Total Market Approach to Family Planning
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?
At PATH, we are strong advocates for the total market approach (TMA) to family planning (FP) to help address these challenges. We see a TMA as a collection of principles to help providers of contraceptives reach the largest possible proportion of the population and make the most of existing supplies of product in a country or region. While every organization working in this space has a slightly different interpretation of a TMA, at its heart are three consistent ideas:
- The government is the steward of the family planning market...
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...
How PSI Views the Total Market Approach
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.
In an uncertain funding climate, donors, governments, and implementers need to target resources and create solutions that have the highest impact and return on investment. One approach that has gained increasing traction this past decade is the Total Market Approach, or TMA.
At its core, TMA for...
Women in Cameroon receive membership cards for a mutual health organization intended to reduce out-of-pocket healthcare costs. © 2012 Okwen Patrick Mbah, Courtesy of Photoshare
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...
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.
Why is it important to consider family planning services?
A total market approach for USAID programs considers products but must also consider family planning services. A TMA focused on products might not help us achieve our objectives of expanding method choice, meeting unmet need, and access for all. TMA that includes family planning services can help us do even more:
- Focus on all contraceptive methods, including the following:
- Provider-dependent methods like implants and IUDs
- Methods that don’t have a commodity (but may have surgical supplies or tools) immediately associated with them (tubal ligation, vasectomy, standard days method)
- New and/or underused methods
- Consider key issues associated with making contraceptive...
Topic last updated: March 13, 2018