When it comes to doing family planning work in low- and middle-income countries, where there is so much (and so many different types of) work to be done, where do you start? How do you decide where to focus your efforts, or how to make sure you aren’t repeating the same research or offering the same services as another group?
The DRC needs a family planning program that works for all women. Photo: PATH/Georgina Goodwin
In November 2016, PATH partnered with the Democratic Republic of the Congo’s Ministry of Health to hold a three-day workshop in Kinshasa that brought together the public, commercial, and private nonprofit sectors to advance a total market approach to family planning. A total market approach is a process that combines the strengths of all marketplace sectors to ensure that women get the supplies and services they need, through the right channels, and at the right price. In the DRC, aligning marketplace sectors can help to solve the inequities in our current system—where many poor women can’t access or afford family planning services. This lack of access contributes in part to the DRC’s high rates of maternal mortality and unmet need for contraception.
There are now more than 300 million women and girls using modern contraception in the world’s 69 poorest countries, with more than 30 million of those users added since 2012. That’s the good news. The more challenging news is that despite this progress, health markets in low- and middle-income countries often operate inefficiently, failing millions of potential family planning (FP) consumers.
Pathfinder International | Technical Advisor for Capacity Building
Younger women having their first or second child may not recognize access to health services as a right and as something that could improve their lives. Photo: Pathfinder.
Evidence-based interventions. High-impact practices. Using data for decision-making.
As program implementers, we (rightly) spend a lot of time focusing on these concepts. But, sometimes, we get so caught up in trying to implement development strategies and interventions “correctly” that we lose sight of the perspectives of the people that our projects are intended to support—local partners, service clients, and community members. Evidence across sectors shows that the people best able to solve problems are often those closest to the situation itself. Thus, effectively removing barriers to sexual and reproductive health services use means taking a step back from our checklists and our data and actually talking to community members to understand what is getting in their way.
How do we raise strong women? How do we support and nurture the transition from girl to woman? The answer is complex, but to me, part of it is ensuring that when it is appropriate, every girl is provided with the sexual and reproductive health services and information she needs, in a format that speaks to her.
Markets are made up of human beings. They are not just emotionless spaces where products and services are bought and sold. This is especially true of the market for family planning products, which ideally provides “...women with a range of options, enabling them to choose for themselves how to best fulfill their individual reproductive intentions” (see Market Shaping for Family Planning, p4). And yet, when mired in theoretical discussions of total market approaches, market dynamics and supply chains, it is all too easy to forget these people within the market. But to ensure a healthy market where a woman can choose the contraceptive method that works best for her, we first must understand what she wants and needs (think human-centered design).
USAID/Washington | Health Development Officer, Office of Population and Reproductive Health, Service Delivery Improvement Division
Total market approach (TMA): A lens for assessing actors and interventions in all three sectors (public, private non-profit, and private for-profit) of the health system. Programs and policies promote and enhance contributions from all sectors and are client-focused.
Management Sciences for Health, Nigeria | M&E and eHealth Advisor
The Global Digital Health Forum 2016 was a perfect fit for me. It was a space where I met many practitioners working in the global health environment, more so than in previous meetings. The Forum provided a supportive professional environment to discuss similar challenges and opportunities between people and organizations working in the area of technology for health.
A common theme throughout the 2016 Global Digital Health Forum (GDHF) was sustainability. From the opening panel, through almost every session and hallway conversation, to the closing plenary, sustainability was a major topic of discussion. And, it seemed that each conversation almost always led to the same conclusions:
In the digital health community, we know very little about successful approaches to program sustainability.
We do know that identifying such approaches will require disruptive thinking.
Members of the digital health community are ready to take on the challenge.