Elements of Family Planning Success

South Africa is one of the few developing countries with a national confidential inquiry into maternal deaths. 164 health facilities obtain audit data for stillbirths and neonatal deaths, and a new audit network does so for child deaths. Three separate reports have been published, providing valuable information about avoidable causes of death for mothers, babies, and children. These reports make health-system recommendations, many of which overlap and are intertwined with the scarcity of progress in addressing HIV/AIDS. The leaders of these three reports have united to prioritise actions to save the lives of South Africa's mothers, babies, and children. The country is off -track for the health-related Millennium Development Goals. Mortality in children younger than 5 years has increased, whereas maternal and neonatal mortality remain constant. This situation indicates the challenge of strengthening the health system because of high inequity and HIV/AIDS. Coverage of services is fairly high, but addressing the gaps in quality and equity is essential to increasing the number of lives saved. Consistent leadership and accountability to address crosscutting health system and equity issues, and to prevent mother-to-child transmission of HIV, would save tens of thousands of lives every year. Audit is powerful, but only if the data lead to action. (author's)

This study of Brazil has been commissioned by the Commodity Security and Logistics Division of the Global Health Bureau of the United States Agency for International Development (USAID), with Global Leadership Project funding, to identify important lessons learned following USAID's phaseout of Brazil as a recipient of contraceptive donations and other family planning funding. This document reports on the state of contraceptive security in Brazil, more than five years after USAID stopped donating contraceptives to the country. The report is based on interviews with key informants from the public, non-governmental organization and commercial sectors, a review of public policy and published documents, and databases of pricing information. In addition to lessons learned about phaseout, a summary of the current country situation, procurement practices, laws, policies, and regulations is presented. This information will help in the preparation of a procurement strategy for USAID presence countries and help these countries prepare for their eventual phaseout from USAID donations. (author's)

The Autonomous Region in Muslim Mindanao (ARMM) is one of the six administrative regions of Mindanao. It is composed of five provinces: Basilan, Lanao del Sur, Maguindanao, Sulu and Tawi-Tawi; and one city, Marawi. It has a population of more than 2 million, 98 percent of the population predominantly are Muslims. It is populated by five major ethnolinguistic groups, namely Yakan in Basilan, Maranao in Lanao del Sur and Marawi City, Maguindanaon in Maguindanao, Tausug in Sulu and Sama in Tawi-Tawi. With poverty incidence of 71.3 percent and a population growth of 3.86 percent (compared with the national average of 2.36 percent), the five provinces and one city are included in the most depressed provinces in the Philippines. The region regularly reports the lowest health and family planning (FP) statistics. According to the National Demographic and Health Survey, fully immunized child (FIC) coverage is at 44 percent (the national mark is 73 percent) while infant mortality rate is at 55/1000 live births (the national record is 35/1000 live births). Women using modern FP methods account for only 11.6 percent as compared to the national figure of 33.4 percent. Political instability, weak leadership, frequent armed conflicts and the geographic inaccessibility of many areas have made the delivery of health services difficult and unstable. (excerpt)

Over the last four years, the DELIVER project in Mali assisted the Ministry of Health (MOH) and its stakeholders to carry out appropriate activities to improve the program. Major achievements, described in this report, include logistics assessment, strengthening of the logistics management information system, and monitoring of national inventory. Throughout the life of the DELIVER project, supervisory visits were conducted by a team composed of DELIVER's resident advisor, a representative of the Direction de la Pharmacie et du Medicament, and a regional pharmacist. These visits contributed to the improvement of both the logistics system and human capacity. Through OJT, DELIVER was able to improve the skills of various personnel at all levels of the supply chain to enable them to carry out their duties. DELIVER worked to implement the Mali Strategic Contraceptive Security (CS) Plan by coordinating stakeholder activities, various Government departments, private-sector partners, and donors. In addition, DELIVER fostered engagement of political leadership for contraceptive security at all levels of Government, civil society, donors, decision makers, and opinion leaders. DELIVER carried out a number of studies and assessments in Mali to identify CS issues in general and logistics issues in particular. These assessments included the Logistics Indicator Assessment and Logistics System Assessment Tools, market segmentation, and informed buying. Some of the studies were aimed at finding solutions to CS issues and measuring the performance of the program. This report outlines major recommendations from these assessments. DELIVER also assisted the MOH in Mali over the last four years to estimate contraceptive requirements. These requirements were estimated for USAID-procured products but also for other donors such as the United Nations Population Fund. The Malian forecasting team is now able to do the estimation and procurement planning with little or minimal assistance from DELIVER. Important progress has been made in recent months in collecting dispensed-to-user data for the estimation of contraceptive requirements. Looking into the future, DELIVER has designed a transition plan for the Mission and the MOH. The DELIVER project closed out in September 2006. The transition plan covers the period October 2006 to September 2007 and is described in this report. (author's)

USAID funded the DELIVER project from 2000 through 2006. Implemented by John Snow Inc., the overarching aim of the project was to improve commodity security for health products in the public sector in developing countries. The project worked more with contraceptives than other product categories, but essential drugs, and drugs and diagnostic supplies also received significant attention. Based on needs that USAID had identified, the project carried out work under the following headings: logistics improvement; human capacity development; resource mobilization for commodity security; adopting advances in logistics technology; estimation of USAID's contraceptive needs; and operating USAID's contraceptive procurement database. (author's)

As part of the Madagascar president's plan for leadership and management training of neighborhood (fokontany) chiefs, this poster advertises upcoming training sessions on family planning and outlines their objectives. The goal of this training plan is to empower local leaders with grassroots development skills. The objectives listed on the poster are as follows: Overall Objective: Ensure leadership in promoting FP at community level Specific Objectives: 1. Know: Priority of Madagascar Action Plan Define Family Planning Advantages of Family Planning Barriers to Use of Family Planning Source and Method Mix 2. Know how to: Talk and promote Family Planning Take leadership role in mobilizing community actors Facilitate health and community workers work in Family Planning Orient couple toward Family Planning service providers

This article reviews 44 operations research projects aiming to improve reproductive health services in Guatemala, conducted by the Population Council from 1988 to 2001. It documents the experience of the research programme, traces the extent to which research results are identifiable in existing programmes, and analyses factors influencing utilization. Utilization of research results occurs as a gradual process of information sharing, where researchers influence decision-makers through a continual stream of information rather than a single set of findings. Utilization depends on leadership, collaborative planning and implementation, close monitoring, and feasible research designs, among other factors. To influence policy formulation, organizations should form enduring links among institutions and develop critical research skills among personnel who collaborate with or manage service programmes. To understand how operations research affects policy and programme change, one must consider not just individual projects, but rather the synergistic impact of multiple projects on a broad range of themes over time. (author's) | This article reviews 44 operations research projects aiming to improve reproductive health services in Guatemala, conducted by the Population Council from 1988 to 2001. It documents the experience of the research programme, traces the extent to which research results are identifiable in existing programmes, and analyses factors influencing utilization. Utilization of research results occurs as a gradual process of information sharing, where researchers influence decision-makers through a continual stream of information rather than a single set of findings. Utilization depends on leadership, collaborative planning and implementation, close monitoring, and feasible research designs, among other factors. To influence policy formulation, organizations should form enduring links among institutions and develop critical research skills among personnel who collaborate with or manage service programmes. To understand how operations research affects policy and programme change, one must consider not just individual projects, but rather the synergistic impact of multiple projects on a broad range of themes over time.

Through its numerous contacts in Latin America, the Leadership, Management and Sustainability (LMS) program identified a strong interest and need for more discussion around the topic of financial sustainability within reproductive health programs and organizations. In order to take advantage of the existing expertise and experiences in the region, the Global Exchange Network (GEN) engaged NGOs in Latin America who have achieved financial sustainability to document and share their experiences through a virtual forum. A two week forum was held on the GEN website in June that centered around the discussion of a document on financial sustainability written by Dr. Colindres as well as the experience of three Reproductive Health NGOs in Latin America. Out of 294 registered participants, 161 actively participated in the forum. The primary themes that emerged during the forum discussion were: establishing a culture of financial sustainability, service quality, management and leadership, the role of the state and the role of the private sector. The comments shared in the forum discussion and the large numbers of active participants serve to reinforce the perception that the topic of financial sustainability of reproductive health programs is very relevant and of particular interest to many organizations in Latin America. (excerpt)

The Global Exchange Network for Reproductive Health (GEN) is a virtual network of the USAID-funded Leadership, Management and Sustainability Program, implemented by Management Sciences for Health. Its goal is to contribute to improving the capacity and effectiveness of family planning and reproductive health programs and organizations by supporting the exchange of information about the management, leadership and organizational processes necessary to improve organizational sustainability and service quality. GEN has held a variety of virtual events such as conferences and forums to promote knowledge exchange between reproductive health practitioners and advocates. (excerpt)

As global demand for family planning (FP) services and supplies increases, more countries are preparing strategies for achieving contraceptive security (CS)--the point at which people are able to choose, obtain, and use high-quality contraceptives and condoms whenever they want them for family planning and HIV/AIDS/STI prevention (USAID, 2004). Many countries attempting to achieve contraceptive security operate under a decentralized healthcare or political structure, which gives rise to challenges and opportunities that differ from those associated with centralized initiatives. This brief is intended to help national and subnational governments and program managers to work together to achieve their countries' CS goals. Even when authority and responsibility are transferred to lower levels of government, a successful CS initiative still requires the central government's leadership, commitment, and coordination. This brief is organized into five areas that focus on issues to be addressed while aiming to achieve contraceptive security at lower levels of government: (1) policy; (2) strategic planning; (3) finance; (4) logistics, procurement, and management of human resources; and (5) community participation. In each area, the brief proposes strategies for capitalizing on the opportunities for working in decentralized setting while addressing the associated challenges. Also included are examples of countries that have been successful in making progress toward contraceptive security in decentralized settings. However, CS initiatives do not occur in a vacuum; therefore, the recommendations proposed in this brief should be considered within the broader health and political framework. (excerpt)

China's family planning program ranks as history's most intensive effort to control national population growth. While many have lauded China's effort to limit births as a fundamental part of its sustainable development goals, the population policy has also generated much international criticism. A long overdue reform of its approach to implementing the family planning program has begun to re-focus the program on client needs, informed choice of contraceptives, and better quality services. Originally inspired by the Cairo ICPD conference, the reform program began as a pilot project among six counties and has now become a blueprint for re-orienting the national family planning program. This article reviews the process by which a small innovative pilot project was scaled up into a national reform effort and the lessons learned about scaling up sensitive but needed innovation in a difficult political environment. These lessons include the importance of local ownership, adapting concepts to make them locally meaningful, careful choice of pilots to ensure success, strategic use of political networks, cultivating and educating allies in senior leadership positions, strategic use of donor funding and technical assistance, and the willingness to transfer project management to a new generation. (author's)

The two-day workshop focused on strengthening the quality and viability of the participants' practices by improving business skills, access to credit, and introducing participants to essentials of quality improvement. Workshop objectives were as follows: Apply tools and approaches to improve the quality of RH/FP services provided; Identify ways to increase the number of family planning clients who seek the services of the private midwife; Create a strategy to improve the viability and sustainability of the midwife's clinic; Understand basic principles of financing and how to approach banks for business loans; Understand the opportunities by which mechanisms (e.g., franchises and networks) to work in groups can be strengthened; Assess the interest level of midwives in their country to enter or expand their private practices; Provide leadership to other midwives in their countries who are interested in entering or expanding their private practices. (excerpt)

In 2000, USAID/Nicaragua asked that the Quality Assurance Project (QAP) work with PROFAMILIA, the private sector provider of reproductive health services with a network of 17 clinics throughout the country, to develop a quality assurance program. QAP was already engaged in supporting quality assurance activities with the Ministry of Health in two SILAIS heavily affected by Mitch, Matagalpa and Jinotega. QAP first conducted a quality awareness seminar for PROFAMILIA's senior staff in the fall of 2000. Subsequently, PROFAMLIA accepted QAP's invitation to conduct some initial assessment activities. Suggestion boxes were placed in each of PROFAMILIA's 11 clinics in January 2001, with feedback forms asking about availability of services desired, affordability, waiting time, and quality, to collect feedback from clients. QAP conducted exit interviews with 1119 clients and in-depth interviews with 117 clients in 12 clinics, covering how the patient was treated and perceptions of quality, cleanliness of the facility, affordability, costs, accessibility, level of satisfaction with the services received, and reasons for seeking care at the particular clinic. QAP also commissioned a series of focus groups in the communities surrounding seven of PROFAMILIA's clinics with non-users of PROFAMILIA's clinics, and used mystery clients to get a sense of how patients were treated. (excerpt)

The most relevant stakeholders (such as government officials, civil-sector leadership, health professionals, education leaders, and youth groups) are informed and encouraged to support peer education efforts. Youth are actively involved in the planning process. Their needs and preferences are identified and are used to define the programme. Key contextual concerns (such as gender, sociocultural factors, vulnerability, and age) are considered and appropriately incorporated into the plan. Working goals and objectives and an operations plan are developed, and practical refinements are made. Target audiences (those who can benefit from and be reached by the programme's offerings) are identified. The needs of the target audience are assessed through surveys, focus groups, and informal means, with relevant representation of the group included. Resources needed to deliver programme activities (based on programme needs) are identified as available, obtainable, or as existing gaps. (excerpt)

In response to a request from USAID, the Management and Leadership (M&L) Program of Management Sciences for Health (MSH) created the Global Exchange Network (GEN) for Reproductive Health to support countries that no longer receive population and reproductive health funding from USAID: countries that have "graduated" from USAID assistance. The goal of the Global Exchange Network is to encourage the exchange of ideas, lessons learned and good practices in the area of reproductive health and family planning in the countries that have received or receive population funds from USAID. One of the primary activities of the Global Exchange Network in 2004-2005 was the planning and implementation of a virtual conference led by organizations in the three "graduated countries" of Colombia, Ecuador, and Mexico, and supported by MSH. The Latin American Virtual Conference was the first virtual conference to have ever been conducted by MSH and the Latin American partners. It proved highly successful and participants have requested more exchanges such as this one. It was agreed that a three-day conference would be held and that each country would present two successful experiences or lessons learned in adolescent reproductive health where they had implemented an interesting approach and had produced demonstrated results. (excerpt) | En respuesta a un pedido de la Agencia Estadounidense para el Desarrollo Internacional (USAID, United States Agency for International Development), el Programa de Gestión y Liderazgo (M&L, management and leadership) de Ciencias de Gestión de la Salud (MSH, management sciences for health) creó la Red Global de Intercambio (GEN, Global Exchange Network) para la Salud Reproductiva a fin de apoyar a aquellos países que hayan dejado de recibir fondos de USAID para la población y para la salud reproductiva: los países que se han ?graduado? en la asistencia de USAID. El objetivo de la red es alentar el intercambio de ideas, lecciones aprendidas y prácticas eficaces en las áreas de salud reproductiva y planificación familiar en los países que han recibido o reciben fondos de USAID para la población. Entre las principales actividades de la red durante el período 2004-2005 se incluyeron la planificación e implementación de una conferencia virtual realizada por organizaciones de los tres ?países graduados? (Colombia, Ecuador y México) y apoyada por MSH. La conferencia virtual latinoamericana fue la primera conferencia virtual realizada en forma conjunta entre MSH y socios latinoamericanos. La iniciativa resultó sumamente satisfactoria y los participantes han solicitado que se multipliquen los intercambios de este tipo. Se acordó realizar una conferencia de tres días en la que cada país presentará dos experiencias exitosas o lecciones aprendidas a nivel de salud reproductiva en adolescentes, área en la que han implementado una interesante metodología y obtenido probados resultados. (extracto)

The Management and Leadership (M&L) Program implemented by Management Sciences for Health (MSH) is pleased to present its Final Report, covering the five-year period of the cooperative agreement, from October 2000 to September 2005. Funded by the Office of Population and Reproductive Health of the U.S. Agency for International Development (USAID), the program was designed to: improve the performance of leaders and managers; the performance of organizational and programmatic management systems; and improve the ability of organizations and programs to anticipate and respond effectively to the changing external environment. M&L works with teams, managers, and leaders in many settings?from senior ministry officials to village health workers. Beneficiaries have been public sector employees, staff from donor organizations, hospital workers, elected officials, community leaders, and non-governmental (NGO) managers. All have a role in providing high quality family planning and other health services to women, children, and families. In its five years of implementation, M&L has completed many activities, several of which are highly innovative approaches to leadership and management development. This report provides summaries of each of the substantive activities and programs in which M&L has engaged, and results achieved, including outcomes at the service delivery level. In addition, instructions are provided on how to access more detailed information and products developed by M&L through various Web-based resources at MSH and USAID. The first four sections of this report are organized according to M&L?s four strategic directions implemented with core funds from USAID/Washington: Developing Capacity of Individuals and Teams to Lead and Manage; Improving Management Systems; Partnering Locally for Sustainability; Capturing and Applying Knowledge. (excerpt) | EL Programa de Gestión y Liderazgo (M&L, Management and Leadership) implementado por Management Sciences for Health (MSH) se complace en presentar su Informe Final, que abarca el período de cinco años de acuerdo cooperativo (desde octubre de 2005 a septiembre de 2005). Fundado por la Oficina de Población y Salud reproductiva de la Agencia para el Desarrollo Internacional de Estados Unidos (USAID), el programa se diseñó a fin de mejorar: el desempeño de líderes y directores; el rendimiento de los sistemas de gestión de programas y organizaciones; la capacidad de las organizaciones y los programas para anticipar y responder con eficacia al cambiante entorno externo. M&L trabaja con equipos, directores y líderes en muchos entornos: desde funcionarios senior en los ministerios a trabajadores de la salud de los distintos poblados. Los beneficiarios son empleados del sector público, personal de organizaciones donantes, trabajadores de hospitales, funcionarios electos, líderes de la comunidad y directores de organizaciones no gubernamentales (ONG). Todos desempeñan un papel en proveer planificación familiar y otros servicios de salud de calidad a mujeres, niños y familias. En sus cinco años de implementación, M&L ha completado muchas actividades, muchas de las cuales son enfoques muy innovadores con respecto al liderazgo y al desarrollo de gestiones. Este informe presenta un resumen de cada una de las actividades y programas destacados en los que M&L ha participado y de los resultados alcanzados, entre ellos, los que se refieren al nivel de prestación de servicios. Además, se imparten instrucciones sobre cómo acceder a información más detallada y a productos desarrollados por M&L a través de diversos recursos electrónicos en Management Sciences for Health y en USAID. Las primeras cuatro secciones de este informe se organizan según las cuatro direcciones estratégicas de M&L implementadas con fondos centrales de USAID de Washington: desarrollo de la capacidad de personas y equipos para liderar y gestionar; mejoramiento de los sistemas de gestión; asociaciones locales para la sostenibilidad; captura y aplicación de conocimientos. (extracto)

At the request of USAID Washington, Management Sciences for Health?s (MSH) Management and Leadership (M&L) Program developed the Global Exchange Network (GEN) for Reproductive Health. GEN is a virtual network designed to foster and sustain virtual exchange and sharing among reproductive health decision makers, policy-makers and service providers in countries no longer receiving USAID reproductive health and population funding. At the end of years of support USAID continues to be interested in supporting an exchange of information between ?graduated countries? and USAID. GEN activities frequently include professionals from reproductive health organizations from other countries as well. Morocco is one of the countries no longer receiving population support from USAID. In 2004, M&L began to work with the Moroccan Ministry of Health (MOH) to encourage Morocco?s participation in the GEN Network in order to share its many important experiences in reproductive health and family planning that the country. The Moroccan MOH also operates the regional bureau of Partners in Population and Development and was actively strengthening its capacity to provide south to south technical exchange and disseminate its experience and expertise. MSH met with the MOH in April 2004 to explore ways of creating south to south information exchanges in the context of the GEN network. Based on these discussions and support from USAID Morocco and USAID M&L funds, the MOH and MSH formed a partnership to deliver an international virtual conference on Safe Motherhood. (excerpt) | À la demande de l'USAID/Washington, Management Sciences for Health (MSH), sous l'égide de son programme " Management & Leadership " (M&L), a créé le Réseau mondial d'échanges (GEN) pour la santé reproductive. Le GEN est un réseau virtuel ayant pour mission d'encourager et de perpétuer l'échange et le partage par voie virtuelle d'informations entre les responsables de la santé reproductive, les décideurs et les praticiens dans les pays qui ne reçoivent plus de soutien financier de la part de l'USAID en matière de population et de santé reproductive. Au bout du nombre prévu d'années d'assistance, l'USAID souhaite perpétuer l'échange d'informations entre les pays ayant bénéficié de son soutien et ses antennes. Dans le cadre de ses activités, le GEN fait souvent appel à des professionnels appartenant à des organisations de santé reproductive dans d'autres pays. Le Maroc est un des pays qui ne bénéficie plus du soutien de l'USAID en matière de population. En 2004, M&L s'est associé au Ministère marocain de la santé pour inciter ce pays à entrer dans le réseau GEN, afin de partager avec le reste du monde son important savoir-faire en matière de planification familiale et de santé reproductive. Le Ministère marocain de la santé, qui dirige également le bureau régional de " Partenaires pour les Populations et le Développement ", s'efforçait alors d'améliorer sa capacité à fournir un échange technique sud-sud en vue de mieux partager son expérience et son expertise. En avril 2004, MSH a rencontré le Ministère pour envisager les moyens de créer des échanges d'informations sud-sud sous l'égide du réseau GEN. Grâce à ces discussions et au soutien financier de l'USAID/Maroc et de l'USAID/M&L, le Ministère de la santé et MSH ont établi un partenariat dans le but d'organiser une conférence virtuelle internationale sur la Maternité sans risques. (extrait)

The Local Enhancement and Development for Health (LEAD) project was designed by USAID/Philippines to support its IR 1 and IR 4 under strategic Objective 3 (Desired family size and improved health sustainability achieved). The project is expected to cover 530 municipalities and cities (Local Governmental Units or LGUs) over a three-year period (2004-2007), covering around 40% of the population of the Philippines, and 80%of the barangays in each LGU. There is also a special emphasis on Mindanao. Dr Ronald Magarick and Dr. Ricky Lu of JHPIEGO joined Dr. Douglas Huber of Management Sciences for Health (MSH) in providing analytic leadership and perspectives in developing strategies to improve contraceptive prevalence, and in the design of training and provider performance interventions. Teams visited a number of rural health units (RHUs) and district hospitals in Cebu, Bago, Davao, Bacolod, Negros Occidental and Tanza. During these visits, discussions were held with service providers, supervisors and administrators regarding both longterm and spacing methods of contraception. The purpose of the visits were to better understand provider performance and the resources to support them, and identify opportunities for LEAD to focus its resources to improve access and quality of FP services. The team made recommendations in ares relating to the strengthening the performance of midwives, nurses and physicians providing family planning services, including approaches to strengthen the provision of long-term and permanent methods of contraception (NSV, minilaparotomy, injectable contraception). The team also reviewed the numerous existing training materials and recommended how each could be strengthened or revised. (excerpt)

The death toll from the recent tsunami is staggering, straining an already fragile health system. But the disaster threatens to overshadow an equally tragic?and far less talked about?reality. Every year in the developing world, millions die from preventable health problems. While hundreds of millions of dollars have been generously donated to help tsunami victims, millions more are needed to address devastating and preventable diseases like malaria, tuberculosis, and HIV/AIDS. Around the world, MSH is working to create long-term, sustainable solutions to public health challenges. In Indonesia, we?ve helped develop systems that extend the reach of health care throughout the nation and a practical approach to support a complex and evolving health infrastructure. MSH worked with senior health ministry staff to frame the definition of essential public health functions and developed a system that allowed the government to categorize what services were being provided in each of its 420 districts and municipalities to ensure that Indonesia was meeting its national and international obligations. At the district level, MSH developed and implemented a program called PROSPEK, which helps managers assess and improve the performance of essential public health services. Working in partnership with USAID and other donors, the ministry intends to apply PROSPEK in other districts and municipalities. (excerpt) | L'énormité du bilan du récent tsunami a poussé à bout un système de santé déjà fragilisé, mais cette catastrophe risque d'éclipser une réalité tout aussi tragique et moins médiatisée. Chaque année, des millions de personnes meurent de problèmes de santé évitables dans les pays en voie de développement. Alors que la communauté internationale s'est mobilisée pour recueillir des centaines de millions d'euros pour les victimes du tsunami, une contribution sur la même échelle est nécessaire pour répondre à des maladies dévastatrices et évitables comme le paludisme, la tuberculose et le VIH/SIDA. Partout dans le monde, MSH se consacre au développement de solutions à long terme durables pour relever les défis qui menacent la santé publique. En Indonésie, nous avons contribué au développement de systèmes permettant d'étendre les soins de santé à tout le pays et favorisé une approche pratique pour soutenir une infrastructure de santé complexe et en constante évolution. Afin de garantir que l'Indonésie se conforme à ses obligations nationales et internationales, MSH a collaboré avec de hauts responsables du ministère de la santé en vue de définir les fonctions publiques essentielles en matière de santé et développer un système qui permette au gouvernement d'établir une classification des services fournis dans chacun des 420 districts et municipalités. Au niveau des districts, MSH a développé et mis en ?uvre le programme " PROSPEK " afin de permettre aux managers d'évaluer et améliorer les performances des services publics essentiels en matière de santé. En collaboration avec USAID et d'autres donateurs, le ministère prévoit d'appliquer PROSPEK dans d'autres districts et municipalités. (extrait) | El número de víctimas fatales del reciente tsunami fue tan abrumador que agotó buena parte de los recursos de un sistema de salud ya frágil. Sin embargo, el desastre amenaza con eclipsar una realidad igualmente trágica y mucho menos publicitada. En los países en vías de desarrollo mueren cada año millones de personas por problemas de salud prevenibles. Si bien se han donado generosamente cientos de millones de dólares para ayudar a las víctimas del tsunami, se requieren otros tantos para responder a enfermedades tan devastadoras y prevenibles como la malaria, la tuberculosis y el VIH/SIDA. Management Sciences for Health trabaja en todo el mundo para generar soluciones sostenibles a largo plazo a los desafíos de salud pública. En Indonesia, el organismo ha ayudado a desarrollar sistemas que extienden el alcance de la atención de la salud a toda la nación y un método práctico para apoyar una infraestructura sanitaria compleja en plena evolución. MSH trabajó con el personal más experimentado del Ministerio de Salud para configurar la definición de las funciones esenciales de salud pública y desarrolló un sistema que permitió al gobierno categorizar los servicios que se estaban prestando en cada uno de sus 420 distritos y municipios para garantizar que Indonesia cumpliera con sus obligaciones nacionales e internacionales. A nivel de los distritos, MSH desarrolló e implementó un programa denominado PROSPEK, que ayuda a los directores a evaluar y mejorar el desempeño de los servicios esenciales de salud pública. Trabajando en forma mancomunada con USAID y otros donantes, el ministerio pretende aplicar el programa PROSPEK en otros distritos y municipios. (extracto)

Many countries face the challenge of meeting people?s rising demand for contraceptives, including condoms, and other essential reproductive health supplies. Attention was first drawn to the challenge by projections of shortfalls in the financing required to pay for these supplies. The problem, though, is often not only one of financing, but also of disruptions and vulnerabilities in the many systems that need to work well, work together, and have the resiliency to adapt to changes to ensure that reproductive health supplies are available to people. SPARHCS (pronounced ?sparks?) ? Strategic Pathway to Reproductive Health Commodity Security ? is an approach to help countries address these concerns and develop and implement strategies for reproductive health commodity security (RHCS). During the 2001 conference Meeting the Reproductive Health Challenge: Securing Contraceptives and Condoms for HIV/AIDS Prevention, held in Istanbul, donors and countries called for a common approach and framework to operationalize RHCS. In response, under the leadership of the U.S. Agency for International Development (USAID) and United Nations Population Fund (UNFPA), a wide range of collaborating agencies provided technical inputs, participated in workshops, and assisted with field tests to develop SPARHCS. (excerpt)