Strengthening Linkages Between the Franchise Program & the Public Health System through A Total Market Approach (TMA) PACE UGANDA APPROACH FOR INCREASING ACCESS TO LARCs, By Dr. Dorothy Balaba October, 2014

BACKGROUND Uganda’s MDG 5b target: Increase Contraceptive Prevalence Rate from 30% in 2011 to 50% in Public (47%) and private sectors (45%) are the key sources of modern contraception (UDHS 2011). CPR method mix is dominated by short-term methods PACE’s WHP Goal: Contribute to the increase of the national IUD-specific CPR from 0.5% in 2011 to 3% in page 2

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LARC health market page 4 Public sector (38.9%) Private sector (50.4%) Others sources (7.2%) Hospitals (7%) Health Center IV & III (21.9%) Family planning clinic (5.4%) Out reach (4.6%) Hospitals/clinics (46.3%) outreach (4.1%) Friends and relatives( 7.2% ) Source UDHS 2011

Total Market Approach Targeting all varying segments of the populationTargeting all varying segments of the population based on their socio-economic status and willingness/ ability to pay Engagement of all key playersEngagement of all key players Public, social franchise, commercial sectors, at all levels both national, district and community to scale up LARCs service provision. Good coordination by MOH, Good coordination by MOH, of a strong health system, for the purpose of increasing the uptake of IUD Functional data managementFunctional data management system, that can monitor progress accurately. page 5

DESCRIPTION OF INTERVENTION Identifying district with social franchiseIdentifying district with social franchise ProFam, Blue star and Good life social franchise Create partnerships with GovernmentCreate partnerships with Government: Sign MOU with MOH and districts to commit MOH and DHTs to take lead in strengthening national & district coordination of all players at all levels Partner with Family Planning Consortium of NGOs (UFPC)Partner with Family Planning Consortium of NGOs (UFPC) for advocacy, capacity building, social franchising, service provision for LARCs. Use public, private partnershipUse public, private partnership, based on the comparative advantage, for equity and sustainability page 6

DESCRIPTION OF INTERVENTION –Joint forecasting of IUDs required supplies and equipment all sectors both Public sector and Private ( social franchising) and maintaining a supply chain –Dedicated, skilled and motivated service providers especially in the public sector, (Government mentors who facilitated to supervise health workers –Baseline survey conducted in 30 districts (facility preparedness) –Demand generation Utilizing IPC,VHT satisfied users referring clients to both public and private page 7

GEOGRAPHICAL COVERAGE: 20 TMA DISTRICTS page 8

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RESULTS OF THE INTERVENTION page 10

LESSONS LEARNED The TMA has potential to strengthen the public and private working relationship Joint forecasting and planning for both the public and private is critical if we aim to grow the IUD total market. District leadership is key in ensuring good supply chain management and ensuring that providers are motivated to provide LARC With the TMA there is high potential of growing the IUD CPR. strengthening data management. page 11

NEXT STEPS Development of a National FP work-plan using TMA principles by the Ministry of Health (ongoing). page 12

Thank you! PAGE 13