Monday, January 23, 2012

ATIP: CIDA and IPPF (Part 3)

Below I have scanned the Programme Goals and Objectives of the proposal to CIDA from IPPF for funding from the Government’s Muskoka initiative on maternal and child health initiative approved by Minister Oda (pages 7, 8, 9, part of page 10, and part of page 12).

I also referred to some of what is below, in my previous entry.

Sorry for the length of this entry.


Programme Goal
All people, particularly the poor, marginalized, the socially excluded, and underserved are able to exercise their right, to make free and informed choices about their SRH, and have access to SRH information, sexuality education and high quality services, including family planning, all of which are stigma-free, sensitive to gender dynamics and sexual diversity, and offer a positive approach to sexuality. (10)

1. To ensure access to IPPF quality-assured, client-oriented, rights-based and integrated package of SRH services including family planning, ante-natal care, STI prevention and care including HIV;
2. To ensure affordable community based outreach services and easy access to services, with a focus on the poor, marginalized and socially-excluded, stigmatized and underserved women and young people;
3. To ensure contraceptive and RH commodity security and to promote under-utilized and new contraceptive technologies;
4. To strengthen health systems through strong partnerships

Expected Results (11)
In partnership with CIDA, IPPF will deliver a comprehensive response to the Muskoka Initiative at two levels - globally and at country level. Globally, IPPF will drive the delivery of expected results and contribute to:
o Preventing the deaths of 1.3 million children under five years of age;
o Preventing the deaths of 64,000 mothers;
o Giving access to modern methods of family planning for 12 million couples

Through funding from the Government of Canada, IPPF's network of service delivery MAs based in 5 ountries (12) will deliver:
• 307,273 unintended pregnancies averted; (13)
• 1,229,092 CYPs provided by method including 98,971 IUD, 191,450 sterilization, 623,706 oral contraceptive pills, 140,511 condoms, 134,104 Injectables, 28,964 Implants, 10,438 Other Barrier Methods, 89 Other Hormonal Methods;
• 3,676,063 SRH services (excluding family planning) and provided by type of service: 186,623 gynaecological, 1,551,019 maternal and child health, 476,518 STI and RTI, 697,166 HIV and AIDS, 436,459 other SRH medical, 571 urological, 35,161 infertility;
• 5,738,052 SRH services including 3,245,485 family planning services provided to young people under age 25;
• 7,090,090 family planning (FP) services provided by method provided by type of service: 37,943 IUD, 19,192 sterilization, 5,196,801 oral contraceptive pills, 1,190,709 condoms, 511,674 Injectables, 67,440 Implants, 18,256 Other Barrier Methods and 568 Other Hormonal Methods;
• 1,321,938 HIV-related services provided along the prevention to care continuum
• 70 estimated percentage of Member Association's clients who are poor, marginalized and/or socially excluded.

A Logical Framework is presented at Annex 1 to demonstrate the programme's goal, objectives, idicators, targets, and contribution to the MDGs. Annex 2 includes a breakdown of these figures by member Association.

Strategy and Approach
IPPF proposes to scale-up services focused on delivering a core set of health outputs in 5 countries. We will drive the delivery of expected results in line with the Muskoka Initiative through IPPF's strategic Goal on Access. Our approach builds on IPPF's global experience of comprehensive family planning programming and the provision of integrated services, lessons learned and best practice hared among our network of MAs.

Objective 1: To ensure access to IPPF quality-assured, client-oriented, rights-based and itegrated package of SRH services including family planning, ante-natal care, STI prevention and care including HIV

Over 31 million clients, men or women, married or unmarried, young or old visit our 64,500 service delivery points every year. Every client visiting an IPPF service delivery point can expect to receive a holistic and integrated package of services. Clients arriving at our clinics for contraceptive services will typically be informed about other common SRH issues. They will also be offered the choice to be asked a set of rapid and standardized screening questions to elicit STI symptoms, safer sex practice, including condom use and voluntary counselling and testing (VCT), risks of gender-based violence, and as appropriate reproductive cancer screening history, such as cervical cancer. Additionally, every client coming to the service delivery points for non-contraceptive services will be asked about their contraceptive practices, family size and child-spacing desires. These services are essential integrated package of SRH services that IPPF MAs endeavour to make available at the primary level of care.

Our service delivery points are designed to be non-intimidating, as well as user and youth-friendly. They offer a safe space free from stigma and judgment. Our SRH information and services emphasize a positive approach to sexuality. In settings with a shortage of doctors, and whenever safe and effective, we train and provide supportive supervision to community-based health workers and mid-level providers to deliver specific procedures. This ensures that clients in resource-poor settings are still able to access high quality services from trained service providers.

• Quality-assured, client-centred care
Quality-assured and client-centred care means that clients' needs guide the planning and implementation of our services. IPPF services meet clinical standards, which require the commitment and expertise of clinic managers and service providers. We believe that clinic and programme tanagers, service providers and clients, all play a role in achieving quality-assured, client-centred care.

IPPF will strengthen the quality of care at service delivery points, taking into account our commitment to a holistic, no-missed opportunity and stigma-free approach through providing:

o Updated self-assessment checklist tool to reflect most recent technical developments.
o Guidelines and job-aids based on current global standards (WHO Medical Eligibility Criteria, Selected Practice Recommendations, or Decision Making Tool for Family Planning, including the tool for people living with HIV)
o A revised Quality of Care tools through revised edition of `IPPF Medical Service Delivery Guidelines, (14) which complements 'IPPF's Global Handbook on Family Planning. (15)

Objective 2: To ensure affordable community based outreach services and easy access to ervices, with a focus on the„poor marginalized and socially-excluded, stigmatized and underved women and young people

IPPF MAs are committed to ensuring easy access to services by using an integrated model of service delivery points, which are conveniently available to everyone, especially to the poor, marginalized, socially-excluded, stigmatized and underserved. All services are of quality, free of unnecessary administrative and medical barriers. People can choose from a wide range of SRH services and a large mix of contraceptive methods.

• Innovative outreach channels
Our MAs offer services through multiple channels, including static and mobile clinics, community-based distributors, retail outlets and other public and private-sector providers. IPPF's community-based health workers offer information and education as well as contraceptives such as condoms and oral contraceptives. They refer people to clinics for other contraceptives and SRH services. IPPF offer clients a larger mix of contraceptives, and in particular long-acting and reversible contraceptives (LARC), such as IUDs and implants, through mobile clinics.

We build the capacity of primary health care public and private-sector providers on new contraceptive technologies, supply them with contraceptive commodities where needed, and offer them regular technical support and supportive supervision. As grassroots organizations part of the national health system, IPPF MAs are committed to strengthening the health care system where they operate.

• Information and education
IPPF's high quality and accessible services are pointless if people do not know about them or want them. Demand generation will be conducted through a combination of channels, such as mass media, interpersonal and community channels, in order to maximize the effect of behaviour change communication (BCC). Instead of one-time BCC campaigns, we will ensure sustained healthy behaviour through continuous communication materials and campaigns.

Objective 3: To ensure contraceptive and reproductive health commodity security and to promote under-utilized and new contraceptive technologies

IPPF aims to deliver a continuous supply of a variety of contraceptives, so that clients can choose their preferred method without interruption whenever they want. Other SRH commodities needed to implement the integrated SRH package, such as antimicrobials for STI treatment, will also be secured. IPPF and our MAs will promote and offer under-utilized and new technologies:

o Oral contraceptives, emergency contraceptive pills and condoms are known to be challenging to use perfectly and consistently. These short acting methods will be readily available and accessible to people using such methods, including young people. J
o LARC (16) and surgical methods such as IUDs, vasectomy and bilateral tubal ligation, based on the needs of communities and the training needs of service providers.
o We will continue to participate in research and development initiatives with partners such as the World Health Organization (WHO), by piloting new service delivery models and contraceptive technologies, such as the Uniject injectable contraceptive that will be available by 2012. (17)

Objective 4: To strengthen health systems through strong partnerships.

IPPF MAs will continue to build on partnerships with key agencies, including Ministries of Health
(MOH), and UNFPA Country Offices to strengthen health systems. Most is participate in me annual planning meetings of their respective UNFPA Country Office and MOH, and play an important role as their implementing partner. (18) Many MAs play a critical role as national service providers on behalf of the government, with whom they have contractual arrangements.

Throughout the proposed initiative, IPPF MAs will continue to partner with key agencies, including
MOH and UNFPA Country Offices. In addition we will strengthen our collaboration with other national partners, such as:

o The national branch of the International Federation of Obstetrics and Gynaecology (FIGO), with whom IPPF also has a global Memorandum of Understanding. Many of our MAs' volunteers belong to the national FIGO branch, and will provide technical assistance through competency-based training on new contraceptives or quality of care supervision to our service providers;
o Public and private-sector providers will play an important role as implementing partners of the social franchising of our integrated SRH delivery models. We will give emphasis on training them on under-utilized and new contraceptive technologies;
o Training institutions, including nursing, midwifery, medical schools and MOH, to ensure that their pre-service training curricula are up-to-date with regard to contraceptive and SRH technologies, and quality of care standards.

10 IPPF Strategic Framework Goal 4: Access to SRH services.
11 The program expected results are based on expected results in 5 countries as presented in the Logical Framework Analysis at Annex 1
12 Member Associations selected work in OECD DAC recipient countries
13 Number of Pregnancies Averted is currently calculated using the impact calculator. The Impact Calculator is currently being used by the Futures Group to harmonize Couple Years of Protection conversion. Multiples of the three are generally used worldwide by USAID, WHO, and MSI. IPPF uses the lowest values so as to not inflate performance. If IPPF used the highest, its CYP would be 45 per cent higher.
14 'IPPF Medical Service Delivery' can be accessed at
15 Global Handbook on Family Planning' can be accessed at
16 LARC and surgical methods are known to be more cost-effective in terms of couple years of protection (CYP) than short-term methods, such as condoms, Injectables and oral contraceptive pills. LARC methods may be suitable for many clients but require frequent repeat visits.
17 Uniject has an integrated hypodermic needle and a small squeezable bubble-like container, Uniject has the potential to improve the safety and acceptability of injectable contraceptives given by service providers, and in particular by community-based distributors. Uniject will be easier for clients to self-administer their injectable contraceptive in the privacy of their home, which is in line with the demedicalization philosophy of IPPF.
18 UNFPA-IPPF collaboration is backed up by a global Memorandum of Understanding and action plan that was updated in July 2010 by both agencies.

(and this from page 12):

Eligible Countries
IPPF will deliver a comprehensive response to the Muskoka Initiative at the country level in Afghanistan, Bangladesh, Mali, Sudan and Tanzania. IPPF's Secretariat, through joint collaboration with Central and Regional Offices, will drive expected results globally in line with the Muskoka Initiative through IPPF's Strategic Goal on Access. The Secretariat will also manage the programme through offering technical expertise on comprehensive family planning and other SRH services, and the development, harmonization and implementation of the programme's main components. Central Office and Regional Offices will also support selected MAs in terms of technical assistance and capacity building. The Secretariat will support implementation in areas such as financial and human resources management, resource mobilization and monitoring and evaluation. 75 per cent of the programme budget will be allocated to MAs to deliver health outcomes in the 6 countries. The 6 MAs all fall into the list of 49 low-income countries identified in the Taskforce on Innovative International Financing for Health Systems (22) the Muskoka Initiative (23) and CIDA priority countries.

IPPF will ensure that no MA will use Canadian funds for abortion activity. In the past certain Governments have placed various legislative or policy restrictions on the use of funds, including for induced abortion services. IPPF has procedures in place that can immediately be reinstated to ensure that no funds from the Government of Canada are used for abortion services. This includes he holding of funds in a separate bank account.

22 The Taskforce on Innovative International Financing for Health Systems identifies 49 low-income countries where investments in national health systems would save four million children and babies annually, and up to 322,000 maternal deaths, and 193,000 adult HIV deaths.
23 The Muskoka Initiative is focused on achieving significant progress on health systems strengthening in countries with high burdens of maternal and under-five child mortality and an unmet need for family planning.

No comments:

Post a Comment