Tanzania National Family Planning Costed Implementation Program (NFPCIP) 2010-2015.

Tanzania National Family Planning Costed Implementation Program (NFPCIP)2010-2015

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

6.35.8 5.6 5.7

0

1

2

3

4

5

6

7

1991–92 1996 1999 2004–05

Year

Fert

ilit

y r

ate

(ave

rage n

um

ber

of

child

ren p

er

wom

an)

45% under the age of 15

A Young Population soon to be in their reproductive years . . .

-10% -8% -6% -4% -2% 0% 2% 4% 6% 8% 10%

Male Female

Percent of the population

80 +75-7970-7465-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-14

5-90-4

0 4810 2 6 86 4 2 10

Ag

e in

ye

ars

529578

193

0

100

200

300

400

500

600

700

1999 2004 2015

Yr

MM

R

Target by 2015

Persistent High Maternal Mortality Ratio

Total Demand and Unmet Need for FP

0

10

20

30

40

50

60

1992 1996 1999 2004

Unmet Need

Total Demand

Increasing Demand and Constantly High Unmet Need

A Slowly Rising Modern CPR

713

1720

0

10

20

30

40

50

1991–92 1996 1999 2004–05

Year

Mo

dern

co

ntr

acep

tive u

se

Key Issues and Challenges Facing Family Planning

Declined Annual CPR Growth Rate Over Time

Declining Annual Percentage Growth Rate

1.4

0.6

0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

1992 - 1999 1999 - 2004

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 Tanzania2008 - 2015

Rationale for the NFPCIP

Goal: Increase Contraceptive Prevalence Rate to 60% by 2015

Annual Percentage Growth Rate

1.4

6

0.6

0

1

2

3

4

5

6

7

1992 - 1999 1999 - 2004 2010-2015

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?!

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

June2009

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 Area TotalPercentage

Of Total Budget

Contraceptive Security & Logistics 89,873,499 91%

Capacity Building 4,210,132 4%

Service Delivery 2,105,818 2%

Advocacy 1,639,993 2%

Management Systems/ M&E 830,541 1%

Total ( In USD$) 98,659,985

***Central Budget Only

Cost Estimates by Year (In USD$)

Year USD$

FY 2010-2011 14,547,160

FY 2011-2012 15,493,092

FY 2012-2013 15,602,217

FY 2013-2014 16,041,735

FY 2014-2015 17,513,809

FY 2015-2016 19,461,971

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