1. Grappling with the realities of Changing Environment for IDA for RH Commodities - Ghana Presented at the 7 th Semi-Annual Membership Meeting of the RH Supplies Coalition April 27-28, 2007 London

2. Ghana Contraceptive Financing Gap 2004 - 2010

3. 2003200420052006Total USAID$2.57 m$2.55 m$1.72 m$3.9 m$10.74 m DFID$1.55 m$1.86 m$0.9 m$0.5 m$4.81 m UNFPA000$1 m$1.0 m MOH$1.57 m$0.66 m$1.85 m$1.0 m$5.09 m Total$5.69 m$5.07 m$4.47 m$6.4 m$21.63 m Contraceptive Financing Background

4. Who was funding contraceptives?

5. YearTotal Requirement (US $) Commitment (US $) Funding Gap (US $) 20076.01.8 (DFID $0.7m, USAID $1.1m) 4.2 20086.50.2 (DFID) 6.3 20097.70 20108.10 20118.30 TOTAL$36.6$2.0 $34.6 2007-2011 Funding requirements, commitments and Gap

6. Challenges of New IDA Potential Competition for funds with other programmes – Health funds –Commodities –Programme Activities, overwhelmed & understaffed Assessing funds outside the Health fund –E.g. DFID funds for condoms with Ghana AIDS Commission Inadequate Transparency from donors –Unpredictable donor funding - “Withdrawal” plan (general and commodity specific) –Funds with unknown “conditionalities” – e.g. will not/ canot be used to purchase certain commodities. –Dealings with other partners sometimes not known to programme staff. Lack of funding for RH/FP from new funding initiatives e.g. Global fund

7. Ghana’s “Be Safe” Male Condom DFID supported male condoms for public and social marketing programme from 2002-2006. Opportunity to change/beautify foil of male condoms. Public sector with PPAG –introduced new foil “Be Safe” with family planning and STI/HIV logos denoting dual protection, to replace plain white “No Logo” condoms previously donated by USAID Have had to go back to “No Logo” from USAID as a stop-gap measure to forestall shortage while new procurement arrangements for are being made to re-instate “Be Safe” Female Condom mostly supported by Government procurement

8. Responses to challenges ICC/CS proactive in addressing problems e.g. “No Logo” condoms from USAID as a stop gap measure for “Be Safe” male condoms. Strengthen Advocacy role of ICC/CS Increased “ring-fencing” of funds for procurement of contraceptives in MOH budget Source funding to implement strategy on CS Financial Sustainability plan for CS drafted Implement “Road Map” for Repositioning of Family Planning (Multi sectoral response)

9. Lessons and insights for the future Confirm donor commitments Identify new partners (International and local) Raise profile of Family Planning –Need for dedicated and sustained fund for RH Commodities – Advocate for FP through collaborating with the MOH/GAC/NPC as one voice for funds outside of the MoH budget –Create a contraceptive development fund within the MoH National Health Insurance –Cover all FP commodities and condom for STI and HIV prevention –Improve the NHIS to eliminate the ‘cash and carry’ system as a health financing mechanism Need for Increased transparency and dialogue between donors and local counterparts (including programme level) Need for integration of RH/FP with HIV/AIDS Advocate for multi donor budget support Need for gradual withdrawal of funding from traditional donors Diversification of funding sources Self procurement Monitoring and Evaluation

10. Thank you for your attention Presented by Dr. Gloria Quansah Asare Ghana