Join FP2020 by Making a Commitment

• With support from USAID, the Bill & Melinda Gates Foundation, and other donors, FHI 360 is implementing a wide variety of projects to expand the evidence base for safe and effective family planning and translating high-quality evidence into policy and practice. For instance, a new award from the Saving Lives at Birth program will seek to synchronize immunization visits with family planning re-supply to improve immunization coverage, promote a more logical infant growth-monitoring schedule and raise contraceptive prevalence. Under the Advancing Partners & Communities (APC) Project, FHI 360 is studying self-injection of the contraceptive DMPA in a subcutaneous formulation and delivery system known as “Sayana Press” in Malawi. Also under the APC project, FHI 360 advocates for the scale-up of community-based family planning programs and supports the implementation and monitoring of national costed implementation plans (CIPs).

• Support to the family planning strategies of local governments and for scale-up of evidence-based practices is provided by FHI 360 in multiple countries, including India (Uttar Pradesh state), where FHI 360 leads the Urban Health Initiative. FHI 360 also conducts systematic reviews on family planning for the Cochrane Collaboration, an important source of evidence for the WHO Medical Eligibility for Criteria (MEC) Guidance.

In August 2015, the Bill & Melinda Gates Foundation shared an update on progress in achieving its commitments to FP2020.

• The foundation has been implementing an aggressive and progressive contraceptive research and development strategy since 2011. The portfolio of new product candidates includes diverse methods intended to address the significant barriers that many women experience in using existing family planning products, including access, cost and preferences around product performance and use. Since 2013, the foundation’s family planning team has dedicated 20% of the annual family planning budget to research and development of contraceptive technologies. New methods must be safe and effective for all populations of women; the foundation’s portfolio is geared toward improvements that will meet the needs of groups of women with the greatest need, including young women.  

By cultivating high-level political leadership around countries’ FP2020 commitments, the Gates Foundation and its grantees have been able to work with government to expand access to family planning in priority countries. For example:

• In Nigeria, the foundation is supporting the GONigeria to develop and implement the family planning costed implementation plan (National Family Planning Blueprint), and scaling up high-impact family planning approaches and supporting the development of supply chain solutions in Lagos and Kaduna states.
• In Pakistan, the foundation is supporting Pathfinder International to work with ministers in Sindh and Punjab provinces to develop provincial family planning costed implementation plans.
• In DRC, Gates Foundation grantee Advance Family Planning (AFP) worked with partners to garner high-level commitment among the DRC’s top leadership, resulting in unprecedented subsequent changes in the policy environment. In the two years since committing to FP2020 at the 2013 ICFP, the government has significantly improved access to family planning services and contraceptives through national policy and funding commitments. Most recently, the Prime Minister formalized the national CTMP (Comité Technique Multisectoriel Permanent), which includes active participation by the DRC government, including the National Program for Reproductive Health of the Ministry of Health and the Ministry of Gender and Family. Since the official launch earlier this year, the President of the CTMP notes that the group enjoys stronger convening power, including colleagues from the Ministries of Budget, Planning and Finance, who participated in an AFP SMART facilitation in August 2015.
• In Uganda, AFP is also working with partners to fulfill President Museveni’s ambitious pledge at the London Summit in 2012. Three years later, the President’s leadership and the collective efforts of government, implementing partners, civil society, and donors have carried forward those commitments into concrete, positive changes. In July 2014, the President opened the country’s first national family planning conference by favorably endorsing family planning as a key pillar to accelerating the social and economic transformation of Uganda. The Gates Foundation’s advocacy partners supported the participation of both high-level and district-level leaders and used the conference as a platform to mobilize them to renew their commitments to family planning and construct a road map to achieve them. The country’s costed implementation plan was launched four months later.

In September 2016, the Government of Tanzania shared an update on progress in achieving its policy, financial and program and service delivery commitments to FP2020.

The government reports performing the following activities in support of its financial commitment: 

• In the 2015-2016 time period, the government reports its honored its commitment by disbursing 1.186 billion Tsh. In 2016-2017, the government reports increasing its allocation for family planning to 5 billion Tshs. Advocacy at the sub-national level especially in low CPR regions has steadily increased with sub-national governments continuously acknowledging the role of family planning in their development plans.

In August 2015, the Government of India shared an update on its commitment to FP2020. Here are the government's responses. 

• 34 million eligible couples in India have been provided with modern contraceptives in 2014 (3.9 million female sterilization, 0.78 million male sterilization, 5.2 million IUCD insertions, 4.5 million condom users and 3.2 million [oral contraceptive pill] (OCP) users)

• India has already developed indigenous capacity, in public and private sector, to manufacture the entire range of family planning commodities in use under the national program. The procurement is done through federal funds. Commodities worth Rs. 254 crore (42.3 million USD) is being procured each year in the country.

• For 2014-15, the financial outlay under NHM was Rs. 18020 crore (3003 million USD). The country has differential share for high-focus and non-high focus states. States have now built the in-house capacity for training of providers and fund allocation. Under NHM rational deployment of human resource is one of the key conditionality for fund allocation. The financial outlay for family planning has increased by 45% from 2012 to 2014.

• The process of resource and budget allocation under NHM is a structured process where the states are provided the platform to discuss their budget with the national officials

• India has already launched National Urban Health Mission (NUHM), covering the urban poor population in the country. NUHM was launched in 2013-14.

• The detailed framework has been devised and shared with all the states of the country. National Rural Health Mission and National Urban Health Mission has been subsumed under the umbrella of National Health Mission. Each year, approx. Rs. 18020 crore ($3003 million USD) is approved under NHM. Rs. 2288.31 crore ($381.4 million USD) has been approved so far for infrastructural strengthening specifically under NUHM. The service delivery cost is covered for both urban and rural population under the NHM framework

• Annual costed plans covering all RMNCH+A activities are formulated in all districts, which are consolidated at the state level and further appraised at national level. To fulfil the gaps and effective implementation of family planning activities and to achieve Family Planning 2020 goals, all districts across the country were oriented, mentored and facilitated for development of their district action plans and further the costing was reflected and approved under the state PIPs. These district action plans were the result of detailed gap analysis for different resources needed to achieve FP 2020 goals (e.g. equipment, infrastructure, training needs, etc.)

• Besides helping in estimation of costs, the district action plans also acted as a guiding tool for structured implementation of planned activities. Moreover these plans augmented the rationalization of both human resources and logistics. The progress of implementation has been closely monitored through supportive supervision visits and report reviews thereon.