Tanzania National Family Planning Costed Implementation Program (NFPCIP)

Presentation Outline Our Reproductive Health Situation Issues and Challenges in Family Planning NFPCIP – Rationale, Development Process, Strategic Objectives, and Funding Estimates Next Steps: From Planning to Action

RH Situation

A Consistently High Fertility Rate

45% under the age of 15 A Young Population soon to be in their reproductive years... Percent of the population Age in years

Persistent High Maternal Mortality Ratio

Increasing Demand and Constantly High Unmet Need

A Slowly Rising Modern CPR

Key Issues and Challenges Facing Family Planning

Declined Annual CPR Growth Rate Over Time

Program Attributes during the Golden era  Heavy Donor Support – Direct Funding  Centrally Managed Vertical National Program  Strong National Communication Campaign – Green Star  Well executed National FP Training Strategy  Active Engagement of NGOs/FBO in Service Delivery  Strong National CBD Program

What Happened? Global Factors Reduced Donor Support Sector Reforms - Shift from Direct to Basket Funding -Decentralization -Integration in RCH Competing Health Priorities - HIV/AIDS - Infant deaths - Malaria Considerably Underfunded Program

Issues and Challenges (1) Contraceptive Security: Contraceptive availability not meeting current demand Method Mix highly composed of short-acting methods which raise costs considerably Human Resources: Critical Shortage of Human Resources - 35% capacity Inadequate number of providers with updated/optimal FP training Knowledge-Use Gap: High level of awareness of FP does not equal use of FP services

Issues and Challenges (2) Service Delivery Systems Infrastructure Limitations to offer accessible and comprehensive FP services Missed Opportunities as a results of inadequate integration with other health services Functioning community-based distribution confined to very few areas Social Marketing program limited to few methods – pills and condoms

The NFPCIP Rationale, Development Process and Strategic Objectives

Renewed Focus on MNCH The National Road Map To Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania

Rationale for the NFPCIP Goal: Increase Contraceptive Prevalence Rate to 60% by 2015

Repositioning Efforts Advocacy at various levels Re-establishment of the National FP Working Group in 2008 Nationwide training efforts Enhanced Social Marketing Increasing role of Private sector Missing Link?!

Overview of the NFPCIP Costed strategic actions that sets direction on what needs to be done to achieve the national target Call for a Renewed Commitment, Partnership and Coordination among all partners to reposition FP

Participatory & Consultative Development Process

Development Process Overview & Timeline PHASE I: Gathering and Synthesizing Information PHASE II: Planning and Drafting the Plan PHASE III: Production and Launch March 2009 March 2010 June 2009

Purpose of the NFPCIP 1.Strengthen FP as a priority area in the National Development Agenda 2.Understand the budgetary needs to implement a FP program to reach projected targets 3.Mobilize and sustain quality resources 4.Prioritize FP program strategic actions for implementation 5.Provide benchmarks and indicators to monitor and support the FP program

Strategic Objectives Contraceptive Security Capacity building of providers Strengthened service delivery systems Advocacy and Demand Generation Strengthened health systems management

Cost Estimates by Strategic Area (In USD$) Strategic Action AreaTotal Percentage Of Total Budget Contraceptive Security & Logistics89,873,49991% Capacity Building4,210,1324% Service Delivery2,105,8182% Advocacy1,639,9932% Management Systems/ M&E830,5411% Total ( In USD$)98,659,985 ***Central Budget Only

Cost Estimates by Year (In USD$) YearUSD$ FY ,547,160 FY ,493,092 FY ,602,217 FY ,041,735 FY ,513,809 FY ,461,971

Key Points - Resource Estimates Central Government Budget Local Government (District) Budget NFPCIP CCHP

Key Points - Resource Estimates (2) Not Included: Salaries for Human Resources and Infrastructure costs Equipment and Supplies except for Commodities District Level Budget Areas of Priority Focus: Meet Current Demand by Strengthening Supply System Implement integration of FP Service delivery across the health sector Address knowledge-use gap issues Implement sustainable measures to practical approaches such as CBD of FP, demand generation

Next Steps: Planning to Action By July 2010, Performance Monitoring Plan - Resource Mobilization - Program Implementation Progress Quarterly Progress Reporting to MOHSW Management Revisiting Terms of Reference of National FP Working Group