENT International Planned Parenthood Federation (IPPF), South Asia Regional Office (SARO) Director, Programmes Responsibilities: Part of the Senior Management Group at IPPF SARO which provides leadership for building robust and contemporary Member Associations (MAs) in the South Asia Region. Responsible for all technical issues relating to sexual reproductive health and rights (SRHR). Responsible for the implementation of SARO’s Strategic Plan on Adolescents, AIDS, Abortion Access and Communications. Plan, coordinate, guide and monitor the programme operations across the South Asia region in terms of: quality, performance (impact), outreach, deployment and utilization of resources, development of people and finance. Advise POs, Regional Director and other Directors on respective country specialisation. Staff management responsibility for five Programme Officers covering Adolescents, Abortion, Access, AIDS, and Communications/Campaigns. Represent the South Asia Region at various international and national meetings and workshops. Johns Hopkins University Center for Communication Programs (JHU/CCP), India Office, Mumbai Associate Director, Programmes Senior Program Manager Responsibilities: Part of the Technical Assistance Team responsible for the development, implementation, monitoring and evaluation of the Unified Strategic Communication Response for the Second Phase of the HIV/AIDS Prevention, Care, Treatment and Support Program in India (USAID-funded). Worked with the Country Director (CD) to respond to TA requests from the National AIDS Control Organisation, USAID Mission and the State AIDS Control Societies. Prepared country office work plans and held responsibility for the overall budgetary planning and management. Led a national multimedia campaign for NACO on generating demand for services provided by Integrated Counseling and Testing Centres (ICTC), with a major focus being Prevention of Parent-To-Child Transmission (PPTCT) of HIV. Led the production of a music video for young people for generating awareness about HIV/AIDS. Worked with writers to develop a series of storybooks for children affected and infected by HIV. Conducted needs assessments and design communication strategies with in-country stakeholders.
2010-Present
2008-2009 2007-2008
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EngenderHealth (EH), India Office, New Delhi Program Manager Responsibilities: Led a team (including two partner NGOs) to implement the ‘Access to Care and Treatment’ project in six high prevalence states of India. This was the first civil society grant in Asia to be supported by the Global Fund to Fight AIDS, TB and Malaria (GFATM) Round IV. Responsible for overall financial management, and developed the proposal for the three-year second phase of Round IV of the GFATM funding. Worked with the NGO consortium partners (Population Foundation of India, Indian Network of Positive People, Confederation of Indian Industries, and Freedom Foundation) to advocate with NACO for more civil society involvement in GFATM programs. Provided technical assistance to SACS, NGO consortium partners and sub grantees for providing care and support services to people on Antiretroviral Therapy (ART). Developed training curricula and job aids on treatment adherence for peer educators and counselors. Conducted trainings for peer educators, counselors and NGO staff on ‘Adherence to HIV treatment’ and ‘Positive Living’. Coordinated national level workshops, dissemination meetings and technical seminars.
2006-2007
Committee (PHSC), Family Health International (FHI), India Office, New Delhi Program Officer and Country Coordinator-Protection of Human Subjects Responsibilities: Coordinated the development of the country office annual workplan, budget, activity schedules and technical assistance plans. Worked with the CD to develop the country office five-year expansion plan 20032007. Involved in strategic planning of the research, program and technical units as a cross-unit task force member. Developed and managed a project on reducing vulnerability to HIV/AIDS among young people. Coordinator of the annual national seminar on the theme of Orphans and Vulnerable Children (OVC). Planned and organized the Implementing Best Practices (IBP) India Initiative in Reproductive Health as Steering Committee member, in collaboration with the WHO and 17 IBP member agencies. Conducted a situational assessment of the HIV/AIDS situation in Northeastern India in consultation with the Health Department, State AIDS Control Societies, regional NGOs and various stakeholders.
2002-2005
German Technical Cooperation Agency (GTZ), Calcutta, India Program Officer Responsibilities: As part of the GTZ Technical Assistance Team I was involved in the West Bengal Health Project implemented by the Department of Health and Family Welfare, Government of West Bengal, with GTZ support. Its objective is to improve the quality and coverage of basic health services in eight districts of West Bengal.
2001-2002
Child In Need Institute (CINI), Calcutta, India Program Officer Program Associate Responsibilities: Provided programmatic support for strategic planning, work plan formulation and budgetary management for overall organizational program. Facilitated the establishment of the CINI Adolescent Regional Resource Center, a pioneering initiative on adolescent reproductive health in eastern India. Led a six-member team to implement a project for ‘Improving reproductive health of young married couples’ (15-24 years) in rural pockets of West Bengal. Developed a regional network of NGOs in eastern and northeastern India for advocacy on adolescent reproductive and sexual health and rights.
2000-2001 1998-2000
LANGUAGES Bengali (native), English (fluent) and Hindi (fluent)
SELECTED PUBLICATIONS Velu S, Shastri V, Das S, Kumar P. ‘Reaching Women in Households through Innovative Partnership with Dabbawalas and Media.’ Poster presentation, XVII International AIDS Conference, August 08, Mexico City. Velu S, Shastri V, Das S, Kumar P. ‘The Dabbawala Initiative: An Assessment of a Partnership Model to Deliver HIV/AIDS Messages.’ Poster presentation PEPFAR 2008 HIV Implementers’ Meeting, June 08 Kampala, Uganda.
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Velu S, Das S, Shastri V, Allen K, Kumar P. ‘Use of Mass Media and Interactive Games to Promote HIV/AIDS Awareness among Youth in Maharashtra’ Jawan Hoon Nadan Nahin Campaign (“I am young, but not irresponsible”). Poster presentation, Investing in Young People’s Health and Development: Research that Improves Policies and Programs, April 08, Abuja, Nigeria. Das S, Venugopal G, Vajpayee J, Kandula VBR, Sethuramashankaran A, Bhalekar V, Peyyala C, Ratnani M, ‘Role of a civil society consortium in improving HIV treatment, care and support in six high prevalence states in India’. Poster presentation, 135th APHA Annual Meeting & Exposition, November 07. Washington DC. Ratnani M, Venugopal G, Kandula VBR, Das S, Vajpayee J, Bhalekar V, Peyyala C, Sethuramashankaran A. ‘Enhancing adherence to antiretroviral therapy in India: Training PLWHAs as peer treatment educators’ - Poster presentation 135th APHA Annual Meeting & Exposition, November, 07.Washington DC.
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CV - John Good John Good is an experienced Finance Director with broad financial and strategic experience in the corporate and not for profit sector, both in the UK and Internationally. He has a proven track record in financial management, strategy development and business acquisitions.
John is a commercial decision maker with the ability to work with a diverse cross-functional teams and stakeholders to resolve complex business issues. He is also good at training financial managers for improved commercial decisions. He is experienced at introducing rigorous
financial processes, identifying cost savings, initiating budget monitoring systems and developing financial controls for Grants to Member Associations. A recognised company expert in Value Based Management approaches.
EDUCATION Associate Chartered Management Accountant
1986
BSc Economics and Accounting Bristol University
1984
EMPLOYMENT International Planned Parenthood Federation (IPPF) Finance Director Responsibilities: Overall responsibility for all aspects of the Finance function for IPPF. Lead a significant project to develop culture of performance across the Federation, and introduced monthly budgeting and actual financial process. Introduced a detailed process to monitor and develop financial controls at grant receiving Member Association level. Leonard Cheshire Head of Finance Responsibilities: Developed and drove the implementation of a new approach to Strategy Development, making strategy more explicit and better linked to operational plans and budgets. Initiated and lead a project to outsource payroll for 7,500 employees. Implemented a structured to monitor a £30m capital expenditure programme leading to better control and visibility of project expenditure. Introduced monthly financial reviews and action planning processes with regional teams.
2008-Present
2006-2008
2005-2006 Cadbury Schweppes Strategy and Commercial Finance Director Responsibilities: Led the Strategy Development process for the Europe, Middle East and Africa region – a £2.4bn business covering 30 countries. Directly answerable to EMEA President, led an Indirect Cost Reduction Project, defining areas of potential and establishing working teams to develop programmes which resulted in identified savings of £88m. Established a disciplined approach to Strategy Development linking strategy to committed financial outcomes. Worked with business units to develop a region-wide process resulting in a clear set of valued priorities. Developed a programme to improve capability of the commercial finance team for the region, leading a training programme for 80 senior financial managers.
38 PO 5555: DFID RHFS Cadbury Schweppes 2002-2005 Finance Director Africa Middle East Responsibilities: Accountable for all aspects of financial management and control in a £450m business. Chairman of Central African Business Unit, heading the Board of Directors. Developed market entry plans for Mozambique, Angola and Uganda resulting in successful commercial launches. Developed a commercial strategy for Kenya, leading to increased product penetration and sales growth. Ensured that capital spend was well justified and that projects were delivered within budget. To support the high growth of the region, a major capital programme of circa £30m per annum was put in place. Individual projects included the construction of major new confectionery plants. Managed the development of the finance function following the purchase of Adams confectionery business, resulting in an integrated function with reduced headcount. Subsequently led development of finance talent leading to upgrade of capability in the function. Worked with local Finance Directors improved financial control and documentation to ensure audit clearance. Cadbury Schweppes Group Head of Value Based Management Responsibilities: Developed approach to Value Based Management and became recognised company expert, speaking at both internal and external events. Formed a team, which introduced new company wide Strategy Development process across Cadbury Schweppes. Provided Group wide structured strategic support to business units resulting in a number of business transforming strategies.
1999-2002
Developed and delivered training materials on the Strategy Development process taking 200+ senior managers through a five day training programme. Promoted the introduction of the Balanced Scorecard as Group standard for communication and measurement of strategy enabling better tracking of key strategies. Developed new processes for future scenario planning, which was used successfully to manage Polish and Argentinean business through periods of economic and political change. Cadbury Schweppes Finance and IT Director – Schweppes Portugal Responsibilities: Accountable for all aspects of Finance and IT function. Implemented balance sheet control measures, which lead to a reduction in operating assets of 30 per cent. Managed the development of strategy that lead to a 50 per cent increase in operating profit in 1998 and 1999.
EARLIER EXPERIENCE 1997 to 1998
European Bottling Director Value Chain
1993 to 1997
Finance Director, Schweppes European Franchises
1992 to 1993
Financial Controller, Cadbury Schweppes
1989 to 1992
Finance Manager M&A, Cadbury Schweppes
1988 to 1989
Financial Analyst, Express Foods
1986 to 1988
Consultant, Andersen Consulting (Accenture)
1985 to 1986
Planning Manager, ICL (Division of STC/Nortel)
1984 to 1985
Graduate Trainee, STC plc
1998-1999
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CV - Ibrahim Muhammad Ibrahim Ibrahim Ibrahim is a trained physician with excellent experience and a good track record of planning, co-ordinating and implementing large-scale public health programs at a national level in Nigeria. Ibrahim has experience in Reproductive Health as well as HIV and AIDS programmes. He has skills in research, management, strategic leadership, advocacy, policy development and analysis. He has over seven years experience of
working at senior management level for the Ministry of Health (State and Federal), and five years experience as CEO of Planned Parenthood Federation of Nigeria – providing reproductive health services nationwide. He has broad training in epidemiology, applied population research and reproductive health. He also has first hand experience of organisational leadership, managing organisational change and working in partnership with
both the public and private sectors. He is highly analytical, with the ability to apply evidence-based approaches to problem solving. Ibrahim also has strong quality assurance management and evaluation skills for Reproductive Health/HIV&AIDS services; having set up and managed a Quality Management system for an international NGO and its implementing agencies.
EDUCATION Graduate School of Business Administration Executive Development Program University of the Witwatersrand, Johannesburg, South Africa
2004
M.A in Applied Population Research Institute of Population Studies, University of Exeter, UK
1999-2000
West African College of Physicians Ahmadu Bello University Teaching Hospital Zaria, Nigeria
1994-1997
Bachelor of Medicine and Surgery MB, BS Ahmadu Bello University Zaria, Nigeria
1983-1989
EMPLOYMENT Planned Parenthood Federation of Nigeria (PPFN) Director General Responsibilities: Provide strategic leadership, direction and guidance in implementing the organisations’ strategic plan. Chairperson of the PPFN Senior Management Team, leading and coordinating problem solving efforts and decisionmaking to ensure effective policy formulation and implementation of PPFN’s strategic plan. Analyse national and international population and reproductive health trends and developments. Provide leadership in the development and implementation of systems and procedures for implementing, managing and evaluating the PPFN strategic plan – including integration of relevant policies, guidelines and procedures emanating from International Planned Parenthood Federation. Coordinated high level advocacy activities for the progress of RH at national and sub-regional level. Expanded partnerships and resource mobilization efforts. Provide leadership, overall coordination and oversight for the collective efforts of PPFN’s Executive and Regional Directors towards effective implementation of the strategic plan, the IPPF electronic Integrated Management System (eIMS), and donor-funded projects. Serve as Secretary to the national governing bodies of PPFN (National Council, National Executive Committee and Board of Trustees), providing leadership, guidance and support to enable them to operate effectively and collaboratively.
2005-Present
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Planned Parenthood Federation of Nigeria (PPFN) Acting Director Responsibilities: Served as the Chief Executive Officer and chief accounting officer of PPFN, providing focused strategic leadership, direction and guidance in implementing the organisation’s plans. Lead the development and implementation of effective policies and strategies that strengthen the involvement, participation and contribution of PPFN human resources (volunteers and staff) at all levels, promoting harmonious working relationships between and among volunteers and staff. Provided leadership in the development and implementation of systems and procedures for implementing, managing and evaluating the PPFN strategic plan, including integration of relevant policies, guidelines and procedures emanating from the International Planned Parenthood Federation. Analysed national and international population and reproductive health trends and developments, and in consultation with the governing bodies, implemented the necessary actions for ensuring that PPFN remains relevant and effective. Represented PPFN at relevant national and international meetings and conferences, serving as chief negotiator, advocate and spokesperson. Planned Parenthood Federation of Nigeria (PPFN) Director of Operations Assistant Director Service Delivery Responsibilities: Advised on program policies, strategies, guidelines and networking with government, other SRH stakeholders and donors to ensure effective provision and promotion of integrated Reproductive Health/FP services. Coordinated and provided appropriate guidance on program development activities for PPFN, in line with IPPFAR Program Strategic Plan direction as well as other donor funded projects. Coordinated technical assistance missions and took responsibility for oversight of the inputs of technical staff/associates. Identified the training needs of program staff and recommended appropriate training required to improve skills and performance. Supervised the development of operational materials/procedures, manuals and guidelines in service delivery, advocacy and program marketing, and ensured the regions received and utilised them appropriately.
2005
2001-2004 1997-2000
Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, Nigeria Senior Registrar, Department of Community Medicine Responsibilities: Served as Medical Officer of health in a Comprehensive Health Centre. Involved in analysis of data on outpatient attendants including morbidity/mortality patterns and trends. Supported research undertaken by the Department of Community Health and assisted in the training of undergraduate medical students. Enrolled as trainee physician in Community Health.
1994-1997
Disease Control Ministry of Health Dutse, Jigawa Senior Medical Officer Responsibilities: Medical Officer in charge of the tuberculosis and leprosy control program. Chairman of the committee on the eradication of Guinea Worm disease. Deputised for the Director of Medical Service and Disease Control.
1992-1994
General Hospital Dutse Medical Officer Responsibilities: Out-patient management of patients reporting to the hospital. In-patient management in medical, surgical and pediatrics ward. Medical Officer in charge of Special (STI) clinic. Hospital Dambatta Kano Medical Officer Responsibilities: Served as Zonal Medical officer, overseeing two General hospitals and four Comprehensive health centres. Prepared annual budget and reports for the hospitals in the zone.
1990-1991
ADDITIONAL TRAINING 2005
Skills Building for Development: Making HIV/AIDS Proposals Come Alive. IPPF/Japan Trust Fund. Kampala, Uganda.
2004
Training of Trainers for Nigeria National Course on Achieving the Millennium Development Goals: Poverty Reduction, Reproductive Health and Health Sector Reform. The World Bank Institute, Nigeria.
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2003
International Seminar on Strategic Leadership of HIV/AIDS Programs. International Council on Management of Population Programs (ICOMP), Uganda.
2002
Africa Regional Workshop on the WHO Strategic Approach to Improving the Quality of Reproductive Health Services. Population Council/WHO. Nyeri, Kenya.
T2001
raining on Advocacy for HIV/AIDS Program Initiatives. Japan Trust Fund/Planned Parenthood Association of Thailand. Bangkok Thailand.
1998
Strategic Planning Appreciation and Development Workshop. International Planned Parenthood Federation. Lagos, Nigeria.
1998
Building Monitoring and Evaluation Capacity for Health Care Programs in Family Planning Associations. IPPF Africa Region, Lusaka, Zambia.
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CV - Teong Seow Kin SK Teong (Kin) is a highly experienced Monitoring, Evaluation and training specialist with 25 years of broad-based experiences with non-government organisations (NGOs), training organizations and the education sector. She is currently Evaluation Manager at IPPF-ESEAO Regional Office (RO). Here, she ensures the
availability of an integrated and functional Monitoring & Evaluation System within the Regional Office. She is also responsible for driving IPPF Member Associations (MAs) performance and sustainability, and enabling the Regional Office and MAs track, assess and improve their performance for increased organisational effectiveness.
She has experience in the development, management, coordination and evaluation of training programmes. Her background is in Family Planning and she worked for over ten years as an executive assistant at the Federation of Family Planning Associations, Malaysia.
EDUCATION Master of Public Health (Services Administration and Planning) University of Hawaii, Manoa, USA
1992
BA Hons (Population Studies) University of Malaya, Kuala Lumpur, Malaysia
1983
EMPLOYMENT IPPF - East and SE Asia and Oceania Regional Office Evaluation Manager Responsibilities: Set up and maintain an integrated Monitoring and Evaluation system at the SE Asia Regional Office. Responsible for the assessment of overall performance and offering recommendations for making improvements in organisational effectiveness.
2010-Present
IPPF-ESEAO RO Evaluation Officer Responsibilities: Assistant to the Evaluation Manager, worked on M&E system. Maintained M&E records.
2006-2010
Centre for Extension Education (CEE), University Tunku Abdul Rahman (UTAR) Senior Manager Manager
2005-2006 2000-2004
Berjaya International College Coordinator/Lecturer – American Degree Programme (ADP)
1997-2000
Coordinator/Lecturer – Sepang Institute of Technology
1996-1997
Institute of Bankers Malaysia Assistant Manager
1995-1996
Federation of Family Planning Associations Malaysia (FFPAM) Head of Administration and Finance Executive Assistant
LANGUAGES English, Malay, Chinese (Mandarin and 3 Chinese Dialects).
1993-1994 1985-1993
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CV - Kouassi Lucien Kouakou Lucien Kouassi Kouakou is a Reproductive Health Policy and Programme Development Manager with specialist experience in the management of organizations. Lucien has specific experience in the management of the Quality of Health Services and holds a higher Diploma in
Total Quality Management with a bias in Health Management. He has experience in National Gender Policy, Programme Development, Gender Mainstreaming and strategic planning. He is familiar with community-based programming as well as operational research, Monitoring and
Evaluation. Kouassi has worked on training tools, manual development and training of trainers. He also has experience of advocacy and fundraising. He currently heads up the West and Central African Sub Regional Team for IPPF in the area of SRHR.
EDUCATION Certificat troisième Cycle de Spécialité en Responsable Qualité Institut Africain de la Qualité Totale
2007
Diplôme Supérieur de Perfectionnement en Management des Organisations/CAMES Centre Africain de Management et de Perfectionnement des Cadres/ Université Abidjan Cocody
2001
Maîtrise des Sciences Economiques, Option Economie Publique Université d’Abidjan, Faculté des Sciences Economiques
1990
EMPLOYMENT International Planned Parenthood Federation, Africa Regional Office Team Leader for West and Central Africa Sub Region Responsibilities: Head of the West and Central Africa Sub Regional team, helping them to improve the management of all members associations or affiliates in the sub region, and leading them in the area of SRHR in their respective countries.
2010-Present
International Planned Parenthood Federation, Africa Regional Office Accreditation and Governance Advisor / Emergency Response Advisor Responsibilities: In charge of ensuring good management and governance of the seventeen IPPF member associations in Sub Sahara Africa Region (across 44 countries). Also acted as Emergency Response Advisor.
2009-2010
International Planned Parenthood Federation, Africa Regional Office Emergency Response Advisor for Sexual/Reproductive Health and Rights Responsibilities: Developed the Sub Saharan Africa Region’s Project including policy, planning, and wide scale programme, in the area of Sexual and Reproductive Health and Rights. The focus was on humanitarian intervention and targeting marginalized and displaced people. Mobilized additional resources to promote Sexual and Reproductive Health and Rights in any crisis and post crisis situation in Africa (AUSTRALIA AIDS) in partnership with UNHCR and UNFPA.
2008-2009
AIBEF Executive Director Responsibilities: Responsible for the overall management of the Association including: strategic planning; incorporating governance policy into plans, programmes and projects; ensuring programmes are well implemented; managing the Associations budget and policies – as decided by the National Council; improving the management system; and appointing/restructuring staff. Managed the National Reproductive Health programme at a time of crisis and financial debt. Successful fundraising since 2003, AIBEF leadership increased, and its image at national level and at IPPF level improved. A National referral centre of RH was funded by the World Bank via the Ministry of Health and built for AIBEF. International Award obtained in Switzerland for Excellent Management approach, June 2005
2003-2008
44 PO 5555: DFID RHFS 1998-2003 AIBEF National Programme Director Responsibilities: Managed the national Reproductive Health Programme developed by AIBEF; creating a favourable environment to develop innovative projects, tools and approaches and lead a team to achieve annual objectives. Monitored, supervised, coordinated and evaluated the national annual programme. Created a projects base to mobilize funds. Reported to partners and AIBEF. Initiated a very important project that lead AIBEF to be owner of three centres built by The Government of Cote d’Ivoire via the World Bank funding. AIBEF programme shared during the national workshop that developed the National Strategy of Poverty reduction. Effective contribution of AIBEF programme in the improvement of national results in the health sector 1993-1998 AIBEF Chief of CBD and Clinics Division Responsibilities: Developed approaches, tools and guidelines to manage all the Clinics and Community- based services in the country. Improved the quality of services provided to clients, and reduced barriers to contraceptive methods. Managed the national CBD Programme developed by AIBEF, funded by Pathfinder International and USAID. Monitored, coordinated and evaluated the national annual programme. Developed a training plan to train community agents (over 150 trained), and got communities involved in the programme of Family Planning and HIV/AIDS. Developed and extended SRH services provision into communities with their involvement. AIBEF National Project Coordinator Responsibilities: Managed a Welfare Project funded by Pathfinder International. Ensured that Family Planning clinics provided services according to norms. Supervised FP clinics service provision.
1992-1993
AIBEF National Coordinator of Operational Research Project Responsibilities: Conducted an Operational Research Situation Analysis – involving a survey to evaluate the quality of Family Planning services. Created a database, co-ordinated and analysed the data collection, organized a workshop to present the results and planned the dissemination. Produced a final report upon which final decisions were made. Reported to AIBEF and The Population Council.
1992
LANGUAGES Fluent in English and French.
SELECTED PUBLICATIONS “Gender Mainstreaming in the national HIV/AIDS policy and strategic plan,” World Bank, Act Africa, 2008. “National Gender Policy,” Côte d’Ivoire, 2006. “Approaches and tools to face management crisis and reduce debt in the Family Planning Association of Benin,” 2004.
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CV - Matthew Lindley A highly experienced professional with over 15 years expertise in advocacy, technical assistance and resource mobilization for Sexual and Reproductive Health and Rights (SRHR). A strong track record in resource mobilization and marketing with an indepth knowledge of systems and processes, including risk assessment and management. Senior level experience of devising, implementing and monitoring global
marketing and fundraising strategies. An excellent networker with skills in building strategic alliances and working relationships in political and technical spheres, and establishing credibility and awareness amongst donors, politicians and opinion leaders. Provides Technical Assistance to parliamentarians to build capacity and understanding of issues relating to sexual and reproductive health and ODA
structures. Specific experience of increasing overall funding for sexual and reproductive health and rights programs, international program management, and team building/ mentoring.
EDUCATION Post Graduate Diploma in Marketing London Guildhall University
1998
Bachelor of Commerce (Business Administration) University of Birmingham
1995
EMPLOYMENT International Planned Parenthood Federation Senior Advisor/Head of Resoure Mobilization Responsibilities: Responsible for devising, implementing and monitoring IPPF’s global marketing and fundraising strategy. Increased the overall development funding available for sexual and reproductive health and rights (income increased by 65 per cent in the last five years). Engages in policy level dialogue and advocacy discussions with donor governments to inform their official development assistance for sexual and reproductive health and rights including HIV/AIDS. Analysis of geo-socio-political trends affecting ODA and developed appropriate strategies to maximize funding. Direct resource mobilization advocacy campaign in favour of SRHR in donor countries and with World Bank. Negotiates IPPF’s funding commitments with its major donors (maximum value USD100 million) and manages IPPF’s Resource Mobilization Liaison Offices and staff. Author of the ‘Funding Formula’ to support IPPF affiliated national organizations develop and implement resource mobilization and advocacy strategies.
2004-Present
Resource Mobilization Officer Responsibilities: Responsible for developing and implementing fundraising strategies from European donor governments and North American private foundations. Raised over $35 million per year, supported and trained regional and national colleagues in preparing restricted funding proposals, and monitored and evaluated the effectiveness of donor-funded projects.
2002-2004
Mencap Senior Grants Fundraising Manager Responsibilities: Member of Mencap’s senior fundraising management team. Fundraising from a select group of key trust and statutory sources including the EC, undertook feasibility studies into new funding markets and explored cross selling opportunities. Involved in the organizations strategic development of fundraising. Trusts, Foundations and Statutory Fundraising Manager Responsibilities: Developed the organizations Trusts, Foundations and Statutory fundraising programme, increased income threefold in two years, researched new funders and revitalized old contacts, managed and developed a team of five people.
2001-2002
1999-2001
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1999 Thirty Three Business Development Consultant Responsibilities: Short-term contract as the sales and marketing function of a newly established advertising agency based in London’s financial district. Overall responsibility for establishing the long and short-term development, revision and implementation of the company’s integrated marketing strategy. Purchased contact lists of appropriate companies and personnel, established a contacts database and initiated a broad based awareness campaign. Marie Stopes International North America Resource Development Manager Responsibilities: Overall responsibility for managing Marie Stopes International’s USA and Canadian operations. Working with an USA-based representative to develop and implement strategic plans to maximize grants from multinational donors (such as UNFPA), national donors and private foundations. Largest single grant award – $11 million from a private foundation.
1998-1999
1997-1998 Enterprise Grant Manager Responsibilities: Responsibility for managing Marie Stopes International’s Enterprise Grant Scheme. Raising project nonspecific funding from a pool of international donors, amounting to approximately £1.1 million (US$2.2 million) to make small and medium sized grants to the developing country partners of Marie Stopes International. Resource Development Co-ordinator Responsibilities: Working under the supervision of the Head of Resource Development to fundraise for Marie Stopes International’s developing country partner organisations.
1996-1997
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CV - Dr Heidi Marriot Dr Marriott has a strong background in performance evaluation, organisational learning, international development issues and programme management, together with extensive knowledge of Sexual and Reproductive Health, Youth and HIV/AIDS. Her current role as Head of Organisational Learning and Evaluation at IPPF promotes continued organisational learning and regular evaluation to increase overall
effectiveness and performance. She has also managed several Youth Reproductive Health projects, and played a key role in coordinating complex programmes with multiple partners. She has significant experience in strategic planning at local, regional and international level, and a proven track record in management with staff supervision and budgetary responsibilities. She has substantial overseas
experience, and has played technical support roles in proposal development, monitoring and evaluation, and strategic development. Dr Marriott is also an experienced researcher with knowledge of quantitative and qualitative data analysis and interpretation, and a PhD in demographic anthropology.
EDUCATION PhD Demographic Anthropology University of London
1993
BSc Human Sciences University College London
1987
EMPLOYMENT International Planned Parenthood Federation Head of Organisational Learning and Evaluation Responsibilities: Overall management of the Organisational Learning and Evaluation Unit in the Organisational Effectiveness and Governance Division (OEG). Lead role in the development of a culture of performance, evaluation and learning throughout the Federation. Promote organisational learning initiatives – including a Federation-wide website open to all IPPF volunteers and staff. Coordinate and chair IPPF’s Evaluation Working Group. Develop mechanisms for collecting, monitoring and evaluating IPPF’s results, to report on progress in implementing IPPF’s Strategic Framework. Work in close collaboration with the Knowledge and Information Systems, and Governance and Accreditation Units to build a knowledge base for IPPF, and implement a results-based management system. Develop evidence-based documentation to demonstrate the results of IPPF’s work and document successful programmes. In 2009-10 led the midterm review of IPPF’s ten-year Strategic Framework, resulting in the IPPF ‘Agenda for Change’ which will guide the Federation over the next five years. Also, lead IPPF’s Innovation Fund to support Member Associations to implement innovative projects. Currently partnering with MEASURE Evaluation on two initiatives: a leadership development programme (in two of IPPF’s regions), and developing a methodology to measure client profile (poverty status and SRH vulnerability).
2002-Present
1999-2002 Youth Programme Manager Responsibilities: Managed three IPPF youth programmes (i3 Youth Programme, Sexwise and Y- Centres) supported by restricted funding (USAID, the European Commission, and the Gates and Packard Foundations). Lead a team in London and coordinated with IPPF’s Regional Offices. Responsible for programmatic and financial management of programmes with budgets of over $11 million in total. International Planned Parenthood Federation Programme Development Officer Responsibilities: Conducted a review of literature and analysis of global demographic and health trends for policy development. Reported on field developments (FPA and government) to monitor Vision 2000 achievements. Coordinated the development process for IPPF’s Vision 2000-2010 Strategic Plan.
1998-1999
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Results UK (Advocacy and Campaigning NGO) Research and Issues Manager Responsibilities: Researched, identified and developed campaign initiatives on health and education issues, including on micro-credit, tuberculosis, child labour, malnutrition, youth sexual and reproductive health and third world debt. Reviewed literature and produced briefings and other documentation for volunteers, MPs and MEPs.
1997-1998
Population Concern (now called Interact Worldwide) Consultant Responsibilities: Researched and wrote a position paper on Population Concern’s work with young people entitled: “Population Concern Addressing the Reproductive and Sexual Health Needs of Young People.”
1997
University of Oxford, Institute of Biological Anthropology Lecturer in Human Ecology, Biological Anthropology Responsibilities: Course organisation, teaching, university management, research in areas of population, environment, nutrition, epidemiology, health, gender and development. Consultancies conducted in Tanzania (School Health Programme) and Uganda (RSH of Indigenous and Displaced Populations). University College London, Department of Anthropology PhD Student PhD entitled: “Determinants of Natural Fertility Differentials: A Comparative Survey of the Rural Populations of the Inner Niger Delta of Mali.” Research and project preparation, theoretical background and literature review, methodology and questionnaire design.
1989-1993
International Union for the Conservation of Nature (IUCN) Research Consultant Research and development project investigating demographic patterns in the Inner Niger Delta, Mali. Trained and supervised field staff, budget management, analysis of data and report writing.
1987-1988
LANGUAGES Fluent in English and French.
SELECTED PUBLICATIONS Marriott, Heidi and Sen, Mahua (2009) “Putting the IPPF Monitoring and Evaluation Policy into practice. A Handbook on collecting, analyzing and utilizing data for improved performance.” IPPF, London. Brooker, S, Marriott, H., Hall A., et al (2001). “Community perception of school-based delivery of antihelminths in Ghana and Tanzania.” Journal of Tropical Medicine and International Health. 12: 1075-1083. Marriott, Heidi (2000). “Micro-demography of a farming population of Western Uganda: a preliminary analysis investigating population pressure on the Budongo Forest Reserve.” Policy Briefing, Budongo Forest Project.International Development Committee, House of Commons – Seventh Report on Women and Development. 1999. Memorandum from Heidi Marriott, Results UK, pages 137-145.
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CV - Daniel Messer Daniel Messer is a proven Chief Information Officer with eleven years experience in implementing knowledge management systems in the global NGO sector. He is highly skilled in planning, designing and implementing clinical management solutions (manual and electronic), as well as world-wide accessible results-based planning and reporting systems. Daniel has excellent analytical and problem solving skills, together with a wide range of expertise including monitoring and evaluation of global projects. His strengths
lie in analyzing business requirement needs to design the architecture of clinical systems, as well as global integrated database driven management systems. He initiated, designed and implemented an integrated management system (eIMS) for the International Planned Parenthood Federation. Now over 120 countries use eIMS in four languages over the internet for results based management, strategic planning, budgeting and evaluation as well as information and knowledge sharing through direct reports from
clinical systems for further global analysis. Daniel also initiated and is now Chair of the Non-Profits Organization Knowledge Initiative (NPOKI) network of global health organisations, working together to tackle common MIS related challenges. The eIMS was a model for desired future NPOKI tools and resulted in a partnership with software providers to deliver the next generation project management system.
EDUCATION Masters Degree in Sociology - Free University of Berlin Erasmus Diploma of the European Community - Manchester Metropolitan University
EMPLOYMENT International Planned Parenthood Federation (IPPF) 2005-Present Head of Knowledge Information Systems Responsibilities: Refocusing IPPF’s management systems to measure progress regarding the implementation of the Federation’s Strategic Framework. Cover all aspects of the organisation’s operations, including field level data collection, procurement, budgeting and reporting – all helping management to take informed decisions. Responsible for Knowledge Information Systems, Clinical systems development and implementation, mobile data collection systems and collaborating with other agencies by initiating the Non-Profit Organization Knowledge Initiative – NPOKI. Changed IPPF clinics in Nepal, Indonesia, India, Bangladesh, Armenia and the Caribbean using a client focused approach. The latter required substantial changes to manual and electronic systems, covering client flow, quality of care, follow-up and referral procedures as well as inventory and financial management. A team of international experts was identified, which implemented a re-designed license free (open source) clinical management system. The latest release is used in clinics world-wide (IPPF and non-IPPF) and features state of the art client record keeping and reporting. Having attracted support from US and European funders, the system is currently enhanced by an open source mobile phone technology add-on. 2002-2005 Manager of Information Systems Responsibilities: Responsible for the global implementation, design and development of the Federation’s Integrated Management System (eIMS), the provision of reliable IT services, and support to Regions and Member Associations world-wide. Supervised two teams: Management Information Systems (development and implementation) and IT services. Implemented IPPF’s long term IT, web and knowledge information systems strategy, including an Intranet and 1999-2002 Extranet accessible by all IPPF member countries. Program Information Analyst Responsibilities: Analyzed System requirements for an Integrated Management System covering project/program planning and reporting as well as budgeting/financial integration. Designed back and front-end of the database, hired and supervised consultants for coding. Developed cascading training methods to for global system implementation. Free University of Berlin - Social Scientist: Research Projects Responsibilities: Experience in working together with NGO’s in an international environment with the challenges of implementing research projects in developing countries, including long field study periods in rural African areas.
LANGUAGES Fluent in English, German and French. Basic Spanish.
1996-1999
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CV - Kevin Osborne With close to twenty years experience of HIV/AIDS and reproductive health programmes, Mr. Osborne is a specialist in HIV policy and program development, with experience of collaborating with international donors including USAID. A strategic thinker with the ability to design and forward plan for resource mobilization
and sexual reproductive health responses Mr. Osborne has been the Chair and facilitator at numerous international conferences, with a wealth of experience in designing and leading capacity building workshops on a broad range of reproductive health issues. Technical Assistance skills include policy analysis and
development, project development and implementation, group facilitation and consultation, advocacy and networking. Excellent at monitoring and evaluation, organizational development, staff selection and mentorship.
EDUCATION H.D.E (Higher Diploma of Education) University of South Africa, New York
1994
LLB University of Cape Town
1991-92
BA Hons Degree (English) Rhodes University
1984-88
EMPLOYMENT The International Planned Parenthood Federation, London Senior HIV/AIDS Advisor Responsibilities: Development of IPPF’s Federation-wide strategy on HIV (2005-2015). Technical assistance to six regional offices and selected global focus priority countries. Responsible for resource mobilization for HIV and sexual and reproductive health, excellent skills in donor collaboration and stakeholder participation. Pioneered the agenda on linking HIV and sexual and reproductive health responses. The Futures Group International, Washington DC. Deputy Director of the POLICY Project HIV Advocacy and Policy Adviser Country Director: South Africa and Southern Africa region Responsibilities: Programme design, implementation and evaluation. Liaison with USAID and other international donors. Designed and conducted capacity building workshops on a broad range of RH issues. HIV policy and programme specialist including: HIV Strategic Planning in Malawi, Reproductive Health Advocacy in Tanzania, MSM HIV Advocacy in Latin America, HIV Programme Development in Zambia. Also looked at HIV policy gaps analysis Nepal and Cambodia, PLHIV Regional Capacity Building Programme SADC countries. Acted as facilitator at numerous international conferences including 10 World AIDS Conferences 1996-2010, World AIDS Conference 2000, South Africa and Global Health Council Conference 2000, USA. Also supported and facilitated US delegation and multinational donor visits. NAPWA, South Africa Provincial Director Responsibilities: developed long range organizational objectives and strategies, established an effective organizational and operational framework, chaired HIV Advocacy group. Also designed and initiated HIV programmes in prisons, schools, and for support groups. Chaired HIV Advocacy group, as well as HIV and STD media and funding committee. Guest speaker at international conferences, assisted with funding proposal development, staff recruitment and evaluation.
2004-Present
2001-2003 2000-2001 1998-2000
1992-1998
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United Nations Development Programme (UNDP) Lilongwe, Malawi Gender Specialist & Program Officer Responsibilities: Implemented the UNDP/Government of Malawi’s joint Advancement of Women Programme worth US$1.3m. Built capacities of government to manage the programme and provided gender analysis expertise within the UN Country Office and within UNDP
1997-2000
Federal Ministry of Women & Social Development, Abuja, Nigeria Planning Officer Responsibilities: Management and successful implementation of the UNDP/Federal Government of Nigeria’s Women Economic Empowerment Programme. Secretary to the NGO Selection Committee to assess national civil society organisations to access grants/loans.
1991-1997
SELECTED PUBLICATIONS “PLUS LIFE” – A bi-monthly AIDS Advocacy column that highlights various topical issues (e.g. AIDS and Religion; The role of sports bodies in the fight against HIV/AIDS; Social Immunization and HIV; The Media’s response to a Global Challenge; etc). Independent Newspapers, The Argus Newspaper, South Africa. “The Story of our Future: South Africa 2014,” November 2004, (contributed HIV chapter). Editors: Brett Bowes and Stuart Pennington. “HIV/AIDS in South Africa,” BBC Brazilian Section, The State of the Nation. December, 2000. HIV/AIDS Toolkit: Building Political Commitment for Effective HIV/AIDS Policies and Programmes, “Broadening Participation on the Policy Process.” The POLICY Project/USAID, Washington, DC. August 2000.
ASSIGNMENT COUNTRIES South Africa and Southern African region.
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CV - Elly Mugumya Elly Mugumya is a highly recognized sexual and reproductive health management professional having successfully managed the transformation of Reproductive Health Uganda (RHU), from an institutionally challenged organization to being the first
Member Association of IPPF in the Africa Region to be accredited in Africa and becoming the current Learning Center for all IPPF Africa Member Associations. Mr. Mugumya has over 25 years of extensive experience in organizational development
and leadership, community development, governance, resource mobilization, human resources development, and developing and managing multi-million dollar donor projects.
EDUCATION MA Family Planning Program Management Institute of Population Studies, University of Exeter, U.K
1992
BA Hons, Social Work and Administration Makerere University, Kampala, Uganda
1984
EMPLOYMENT The International Planned Parenthood Federation, Africa Region Team Leader for Eastern and Southern Africa, Nairobi, Kenya Responsibilities: Provides leadership and supervision to a technical team of 16 people. Responsible for oversight and strategic management of IPPF’s programmes in 21 African countries. Successfully delivered IPPF’s re-establishment in South Africa, ensuring proper management of Member Associations that were previously assessed to be underperforming.
2010-Present
Reproductive Health Uganda (RHU) Executive Director, Kampala, Uganda Responsibilities: Provided strategic, operational and policy leadership to guide the work of RHU. Donor evaluations conducted in 2006 recognized RHU as leading SRHR organization in Uganda. Provided leadership and effective highlevel national and international representation to key audiences. Increased public and private awareness of RHU and led to increased sustained funding from twelve donor agencies. Ensured effective direction and management of the organization. In 2004, RHU was fully re-accredited by the IPPF governing council.
2001-2009
Family Planning Association of Uganda (FPAU) National Programme Manager, Kampala, Uganda Responsibilities: Initiated and developed programme activities on sexual and reproductive health. Coordinated and monitored programme implementation to ensure attainment of planned results. Provided technical support to improve the performance of technical staff.
1996-2006
Regional Manager, South Western, Uganda Responsibilities: Coordinated the implementation of FPAU program activities in the region including the preparation of work-plans, budgets and reports. Linked FPAU program activities with Government and partner organizations and developed strategies for mobilizing the community to support and utilize services offered.
1991-1996
Area Officer Mbarara/Bushenyi branch, Uganda Responsibilities: Developed branch specific projects consistent with FPAU work plans and budgets and coordinated the implementation, and M&E of FPAU program activities in the branch.
1985-1991
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LANGUAGES English – Fluent, Swahili – Fluent.
SELECTED PUBLICATIONS Mugumya, Elly, Rutaraka, Claudius, Ochan, Wilfred, Opolot, Diana, “Saving Lives & Saving Livelihoods; Linking Community Based HIV/AIDS Prevention with Youth Empowerment & Economic Activation” 2004. Elly Mugumya, Dr. S. Sekirime “Family Planning Association of Uganda, a pocket guide for service improvement” 1998. Contributor to the Aidsnet manual for Danish NGOs; “Synergising HIV/AIDS and Sexual and Reproductive Health and Rights” 2005.
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CV - Ilka Rondinelli A registered nurse and Quality Improvement specialist with over 20 years experience in Reproductive Health, HIV/ AIDS, Quality of Care systems and STI. Experience includes technical leadership, support and assistance to improve universal access to sexual and reproductive
health services (SHR). An expert in leadership, training and capacity building for Quality Improvement (QI) of public health programs. Developed Quality of Care systems to strengthen the quality of services for sexual and RH. Experienced in a wide range of sexual and reproductive
health services and voluntary counseling and testing services for HIV and STI programs. Developed training materials and quality assessment tools for STI/ HIV integrated services and conducted numerous training workshops.
EDUCATION Nursing Degree Catholic University of Campinas, Brazil
1984
Additional Courses: Clinical Training Skills in Family Planning JHPIEGO-Johns Hopkins University, Baltimore-Maryland, USA Instructional Design for Master Trainers JHPIEGO-Johns Hopkins University Principles of Epidemiology Johns Hopkins University, School of Public Health Introduction to Biostatistics Johns Hopkins University, School of Public Health Family Planning Policies Johns Hopkins University, School of Public Health
1992 1996 1997 1997 1998
EMPLOYMENT Access Senior Advisor Responsibilities: Coordinate activities to strengthen and expand strategic partnerships for the delivery of reproductive health services with an emphasis on health systems strengthening (HSS) and provision of comprehensive sexual and reproductive health (SRH) services for people who are poor, marginalized and under-served. Support Regional Offices (ROs) and Member Associations (MAs) in the development and implementation of appropriate strategies to improve universal access to sexual and reproductive health services, with a particular emphasis on strengthening the provision of family planning methods. Oversea the development of policies, guidelines and protocols to ensure interventions are rights-based and gender sensitive regarding sexual and reproductive health and rights (SRHR) program delivery.
2010-Present
Family Health International, VA Senior Technical Officer Responsibilities: Provided technical leadership, training, support and assistance in QI to public health programs. Lead capacity building of country programs in QI; documented QI efforts and wrote improvement stories for dissemination. Provided technical assistance to country programs to design, manage and evaluate their QI activities. Participated in collaborative reviews of country programs, with a focus on their QI systems and activities; and organized capacitybuilding/training events that respond to the needs of country programs. Liaised with technical divisions to develop standards for QI.
2009-2010
International Planned Parenthood Federation (IPPF), Western Hemisphere Region Senior Quality of Care Advisor Responsibilities: Developed and implemented QOC systems to strengthen quality of services for sexual and reproductive health (SRH) federation-wide. Developed and implemented a system of continuous quality assurance of IPPF affiliated associations in Latin America and the Caribbean. Provided technical assistance to Member Associations (MA) in the development and implementation of quality assurance mechanisms. Developed instructional materials and implemented training strategies in comprehensive SRH in Latin America and the Caribbean, Europe, Africa and Asia.
2004-2009
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2001-2004 IPPF, Western Hemisphere Region Quality of Care Manager Responsibilities: Managed activities of the Interregional Program “Strengthening the Quality of Reproductive Health Care” including: implementation of QI process and a QOC Award system. Assisted in training programs including instructional design and training M&E process; and monitored MA and other sub-contractor agencies in for compliance with grant/donor funded project objectives and requirements. Conducted quality of care situation assessments, developed tools and protocols for QI processes, and developed training strategies for capacity building. Pathfinder, Brazil Senior Programme Development Manager Responsibilities: Developed training materials and quality assessment tools for STI/HIV integrated services and conducted numerous training workshops. Responsible for the development, coordination and implementation of two UNFPA-funded proposals, one on STI/HIV and RH and one to improve quality of care in RH. Developed project proposals; conducted RH training needs assessment including STD/HIV. Worked with USAID/Brazil mission, UNFPA representatives and State Secretaries of Health for project development and implementation, and conducted training courses for health professionals in RH.
1998-2001
Johns Hopkins Program for International Education in Reproductive Health-Jhpiego, Baltimore, MD Senior Training Advisor for Latin America and the Caribbean Responsibilities: Conducted country needs assessment in reproductive training in Bolivia, Brazil, Ecuador, Guatemala, Peru, Panama and Nicaragua. Managed proposal development and budget, worked with USAID missions, Cooperating Agencies, and Ministries of Health to ensure that training programs were planned, organized, implemented, monitored and evaluated.
1993-1998
JHPIEGO, Baltimore, MD Program Development Officer Responsibilities: Developed programs to increase access and quality of RH services at national institutional levels in Latin America and Caribbean region.
1992-1993
LANGUAGES English, fluent. Portuguese, fluent. Spanish, proficient.
SELECTED PUBLICATIONS IPPF Quality of Care Training Guides, July 2007. Kaufman, Maria Amélia Dias & Rondinelli, Ilka Maria. “MT1-Family Planning Training Manual
for Nurses.” Rio de Janeiro, ABEPF, 1989
Kaufman, Maria Amélia Dias & Rondinelli, Ilka Maria. “MT2-Family Planning Manual for Health Professionals.” Rio de Janeiro, ABEPF, 1990. Kaufman, Maria Amélia Dias & Rondinelli, Ilka Maria. “MT3-Family Planning Training Counseling for Adolescents.” Rio de Janeiro, ABEP, 1991. Achiever, John and Results, Mary. “Health Sector Reform and Impact on Reproductive Health Services.” In J. McAfferty (ed.) Challenges of Health Sector Reform, Oxford University Press, forthcoming.
ASSIGNMENT COUNTRIES Short-term assignments: Belize, Bolivia, Brazil, Cape Verde, Dominican Republic, El Salvador, Guatemala, Guinea-Bissau, Haiti, Kenya, Malaysia, Mexico, Mozambique, Panama, Philippines, Puerto Rico, Trinidad and Tobago, Venezuela, Malawi, Nigeria, Zambia.
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CV - David Smith David Smith is an international contracting and procurement manager with an excellent track record in innovative management. He has designed and implemented a comprehensive procurement business improvement strategy, and highlighted the importance of the function
to his current company. He has led teams of over 100 staff and is accustomed to leading global supply chains and ensuring the sharing and implementation of procurement best practices across all operating companies and subsidiaries.
EDUCATION BSc Electrical Engineering
1991
Management of Defence Procurement training Royal Military College, Shrivenham
1986
EMPLOYMENT General Manager – ICON. IPPF Central Office Responsibilities: Procurement services to IPPF Member associations throughout the world. Restructured the business to focus on core procurement business and improved services to member associations. Member of The Executive Committee of The Reproductive Health Supplies Coalition and Chair of The Systems Strengthening Working Group since 2008
2010-Present
Chief Procurement Services Branch UNFPA New York and Copenhagen Responsibilities: Management and development of robust supply base for reproductive health commodities and general procurement for country offices to the value of $250 million p.a. Transformed Branch from transactional to strategic procurement and became the only UN Procurement Agency to be accredited to ISO 9000 in 2007. Managed transfer of Reproductive Health Interchange from JSI to UNFPA and led in the development of The AccessRH concept.
2002-2010
1999-2002 Rolls Royce Naval Marine Director of Procurement Responsibilities: Lead a team of over 100 professional procurement staff accountable for all aspects of the procurement process, in a complex engineering business. Procurement spend stands at around 70 per cent of the total cost of sales. Devised and implemented a comprehensive procurement business improvement strategy, and to continue to innovate and change as required. Procurement has become a seamless part of the overall business of Naval Marine. Shell Europe Oil Products (SEOP) Contracting and Procurement Manager, Rotterdam Responsibilities: Set the strategic direction for all contracting and procurement activities for Shell’s Retail Business in Europe. Led a geographically dispersed team and had direct management of an annual operating and capital expenditure of $3 billion in 28 European countries. Responsible fore the cost effective provision of goods and services and managed the global supply of specific commodities and equipment. Ensured the sharing and implementation of procurement best practices across all European operating companies.
1997-1999
Shell European Retail Convergence Team (EURET) Rotterdam Procurement and Contracting Manager Responsibilities: Provided professional leadership for all aspects of procurement and commercial contracting to the EURET Team. Responsible for the development and implementation of the pan European supply base for the refurbishment of Shell’s European Retail network, managing an annual spend of $250 million. Ensured the timely and cost effective supply of quality materials at the lowest cost. Initiated and managed an effective cost reduction programme, which delivered real savings of $4 million per annum. Identified further potential savings of £3.5 million per annum over three years, achieved by re-engineering the supply chain.
1995-1997
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Shell International BV The Hague, The Netherlands Business Management Advisor Responsibilities: Leading member of the development team, delivered recommendations for the future role and structure of the division as part of the Shell Groups major restructuring process. All recommendations were accepted and implemented. Responsible for the development and introduction of the divisions business management system. Played a major role in the organisational improvements and addressed many of the ‘soft issues’ of the business to achieve first class business performance. Acted as facilitator to the management team, developing strategy papers, leading discussions and ensuring management meetings were productive.
1994-1995
The Troll Platform Project, A/S Norske Shell, Oslo and Bergen, Norway Head of Procurement and Logistics Responsibilities: Led a team of 35 commercial staff in three Norwegian locations. Responsible for all aspects of procurement and logistics in support of the engineering and construction of the Troll Gas Platform – one of the largest energy projects ever undertaken with a procurement spend of $150 million. Achieved timely delivery of all items within tight budget and time constraints.
1991-1994
Shell UK Materials Services Supply Chain Management Special Projects Responsibilities: Carried out a number of Supply Chain Management Studies for Shell UK, whilst learning about the Groups operations worldwide.
1991
Royal Navy Career Lieutenant Commander Left the Royal Navy in the rank of Lieutenant Commander after a very successful career as an aviation and electronics engineer. Worked in commercial jobs within the Ministry of Defence from 1986 onwards.
Up to 1991
Ministry of Defence, Procurement Executive London Procurement Manager Responsibilities: Responsible for all aspects of the procurement of major aircraft systems from feasibility studies to production and in service support. Managed an annual spend of £30 million and carried out a major contract strategy review.
1986-1989
The Royal Navy Various Appointments Responsibilities: Served several appointments. Specialised as an aviation engineer
1968-1986
58 PO 5555: DFID RHFS
CV - Nguyen Toan Tran Fourteen years of sexual and reproductive health and rights (SRHR), family medicine and leadership experience in the NGO, public and United Nations sectors. Successful track record in senior strategic leadership, technical/medical advice, policy
shaping, advocacy, fundraising, and coordination (with donors, Ministries, UN agencies and NGOs). Management of multimillion dollar programmes, together with clinical training experience. An overall focus on advancing and advocating access to
SRHR information and services for poor and marginalized populations in low-resource settings (on issues of contraception, safe abortion, cervical cancer screening, and postpartum hemorrhage).
EDUCATION DrMed, Doctorat en Médecine McGill University, Montreal, Canada & Université de Lausanne, Switzerland
1994
MSc in Health Services Management London School of Hygiene and Tropical Medicine
1988
MD, Diploma in Médicine Université de Lausanne, Switzerland
EMPLOYMENT 2010-Present International Planned Parenthood Federation, Central Office Global Medical Advisor Responsibilities: Providing medical/technical and evidence-base strategic leadership and advice to the Director General, Regional Directors, and other Senior Team members. Participating in Senior Team and Central Office Director’s meetings. Shaping SRHR policies in collaboration with the International Medical Advisory Panel (IMAP) and Senior Advisors (e.g. updated IPPF Abortion Policy 2010). Leading the global scale up of the SPRINT Initiative – SRHR in Humanitarian Settings. Engaging with donors to increase the diversification of IPPF funding streams, e.g. SRHR in Humanitarian Settings. Representing IPPF at WHO (e.g. World Health Assembly, Human Reproduction Programme), UNFPA, FIGO and other global consultations. Leading the crafting and implementation of IPPF Agenda for Change (e.g. universal access to SRHR). Strategic leadership and technical advice to Senior Advisors at Central Office. 2009 United Nations Population Fund (UNFPA) - Humanitarian Response Branch, Geneva, Switzerland IAWG Training Partnership Coordinator Responsibilities: Represented UNFPA at high level technical and policy meetings at WHO and other UN and non-UN events. Represented UNFPA on SRHR in the region and globally (e.g. presented at the Asia Pacific Conference on Reproductive and Sexual Health and Rights, Beijing 2009). Advocated to donors and policy-makers, designed, planned, implemented, monitored SRHR programmes in humanitarian settings. Advocated to ministers and UN officials and provided in-country technical support, review and evaluation of national humanitarian strategies and programmes (e.g. Sri Lanka, East Timor, Thailand). Developed and managed over US$2 million budget programme. Managed and monitored sub-grants of US$100,000 to implementing partners. Trained and advocated for SRHR globally. International Planned Parenthood Federation - East Southeast Asia Oceania Region, Kuala Lumpur, Malaysia Medical and Technical Programme Manager Responsibilities: Managed all medical and technical aspects of SRH programmes in the East, Southeast Asia and Pacific Region (25 countries). Advocated to ministries and policy-makers, designed, planned, implemented, monitored and managed SRH programmes related to Access to SRH for underserved populations. Advocated to ministries and policy-makers, fundraised, designed, planned, implemented, monitored and managed SRH programmes related to Safe Abortion (introduced Medical Abortion in DPR Korea, and Manual Vacuum Aspiration Plus technique to Lao PDR, Myanmar, Thailand, DPR Korea and Indonesia). Participated in relevant international consortia, training courses and task forces to ensure IPPF effective inputs and productive outcomes in collaborative partnerships (Interagency Working Group on SRH in Crises - IAWG, co-founded the Asia Safe Abortion Partnership - ASAP). Provided in-country technical support, review and evaluation. Developed and managing over US$3 million budgets. Managed and monitored sub-grants of US$100,000 to implementing partners. Managed the country desk office for China and DPR Korea. Advocated to donors, designed and managed the SPRINT Initiative (regional SRH programme in crises and post-crisis situations).
2006-2009
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2001-2006 Shechen Projects, The Bridge Fund, One HEART, Tibetan Plateau, China Medical Consultant in Reproductive and Community Health Responsibilities: Designed, implemented and managed maternal survival programmes in the nomadic areas of Central and Eastern Tibet, China. Identified funding sources, developed proposals, wrote grants and maintained contact with foundations and donors. Developed and managed $100,000 budget. Wrote and edited articles, field notes and reports submitted to donors, contacts and health care professionals. 1998-2003 Université de Lausanne, Switzerland University of Utah Department of Family and Preventive Medicine, Utah, USA Medical Officer Responsibilities: Managed the improvement of health services and provided outpatient clinical care at Community Health Centers targeting underserved and (mostly undocumented) migrant population. Focus was on Family Planning including vasectomies, Women’s Health, Maternal and Child Health, Internal Medicine and Cross-Cultural Medicine. Provided inpatient clinical care at university and district hospital levels with emphasis on Pediatrics, Obstetrics (including emergency Obstetrics Care and Cesarean sections) and General Internal Medicine. Self Employed - Private Tutor Responsibilities: Created learning tools and facilitated the learning process of Latin, Mathematics and French for primary, secondary, high school and university students.
1988-1997
LANGUAGES English, Fluent. Vietnamese, Fluent. French, Fluent. Spanish, proficient. Italian, proficient.
SELECTED PUBLICATIONS “Universal Access to Reproductive Health, accelerated actions to enhance progress on MDG 5 through advancing target 5B,” World Health Organization, 2011. “Comprehensive Cervical Cancer Prevention and Control: Programme Guidance for Countries,” UNFPA, IPPF, WHO, PATH, UICC, JHPIEGO, 2011. “Sexual and reproductive health core competencies in primary care: Attitudes, knowledge, ethics, human rights, leadership, management, teamwork, community work, education, counseling, clinical settings, service, provision,” WHO, 2011. “Reproductive Health in Humanitarian Settings, an Inter-Agency Field Manual,” Preface & Introductions, IAWG, 2nd edition, 2009. “Life-saving: why Sexual and Reproductive Health matters in crises,” ARROWS for Change, Vol 15 (1), 2009. “Consultation on RH Technologies in Crisis Settings: a summary of proceedings,” PATH, 2008.
TECHNICAL REVIEW “Girls Decide,” IPPF, 2010. “Abortion Diaries, Girls Decide,” IPPF, 2010. “First Trimester Abortion Guidelines & Protocols, Surgical & Medical Procedures,” IPPF, 2008. “Access to Safe Abortion: A Tool for Assessing Legal and Other Obstacles,” IPPF, 2008.
ASSIGNMENT COUNTRIES Long-term assignments: Tibet/China, DPR Korea, Vietnam, Malaysia, UK, USA, Switzerland. Short-term assignments: Haiti, Guatemala, Dominican Republic, Colombia, Peru, Thailand, Indonesia, Timor Leste, Philippines, Sri Lanka, Fiji, Senegal, Egypt, Kenya, Australia, Canada.
60 PO 5555: DFID RHFS
CV - Alejandra Trossero Over twelve years experience managing sexual and reproductive health, HIV and gender related projects. Technical expertise in HIV & SRH service integration, strategic planning, proposal development, programme implementation and evaluation, policy analysis and advocacy. Excellent track
record in managing multi-country programs providing technical and managerial leadership in multi-cultural settings. Specific technical expertise implementing gender sensitive programs across Africa, Asia and Latin America
EDUCATION MSc Reproductive and Sexual Health Research London School of Hygiene and Tropical Medicine
2008
BA, Psychology Universidad Nacional de Rosario, Argentina
1990
EMPLOYMENT International Planned Parenthood Federation, East and SE Asia and Oceania Regional Office, Kuala Lumpur, Malaysia Director, Integrated SRHR Programs
2011-Present
Responsibilities: Provide technical leadership on key programmatic areas of work in the region, including adolescent sexual and reproductive health, abortion, FP/RH and HIV and AIDS. Develop strategies for scaling up impact and reach of IPPF ESEAOR programs focusing on performance and lead strategic planning and capacity building processes for IPPF member associations and the regional office. Build strategic alliances with regional and national partners. Oversee programme implementation with a focus on enhancing systems for improving quality, cost-effectiveness, monitoring and evaluation. 2004-2011 International Planned Parenthood Federation, London Senior HIV Officer: Linking HIV & SRH Responsibilities: Provided technical leadership and supported development of technical competency of IPPF regional offices and member associations on HIV and SRH linkages. Provided technical leadership in the expansion of HIV interventions within sexual and reproductive health settings, including the development of HIV prevention programmes for most-at-risk populations, gender based programming and establishment of a regional initiative to address men’s sexual health in urban Asian cities. Managed a five-year multi-country research initiative supported by the Bill and Melinda Gates Foundation – the initiative was implemented in three Sub-Saharan countries. International HIV/AIDS Alliance, Brighton Programme Officer: Positive Prevention Responsibilities: Provided technical guidance and capacity development to the Alliance partner’s organizations and secretariat staff on Positive Prevention (prevention for/by and with people living with HIV). Developed technical materials, guidelines, policy documents and training materials on HIV Prevention and facilitated technical meetings and training sessions for civil society organizations in Asia, Africa and Latin America.
2003-2004
International HIV/AIDS Alliance, Brighton Programme Officer: Latin America Responsibilities: Managed the implementation of a capacity development programme for civil society organizations in Mexico and Brazil supported by USAID. Responsible for coordinating the delivery of technical and financial support for HIV prevention programs implemented at country and regional level with a focus on most-at-risk populations.
2000-2003
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The International Community of Women Living with HIV/AIDS, London Latin American Liaison Worker Responsibilities: Established a leadership and skills-building training programme for women living with HIV in Central America and the Caribbean, including proposal development, programme design, policy analysis and facilitation skills. Developed resource materials and newsletters in Spanish and Portuguese for women living with HIV/AIDS
LANGUAGES
Spanish, fluent. English, fluent. Portuguese, fluent. Italian, basic. French, basic.
SELECTED PUBLICATIONS IPPF, INP+ & FPA India. “Positive Prevention – Prevention strategies for people living with HIV” Published February 2010. WHO, UNFPA, UNAIDS and IPPF. “Gateways to Integration – Case studies from Kenya, Haiti and Serbia.” Published 2008
ASSIGNMENT COUNTRIES Long-term assignments: Africa, Asia, Latin America.
1998-2000
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CV - Dora Lind Braeken van Schaik A sexual and reproductive health and youth expert with 25 years experience throughout the developing world. Responsible for initiating youth friendly services and sexual education for governments and nongovernmental institutes and organizations, Dora Van Schaik also initiated and standardized youth participation at the highest decision-making and policy level in IPPF. Responsible for the developing standards for youth participation, peer
education, youth friendly services and sex education and acted as Senior Adviser on adolescents and young people for the $12 million SALIN + initiative, funded by the Dutch Government. Also acted as adviser on the $7 million Comprehensive Sexuality Education Programs funded by the Danish Government in more than 28 countries in Africa, Asia, South East Asia, the Arab world, Europe and Latin America. Developed and facilitated courses on
Sexual and Reproductive Health for health professionals, policy makers and youth programmers at Cambridge University. Contributed to IPPF’s Strategic Adolescent Framework and led a review of IPPF’s youth programs worldwide. Experience of donor relations, training facilitation, strategic planning, project management and monitoring & evaluation.
EDUCATION MA Child Psychology/Pedagogy University of Amsterdam
1978
Nursing Degree The Netherlands
1971
EMPLOYMENT International Planned Parenthood Federation Senior Adviser Adolescents/Young People Responsibilities: Provided leadership for the development and direction of IPPF Adolescent Strategic Framework. Responsible for directing the SALIN + and DANIDA funds of $16million, resulting in an increase in delivery of youth friendly services and sexual education in 28 countries. Guided the strategic planning, implementation, evaluation and monitoring of project achievements. Provided leadership and capacity building for youth focal points in six regions. Provided leadership for new policies for IPPF resulting in three policies being endorsed by Governing Council of IPPF: Adolescent Policy, Child Protection Policy and Men as Partners Policy. Also provided expertise for funding of youth programming in IPPF resulting in $10 million funding by the Dutch Government. Supervised three Youth Team members of staff. IPPF - Training expert Quality of Care Project Responsibilities: Developed training manuals on the introduction of quality of care self-assessment training methodologies, and offered supportive supervision. Undertook the capacity building of trainers in Asia, Africa, South East Asia training 80 trainers in total. IPPF - Youth Consultant Responsibilities: Provided leadership and direction for the increased participation of young people in IPPF resulting in 20 percent of Governing Council and Regional Council members being under 24 years old. Helped increase the number of Member Associations with young people on their boards to 70 per cent. Provided leadership of a rights-based approach to sexual and reproductive health programming for IPPF resulting in a Youth Manifesto for IPPF endorsed by the Governing Council. Implemented capacity building of health professionals, policy makers and programmers resulting in 120 participants trained at Cambridge University. International Department of Rutgers NISSO, the Netherlands Senior Programme Manager Responsibilities: Directed and led the international Department of Rutgers NISSSO, resulting in the establishment of a Youth Incentives Fund totaling $14 million in five countries. Led the development of courses on Sexual and Reproductive Health for health professionals and managers of the Central and Eastern European School of Public Health, resulting in 120 health professionals trained. Provided technical support for NGO’s and governmental institutes in Bulgaria, Poland, Estonia, Lithuania and Latvia.
2003-Present
2002-2003
1992-2002
1986-2002
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International Department of Rutgers NISSO, the Netherlands Senior Manager of Youth Department Responsibilities: Leadership and direction for sexuality education in Member Associations resulting in a 25 per cent increase in funding for youth programs. Provided leadership and supervision for the education teams in six regions in the Netherlands. Coordinated a $2 million National Campaign for young people and safer sex. Developed an innovative initiative for vulnerable youth resulting in an accredited education course by the Ministry of Justice for juvenile delinquents as an alternative for detention. Developed and implemented toolkits for young people with learning and physical disabilities as well as teacher training manuals.
1980-1986
University of Amsterdam, Researcher Responsibilities: Research on improvement of linkages between primary and secondary school education, developed environmental education materials. Observational studies of child-to-child and child-to-teachers interaction in primary schools
1976-1979
Boerhaave Kliniek, Amsterdam Nurse
1969-1972
LANGUAGES English, fluent. French, intermediate. Dutch, fluent. Italian, moderate.
SELECTED PUBLICATIONS Braeken. Doortje, Cardinal Melissa. “Comprehensive Sexuality Education as a Means of Promoting Sexual Health.” International Journal for Sexual Health Vol. 20 (1-2), 2008. Braeken Doortje. “Public Private Partnership; Strange bed fellows.” International Journal for Sexual Health , 2007, Braeken Doortje et al: Men as partners; Oxfam 2008. Braeken D, Messey D. “They Know It All, manual for everyone involved in sexual education.” IPPF, 1990. Braeken et al. “Voorlichten dat het een lust is: Manual for teachers and educators on sex education.” Rutgers Stichting 1990. Braeken et al. “Ze weten alles al: Book for educators how to discuss sexuality in an integrated way (from a hetero/homosexual perspective).” SUA (University of Amsterdam), 1988. Training manuals and Reference manuals for QOC Programme. QOC programme 2002-2004, IPPF. Training and Reference Manual for Training on Female Genital Mutilation: Forward/IPPF 2002. “Welcome to the Netherlands: A brochure on the success story of the Dutch sexual and reproductive health programmes in the Netherlands.” For the Ministry of Development, Youth Incentives. 2001.
ASSIGNMENT COUNTRIES Short-term assignments: Nigeria, Vietnam, Eritrea, Ethiopia.
64 PO 5555: DFID RHFS
CV - John Worley Over 25 years experience in global health, gained in the international NGO sector and within a high performing UK Government Department. Expertise encompassing reproductive health, family planning,
abortion policy, health systems, market structure and aid architecture. Strong policy analysis and strategy development skills, programme management experience and technical knowledge. Co-chair of the Safe
Abortion Action Fund and Board Member of the Reproductive Health Supplies Coalition.
EDUCATION MSc in Demography London School of Economics & Political Science
1984
Postgraduate Diploma (Merit) in Population and Family Planning University of Wales, Cardiff
1983
BA (2:1 Hons.) in Geography University of Wales, Swansea
1980
EMPLOYMENT Global Advisor: Public Policy and acting Director of Operations, International Planned Parenthood Federation (IPPF), London Responsible for the shaping and development of IPPF public policy. Manage the IPPF Central Office Operations Division. Shape and develop IPPF’s public policy and advise Director-General on all public policy related work. Manage the Operations Division, six operational support teams that lead IPPF’s work family planning access, HIV/AIDS, adolescent, abortion and advocacy. Support and deputise for the Director-General on IPPF engagement with external partners, organisations and stakeholders..
2010-Present
Team Leader Health Services Team, UK Department for International Development (DFID), London
2006-2009
Responsible for the performance and delivery of a team of 14 senior health professional advisory and administrative staff leading DFID’s policy work on health systems and architecture, access to medicines, and communicable diseases. Managed the merger of two DFID policy teams and steered development of policy work encompassing UK engagement with the Global Fund and GAVI, and innovative financing mechanisms such as the Affordable Medicines Facility for Malaria. Represented the UK on numerous international health policy bodies, including the WHA, Global Fund, Roll Back Malaria Boards and G8 health experts group. Acting Head of Profession for Health from August 2008 to February 2009. Team Leader Reproductive and Child Health Team, UK Department for International Development (DFID), London Led a team of 10 professional advisory and administrative staff responsible for developing and shaping DFID’s policy work on sexual and reproductive health, family planning, maternal health, and population and poverty (and winning a DFID team performance award). Provided strategic direction for the work of the team, focusing on reproductive health and rights advocacy, reproductive health commodity issues, reproductive health/HIV integration, safe abortion & maternal health. Managed DFID engagement and support for establishment of Safe Abortion Action Fund. Led UK engagement to secure the target for reproductive health (MDG5b) at the 2005 UNGA MDG review.
2004-2006
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Senior Health Adviser, UK Department for International Development (DFID), London
2003-2004
Developed DFID policy on reproductive health and rights, culminating in a new position paper launched in 2004. Initiated policy work on integration and links between reproductive health and HIV, and analytical work on options for DFID to support reproductive health commodity security. Represented the UK at various regional UN conferences on population and reproductive health, including drafting, tabling, negotiating and securing key resolutions within the UN and WHA on reproductive health and rights at a time of strong political opposition on the global policy scene. Section Head UN Specialised Agencies, UK Department for International Development (DFID), London
2001-2003
Managed UN Department team responsible for DFID’s institutional and financial relations with WHO, UNAIDS and UNFPA. Represented UK at various Executive Board and World Health Assembly meetings, negotiated decisions on health policy issues of priority to UK, and coordinated UK position and strategy with other Whitehall Departments. Commissioned and managed reviews and development of DFID institutional strategies with UNFPA and UNAIDS, and initiated work on multilateral effectiveness and performance to help inform funding decisions. Health and Population Adviser, UK Department for International Development (DFID), London
1993-2001
Developed policy and programmes on population and sexual and reproductive health. Advised on funding for multilateral organisations, international programmes and research on reproductive health totalling in excess of £30m p.a. in value. Developed policy/position and strategy papers including on abortion and maternal health. Initiated and developed support for HIV microbicide PPP and research programmes on maternal mortality and adolescent sexual health. Represented the UK/ DFID on the governing bodies of UNFPA and the WHO, MRC research committees and led official UK input to the 1999 Cairo+5 UNGA Special Session. Led work and provided support to WHO on condom quality standards. Programme and Resource Development Adviser, International Planned Parenthood Federation (IPPF), London
1988-1993
Developed strategy and projects to increase family planning services and secure financial support. Provided support and assistance to regional offices and member affiliates in project development and project cycle management (logframes) and in proposal writing. Prepared, negotiated and managed projects funded from public and private sector donors with a total value in excess of £20m. Assistant Health and Population Adviser, Overseas Development Administration (ODA- now DFID), London
1986-1988
Advised on the appraisal, development, monitoring and review of health, population and family planning projects in Bangladesh (with World Bank), Pakistan and Kenya. Developed first programme of UK support to the Uganda HIV/AIDS control effort, including rehabilitation of Uganda Virus Research Laboratory, the country’s main sentinel survey facility, totalling £5m in value. Advised on and monitored funding of a portfolio of over 30 NGO and research projects totalling £10m in value. Assistant Programme Officer, United Nations Population Fund (UNFPA), Thailand
1984-1986
Seconded to UNFPA regional family planning programme under UK Overseas Development Administration professional training and development scheme. Involved appraisal, development and monitoring of family planning and reproductive health projects in Vietnam, Nepal and Bangladesh. Census Research Officer, Voluntary Service Overseas (VSO), National Statistics Office, Papua New Guinea Oversaw the completion of a pre-census database and mapping frame for North Solomons Province (Bougainville) in advance of first national population census. Assisted in planning and coordinating the main census operation. Coordinated post-enumeration national fertility and mortality survey in Bougainville, New Britain and New Ireland.
LANGUAGES English, fluent. French, intermediate. Dutch, fluent. Italian, moderate.
1984-1986
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CV - Dr Jameel Zamir Over 15 years experience in sexual and reproductive health programming for men, women and young people in South Asia countries. Extensive experience in addressing SRHR of poor, marginalized and underserved populations in the urban slums and rural areas of India. Developed strategies on working with local selfgovernment, on partnership with private medical practitioners and on supporting
women’s group in integrating SRHR in their economic empowerment / poverty alleviation program. Dr. Zamir designed and coordinated interventions and research initiatives that engage boys and men in achieving gender equality, preventing violence and promoting sexual health for all. He is also a member of the steering committee of South Asia MenEngage Alliance, is associated with the White
Ribbon Alliance for Safe Motherhood and has contributed to the expert group on maternal health in India. He holds a masters’ degrees in demography, management and statistics together with doctoral degree on quality of care in the family planning program in India.
EDUCATION Master of Business Administration (MBA) Barkatullah University, Bhopal
2002
Ph.D: Levels and determinants of Awareness, Accessibility and Quality of Family Planning Services in Urban and Rural Segments of Bhopal: A System Analysis
2000
Master of Population Studies International Institute for Population Sciences (IIPS), Mumbai
1992
M.Sc. Statistics Barkatullah University, Bhopal
1991
EMPLOYMENT International Planned Parenthood Federation (IPPF) South Asia Regional Office Program Officer Responsibilities: Developed and implemented interactive tools for the frontline health workers on primary health, sexual and reproductive health, contraceptive choices and birth preparedness & emergency planning that were also adapted by government agencies and other organizations. Supporting Member Associations in operationalizing the strategic area “ACCESS” with focus on contraceptive choices, quality of care, sexual rights, men & masculinities, sexual & gender-based violence and SRHR in humanitarian situations.
2004-Present
White Ribbon Alliance for Safe Motherhood, Madhya Pradesh State Coordinator Responsibilities: Coordinated the UNICEF funded capacity building programme on reduction of malnutrition for Local Voluntary Groups in Madhya Pradesh. Technical assistance to SWA SHAKTI project (World Bank assisted programme), to integrate health component in the Self Help Group programme in Madhya Pradesh. Principal Investigator of the Population Council supported research project “Expanded and Informed Contraceptive Choice: Assessing Barriers to and Opportunities for Policy Implementation” in Madhya Pradesh.
2000-2004
FPAI, Small Family by Choice Project Project Director Responsibilities: Largest and the longest running project supported by IPPF’s Vision 2000 Fund, reaching 6.2 million people in four districts of Madhya Pradesh, India. The total budget outlay was USD 11 million for the period 1994 to 2004.
1994-1999
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LANGUAGES Hindi and Urdu Native language; English: Fluent
SELECTED PUBLICATIONS “Community Participation in Family Planning Programme: An Imperative” in the National Seminar on Environment and Social Development “Reproductive Health: An Operational Framework” in the XVI Annual Conference of Indian Society for Probability and Statistics (ISPS) “Safe Motherhood: Where We Stand?” and “Family Planning: A Glance at Reality” in the National Conference on Recent Development in Design of Experiments, Sampling and Statistical Inference. “Reproductive Health Research to Programmes: Needs and Priorities of Women” in The XX Annual Conference of Indian Association for the Study of Population. “Sustainability of Sexual & Reproductive Health Programmes: An Experimental Model” in the annual conference of ISPS, 1998. “Panchayat Involvement in Reproductive and Child Health Care: An Operations Research” in the annual conference of IASP, 1998.
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Annexes 1. Declaration of Non-Canvassing and Non-Collusive Tendering 2. Conflict of Interest and Disclosure Letters 3. Letters of Intent to form a Joint Venture 4. Capability Statements 5. Service Delivery Matrix 6. Logical Framework Analysis 7. Nigeria Workplan
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Annex 4 - Capability Statements - IPPF
IPPF Capability Statement The International Planned Parenthood Federation (IPPF) is an international non-governmental organization implementing programmes to improve sexual and reproductive health (SRH) of all with a focus on poor, under-served and vulnerable populations in over 173 countries. IPPF contributes to the SRH of all people by a) increasing access and choices through provision of integrated sexual and reproductive health services, information and education; b) contributing to strengthening health systems; and c) advocating to change policy and laws in support of sexual and reproductive health. IPPF has a Secretariat consisting of a Central Office in London and six Regional Offices based in Brussels (Europe), Kuala Lumpur (East and South East Asia & Oceania), Nairobi (Africa), New Delhi (South Asia), New York (Western Hemisphere) and Tunis (Arab World). These offices provide technical support to Member Associations (MAs) and coordinate regional actions and approaches. IPPF employs approximately 31,000 local staff worldwide, with 85 employees engaged in technical, programmatic, and support activities in London. IPPF’s annual income in 2010 was US$124.2 million. IPPF works at the grassroots level through a diverse network of over 65,000 service delivery points that reach people in rural areas and marginalized communities. IPPF will take advantage of its existing multilayered partnership to build upon decades of successful partnership strategies and approaches around the world. We will apply lessons learnt and best practice principles in order to achieve the expected results and impact of the project. Our partnership approach ensures increased coordination of activities, improves quality of interventions, leverages expertise and resources, and ultimately ensures a more responsive project that increases access to FP/RH for target populations. Our partnership strategy focuses on increasing the demand and use of quality FP/RH services while strengthening the entire system at country level. Our approach will engage and partner with numerous individuals, groups and organizations at three levels: Country, Community, and Health Facility. We will also engage the private sector.
Country level: This partnership approach, at country level, will be detailed in a shared work plan and supported through common management tools and systems overseen by IPPF Member Associations. Teams will not be split up geographically throughout the districts, but in the spirit of partnership and the “one team” approach, will carry out their respective activities in the same districts at the same time as the rest of the partnership as far as possible. This strategy is expected to reinforce the existing partnership and working relationships, ensure better project and technical coordination of activities, and increase overall project impact.
Community level: IPPF’s team of partners will “work with” communities and networks as both the primary target population of the project and key stakeholders.
In some cases, partnerships with selected civil society organizations will be formalized through MoUs and contracts for sub-granting. In other instances, partnerships will be developed at the community levels to mobilize clients.
Health facility level: IPPF’s Member Associations offer clinical FP/RH, including gender and youth-friendly approaches expertise, and use their technical knowhow to lead on increasing the uptake of FP/RH services. Member Associations will comprehensively lend its technical support and training to the project partners and the district hospitals, health centres and community networks. At country level, IPPF will be responsible for maintaining and strengthening partnerships with the Ministry of Health, and other line ministries, at all levels. Leveraging on our substantial track record globally in QA/QI, IPPF will ensure that quality FP/RH services are delivered and maintained in all district hospitals, health centres, and in all community level activities.
Engaging the private sector: IPPF recognizes that a strong public-private partnership is necessary to reach all sectors of society, particularly poor people. IPPF has a good service mix at community level, often partnering with private physicians and pharmacists who receive training, support and supplies as an important part of our service delivery network. Of the almost 65,000 service delivery points that IPPF works with, one-third are commercial entities, typically pharmacies or other small private businesses. Globally, IPPF works closely with key international pharmaceutical companies (including Bayer Schering and GlaxoSmithKline). IPPF is increasingly using innovative technology to improve practice in the sector, particularly to reach young people. We are experienced in developing innovative mechanisms for reaching out to poor and vulnerable populations to increase access. In 2010 72 per cent of IPPF’s clients were classified as poor, marginalized, socially excluded and/or under-served. IPPF’s geographical reach into peri-urban and rural areas is unparalleled by any other sexual and reproductive health NGO. In 2010, 50 per cent of our service delivery points were outside urban areas and 87 per cent of IPPF’s service delivery points were located at the community level where the health care infrastructure is weak and SRH services practically do not exist.
IPPF’s Core Capabilities: 1. High impact quality comprehensive and integrated package of services The provision of family planning and other reproductive health services has been at the core of IPPF’s work since the Federation was established. Over fifty six years, with the support of core funding from donor governments, IPPF has built up a network of over 8,000 clinics and 50,000 community based outlets offering access to family planning, reproductive information and education and other services, recording over 30.1 million clients per year. These clinics and community based outlets offer a comprehensive package of integrated
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sexual and reproductive health services spanning family planning, ante-natal and postnatal care, mother and child health, pregnancy tests, gynaecological care, infertility tests, diagnosis and treatment of sexually transmitted infections, linkages to comprehensive HIV and AIDS services, abortion related services, reproductive health screening including cervical-smear tests, breast cancer screening and counselling. In providing these services, IPPF’s focus is to address barriers to access through programmes that empower women, involve men as partners to promote shared decision making, advocate for changes to national and district policy and legislation, and promote and uphold sexual and reproductive rights. IPPF’s policy on the delivery of family planning services states: “High priority is given to programmes that serve the needs of the underprivileged in rural and peri-urban areas, the poor, the illiterate, minority groups, immigrants and young people in all countries and all societies.”1 Across the Federation a wide range of strategies are used to target poor, marginalized, socially-excluded and under-served populations. Whilst not comprehensive, the following are examples of the strategies employed: •
Sliding scale fee structures
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Mobile health Services
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Community based distribution services
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Peer education
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Programmes specifically targeted a vulnerable groups; sex workers, street children, prisoners, Internally Displaced People and refugees, ethnic minorities, people living with HIV/AIDS, Intravenous Drug Users, transient populations and many more.
Between 2005 and 2009 IPPF provided 251 million services, more than half of which were contraceptive services to over 158 million clients, averting an estimated 22 million pregnancies. During this period, our reported service delivery doubled, and the proportion of our clients who are young increased to two in five.
2. Reducing barriers for women and girls to access quality services IPPF concentrates its resources and efforts on those who have the highest unmet need for family planning and reproductive health: poor and vulnerable people, especially women and girls. We ensure that they have access to the information and services they need to live free from ill health, and to avoid unwanted pregnancy, violence and discrimination. IPPF is at the vanguard of defining and providing youth – friendly services – that are non – judgemental, confidential and innovative in engaging young people. Over a third of IPPF’s total services provided in 2010 reached young people (35 per cent). IPPF is often seen as responsible for bridging the gap where the public sector 1 IPPF’s Policy Handbook: Policy 4.2
does not and/or cannot provide adolescent reproductive health services appropriately or sensitively. The number of SRH services provided to young people (including contraceptive and non contraceptive services) reached just over 33 million services in 2010 – an increase of 26 per cent from 2009. IPPF proactively supports those who are poor, marginalized and least served – those who need the most support yet don’t often receive it from traditional providers. Using a rights-based approach, we treat those at the fringes of society with dignity and respect, affording them much-needed inputs to support their health and well-being, and advocating on their behalf within the larger political and cultural structures of their community. IPPF is uniquely positioned to mobilise funding and services in sudden humanitarian emergencies through the flexibility offered by unrestricted core funding. IPPF’s presence on the ground through the Member Associations means that we can quickly offer services and experts to the affected areas and reach those most in need, immediately after a crisis erupts. In 2010 IPPF increased the capacity of more than 4,300 humanitarian workers in 81 countries in providing SRH services in humanitarian settings through the Sprint Initiative.
IPPF’s Sprint Initiative To protect and promote the health of women and girls living in forcibly displaced situations, and mainstream SRH into country emergency plans, IPPF launched the SPRINT initiative in 2007. SPRINT promotes interventions defined by the Minimum Initial Service Package (MISP)g for SRH – a set of priority lifesaving SRH activities to be implemented in humanitarian response to conflict or natural disaster. MISP saves lives and prevents illness, trauma and disability. Initiated in the East & South East Asia and Oceania Region, SPRINT is currently being rolled out globally.
3. Improve Performance and delivery Many of IPPF Member Associations are the largest non-state providers of sexual and reproductive health services within the context of their national settings. As a Federation, the relationship between the IPPF Secretariat and Member Associations has the attributes of a social franchising arrangement, insofar as: (i) Member Associations must comply with minimum standards of governance as well as quality of care; (ii) Member Associations standards are actively monitored through an accreditation system; and (iii) IPPF offers a corporate identity and provides key tools, resources and support to enable Member Associations to operate. Unlike a franchise arrangement however, each Member Association also has its own unique name and brand which it maintains and displays in addition to the IPPF brand. This arrangement allows Member Associations to continue to benefit from their well
94 PO 5555: DFID RHFS earned national and local reputations and identities as authentically indigenous NGOs. Some Member Associations use social franchising models within their countries to expand service provision such as in Ghana, Nigeria and Palestine.
Value for Money In 2010, IPPF collaborated with various technical partners and experts to develop standardized tools to measure the value for money of our programmes. These measurements will allow IPPF to better understand the relationship between our initial investment and the impact on improving the health conditions of the people we serve. We define value for money as: •
economy – the cost of putting the necessary resources (inputs) in place to provide services
•
efficiency – the provision of services (outputs) which are timely, good quality and well-priced
•
effectiveness – the contribution of our services to fulfilling IPPF’s overall objectives as well as to achieving internationally agreed targets for improving SRHR (impact).
Economy Each Member Association of IPPF is audited by a reputable firm annually and is required to complete an audited full review of their internal financial control systems. The combination of these two processes ensures that Member Associations have a robust financial control environment and are able to produce reliable economic data. We also require Member Associations to report annually on their activity and expenditure and key performance indicators. As part of the budget review process, planned activity is reviewed to ensure that it is cost effective and aligned to IPPF’s Strategic Framework. This process often allows us to reduce service delivery costs on an on-going basis. In 2010 IPPF embarked on developing a standardised service activity costing methodology for the Federation to allow the calculation of comprehensive costing information at Member Association level. By developing accurate costing information Member Associations will be able to identify and act upon cost improvements more systematically. This standardised approach to service activity costing will also allow IPPF to track progress at the country level as well as monitor trends across countries and regions.
Efficiency IPPF has developed a results-driven financing (RDF) system to strengthen the connection between funding and the delivery of outputs and to increase accountability of funded programmes and services and efficient use of limited funds. This incentivizes our Member Associations to focus on timely completion of targets and results, and to prioritize the improvement of programme implementation by using evidence for decision-making. In 2010 the RDF system was introduced as a pilot phase with four Member Associations: Bolivia, Ghana, India and Uganda. All four Member Associations agreed that the new system allowed better use of performance data, increased transparency and strengthened accountability of their work. The new financing model is based on performance metrics with clearly verifiable, quantitative indicators that are linked to IPPF’s strategic priorities. The metric represents a diverse range of services covering all of the Five A’s (Adolescent/HIV and AIDs, Abortion, Access and Advocacy), and is
based on serving poor and vulnerable people. By 2012 IPPF will expand the RDF to additional 25-30 countries; and by 2014, 66 per cent of IPPF Member Associations will receive grants through results driven financing.
How will results-driven financing work? Each Member Association will report on 10 performance indicators on an annual basis. These results will be verified by staff in regional offices, and performance scores will be calculated for each indicator. The overall scores will then be used to set the level of financing the MA receives the following year. Many of the indicators that Member Associations will produce for this system will also be used to estimate outcome-level impact. The new financing system is intended to transparently, consistently, and fairly reward good performance on the basis of accurate and verifiable results.
Clinic Management Information system (CMIS) IPPF has already developed and tested an electronic Clinic management information system (CMIS) that is client centered. It enables clinic managers to create and review case records and to bring improvements in quality of care for individuals served in our clinics. The CMIS is an ‘open source’ product, free of costly licenses, thus ensuring long-term sustainability and ease of use. To support the introduction of resultsdriven financing, we will also introduce IPPF’s clinic management information system (CMIS) into more Member Associations. This will facilitate client management, integrating financial and inventory systems thus reducing administrative burden and ensuring that we receive accurate data for unique clients and services. IPPF will provide Member Associations with technical assistance grants to help with building the CMIS. In 2010 we rolled out CMIS to 43 clinics in 7 countries, and we expect to reach 250 clinics in 17 countries by 2012. The CMIS will also enable Member Associations to monitor clinic performance on a real-time basis, enabling them to deliver improved value for money.
Effectiveness Value for money is ultimately a measurement of our effectiveness and impact. Designing and scaling up programmes to achieve internationally agreed targets for SRHR not only requires accurate budgeting and controls of available resources, but also careful evaluation of results in order to improve their health impact. The past year has seen several of our donors and partners strengthen their commitment to demonstrating impact. We at IPPF are just as committed to demonstrating the results of our work effectively and ensuring impact. In 2010, we began working with the Guttmacher Institute to calculate the impact of IPPF’s contraceptive, abortion and obstetric services, and to review the applicability of models for a number of other SRH services that IPPF provides. These results will give us information on a range of impact values; including unintended pregnancies averted, unsafe abortions averted and DALYS (disability adjusted life years). Through this impact model, IPPF for the first time will be able to measure its impact against the internationally-set targets such as the UN Global Strategy for Women and Children’s Health commitments and the health Millennium Development Goals targets.
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Mannion Daniels Capability Statement MannionDaniels (MD) specialises in providing professional services in international public health and social care. As part of the consortium, MD brings extensive experience of Behaviour Change Communication (BCC); monitoring, measurement and reporting on programs, thus helping to support improvements in performance management; experience of working with poor and vulnerable populations in a wide range of difficult contexts; and strong overall Reproductive Health (RH) programme experience.
Behaviour Change Communication MD has extensive BCC experience through our current work as a consortium partner on the Partnerships for Transforming Health Systems Phase II (PATHS2), Nigeria programme. This is a six-year DFIDfunded project in Nigeria to strengthen and reform the health system. MannionDaniels are working with Federal and State Ministry of Health, media and civil society in Nigeria to increase the capacity of citizens’ to make informed choices about prevention, treatment and care for common health conditions within the wider context of personal responsibility and public accountability. The BCC component also works to build the capacity of government and the media to deliver qualityassured and coordinated health promotion. One particularly effective BCC model MD follows is to organize public debates between community members, government officials, and health personnel, called ‘Ask Nigeria’. These State level debates (particularly in the more conservative states of Northern Nigeria) have provided a voice to the socially excluded (such as young people, women, and those in the harder-to-reach rural areas), providing them with an avenue to air concerns about the health system. The State level debates have also resulted in commitments being made by State governments to respond to public demands, such as lack of staff, absenteeism in local health centre’s, lack of drugs and other equipment and ad-hoc charges. The State level debates have also illustrated good practice in private-public partnership, as private sector media organizations are involved in the production and airing of the debates.
Monitoring and Evaluation MannionDaniels is involved in developing Monitoring and Evaluation systems for health care programmes, which then support the efficient and effective use of available resources and improve performance. A significant proportion of MD’s portfolio consists of project working on RH policy and data measurement. MannionDaniels contributed to The China Ministry of Health / Gates Foundation TB Control Project by developing a Measurement, Learning and Evaluation (MLE) framework. MD worked closely with the MLE Working Group (September 2009-January 2010) in China to design a detailed MLE Plan. This supported the development of the National TB Control efforts in China through piloting innovative tools and delivery approaches. The MLE Plan enabled the Ministry of Health and the Bill & Melinda Gates Foundation to make evidence-based decisions on which pilots have been successful in a Phase 1 (performance monitoring) and what package of interventions should be scaled up in a Phase 2 of the project. Knowledge management, in terms of learning the lessons from these pilots and disseminating these widely, was an important aspect of the project.
Specifically in looking at RH performance and monitoring, the Reproductive Health Initiative for Youth in Asia (RHIYA) project was a 5 year, 7-country programme (in Cambodia, Laos, Vietnam, Bangladesh, Pakistan, Nepal, Sri Lanka) implemented by UNFPA and a wide range of national NGOs with funding from the European Commission (DG1B). MD developed and implemented a web-based performance monitoring system which involved an on-line tracking and reporting structure that allowed input of data at project source by implementing NGOs, reports and best practice experiences. The system was centrally administered by the RHIYA project management based in Brussels. UNFPA subsequently adopted the PTRS system and extended its use for tracking work on an Africa Regional Health Programme. More recently (April-May 2011), MD worked with IPPF/European network to design a Methodology for Tracking European Donor Funding for Reproductive Health and Family Planning. The work explored the added value of the Countdown 2015 Europe partners based on national budget and expenditure reports, compared with what was already existing (OECD and NIDI data translated into comprehendible report in Euromapping), and refined the current tracking methodology accordingly. This followed a project for the Hewlett Foundation (August 2010-March 2011) which reported on British ODA for Family Planning and Reproductive Health in subSaharan Africa. It looked at national decision-making structures and policies regarding RH, as well as data on budgets and results, and made specific recommendations on how to move forward in terms of policy and advocacy in RH.
Targeting poor and vulnerable populations Several of MD’s projects are aimed at developing better health services for the poor, vulnerable and more marginalised sections of society. MannionDaniels’ work in Nigeria on PATHS2 has a specific focus on reaching youth, particularly in the culturally conservative Northern states. MD’s most recent work is a WHO/UNICEF Health Systems Strengthening piece of work in Somaliland. MD is carrying out a needs assessment for health management capacity building, followed by a series of capacity building workshops to address the priority areas defined. The overall aim is to build the management capacity of health mangers at zonal and regional levels in this fragile state. Past project examples include the Karnataka Health Sector Development and Reform Programme, which worked to increase the use of essential health services (curative, preventative and public health) amongst poor and vulnerable groups in underserved areas of this Southern Indian state.
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EngenderHealth Capability Statement Organisational Overview EngenderHealth (EH) works to improve the health and well-being of people in the world’s poorest communities by building the capacity of their partners to deliver high quality, accessible and sustainable health services. In partnership with governments, public and private health providers, training institutions and communities, EH provides technical assistance, focused on family planning (FP), reproductive health (RH), maternal, newborn and child health (MNCH) and HIV and AIDS, to increase the supply and uptake of integrated and gendersensitive health services from the community-level upwards. Cultivating local ownership and building indigenous capacity to improve health outcomes are core components in EH’s programme design and implementation. EH engages stakeholders at multiple levels and across sectors, helps forge links between them and develop sustainable partnerships. Over a nearly 70 year history, EH has demonstrated effectiveness in supporting their partners to introduce, expand and strengthen FP/RH service delivery programmes and ensure informed choice in almost 100 countries. Established in 1943, EH initially worked in the U.S. to make sterilisation for women and men legal, accessible, voluntary, and safe. EH’s international programme supporting long-acting and permanent (LA/PM) services - female sterilisation, vasectomy, intrauterine devices and implants - began in 1973 and has since expanded to facilitate highcaliber, integrated programming across the full-spectrum of sexual and reproductive health (SRH) and MNCH services. In 2002, EH received the prestigious United Nations Population Award for its contribution to FP/ RH in low resource countries. EH continues to improve health systems and services by building the capacity of partners to apply best practices, research results, and innovations in the following key areas: •
Integrated clinical FP and SRH, including adolescent RH, comprehensive abortion care, postabortion and postpartum care
•
HIV and AIDS prevention, treatment, care and support, including comprehensive prevention of Mother-to-Child Transmission (PMTCT)
•
EngenderHealth’s Global Presence EngenderHealth’s technical competence, proven leadership, acumen in promoting FP/RH best practices and ability to support partners to take quality FP/RH services to scale are reflected in its highly successful track record in managing complex global, regional and country partnerships. With offices in 16 countries, EH currently implements a portfolio of integrated SRH and MNCH projects in 29 countries,2 largely in Asia and Africa. Major projects under EH’s leadership and management include: three global awards covering 20 countries, eleven bilateral awards3 and five large privately funded initiatives4, in addition to numerous smaller grants. The three global awards include: USAID’s global FP/RH flagship programme, Responding to the Need for Family Planning through Expanded Contraceptive Choices and Program Services (RESPOND) Project ($20 million, 2008 – 2013); Fistula Care (USAID, 2007-2012), the largest global project ever to focus on the treatment and prevention of fistula; and the Maternal Health Task Force (Gates Foundation, 2009-2012), an international forum promoting global collaboration and consensus building on maternal health. EH is also a partner on five global, regional and country USAID health projects covering 25 countries5. With over two-thirds of the 400 staff based outside of the US, 85% of operating expenses are used to directly address the most critical health challenges of the day.
Engenderhealth’s Global FP/RH Leadership EngenderHealth has long been a leading global champion for contraceptive choice, access and quality. Over the decades, we have advanced new ideas and technologies as well as proven approaches and tools at global, regional and national levels. Actively collaborating with interagency partnerships, including USAID, WHO and CDC working groups, EH has participated in developing global standards and protocols, such as WHO’s Medical Eligibility Criteria for Contraceptive Use, Selected Practice Recommendations for Contraceptive Use, and Family Planning: a Global Handbook for Providers. As a founding member of the Implementing Best Practices Consortium and a member of the Steering Committee, EH has helped plan and implement IBP conferences (Nepal, China, Egypt, India and Uganda), support country teams in adopting and scaling-up best practices; and develop and roll out ‘A Guide for Fostering Change to Scale Up Effective Health Services’ (published in 2007).
Engenderhealth’s Holistic Programming Model
MNCH care, including prevention and treatment of obstetric fistula
2 Albania, Angola, Azerbaijan, Bangladesh, Benin, Burkina Faso, Cambodia, Cote d’Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana, Guinea, India, Kenya, Malawi, Mali, Mauritania, Namibia, Nepal, Niger, Nigeria, Rwanda, Senegal, Sierra Leone, South Africa, Tanzania, Togo, Uganda and the United States of America. 3 The ACQUIRE Tanzania Project (Tanzania); Access to Better RH Initiative (Ethiopia); Adolescent Reproductive and Sexual Health Program – Phase II (India); Channeling Men’s Positive Involvement in a National HIV/AIDS Response (Tanzania); Gender Matters: Teenage Pregnancy Prevention Project (USA); Implementing HIV Prevention for Most At Risk Populations in High Prevalence Urban Areas, Program H for Young Men in Los Angeles, Reducing Maternal Morbidity and Mortality, RH/FP and Prevention of Post-Partum Hemorrhage, Shang Ring Research Demonstration Project. 4 Access to Better RH Initiative, Adolescent Reproductive and Sexual Health Program – Phase II, Program H for Young Men in Los Angeles, Reducing Maternal Morbidity and Mortality, Shang Ring Research Demonstration Project. 5 Niger, Ethiopia, DRC, Benin, Albania, Angola, Azerbaijan, Burkina Faso, Cambodia, Cote d’Ivoire, Guinea, Kenya, South Africa, Namibia, Bangladesh, India, Togo, Tanzania, Liberia, Mali, Uganda, Sierra Leone, Rwanda, Nigeria.
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Using its proven Supply-Enabling Environment-Demand (SEED) programming model, evolved over decades of practical experience, EH seeks to comprehensively address the multifaceted determinants of health and build capacity for scaling up FP/RH/MNCH services. (See diagram on the next page.) By responding to the challenges of delivering quality services (supply); strengthening health policy, governance and resourcing (enabling environment); and removing client barriers to using health services and adopting healthy behaviors (demand), EH supports mutually-reinforcing interventions and enduring impact on health outcomes. The SEED approach highlights and builds on the three areas of synergy between the program components – Quality Client-Provider Interaction, Systems Strengthening, and Transformation of Social Norms – to bring about sustainable improvements in RH services. Four underlying principles – the fundamentals of care, evidence-based programming, gender equity and stakeholder engagement – inform EH’s programme design and
implementation. In particular, EH supports deepening the relationships between health facilities and the communities they serve to ensure services are responsive to local needs and engage communities in actions to improve their own health. Tackling gender inequalities, which undermine women’s and girls’ as well as men and boys’ control over their health, is fundamental to improving health. EH therefore integrates gender-transformative approaches across its FP/RH, MNCH and HIV and AIDS programs. Through the Men As Partners® program, EH has undertaken innovative and highly successful work involving men and boys in behavior change communication to improve the SRH of both sexes and to reduce harmful practices, including gender based violence. At the same time, EH works to empower women and girls to realize their rights and make informed choices about their health.
Based on the SEED programming model, EH has developed a capacity-building diagnostic tool to assist local managers in: a) assessing 25 key supply, demand, and enabling environment elements in their national FP service delivery programs, b) identifying areas that need improvement, and c) guiding program design and implementation to address the gaps. The SEEDTM Assessment Guide for Family Planning Programming, published in June 2011, received significant review and input from numerous internal and external FP global technical experts, and will assist national FP managers and others in strengthening their national programs.
Quality client-provider interaction
Supply Staff supported in delivering quality services that are accessible, acceptable and accountable to clients and communities served
Demand Improved sexual and reproductive health
Individuals, families and communities have knowledge and capacity to ensure SRH and seek care
Systems strengthening
Transformation of social norms
Enabling Environment Policy, program and community environment, coupled with social and gender norms, support functioning health systems and facilitate healthy behaviours
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Engenderhealth’s Key Capacity-Building Competencies * Establishing and leading global partnerships for FP/RH * Evidence-based advocacy for advancing FP and evidence-based best practices * Developing and disseminating evidence-based FP/RH service delivery standards, protocols and guidelines, training curricula, job aids, and other programmatic tools * Knowledge management including the compilation, synthesis and targeted dissemination of technical and programmatic evidence and of FP/RH best practices * Designing and implementing evaluation and research studies to test and evaluate implementation of innovative approaches and promising best practices * Creative design and use of web-based approaches, social media, and other information technology to engage audiences in policy dialogue and as means for disseminating evidence-based best practices * Engaging and mobilizing local leadership in policy dialogue for adaptation of evidence-based best practices for strengthened FP/RH service delivery and FP revitalization * Applying a holistic programming approach for design, implementation, and improvement of FP/RH service delivery (SEED Model) * Introducing and scaling-up best FP/RH practices * Strengthening all service delivery support sub-systems, including training, supervision, referral systems, and commodity logistics * Applying participatory methodologies for local stakeholder engagement, program design, partnering, consensus-building, and development of local ownership * Programming for FP/RH service delivery at the facility and community levels, including integration of FP/RH services with HIV, MNCH, nutrition, and non-health activities * Promoting gender-equitable FP/RH services and community engagement to advance the needs and status of women and girls, engage men and boys as partners in health, promote spousal communication, and mitigate gender-based violence * Programming for youth, particularly the contraceptive needs of very young girls, adolescents, unmarried women, and young married women. * Quality assurance, quality improvement and performance improvement * Managing effective partnerships and collaborations for global and field-based
Quality And Performance Improvement For FP/RH/ MNCH Services EngenderHealth is recognized globally for its innovative, practical and low-cost quality assurance (QA), quality improvement (QI), and performance improvement (PI) methodologies for low-resource settings. Based on principles of quality management, EH utilises a whole-district approach to QI, strengthening the links between clinicand community-based services and public and private sectors; engaging communities in the health system to address barriers to access and quality; building capacity for health planning and governance; and introducing alternative service delivery modalities with QA mechanisms as needed to reach remote and vulnerable populations. EH assists governments and other stakeholders to strengthen health systems; update service standards, guidelines and curricula; support in-service
and pre-service training, and provide facilitative supervision and on the job coaching. Client-Oriented Provider-Efficient - COPE®, a QI approach developed by EH, has been introduced in more than 45 countries, adopted by over 25 Ministries of Health, translated into 14 languages, and adapted to a broad range of FP/RH services. COPE tools and manuals include: COPE for Contraceptive Security, Maternal Health, Child Health, PMTCT, VCT, FP-ART Integration, and most recently, Contraceptive Security and Male Circumcision. The Quality Health Partners (QHP) project (USAID, 2004-2010) in Ghana is one example of EH’s QI/PI approach in practice. QHP worked to strengthen enabling policies, QA systems and overall quality of RCH services provided by health centers in 37 of the country’s ‘most deprived’ districts – reaching a population of 4 million people. In partnership with the Ghana Health Service, QHP’s work involved the
PO 5555: DFID RHFS 99 development, dissemination and implementation of standards and guidelines, provision of equipment and supplies and staff capacity building through in-service and on-the-job training and facilitative supervision. QHP trained over 3,500 doctors, medical assistants, nurses, midwives and community health nurses in COPE for RH, and in the provision of LA/PM (minilaparotomy, intrauterine devices (IUDs), and Implants); Postpartum FP, and SRH/FP counseling – increasing the proportion of health centers with qualified staff providing FP services from 62% to 95%. Despite intermittent stock-outs of contraceptive commodities and HR turnover, a successful campaign to generate demand for LA/PM enabled the project to realize a 50% jump in couple years of protection by the end of the project.
Increasing Access To LA/PMs Global Leadership Programmes: specialist expertise on LA/PMs, combining experience of research, pilots and project implementation, enables EH to provide first-class technical assistance to international partners. EH’s approach seeks to promote client choice on reproductive intentions through informed and voluntary decision-making, clinical safety and QA. EH has been entrusted with the leadership of USAID’s global LA/PM flagship programme for two consecutive awards. Access, Quality and Use in Reproductive Health (ACQUIRE) Project ($86,658,407 million, 2003 – 2008), the first programme was acclaimed by a USAID strategic assessment as providing strong technical focus in FP and LA/PM service delivery, and support for effective interface between global learning and practical application within field programs. ACQUIRE supported government, NGO private partners to introduce and/or scale up LA/PMs in 19 countries and achieve important increases in LA/PM uptake which included the following: •
In Bangladesh, the decade-long decline in the use of IUDs and vasectomy was reversed through technical assistance on programming and implementation of state-of-the-art LA/PM.
•
In Nepal, an effective community-based model encouraged young people in remote areas to postpone marriage and child-bearing and promote birth-spacing.
•
In Ghana, the number of supported sites offering at least one LA/PM more than doubled (from 97 to 250), service uptake tripled, and the number of female clients choosing implants or minilaparotomy sterilisation increased from 4,400 to almost 15,000.
•
In Kenya, the annual number of IUD insertions in Kiisi district increased by more than 300% , a change that was sustained after the project ended.
USAID’s follow on global LA/PM programme to ACQUIRE, Responding to the Need for Family Planning through Expanded Contraceptive Choices and Program Services (RESPOND) Project ($20 million, 2008 – 2013), was competitively bid and won by EH. Working in 14 countries in Africa (Angola, Burkina Faso, Cote d’Ivoire, Guinea, Kenya, South Africa, Namibia, Togo and Tanzania) and Asia (Albania, Azerbaijan, Cambodia, Bangladesh and India) RESPOND has actively promoted evidence-based best practices through hands-on implementation, testing and evaluation of service delivery models and tools with coreand field-support funds. RESPOND works in close partnership with Ministries of Health and other local stakeholders to assess needs and current/emerging demand, and to establish and/or strengthen high
quality, sustainable services and systems using methods that also build capacity in local counterparts. To date, RESPOND has established a thriving LA/PM community of practice which brings experts together to review resources and best practices for dissemination in toolkits and to connect LA/PM program practitioners. RESPOND is also spearheading research to support evidence-based advocacy and improved FP program design (e.g. secondary analysis of DHS data regarding LA/PM; user-dynamic studies to explore LA/PM use and non-use; mobile outreach approaches; FP for post-partum women; PI for contraceptive security connecting districts and facilities). Using Reality √, a FP/RH services advocacy and planning tool, RESPOND is providing local evidence-based data and rationales for FP/RH resource mobilization and for capacity-building planning. RESPOND has provided technical consultation regarding LA/PM to 15 organizations and has engaged international professional organizations (FIGO, ICN and ICM) to advocate and promote PAC and FP among their members. Regional/Country Scale-Up Programmes: EngenderHealth has successfully worked with local partners to scale up pilot LA/PM activities within numerous projects, introduced and expanded access to clinical services at district and national levels in more than 50 countries, and adapt internationally accepted standards in local service delivery contexts. In addition to the RESPOND countries, EH leads FP/ RH projects, including significant LA/PM components in Bangladesh, Ethiopia, Ghana, India and Tanzania, and is working through subawards to provide technical support in Burkina Faso, Mauritania, Nepal, Togo and South Africa. The following programmes are examples of how EH uses the holistic SEED programming model, to support partners to increase access, quality and use of FP/RH, with a focus on underutilized LA/PMs:
ACQUIRE Tanzania Project, Tanzania ($33 million, USAID, 2007-2012) Under the objective of increasing the supply of quality FP services, the ACQUIRE Tanzania Project (ATP) is supporting the Ministry of Health and Social Welfare (MOHSW) to enhancing the capacity of health workers at the in-service and pre-service levels to provide LA/PM, alongside short-acting methods. ATP has so far enabled the MOHSW to serve 719, 416 clients; providing 239,968 minilaparotomy under local anesthesia, 969 no scalpel vasectomy, 129, 067 intra-uterine contraceptive devices and 350, 412 implants; trained over 17,000 health care providers and introduced a QI process, using EH’s COPE methodology. Improved competence of the LA/PM providers combined with ATP’s support in developing and implementing a highly effective outreach model, serving vulnerable populations in underserved and remote areas, has made a major contribution to a national increase in the use of LA/PM methods. Tanzania DHS 2010 noted that from 2005 to 2010, the LA/PM share of the modern method mix increased from 11.6% to 16.4%. MOHSW, with support from ATP and other actors, has increased contraceptive prevalence rate (CPR) from 17.6% to 23.6% in the same period.
‘Mayer Hashi’ Project, Bangladesh ($12 million, USAID, 2009-2013) Working in 21 districts of the three low performing divisions of Sylhet, Chittagong and Barisal, the the ‘Mayer Hashi’ project provides technical assistance and capacity building to the Government of Bangladesh, NGOs and the private sector. ‘Mayer Hashi’ aims to achieve the following key objectives in the LA/PM area: a) Strengthened effective delivery and increased/sustained performance of LA/PM services through holistic and evidence-based approaches; b) Increased demand
100 PO 5555: DFID RHFS and sustained use of LA/PM through evidenced based and innovative approaches; c) Knowledge generated, organized, and disseminated to strengthen commitment, policy support and enabling environment for LA/PM services.
to implement them at district and facility levels interventions. EH supported scale-up of FP/RH best practices through implementation of postpartum FP services, expanded seasonal mobile LA/PM services, and designed and distributed RH counseling kits.
In partnership with the Government, EH guided and supported revisions in 2011 of the national LA/PM and postpartum FP curricula. Through support for a cadre of trainers of trainers, Mayer Hashi has facilitated the roll-out of quality LA/PM training and supportive supervision for health professionals in public and private facilities, including college and district hospitals, clinics and NGO facilities. Recognizing effective integration of FP into MH services as a major opportunity to further increase FP availability and uptake in Bangladesh, EH has supported a pilot integrating postpartum FP with MCH services in two Upazila sites. Building on an EH’s model for FP integration, the pilot is providing a comprehensive method mix during the postpartum period at household, community and facility- levels as appropriate.
Reproductive Health and Family Planning Project, Azerbaijan (USAID, 2004-2010)
Expanding Awareness, Acceptance and Access to No Scalpel Vasectomy Project, India (USAID, 2009 to 2012 In response to the drastic decline in vasectomies in India, EH leads a project with to expand awareness, acceptance and access to No-Scalpel Vasectomy (NSV) services. Managed by EH in partnership with the Center for Communication Programs, the project is closely aligned with the National Rural Health Mission plans and provides technical assistance to the Government of Uttar Pradesh and Jharkhand to build the capacity of public and private facilities to provide quality NSV services, engage communities and increase demand as well as strengthening the enabling environment. In its first year, the project achieved increased NSV acceptance by 23% across the intervention districts.
Strengthening And Scaling Up Fp/Rh/Mnch Country Programmes EH has an outstanding track record in building the capacity of local partners to identify, apply and scale up best practices to strengthen FP/ RH/MNCH service delivery. Extensive monitoring and evaluation efforts are designed to test and document effective practices that can be scaled up for maximum impact across all of EH’s programmes.
Adolescent Reproductive and Sexual Health (ARSH) Project, India (Packard Foundation, 2009-2011) Through the ARSH Project in India, EH is supporting the state of Jharkhand to provide youth-friendly SRH services in 12 districts and to support the institutionalization of a flexible, comprehensive, districtcentered program model that could be scaled up and sustained by local partners. As a result of the project, Jharkhand is the first state in India with plans to roll-out a state-wide ARSH program, which EH will be supporting and extending to the state of Bihar through a follow-on grant.
Family Health Program II, Nepal (USAID, 2007 – 2012 Under the John Snow International-led Nepal Family Health Program II, EH is leading efforts to improve access and to support the use of high impact, integrated FP, RH and maternal and newborn health interventions focused on marginalized and disadvantaged groups in 20 districts. Work at the national level has supported the development of three volumes of Nepal’s National Medical Standards for RH Services and the development of FP Postpartum Service Delivery Guidelines; and support for developing providers’ clinical and counseling skills
The Azerbaijan Reproductive Health and Family Planning Project increased access to and use of quality and safe FP/RH services by applying EH’s holistic SEED model to strengthen all components of the health system. EH led the development and roll-out of national guidelines and protocols for FP services, expanded the training and monitoring capacity of the public health system, engaged in high level policy dialogue and advocacy to achieve significant policy reform to support wider access to FP/RH services (including task-shifting), and supported social marketing of quality contraceptives and behavior change communication and media advocacy. As a result of the project, FP use dramatically increased in targeted districts with 40.7% of married women in these areas using modern contraception in 2010 compared to 22.3% in control areas. Service quality also vastly improved. The number of service providers performing to standard in three target areas increased from 8.2% to 61%, and endline survey clients reported nearly 97% satisfaction with services received.
Action for West African Region -Reproductive Health (AWARE-RH) Project, West Africa (USAID, 2003 - 2008) AWARE-RH worked with regional organizations and national governments to create a favorable environment for adapting and scaling-up of best practices in FP/RH, child survival, and malaria. By building the capacity of regional institutions, the project successfully developed and advanced service improvements at both regional and country levels. AWARE-RH facilitated the adoption of 19 regional- or national-level policies, 54 country applications of selected promising and best practices, and the development of seven national commodity security plans. Extending this work, EH now provides technical leadership to advance the regional policy and operating environment for the RH/FP component of the follow-on AWARE II Project.
Supporting Actions To Increase Task Sharing And Scale Up Services The expansion and scale up of FP/RH services are constrained by serious shortages in skilled health professionals. EH is providing technical assistance to help partners identify opportunities for task sharing, to develop, monitor and evaluate pilot initiatives and to adopt and scale up effective practices to make more efficient use of available human resources for health. See some selected examples below. Under the ACQUIRE Tanzania Project, EH started a demonstration evaluation in 2011, which is training clinical officers to perform female surgical contraceptive services. If this task shifting measure proves successful, ATP will unlock enormous potential for expanding FP access across Tanzania. •
In Bangladesh under ACQUIRE, EH advocated for policy reform to allow paramedics to provide vasectomy and implants, a critical task-sharing measure, which with capacity building support from EH’s helped improve FP access nationwide.
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In Ghana, the Reducing Maternal Morbidity and Mortality Project, EH trained midwives to insert contraceptive implants, increasing
PO 5555: DFID RHFS 101 the method’s CPR tenfold (from 0.1 to 1.0%) in five years (19982003). •
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In Kenya, EH is conducting multiple operations and clinical research studies to generate evidence regarding cost-effective approaches, including task-shifting to nurses, to scaling-up male circumcision services. Through the APHIA-II Nyanza Project, EH also provided technical support to the Ministries of Health in Nyanza Province to help strengthen male circumcision services, reaching 10,000 men. In Uganda, EH supported capacity-building of clinical officers to provide male and female sterilization to increase availability of sustainable LA/PM.
Engaging The Private Sector
Management Sciences for Health (MSH) Capability Statement Social marketing MSH approaches “social marketing” as one avenue for increasing uptake of evidence-based health products and services by: (1) stimulating demand through awareness and education; (2) stimulating supply by helping the health market make products and services more available;; (3) improving consumer acceptance of the products through branding, attractive packaging, and clear information for consumers (attractiveness); and (4) maintaining quality of products and services. Social marketing is adapted to the country context and public health challenge at hand; there is no one right model.
Increasing access to FP/RH services requires increased participation of the private health providers and collaboration with the public health system. EH has a long track record of working with NGOs and private service providers to improve the quality of FP/RH services, expand and meet consumer preferences. The following programmes are examples of EH’s work to develop the capacity of the private sector to provide quality FP/RH services.
For instance, under the Rural Expansion of Afghanistan’s Communitybased Healthcare (REACH) program, MSH conducted a social marketing campaign (subsequently spun off to COMPRI-A; see Public-Private Partnerships, below) intended to stimulate demand for and supply of contraceptives, ORS, safe water systems, and insecticide-treated bed nets in rural areas, using traditional trading routes and commercial venues, and combining those outlets with NGO suppliers for the most poor and vulnerable.
In Bangladesh, the ‘Mayer Hashi’ programme is supporting the development of the NGO and private sector to provide LA/PMs. EH has provided clinical training and on-site coaching on IUDs for the Smiling Sun Franchise, a nationwide network of 28 NGOs operating 320 clinics and 8,500 outreach sites. An inventory in 2011 mapped LA/PM sites and assessed the skills of providers in preparation of a capacity building intervention with private providers.
This mixed approach served the aim of strengthening the Private Pharmacy Network as well as the imperative to address the needs of the most poor. The social marketing campaigned was backed by longterm literacy classes for female health extension workers; and quickimpact advertising for products that were new in rural marketplaces, such as safe-water treatments and insecticide-treated nets.
In India, RESPOND started an 18 month employer-based program in late 2010, involving 16 industrial companies, to increase support and wider provision of LA/PMs in Kanpur. In Tanzania, the ‘Channeling Men’s Positive Involvement in a National HIV/AIDS Response’ (CHAMPION) is working to mobilise workplaces to advance gender equity and constructive male engagement in health services. A prototype HIV workplace policy and training curriculum, developed in consultation with partners, is being used to support the scale-up of workplace programs. CHAMPION also assists with gender transformative HIV programming to specific workplaces such as gold mines, tea plantations, wattle producers and construction companies under its Public-Private Partnership for Prevention and Millennium Challenge Corporation projects. In the Philippines, EH partnered with Chemonics, to support the USAID funded ‘Private Sector Mobilization for Family Planning (PRISM) Project’, from 2004 to 2008, which strengthened maternal and child health care services, including expanded access to FP and postabortion care.
A different approach to social marketing was undertaken in Ethiopia on the HIV&AIDS Care and Support Program (HCSP). There, the critical “marketing” gap in increasing demand for and supply of HIV&AIDS services and products was a link between households and facilities. On HCSP, therefore, community health workers—largely from the faith-based community—acted as “case managers” to both stimulate awareness of and demand for, for example, antiretroviral treatment, and to connect clients with the supply of those medicines at facilities. At the same time, performance-based finance was used with both public and private partners to boost supply of quality-assured medicines to meet new demand. This approach adapted social marketing concepts to the realities of Ethiopia’s pattern of health service/product consumption.
Social franchising In the health market, MSH approaches social franchising with a private-sector based business model. An example now being scaled up in East Africa is the Accredited Drug Dispensing Outlet (ADDO), first developed and piloted in Tanzania with funding from the Bill & Melinda Gates Foundation. The aim of the ADDO initiative was to improve access to safe medicines for purchase in the market, provided by well-informed pharmacy operators whom consumers can trust to give accurate dosing information. Social marketing of the ADDO franchises led to a reduction of unregistered products for sale in Tanzania from 26% to 2%. Private drug dispensers (90% of them women) continue to increase access to quality pharmaceutical products and services in underserved areas of Tanzania through regulation, training, and supervision.6 This innovate public-private partnership
102 PO 5555: DFID RHFS was expanded through later initiatives, including the East African Drug Sellers’ Initiative (EADSI). In Uganda, the ADDO franchising model has been incorporated into MSH’s Strengthening Pharmaceutical Systems Program7 as part of a strategy to improve the availability of medicines to treat malaria (artemisinin-based combination therapy, ACT) in private-sector facilities, where most Ugandans seek treatment for malaria. Important work for that franchise model involves support for the National Drug Authority to reclassify ACTs as overthe-counter products. Similarly, in Zambia, MSH is working with the Pharmaceutical Regulatory Authority under the Zambia Access to ACT Initiative to develop an accreditation and regulation framework, and roll out the initiative in four districts.
MSH’s Franchising Approach * Strong incentives for membership * Building capacity by setting challenges, offering feedback, and providing ongoing support * Maintenance of high, but achievable, performance standards * Provision of high-quality services * A powerful marketing strategy that creates demand for services * A sustainable public-private health policy environment * A fair, transparent fee structure adequate to cover essential management functions
Public-Private Partnerships MSH understands that health markets comprise public and private actors, and that the two sectors must work together toward shared objectives. Under the WHO health system building block model, the public sector should lead and govern the market, with the input and participation of private stakeholders. Private partners—primarily nongovernmental organizations, though also private sector for-profit doctors and facilities—are important to almost all MSH projects as service providers. PPP development is a high priority for the Communication for Behavior Change: Expanding Access to Private Sector Health Products and Services in Afghanistan (COMPRI-A) project; as a project consortium member, MSH is helping the Afghan MOPH to establish strong and productive private-sector relationships. The project has helped the MOPH Office of Private Sector Coordination articulate a National Private Sector Policy and Strategy; negotiate a Private Hospitals Regulation Act; arrive at a private hospital accreditation framework; and acquire skills to negotiate PPP arrangements independently. COMPRI-A also has provided technical and financial support to the Afghan Private Hospitals Association and the Afghan Medicine Services Union (commercial pharmaceutical businesses). Performance-based finance is an innovative tool for securing PPPs in all areas of health service delivery and health behavior promotion. MSH is currently at the forefront of PBF innovations and adaptation in eight countries in Eastern, Central, and Western Africa, as well as Central America, under a variety of bilateral and global projects.
Under the global AIDSTAR 2 project in Honduras, we are helping the public sector use PBF to improve NGO provision of HIV& AIDS services to the most at risk populations. In Haiti, through Santé pour le Développement et la Stabilité d’Haïti Project (SDSH), PBF is used throughout the private sector to administer HIV & AIDS, family planning, and maternal, newborn, child health services to nearly half of Haiti’s population. In the Democratic Republic of the Congo, MSH is using PBF to strengthen the integration of primary health care services through the Integrated Health Program.
Ensuring MSH provides value for money MSH considers that clients achieve value for money when planned/ envisions results are achieved, sustainably and cost-effectively. Our results motto is “Begin with the end in mind”: this means results are the focus throughout each project lifecycle, guided by a concrete results planning framework and reinforced by regular management reviews of results data to facilitate continuous improvement and ever stronger impact. Sustainability comes from our concentration on country counterparts as co-implementers as well as beneficiaries: training is workplace-based to the extent possible, with participants both defining challenges and designing solutions. We expand counterpart awareness of their roles in a comprehensive health system, and leave them with skills and tools they can “spread and scale” over their professional lives. We connect people and organizations in sustainable, self-directing networks with access to support from the global community. And we model collaboration with other implementers, and support donor collaboration, so that assistance efforts are focused and concentrated. We practice cost control and cost consciousness through a variety of internal financial controls that join field and home office project teams in continuous budget monitoring, review of cost reasonableness, and reporting to and reconciliation with donor budget officers.
Reaching disadvantaged urban populations MSH projects generally target the poorest and most vulnerable populations, both in rural and urban settings. In Haiti, MSH partners with the Fondation pour la Santé Reproductrice et l’Education Familiale (FOSREF) and other NGO partners to reach vulnerable urban populations—such as commercial sex workers, street children, persons living with HIV&AIDS, and imprisoned youth—with family planning and reproductive health information and products. For example, MSH worked with the Women’s League of Cité Soleil and FOSREF to train community distributors of family planning commodities, part of a strategy to increase contraceptive prevalence in Haiti’s poorest areas. In five months, the program had directly reached more than 10,000 community members thanks to the large network of communitybased distribution agents and agent supervisors recruited through the Women’s League. Of the women reached, 2,000 of them accepted condoms and 400 accepted other methods. Much of this outreach was made possible by the agents referring clients to the Youth Center in Cité Soleil, operated by FOSREF.
Health market structure t is overwhelmingly the case in countries where MSH works that public sector expenditure on health is low - often in the single digits - and
6 E. Rutta et al., “Creating a New Class of Pharmaceutical Services Provider for Underserved Areas: The Tanzania Accredited Drug Dispensing Outlet Experience,” Progress in Community Health Partnerships: Research, Education, and Action, vol. 3, Issue 2, summer 2009. 7 MSH and EADSI, “Uganda Celebrates the Launch of Accredited Drug Shops in Kibaale District,” 2009, http://www.msh.org/Documents/upload/Dec-20-uganda_launch_ success_story.pdf.
PO 5555: DFID RHFS 103 that private expenditure for health by households, firms, non-profit organizations, and medical insurance schemes (where they exist) is the first or second largest source of health care finance. WHO has documented (World Health Report 2006) that the rate of household out-of-pocket spending on health is higher in low-income countries, and impacts poor households disproportionately: the poorer the household, the higher the rate of out-of-pocket spending. As a partner to both donors and country government counterparts, MSH examines the consequences of this market reality for health outcomes, and the implications for policy and health sector strategic planning going forward. Together with all implementers in country, MSH supports accurate and up to date national health spending accounts as essential tools for understanding all market demand and supply patterns in country. We do this in a variety of ways under a variety of projects. Under the flagship Grant Management Solutions Project, MSH has helped 47 principal recipients of GFATM funds to monitor, evaluate, and report on health expenditures, and to transparently procure health commodities adequate for needs. The Leadership, Management, and Sustainability program worked in 26 countries to help public and private sector health providers reach more clients in their market segments by analyzing the impact of expenditures outcomes, and to manage for results. MSH is a partner in the Supply Chain Management System program, a group of 13 private sector, NGO, and faith-based organizations that are among the most trusted names in supply chain management and international public health and development. SCMS is an example of how a project can directly impact a country’s health market (16 so far) by providing trained staff to buy appropriate laboratory commodities in the local market, driving down the cost of procurement, reducing delivery times, and transferring valuable skills to the local workforce. SCMS has also helped transform public health supply chains in many countries, strengthening warehousing, distribution, logistics management, quality assurance and other key supply chain disciplines. Similarly, MSH’s Strengthening Pharmaceutical Systems Program impacts the pharmaceutical markets in 30 countries, based on their specific health, economic, and political conditions. SPS works to institutionalize a pharmacy market framework comprising appropriate policies, laws, and regulations; selection, procurement, and distribution regimes; and management support. At the bilateral level, MSH’s Local Technical Assistance Project in Honduras was an example of US Government support for the Honduran MOH as it proceeds with restructuring the health market to increase both public and private participation in a shared public health vision. With mentoring from MSH technical advisors, the GOH is expanding social security insurance; providing a safety net for the country’s poorest; introducing a sliding scale reimbursement scheme for services based on ability to pay; and refocusing the market on quality and equity of services.
Quality assurance mechanisms for service delivery and commodities. MSH integrates quality assurance mechanisms into each project, for technical as well as management purposes (see “value for money”), using a variety of tools. Just as importantly, MSH both shares its expertise in quality assurance and continually reappraises approaches and tools by inviting stakeholders to participate in knowledge exchange. In addition to the service delivery and commodity management quality assurance tools provided under separate cover,
MSH resources to disseminate and scale up QA globally can be found at http://erc.msh.org, MSH’s Electronic Resource Center. An overview of MSH QA skills transfer approaches and materials is provided in the table overleaf.
Before and after evaluations MSH undertakes “before and after evaluation” in the context of country counterpart data-based decision making for health sector strengthening; that is, we help our counterparts generate, track, and use the indicators in their health management information systems to assess the impacts of interventions on the public health priorities articulated in sector strategic plans. The “before” dimension is the baseline of those indicators at the start of an MSH project, and the “after” is the change in indicator value as measured, usually, at midand end-of-project timeframes. In dozens of countries in Africa, Asia, and Latin America, MSH conducts assessments and surveys to support the design and conduct of baseline and periodic surveys, including community-level cluster and LQAS surveys; quality of care and health facility assessments; service and program evaluations; and assessments of HMIS functionality, use, and data quality. We assist with information system development and implementation, especially design of specific information subsystems such as human resources, logistics management, clinic records, and financial management, including the assurance of the confidentiality of health data. We develop tools and procedures for monitoring and evaluation, including for health team service performance assessment and improvement processes which enhance data use for management and decision-making at facility and district levels. We also help Ministries of Health to design information analysis and dissemination methodologies to raise health awareness among politicians, decisionmakers, the media, and civil society. For example, MSH’s Tech-Serve Project in Afghanistan is strengthening the HMIS for community and hospital services through use of community Lot Quality Assurance Sampling and a national monitoring checklist for facilities. In 2008, Tech-Serve supported the Ministry of Health in carrying out a sector-wide HMIS assessment and develop a five-year Strategic HMIS Development Plan that will enable the MOH to generate health situation reports with “before and after” features. In Uganda, under the STAR-E LQAS project, MSH is currently involved with the MOPH and Makerere University’s School of Public Health to institutionalize LQAS community surveys and Health Facility Assessments across the country, which will generate “before and after” data in regions benefiting from USAID HIV/TB service projects. MSH’s Integrated Health Systems Strengthening Project in Rwanda has a priority focus on helping the MOH to successfully institute its national HMIS and e-Health Strategic plans (developed with MSH) that will harmonize systems and procedures for collecting data from health facilities and community health workers and enable them to access real-time information via an electronic HMIS “dashboard.” The project t is also providing technical assistance for the design and implementation of a cell phone based reporting system for community health workers, a web-based indicator tracking system for the community-based health insurance program, and web-enabled systems for performancebased financing and service quality assessments.
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Quality Assurance Target Mechanism/Resource
Topics
Service delivery
Managing Quality and Clinical Services
Assessment, Planning, Quality Improvement
Guide for Fostering Change to Scale up Effective Health Services
Coordinating and managing the change process among multiple teams to institutionalize best practices
Provider’s Guide to Quality and Culture
Impact of culture on service effectiveness, cultural competence
The Guide to Managing for Quality
Problem solving, team building, and managing the process of quality improvement
Best Practices Compendium for FP and RH
FP and RH program models that can be adapted to meet specific country program needs
Managing Community Health Services
Expanding the community role in the promotion, delivery and funding of desired services, and working with boards of directors
The Health Manager’s Toolkit
Comprehensive coverage of clinical services and quality management, drug and supply management, and all other health system building blocks
Facilitators’ Guide to Integrating Leadership and Management Curricula into Pre-Service Training
Integrating action- and workplace-oriented approaches to leadership for results into health education training
Guide for training community leaders to improve leadership and management practices
Approach to teamwork; creating buy-in for health service delivery and infrastructure
Civil Society Board Governance Development
Developing a shared vision of organizational mission and values; roles and responsibilities; accountability and transparency
Country Coordinating Mechanism Functional Analysis
Oversight of GFATM funds; documentation and communication of GFATM-funded programs
Developing and Managing Human Resources for Health
How governments and organizations can attract, motivate, and sustain an adequate supply of qualified health staff
HRH Planning and Budgeting Framework
HRH costing strategy and HRH Action Framework
HRH Management Rapid Assessment Tool
Analysis of strengths and weaknesses in 22 HRH components
Managing Drugs and Supplies
Comprehensive guide to QA for drug management: selection, procurement, distribution, and use
Pharmaceutical Management
International Drug Price Indicator Guide Guide for Implementing the Monitoring-Training-Planning Approach to Build Skills for Pharmaceutical Management
Antenatal, safe childbirth, and newborn care Maternal, newborn, and child health (MCH) is a priority focus of MSH; its MCH portfolio spans dozens of countries in Africa, the Middle East, Asia, and Latin America. As an active partner in the Partnership for Child Health Care; the Partnership for Maternal, Newborn, and Child Health; and the US Coalition for Child Survival, MSH stresses global integrated action for proven MCH interventions. For example, under the Basic Support for Institutionalizing Child Survival (BASICS) project in Afghanistan, MSH significantly strengthened evidence-based integrated management of childhood illnesses (IMCI) and community IMCI in villages and at district and provincial hospitals. BASICS in Benin is also focused on C-IMCI, particularly incorporating early diagnosis and treatment of malaria, diarrhea, and acute respiratory infections. Maternal/family education on vaccines and nutrition is also a priority. In Malawi, BASICS has been instrumental in solidifying a community case management approach that unites village health surveillance
assistants, district health teams, zonal health officials, and facilitybased providers in evidence-based interventions to mitigate malaria, malnutrition, dehydration and even PMTCT. Under the Sudan Health Transformation II Project MSH, together with the MOH, has surmounted extraordinary difficulties during the transition to independence to introduce international guidelines and standards for MCH service delivery. MSH has rolled out standardized provider training across all 14 South Sudan counties, and is reaching households with an education campaign on birth preparedness, hygiene, nutrition, breast feeding, and the importance of skilled attendance at birth. The project is recruiting, training, and certifying community midwives as a rapid pace; some primary health care centers in Juba are able to provide delivery assistance on a 24/7 basis.
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LSTM Maternal and Newborn Health Unit (MNH Unit) Capability Statement The MNH Unit, set up in 2006, is headed by Dr Nynke Van den Broek, who has been leading research in the area of Maternal and Newborn Health for over 20 years. The 4 strategic areas of the MNH Unit are Skilled Birth Attendance, Essential Obstetric and Newborn Care, Quality of Care and Pregnancy Outcome. Nynke herself has worked in 10 African and 6 Asian countries as clinician, researcher and technical advisor. We have a multi-national, multi-disciplinary team of 15 (9 academics and 6 support staff), and work in partnership with governments and other stakeholders to deliver a range of research, teaching and technical assistance programmes in Africa and Asia. To date the unit has attracted funding of over £20m. Through this we have extensive experience of working with DFID, Europe Aid, WHO and UNICEF. We are proud of the quality of the programmes we manage and deliver and we are recognized by donors for our timely delivery and good management. The unit offers unique expertise in using the rigorous discipline of research to inform teaching and technical assistance programmes to improve the health of mothers and babies globally.
Teaching We have extensive experience in curriculum design and delivery of teaching programmes, and currently run the following: •
Masters programme in International Public Health with a specialisation in Sexual & Reproductive Health (MIPH-SRH)
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Diploma course in Reproductive Health (DRH) in Developing Countries.
Both courses are accredited by Royal College of Obstetricians and Gynaecologists (RCOG). In addition we host a number of international PhD students.
Technical Assistance Through long and short term technical assistance, we actively support a number of in-country programmes that aim to strengthen the health care delivery system with an emphasis on sexual and reproductive health; and maternal and newborn health in particular. Our current portfolio of technical assistance includes work in Kenya, Somaliland, Nigeria and Zimbabwe. We have an impressive track record in: •
strengthening skilled attendance at birth - including baseline surveys and needs assessments, reviewing and developing teaching and training curricula, assessing capacity of countries to scale up SBA coverage and evaluation of interventions that aim to increase coverage.
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strengthening capacity for delivering essential (emergency) obstetric and newborn care including baseline surveys and needs assessments, design of programmes to ensure coverage meets UN guidelines, the cluster based approach to strengthening EOC and identification of barriers to provision of the key signal functions and evaluation of interventions to address these, including a new competency based training package for EOC and early newborn care.
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introducing quality improvement (QI) processes to improve the quality of MNH care - including formation, training and guidance of QI teams, strengthening supportive supervision, building capacity to conduct maternal and peri-natal death reviews, and, supporting the development of standards and criterion-based audits.
Research In the developing country setting, using quantitative and qualitative research methodology, we gather evidence on: What to measure: We develop and agree, with partners •
tools which are applicable in low income settings
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frameworks to measure effect of complex interventions.
What works: We research •
the effectiveness of interventions during pregnancy, childbirth and the post natal period.
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existing evidence by conducting systematic reviews, such as Cochrane.
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the effect of new and innovative ‘packages’ of combinations of effective interventions.
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community and health care provider perceptions of interventions.
How it works: We collect information on: •
how to translate evidence into policy and practice.
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how to effectively scale up programmes.
Recent country experience includes:
Kenya The highly successful DFID funded Kenya Essential Health Services (EHS) Programme, which runs up to September 2011, has a strong focus on MNH. This programme supports efforts at national, provincial and district level to strengthen delivery of the Kenya Essential Package for Health, and in 6 selected districts in Nyanza Province, especially to address women’s and infant’s health needs. The endline survey was carried out in 2011 to establish progress made in the EHS programme target health facilities and communities since the baseline surveys were undertaken. The survey report provides a comprehensive outline on progress made in the following areas:
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Availability of quality MNH services that are in line with the WHO minimum acceptable coverage for EOC
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Improvements in staff skills and competence in performing the six BEOC signal functions in the targeted health facilities
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Changes in the level of skilled attendance at birth in the targeted districts
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Institutionalisation of quality improvement processes for MNH services
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Availability of focussed ante natal care (ANC) and post natal care (PNC) services in targeted health facilities
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Utilisation of MNH services in the targeted facilities
•
The extent to which community mobilisation and awareness around MNH services has improved perceptions, beliefs, attitudes and practices related to utilisation of MNH services.
The survey findings provided valuable and objective information on achievements over the lifetime of the project and were disseminated to Ministry of Health officials at the national, provincial and district levels to inform their future planning. The unit continues to work in Kenya through its ‘Making It Happen’ programme. This DFID funded programme is delivering a unique country adapted competency based LSS-EOC & NC training package, building in-country capacity for training and Supportive Supervision at provincial hospital level across all provinces. Early evaluation points to an increase in EOC and NC signals preformed in the target facilities, with a reduction in Case Fatality Rates and Still Birth Rates.
Malawi We provided technical support to the Ministry of Health (MOH) in Malawi over several years in design and implementation of the health SWAp and DFID and EU contracts on Sexual and Reproductive Health (SRH), 2000-2006. The MNH unit is currently working with UNICEF in Malawi to improve the quality of services for maternal and newborn health in target districts through improving the uptake and quality of SBA and Essential Obstetric and Newborn Care by strengthening the capacity to conduct audit.
Sierra Leone The Unit works in Sierra Leone through its ‘Making It Happen’ programme to increase availability and improve the quality of Essential (Emergency) Obstetric and Newborn Care (EOC & NC). This UNICEF and DFID funded programme is delivering a unique country adapted competency based LSS-EOC & NC training package delivered at both central and district level (up to 14 districts).
Nigeria The unit supports the consortium delivering the Maternal, Newborn and Child Health Programme (PRRINN – MNCH) of the UK-Norway programme in three Northern States. This aims to address the unacceptably high maternal, neo-natal and child mortality rates in three states. The MNCH Initiative will aid the states in delivering their
health reform agendas with a special focus on improving MNCH outcomes. The MNCH work is closely coordinated with PRRINN, a five year DFID programme focused on strengthening routine immunisation. Liverpool Associates for Tropical Health and the MNH Unit were major partners in the 2002-2008 DFID funded Partnership for Transforming Health Systems Programme (PATHS) and acted as a lead agency on improving policy, strategy and implementation of supply-side interventions for safe motherhood in five states across Nigeria.
Somaliland The unit led a DFID funded consortium in Somaliland from 2007-09, in support of the Ministry of Health and Labour (MOHL) to strengthen health systems with a focus on human resources for health and improvement of maternal and neonatal health. The unit currently supports the EC funded programme on “Improving the Reproductive and Sexual Health of Internally Displaced People in Maroodi Jeex, Somaliland.” LSTM has provided baseline assessments of target facilities, training of health care providers in LSS-EOC & NC, family planning, gender based violence, female genital cutting, and introduction of quality improvement initiatives.
Zimbabwe Support to, and impact monitoring of, DFID’s Maternal and Newborn Health Programme in Zimbabwe. The main objectives are to: maintain and increase national access to family planning and reproductive health services; improve evidence-based policy, planning; budgeting and monitoring; increase equitable access to quality antenatal and postnatal care, with a particular focus on the specific needs of HIV positive mothers and their babies; and to improve access to life saving essential obstetric and newborn care. The unit has also delivered a contract for DFID Zimbabwe to support the ‘Saving Maternal and Newborn Lives in the context of HIV and AIDS’ Programme via strengthening of the capacity in-country to provide Skilled Birth Attendance (SBA) and in particular Emergency Obstetric Care among existing health care providers in all regions of Zimbabwe. This work was carried out in collaboration with and supported by the MOH and the Department of Obstetrics and Gynaecology at the University of Zimbabwe. We continue to work in Zimbabwe through the ‘Making It Happen’ programme, focusing on pre-service training of mid-wives, clinical officers and medical doctors. A second phase of the programme, with a total project cost of £2.2million, is in the final stage of agreement, jointly funded by DFID and ARK (Absolute Return for Kids). This will evaluate the effect of strengthening EOC and NC on maternal and newborn mortality and morbidity at provincial as well as community level.
Bangladesh The unit works in Bangladesh through its ‘Making It Happen’ programme. This DFID funded programme is delivering a unique country adapted competency based LSS-EOC & NC training package delivered in four target districts in collaboration with UNFPA, the government of Bangladesh and the Obstetrical and Gynaecological Society of Bangladesh. Early evaluation of the programme points to an increase in EOC signals in the target facilities with a reduction in Case Fatality Rates.
PO 5555: DFID RHFS 107
India The unit works in India through its ‘Making It Happen’ programme. This DFID funded programme is delivering a new country adapted competency based training package with an emphasis on basic EOC, targeting 3 ‘high volume’ facilities, in each of 4 districts in all 7 high focus states. In addition the unit works with the government of India and states to assess capacity of health facilities in high focus states to provide SBA, EOC and NC.
M& E for Making It Happen The M & E framework has been applied in all 5 countries under the MIH programme. Baseline assessments and subsequent M & E have identified gaps in health facility functioning and maternal and newborn outcome data, this is due to poor recording on the part of health care providers and inadequate registers. In Kenya, we have supported the target facilities to adapt the government register to overcome its data gaps. We have highlighted the problems with the register to the MOHS who are in the process of discussing a revision with other relevant departments. In Sierra Leone, we are contributing to the development of a new government register, as some facilities are using up to 5 different registers, which do not capture all necessary information, whilst containing repetitive and sometimes conflicting information. In such facilities, we have supported the introduction of an improvised register with captures all the necessary information in one location. To address the problem of poor recording on the part of the health care provider, the Supportive Supervision workshop looks at what information should be recorded and how better recording can be encouraged. Where Supportive Supervisors are active significant improvements have been made in data collection.
108 PO 5555: DFID RHFS
Annex 5 - Service Delivery Matrix
REGION KEY:
ORGANIZATION KEY: IPPF
International Planned Parenthood Federation
Arab World Region (AWRO)
EH
Engender Health
European Network (EN)
MSH
Management Sciences for Health
South Asia Region (SARO)
LSTM
Liverpool School of Tropical Medicine
Western Hemisphere Region (WHR)
MD
Mannion Daniels
Central Office (CO) Africa Regional Office (ARO)
East and South East Asia and Oceana Region (ESEAOR)
Country
Afganistan
IPPF Region (see key)
Social Marketing
Social Franchising
Capacity Building/ Quality Management
Direct Provision
Community Based Distribution and Outreach
Prevention of HIV/Other STIs
MSH
Safe Abortion Related Services
Antenatal, Safe Childbirth and Newborn Care
Nutritional Supplements
IPPF/MSH
MSH
IPPF
MSH
IPPF
MSH
IPPF
Bangladesh
IPPF
EH/ MSH
IPPF
IPPF/EH
IPPF
IPPF
IPPF/EH/LSTM
Burma
IPPF
IPPF
IPPF
IPPF
IPPF
IPPF
IPPF
DR Congo
IPPF
EH/ MSH
IPPF
IPPF/MSH
IPPF/MSH
IPPF/EH/MSH
MSH
Ethiopia
IPPF
IPPF/EH/MSH
IPPF
IPPF/EH/MSH
IPPF/EH/MSH
IPPF/EH
IPPF/MSH
Ghana
IPPF
IPPF/EH
IPPF
IPPF/EH
IPPF/EH
IPPF
IPPF/LSTM
India
IPPF
IPPF/EH/MSH
IPPF
IPPF/EH
IPPF/EH
IPPF
IPPF/EH/LSTM
Kenya
IPPF
IPPF/EH/MSH
IPPF
IPPF/EH/MSH
IPPF/EH/MSH
IPPF/EH
IPPF/LSTM/ MSH
Kyrgyzstan
IPPF
IPPF
IPPF
IPPF
IPPF
IPPF
IPPF
IPPF
Liberia
IPPF
IPPF
IPPF/MSH
IPPF
IPPF
IPPF
IPPF
MSH
MSH
Malawi
MSH
LSTM/MSH
MSH
IPPF
MSH
IPPF
IPPF/MSH
IPPF/MSH
Mozambique
IPPF
IPPF
IPPF
IPPF
IPPF
IPPF
Nepal
IPPF
EH
IPPF
IPPF/EH
IPPF/EH
IPPF
IPPF
Nigeria
IPPF
IPPF/EH/MD/ MSH
IPPF
IPPF/MSH
IPPF/MSH
IPPF
IPPF/EH/ LSTM/MSH
IPPF
IPPF
IPPF
IPPF
IPPF
IPPF
IPPF
IPPF
MD/MSH
IPPF
MSH
IPPF
IPPF
IPPF/LSTM
IPPF
IPPF/EH/MSH
IPPF
MSH
IPPF/MSH
IPPF
IPPF/LSTM
Sierra Leone
IPPF
IPPF/EH
IPPF
IPPF
IPPF
IPPF
IPPF/EH/LSTM
Somalia
IPPF
MD
IPPF
IPPF
IPPF
LSTM
EH/MSH
EH/MSH
LSTM/MSH
MSH
MSH
MSH
LSTM/MSH
MSH
IPPF
IPPF
EH
IPPF
Occupied Palestine Territories
IPPF
Pakistan Rwanda
IPPF
South Africa Sudan
EH/ MSH MSH
IPPF
Tajikistan
EH/ MSH
IPPF
IPPF
MSH
Tanzania
MSH/ IPPF
EH/ MSH
IPPF
IPPF/EH/MSH
IPPF/EH/MSH
IPPF
IPPF/EH/ LSTM/MSH
MSH
Uganda
MSH/ IPPF
EH/ MSH
IPPF
IPPF/MSH
IPPF/EH/MSH
IPPF
IPPF/EH/MSH
MSH
MSH
IPPF/ MSH
IPPF
IPPF
IPPF/MSH
IPPF
Yemen Zambia Zimbabwe
LSTM
PO 5555: DFID RHFS 109
Annex 6 - Logical Framework Analysis RHFS LOG FRAME GOAL
Indicator
Means of Verification
Empower women and girls to make healthy reproductive choices and act on them through removing barriers, expanding supply of quality services and enhance accountability
1. Save the lives of at least 50,000 women during pregnancy and childbirth and 250,000 newborn babies by 2015 2. Enable at least 10 million more women to use modern methods of family planning by 2015, contributing to a wider global goal of 100 million new users 3. Prevent more than 5 million unintended pregnancies
DFID Framework for Results
Framework for Results
PURPOSE
Indicator
Means of Verification
The NOW! Approach ensures we meet comprehensive needs of women and girls and captures and responds to this information
1. % of contribution to national contraceptive service distribution 2. # of unintended pregnancies averted, estimated by age (all ages and under 25) 3. # of Couple Years of Protection (CYP) 4. # of FP/RH services provided (# total, # young people (YP) 5. # of contraceptive services (all ages and under 25 years) 6. # of LARCs services (IUDs/implants) (# total, # young people) 7. # of STIs related services (all and under 25) 8. #of HIV related services (all and under 25) 9. # of safe abortion related services 10. # of ANC services (Total and under 25)
DHS/ IPPF Service Statistics IPPF Service Statistics, Impact Calculator1
OUTPUTS
Indicator
Means of Verification
1. High impact quality comprehensive and integrated package of services
1. % of HIV positive women receiving contraceptive services 2. % of women receiving antenatal care referred to PMTCT services 3. % of women referred to birth facilities (under and over 25 years of age) 4. % of women receiving post-partum contraceptives 5. % of women receiving at least one post-natal contact after delivery 6. % of women that received safe abortion services receiving contraceptives
IPPF Clinical Management Information System (CMIS) IPPF Clinical Management Information System (CMIS)
1. Estimated percentage of Member Association clients that are poor, marginalized, socially-excluded and underserved (all ages and under 25) 2. % of clients receiving modern contraceptives that are PMSEUs(all ages and under 25) 3. % of clients receiving FP/RH services through outreach programmes 4. % of clients receiving modern contraceptives through outreach programmes 5. % of clients receiving FP/RH services through innovative financing schemes (vouchers, franchising, micro-financing) 6. % of clients receiving FP/RH services that were referred from community services
IPPF Global Indicators/ IPPF Service Statistics
1. Proportion of MAs with quality of care assurance systems, using a rights-based approach 2. # of MoUs established with public and private service providers 3. # established partnership with Community Based Organizations (CBOs) within the project area 4. % of health providers trained to deliver IPES 5. % of women reporting at least a satisfactory experience of reproductive and maternal health services
IPPF Service Statistics
2. Reduce barriers for women and girls to access quality services
3. Performance and delivery
DFID Framework for Results DFID
Risks and Assumptions
IPPF Service Statistics IPPF Service Statistics IPPF Service Statistics IPPF Service Statistics IPPF Service Statistics IPPF Service Statistics IPPF Service Statistics
Risks and Assumptions
IPPF Clinical Management Information System (CMIS) IPPF Clinical Management Information System (CMIS) IPPF Clinical Management Information System (CMIS) IPPF Clinical Management Information System (CMIS)
IPPF Service Statistics IPPF Service statistics/IPPF Clinical Management Information System (CMIS) IPPF Service statistics/IPPF Clinical Management Information System (CMIS) Project Reports /IPPF Clinical Management Information System (CMIS) Project Reports /IPPF Clinical Management Information System (CMIS)
IPPF Global Indicators/ IPPF Accreditation System Global Indicators, Accreditation Reports, Member Association Project Reports Member Association Project Reports Member Association Project Reports
1 Number of pregnancies averted is currently calculated using an impact calculator using couple years of protection (CYP). To convert CYP into number of pregnancies averted, we use the multiplier 0.25 as recommended recently by the Guttmacher Institute (January 2011). There is currently no universally accepted value of multiplier and other organizations use different values, including the highest at 0.571 as recommended by USAID in 1996.
110 PO 5555: DFID RHFS
Annex 7 - Nigeria Workplan Nigeria workplan matrix - inception Phase: ACTIVITIES SUMMARY
WEEKS
1
2
1. Key personnel in place
a
2. Meet with DFID to discuss implementation of the Project
a
a
3. Meet with IPPF management and technical staff to establish core team management
a
a
4. Establish project core team management
a
3
5
6
a
6. Revise and finalize YEAR 1 budget and work plan
a
9. Establish project advisory team with local subcontractors
a
12. Project implementation begins
9
10
a
a
a
a
a
a
a
11
12
a a
11. Reproduce training and BCC materials
8
a
8. Develop MOUs with National partners
10. Meet with Districts Health management teams
7
a
5. Orient staff on project strategy and goals
7. National partners and stakeholders meeting
4
a a
a
Project Name: No Opportunities Wasted-Now! Project Goal: Empower women and girls to make healthy reproductive health choices and act on then through removing barriers, expanding supply of quality integrated services and enhance accountability
Project Purpose: The NOW! Project ensure we meet FP/RH comprehensive needs of women and girls and captures and responds to this information
Technical Capacity PPFN: PPFN is the largest service delivery organisation in Nigeria. PPFN had worked in partnership with all the RH serving organisations in the country; SFH, ARFH, Pathfinder International and Nigeria, PPFA-I, CEDPA, Ipas, AHI, Packard Foundation, MacArthur Foundation at the same time maintaining strong collaboration with the government. Presently PPFN runs its 40 clinics and provide technical and or managerial support to over 1000 Service delivery points through partnership and projects. PPFN like all full member associations of IPPF has a governance and management structure. The two structures complement each other in the management of the organisation. While the governance see to leadership, policy formulation and oversight functions and headed, the management on the other hand oversee to the direct implementation of the policies on day to day basis. The governance and management of PPFN is categorised at three levels (National, State and Local) to provide opportunity of all levels of
the organisation to participate in the effective functioning of PPFN. While at the National level, there exists a National Council and National Executive Committee headed by the National President, similar councils and committees exist at the state and local levels. The management is headed by the Director General/CEO who is assisted by three Executive Directors (National Programme & Technical Support; Finance& Support Services and Marketing & Public relations). The directorate is staffed with Managers in different fields of operation who supervise Programme Officers and other senior staff. At the Regional level, PPFN has six Regional Directors who supervise the programme and finance and support services departments. The Directors and Managers are qualified personnel from various fields such as Medicine, Public Health, Sociology, Accounting, Economic, Statistics, Nursing/Midwifery, Human Resource and Information Systems. The Directors and Senior Managers form the Senior Management Team (SMT). The SMT holds its meetings quarterly to review programmes and decisions, and forecast future direction of the organisation. Programme management performances are reviewed and appropriate actions taken to address critical areas that require attention. It considers external relations of PPFN and takes actions to promote good public relations with other stakeholders. Districts for NOW! Implementation: PPFN currently operates in all the regions of Nigeria. We are also comfortable operating in all the regions; including socially volatile states within the regions. However, it should be noted that DFID has focus states in Nigeria (which cuts across all the regions). It will be advisable the bid focuses on those states.
PO 5555: DFID RHFS 111
Consequently, we propose the following states with the regions: i. North West Region: (Kano, Kebbi, Sokoto and Jigawa) ii. North East Region: (Bauchi, Gombe, Yobe). We may consider Borno if DFID is willing to operate there given the volatile nature of the state iii. North Central Region: (Nasarawa, Kogi and Benue) iv. South-South Region: (Cross River and Delta) We may consider Bayelsa if DFID is willing to operate there given the volatile nature of the state v. South-East Region: (Ebonyi, Anambra and Abia) vi. SouthWest Region: (Osun, Ekiti, Ondo and Lagos) In selecting these states, emphasis was placed on the maternal and child mortality ratio as well as being DFID focused states. The North West Region and the North East Region classified as high maternal mortality regions in Nigeria:
Local Partners: Partnership with Government: PPFN right from its inception has cultivated a strong partnership with Governments (National, State and Local). Given the three-tiered government structure, PPFN has a Memorandum of understanding with the Federal government, a number of state governments and local government. The MOU is anchored on mutual collaboration for the achievement of the country’s population, health and development goals.Specifically PPFN works closely with the Ministries of health (Federal, state) and LGA health departments. At the national level the collaboration with FMOH over policy development and review, service delivery, heath system strengthening, Contraceptive logistics management system and advocacy. In 2005 FMOH and PPFN organised a national Reproductive Health Summit in Nigeria. The summit reviewed reproductive health in Nigeria. Among the recommendations from the summit was a budget line for reproductive health in the National budget. Perhaps as a result of the summit among other efforts, the 2006 National budget had reproductive health budget line item. The partnership with government afforded PPFN recognition in the country’s CLMIS and confers on PPFN
tax exemptions. Similarly PPFN participates in policy review committees and technical implementation committees of FMOH, National Planning Commission and National Agency for the Control of AIDS and the National Primary Health care Development Agency. Partnership with NGOs,CBOs and CSOs: PPFN works with fellow NGOs in Nigeria as part of its leveraging strategy and also within Networks and Consortia. PPFN is a member of a number of networks; Pac-Net The Post abortion care network: A think tank and service providers network on post abortion care; NiNPREH: Nigerian Network of NGOs on Reproductive health, Cishan: Network of civil society organisation on HIV/AIDS; Reproductive health Forum: this network of (PPFN, AHI, IAC, SWAAN and DEVCOMS); White Ribbon Alliance on Safe motherhood. PPFN maintains a good working relation with Society for Family Health (PSI partner) in contraceptive supply, research, malaria and advocacy. Also there were collaborations with Association for Reproductive & Family Health (ARFH) in pioneering dual protection including female condom. At the local level there were collaborations with Community based organisations with our volunteer members. There are partnerships with Service Delivery points (Clinics public and private, Pharmacy/Chemists, and Patent Medicine vendors). Private Sector: PPFN is working with private sector organisations to promote sexual reproductive health and rights services. In 2002, PPFN built the capacity of 8 Banks to start HIV/AIDS work place program. Since 2005, PFFN has been working with Shell Petroleum Development Company (SPDC), a for profit institution to provide HIV/AIDS prevention and care services to local communities in the Niger Delta Region of Nigeria. The project empowers the communities in SPDC operations areas to reduce HIV transmission in the populations. The project is implemented in partnership with the local communities. PPFN has also worked with Nigeria Breweries, Mobil Nigeria Limited, the Central Bank of Nigeria, and the Nigeria Army in the area of training of their health workers RH service provision covering all FP methods including implants.
112 PO 5555: DFID RHFS CAPACITY BUILDING ACTIVITIES MONTHS KEY MILESTONES
Indicators
Activities Summary
1
Rapid assessment conducted on unmet needs in FP/RH within project districts
FP/RH priority services determined
Apply RAP tools (SEED, Reality, and Does it match?) Ask Nigeria
a a
Highly Functioning QI
QI structure Established at all levels # of districts implementing QI practices # of review meetings per year
- Establish a central QI leadership team - Implement routine QI practices - Review results from QI practices - Training a CoreQI Team for the different levels
a a a a
Providers trained to provide the IPES Formal linkages established among RH/ MNC and FP Formal Referral systems in place
- Competency based training for all cadres of providers IPES - QI model applied to develop QI projects to strengthen linkages and referral systems - Assist public and private providers to participate in the referral networking model applied to improve referral systems at all levels - Develop Referral guidelines - Roll out use of guidelines by health facilities - Training staff referral tools and data collection - Implement improved referral
a a
Structure at all Levels
Integrated promotion to care (P2C) continuum built on an effective service delivery network linked by referral and cross- referral systems
2
3
4
6
7
8
9
10
11
12
Remarks
a a
a a
a a a a
Manual and electronic client based management information system (CMIS) in place
CMIS capable to capture and report on IPES for women, young girls and PMSEUs
Manual and electronic tally sheets in place at all levels of care
a a a a
Effective logistics system in place that ensures availability of FP/RH Commodities
Availability of FP/RH commodities assured
- To assist facilities at all levels to improve commodity supply chain to provide adequate levels of FP/RH commodities. - Develop guidelines for logistics management - Training staff in logistics systems
a a a
PURPOSE
INDICATORS
ANNUAL PERFORMANCE TARGET
MONTHS
1 The NOW! Project ensure we meet FP/RH comprehensive needs of women and girls and captures and responds to this information
5
2
Remarks
3
4
5
6
7
8
9
10
11
12
% Percentage of contribution to national contraceptive distribution
12%
a
# of unintended pregnancies averted, estimated, all ages And under 25
134,345
a
# of Couple Years of Protection (CYP), all ages
537,379
a
PO 5555: DFID RHFS 113 OUTPUT 1: HIGH IMPACT COMPREHENSIVE AND INTEGRATED PACKAGE OF SERVICES MONTHS PERFORMANCE INDICATORS
Annual Performance Target
Activities Summary
1
2
3
4
5
6
7
8
9
10
11
12
# of FP/RH services provided (total, under 25) * 2010 SERVICE STATISTICS20% INCREASE IN Y1
Total: 6, 557,216 Under 25: 2,000.000
Provision of the iPES at all levels of the service delivery network
a a a a a a a a a a a a
# of contraceptive services(, all ages and under, under 25 * 2010 SERVICE STATISTICS40% INCREASE IN Y1
Total:10.750.000 Under 25: 5,000.000
Provision of the iPES at all levels of the service delivery network
a a a a a a a a a a a a
# of LARCs services (IUDs/ Implants)-all ages and under 25 * 2010 SERVICE STATISTICS50% INCREASE IN Y1
Total:219.000 Under 25:73.000
Provision of LARCs at all levels of the service delivery network
a a a a a a a a a a a a
# of STIs related services provided (All and under 25 ) * 2010 SERVICE STATISTICS - 30% INCREASE IN Y1
Total:56,180 Under 25: 39,000
Provision of STI prevention, diagnosis, treatment at all levels of the service delivery network
% of STIs clients receiving contraceptive services
60%-33,708
Provision of internal referrals for STIs clients to contraceptive services
a a a a a a a a a a a a
# of HIV-related services provided along the continuum of care * 2010 SERVICE STATISTICS - 40% INCREASE IN Y1
2,027.000
Provision of HIV related services based on the iPES
a a a a a a a a a a a a
% of HIV positive women receiving contraceptive services
100%
Provision of internal referrals for HIV positive
a a a a a a a a a a a a
% of women HIV positive receiving antenatal care referred to PMTCT services
70%
Provision of internal referrals for PMTCT services
a a a a a a a a a a a a
# of women receiving safe abortion related services * 2010 SERVICE STATISTICS-30% INCREASE IN Y1
22,756
Provision of the Continuum Safe abortion related services
a a a a a a a a a a a a
% of women that received safe abortion services receiving contraceptives
70%-15,929
Provision of internal referrals for PMTCT to women that received safe abortion services
a a a a a a a a a a a a
% of women referred to birth facilities over and under 25 years of age
70%
Provision of internal or external referrals to birth facilities
a a a a a a a a a a a a
%of women receiving at least one post-natal contact after delivery
60%
Use mobile technology to reach out women after delivery - text message Provision of post-natal care based on the iPES
a a a a a a a a a a a a
Remarks
114 PO 5555: DFID RHFS OUTPUT 2: REDUCE BARRIERS FOR WOMEN AND GIRLS AND PMSUs TO ACCESS QUALITY SERVICES MONTHS PERFORMANCE INDICATORS Annual Performance Target
Activities Summary
1
2
3
4
5
6
7
8
9
10
11
12
% of clients using modern contraception that are PMSUs (all ages and under 25)
60%
- Identify community level events to promote healthy behaviour messages (BCC) - Provision of modern contraception at all levels of the service delivery network through mid-level providers and community health agents
a a a a a a a a a a a a
Estimated % of clients that are PMSUs (all ages)
60%
Provision of FP/RH services throughout-reach programs
a a a a a a a a a a a a
Estimated % of clients that are PMSEUs (under 25)
50%
Include selected criteria from poverty score cards criteria within the manual or electronic Tally sheets at service delivery sites at urban and rural levels
% of clients receiving FP/RH services through outreach programs
50%
- Provision of FP/RH services throughout-reach programs - - Plan and target communities for outreach strategy Establish linkages with CBO and community leader - Train community leaders to provide information on FP/RH services
a a a a a a a a a a a a
% of clients receiving modern contraceptives through outreach programs
60%
- Provision of modern contraceptives throughout out-reach programs - Plan and target communities for outreach strategy Establish linkages with CBO and community leader Train community leaders to provide information on FP/RH services
a a a a a a a a a a a a
% of clients receiving FP/RH services through innovative financing schemes(vouchers, franchising, micro-financing)
20%
- Provision of FP/RH services through innovative financing schemes-voucher, franchising, micro financing - Pilot innovative financing schemes for selective FP/RH services
a a a a a a a a a a a a
% of clients receiving FP/RH services that were referred from community services
60%
Provide external referrals to FP/RH services from the community services to health facilities
a a a a a a a a a a a a
Remarks
PO 5555: DFID RHFS 115 OUTPUT 3: PERFORMANCE DELIVERY MONTHS PERFORMANCE INDICATORS
Annual Performance Target
Activities Summary
1
2
3
4
5
# of MOUs established with public and private service providers
70
Planning workshops Monitoring workshops
a
a
a
# of MOUs established with Community Based Organizations(CBOs)
140
Planning workshops Monitoring workshops
a
a
a
% of women reporting satisfaction with the FP/RH services
70%
- Client satisfaction surveys(client exit interviews)-once a Year - Client satisfaction boxes within all service delivery sites
% of health facilities , including NGOs, public and private sectors with consistent M&E system for program planning and reporting
40%
- Training management staff on M&E systems - Monitoring implementation of consistent M&E system
a
6
7
8
9
10
11
12
a
a
a
a a a a a a a a a a a a
Remarks
PO 5555: DFID RHFS