The Leadership Gap

Commitment and Performance on Reducing Unmet FP Need

Repositioning Family Planning in West Africa

Accra, Ghana 15-18 February 2005

Developed by the POLICY Project and M. Moustapha Ka

THE LEADERSHIP GAP

 

    What commitments have Governments made?

    Who is in “Leadership”?

    What can they do?

    How well are they doing?

Commitments of Governments:

        1994 Cairo Programme of Action (ICPD)        1997 Program of Action of Ouagadougou        1997 Reproductive Health Strategy for the Africa Region (WHO AFR/RC47/8)        2003 Women’s Health Strategy (WHO AFR/RC53/11)        2004 Repositioning Family Planning Framework (WHO AFR/RC54/11 Rev.1)        National laws, policies and strategies

Commitments – and yet…

In the six years (1994-2000) following ICPD, in this Region of West Africa:

        12,000,000 unintended pregnancies

        650,000 deaths of women and girls from largely preventable pregnancy-related causes

         18,000,000 pregnancy-related infections, injuries, other disabilities

Who is in “Leadership”? Leaders are –

At national, regional, district and local levels

Those who set policies, control resources influence socio-cultural practices…

In legislatures & ministries of health, plan, finance, education, gender, etc

In civil society including NGOs, religious institutions, business and other

        Ensure access to information, services and contraceptives

        Address unmet FP need in national development strategies

        Strengthen public policy, planning and budgeting process

        Implement public-private partnerships

         Reduce vulnerability of women and girls

What can Leaders do?

-Financing in national & decentralized budgets, alternative mechanisms, all sectors- Contraceptive security- Standards of care- Well equipped providers - Least restrictive services &method criteria - Programsthat guarantee informed consent, choice- Multisector physical, human resources

What can Leaders do?

Ensure Access

What can Leaders do?Address Unmet FP Needin Development Strategies         Unmet FP need = serious national problem

·        FP access a fundamental human right

·        Measure impact of unintended fertility

·        Comprehensive multisector strategy

·        FP needs addressed by all ministries

·        Role of unintended fertility related to HIV/AIDS, Poverty, other national problems

What can Leaders do? Strengthen Policy, Planning Budgeting Process

        Systematic and transparent

·        Reflect laws & international commitments

·        Participation of civil society

        Directed by high level of authority

·        Responsive to needs & priorities

Based on timely, accurate data

·        Translated into action

What can Leaders do?

Implement Public-Private Partnerships

Clear roles, reduced competition from free public services

Functional partnership, e.g. shared training

Favorable regulatory climate

What can Leaders do?

Reduce Vulnerability of Women and Girls  Gender-sensitive public and private

policies, programs, budgets Legislative reform, enforcement to

guarantee rights, protect against abuse

How well is leadership performing? Progress…

New RH laws in 5 countriesIncreased parliamentarian role in many countriesReligious institutions adopting supportive policiesSignificant presence of civil society in policy &

advocacyService policies & norms updated frequently

How well is leadership performing? Challenges…

No cohesive effort targeting Unmet FP NeedLittle support from leadership outside health sectorAbsence of “FP need” in key development strategiesGaps in laws, policies, strategies (e.g.Contr.Security)Weak enforcement of existing laws Limited mandate & resources of agenciesLittle authority to enforce multmsector efforts Lack of routine participatory planning, budgetingIneffective implementation of services policies &

norms

The way forward for Leadership

Learn lessons from efforts in other areas

…Tackles HIV/AIDS,

Poverty, Malaria

Mobilizing all

sectors….

Learn lessons from efforts in other areas

         Acknowledge unwanted fertility as a severe national problem

         Demonstrate its impact on all sectors

Mobilize energy and resources of all sectors to reposition FP

Strong leadershipis the key to

multisectoral repositioning of Family Planning

to reduce unmet need

FINAL REMARKS

From Family Planning repositioning to Leadership repositioning