Ministerial Policy Dialogue

2011 Dakar High-Level Meeting (HLM): “Realizing the Demographic Dividend for the Health and Wealth of Nations”

Partners in Population and Development Africa Regional Office (PPD ARO), in partnership with USAID, The World Bank, the Bill and Melinda Gates Foundation, UKAID, Pledge Guarantee for Health, the United Nations Foundation, UNFPA, the Ministerial Leadership Initiative and Advance Family Planning jointly organized a one-day high-level meeting on 30 November on the topic of “Realizing the Demographic Dividend for the Health and Wealth of Nations.”

This meeting was held as a closed session of the Second International Family Planning Conference held from 30 November 30 to 2 December 2011 in Dakar, Senegal at Le Meridien Hotel.

The Dakar HLM brought together approximately 200 participants including ministers of finance, health, economic planning, members of parliament and experts from within sub-Saharan Africa, with a particular emphasis on inclusion of those from Francophone Africa.

The meeting objectives included:
•    South-South knowledge transfer in sub-Saharan Africa;
•    Shared vision for and commitment to addressing health and development challenges in the region and at the country level; and
•    Development of avenues for gaining broader and longer-term support for country initiatives and national government commitments.
•    Post-conference, we expect to see national initiatives and policy directions reflecting new commitment to universal access to reproductive health in consideration of how the demographic dividend can be achieved in sub-Saharan African countries

In addition to the opening ceremony, the sessions of the meeting included: Advancing Economic & Social Development with the Demographic Dividend, Realizing Health & Wealth: Investing in Adolescents & Youth, and Maximizing the Demographic Dividend Now & in the Future.

The first international conference on family planning in November 2009 in Kampala, Uganda, focused new attention on the critical role of family planning in reducing maternal mortality, improving gender equity and increasing socioeconomic development. Following on the high-level meeting on maternal health in Addis in October 26, 2009, the conference reinforced for policymakers that family planning was an essential component of health and development policy. Since the Kampala conference, the African Union turned its attention to maternal health through the Campaign to Accelerate Reduction of Maternal Mortality in Africa (CARMMA) and renewal of the landmark 2006 Maputo Plan of Action.

During the same period, many countries implemented innovative policy and programmatic strategies to address high levels of unmet need for contraception and maternal mortality and morbidity. Countries such as Ethiopia, Rwanda and Malawi have led the way in increasing access to family planning services and supplies, contraceptive prevalence rates and support for women’s choice of method. Other countries, such as Sierra Leone and Uganda, have implemented new policies to provide health care free-of-charge to women and children and increase access to contraceptive injectables via community health workers. As in many other areas of technological advances, sub-Saharan Africa has begun to take a “leap-frog” approach; innovating and adapting with limited resources to provide for the health of its people.

The Dakar Family Planning Conference provides a focal point for capitalizing on these advances and demonstrating their return on investment. A high percentage of African families continue to have mothers wanting to space or limit future births but unable to avail themselves of contraception. While political leadership is critical to driving national support for investment in family planning, government officials within relevant ministries and parliament are essential to establishing the enabling political environment.

The Dakar HLM provided a platform for discussion of the economic and development implications of prioritizing family planning within health expenditures and poverty reduction plans and performance-based financing. The emphasis was on national leadership and sustainability of program and policy innovation.

Harnessing the voices of the South, the evidence base under formation, and the experiential wisdom of global policy leaders, this meeting sought to foster African development of additional actions needed to attain universal access to family planning in Africa.  One day of focused discourse may not launch a contraceptive revolution in Africa, but it act as a tipping point that can be enjoined by the efforts of others to accelerate commitment and resource mobilization.

A number of key documents from the meeting are available online by clicking on the links below.

The full meeting report will be posted shortly.

Agenda in English: http://ppdafrica.org/docs/Ministerial2011/agenda-e.pdf
Agenda in French: http://ppdafrica.org/docs/Ministerial2011/agenda-f.pdf

Pictures from the meeting: https://picasaweb.google.com/PPDAfricaRegionalOffice/ICFP2011HL

Presentation by Hon. Bambang Brodjonagoro, Director, Fiscal Board, Ministry of Finance, Indonesia: http://ppdafrica.org/docs/Ministerial2011/brod.pdf

Presentation by Dr. Adedoyin Soyibo, Professor of Economics, University of Ibadan & Co-Lead on Africa Region for the National Transfer Accounts Project: http://ppdafrica.org/docs/Ministerial2011/soyibo.pdf

Presentation by Hon. Cornelius T. Mwalwanda, Deputy Minister of Finance, Malawi
Slides: http://ppdafrica.org/docs/Ministerial2011/mwal.pdf
Text for presentation: http://ppdafrica.org/docs/Ministerial2011/mwal2.pdf

Presentation by Mr. Aron Betru, Pledge Guarantee for Health, United Nations Foundation: http://ppdafrica.org/docs/Ministerial2011/betru.pdf

The World Bank’s “The Demographic Challenge” video screened during the meeting: http://www.youtube.com/watch?v=2HdyVr4AWN

 

2009 Senior Policymakers’ Seminar on “Financing Health-related Millennium Development Goals: Challenges and Opportunities”

The Senior Policymakers’ Seminar on “Financing Health-related Millennium Development Goals: Challenges and Opportunities” brought together over 150 participants including ministers of finance, health, economic planning; senior policymakers from ministries of health, finance, and gender; representatives from president and vice president’s offices; members of parliament, women leaders and knowledgeable civil society leaders from sub-Saharan Africa. Participants were drawn from 19 African countries, in addition to international participants from donor countries.

The meeting was held in Commonwealth Banqueting Hall at Munyonyo Commonwealth Resort on November 16, 2009 and was jointly organized by the Partners in Population and Development Africa Regional Office (PPD ARO), the African Union (AU) and the World Bank (WB). The meeting was held in conjunction with the International Conference on Family Planning Research and Best Practices in Kampala, Uganda, from 15-18 November 2009.

The meeting program revolved around four focused presentations and an informal discussion to facilitate learning and engagement by senior policymakers toward promising ends. The four presentation areas were directed toward advocating for:
•    Understanding the linkages between population, poverty and health and the importance of policy levers for managing short and long term change in population dynamics;
•    Prioritizing and integrating family planning in the poverty reduction strategy development process;
•    Establishing the means for tracking resource flows, through national health accounts with reproductive health/family planning subaccounts and monitoring budgetary allocations at the national and sub-national levels; and
•    Developing new leadership and increasing human resource capacity to implement population policies and high-quality family planning and reproductive health programs.

A number of key conclusions and recommendations emerged during the plenary discussion. These conclusions and recommendations were made in four key areas: family planning policy and advocacy, leadership, financing, and family planning strategies and programmes.

Key Conclusions
Family Planning Policy and Advocacy
•    Family planning is essential to the achievement of all MDGs;
•    Family planning is a “best buy” in today’s financially strapped environment, with savings in other development areas of three (3) to thirty (30) times the original investment for family planning; and
•    The MDG family planning strategy requires increasing contraceptive prevalence rate (CPR) by 1.5% a year, but African countries are lagging
Leadership
•    Country leadership on family planning is critical—the desire for family planning comes from African women and families, so the leadership for family planning must also come from Africa
Financing
•    There is a need for an additional ten (10) billion dollars for MDG5;
•    Increasing budget support has led to government-owned programs and priorities, but this has resulted in family planning being left off of the agenda and without a separate budget line;
•    Governments in Africa, on average, spend less than 10% of their total budget on health. This is significantly less than the Abuja target of 15%; and
•    Donor and partner harmonization remains a problem, with fragmentation of resources and strategies
Family Planning Strategies and Programmes
•    Underestimating the challenges and using ineffective strategies (such as separating maternal and child health from family planning and create vertical programs for HIV/AIDS)—has prevented Africa from success to date on health-related MDGs;
•    The quality and availability of reproductive health services benefits from strong health systems and financing mechanisms (e.g. performance-based financing, community health insurance). Yet, specific interventions need earmarked resources (e.g., contraceptives, maternal and newborn medical equipment); and
•    Some African countries have scaled up reproductive health interventions that increase community-based distribution of health services, including family planning (Rwanda-two community health workers in each village; Ethiopia’s Health Extension Program-a community-based health programme with 32,000 salaried health extension workers)

Key Recommendations
Family Planning Policy and Advocacy

•    Ensure that family planning is a key component of all national development strategies, including the poverty reduction strategy and action plan;
•    Step up the pace of policy and program implementation;
•    Regularly issue public statements supportive of family planning to mobilize both political and popular support; and
•    Revitalize the Maputo Plan of Action through the momentum created by CARMMA
Leadership
•    Improve stewardship (national and local leadership) and sector ownership on family planning/reproductive health;
•    Increase funding for Population Secretariats, who are currently under-resourced; and
•    Increase harmonization of programmes, with country-led leadership and donors/partners playing harmonized roles
Financing
•    Increase funding through mobilization of global resources;
•    Encourage “results-based financing” for family planning and reproductive health;
•    Establish an enabling environment for effective public-private (e.g. IFC-Health in Africa);
•    Ensure family planning is included in policies and basket funding;
•    Ensure a separate budget line for family planning in country budgets;
•    Support research to inform increased resource allocation from government and donors  for FP/RH commodities (e.g. as in Rwanda’s RHS);
•    Increase government resources to health to realize the Abuja target of 15%;
•    Improve efficiency in using the resources available;
•    Create synergy between international, regional and national efforts in line with the framework of the Paris Declaration; and
•    Improve planning and coordination
Family Planning Strategies and Programmes
•    Reinforce the linkage between reproductive health and family planning services;
•    Continue support for strengthening primary health care systems; and
•    Increase budget allocations for contraceptives in national and district health budgets

The full meeting report in English: http://ppdafrica.org/docs/FinancingHealthMDGs/report-e.pdf

Agenda in English: http://ppdafrica.org/docs/FinancingHealthMDGs/agenda-e.pdf
Agenda in French: http://ppdafrica.org/docs/FinancingHealthMDGs/agenda-f.pdf

Read and download the following presentations from the meeting:
AID Architecture and Health: Outcomes in Africa: Focus on Family Planning by Dr. Khama O. Rogo, Senior Advisor, Health in Africa, World Bank Group
English: http://ppdafrica.org/docs/FinancingHealthMDGs/rogo-e.pdf

Uganda on the Move by Ms. Rhonda Smith, PRB, on behalf of Dr. Jotham Musinguzi, Regional Director, Partners in Population and Development Africa Regional Office
Script in English: http://ppdafrica.org/docs/FinancingHealthMDGs/smith-e.pdf
More of the presentation will be uploaded soon

Financing of Reproductive Health in Rwanda: Contributions of Resource Tracking by Claude Sekabaraga, MD, MPH, Former, Director of Policy Planning and Capacity Building Ministry of Health, Rwanda
English: http://ppdafrica.org/docs/FinancingHealthMDGs/sek-e.pdf
French: http://ppdafrica.org/docs/FinancingHealthMDGs/sek-f.pdf

Presentation of RAPID model for Malawi by Dr. Chisale Mhango, Director, Reproductive Health Unit, Ministry of Health, Malawi
English: http://ppdafrica.org/docs/FinancingHealthMDGs/mhango-e.pdf
French: http://ppdafrica.org/docs/FinancingHealthMDGs/mhango-f.pdf

Re-Affirming Commitments to Achieve the Health-related MDGs/MDG 5b by Dr. Kassa Tsegaya Kebede, Senior Advisor Population, SRHR and Culture, African Union, on behalf of H.E. Adv. Bience Gawanas, Commissioner for Social Affairs, African Union
English: http://ppdafrica.org/docs/FinancingHealthMDGs/commitments-e.pdf