Grappling with the realities of Changing Environment for IDA for RH Commodities - Ghana

Presented at the 7th Semi-Annual Membership Meeting

of the RH Supplies CoalitionApril 27-28, 2007

London

Ghana Contraceptive Financing Gap 2004 - 2010Ghana Contraceptive Financing 2004 - 2010

$0

$2,000,000

$4,000,000

$6,000,000

$8,000,000

$10,000,000

$12,000,000

$14,000,000

$16,000,000

2004 2005 2006 2007 2008 2009 2010

Need

Commitments

2003 2004 2005 2006 Total

USAID $2.57 m $2.55 m $1.72 m $3.9 m $10.74 m

DFID $1.55 m $1.86 m $0.9 m $0.5 m $4.81 m

UNFPA 0 0 0 $1 m $1.0 m

MOH $1.57 m $0.66 m $1.85 m $1.0 m $5.09 m

Total $5.69 m $5.07 m $4.47 m $6.4 m $21.63 m

Contraceptive Financing Background

Who was funding contraceptives?

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

3,500,000

4,000,000

4,500,000

1998 1999 2000 2001 2002 2003 2004 2005 2006

US

$

Projected Contribution

Actual Expenditure

USAID

UNFPA

DFID

IPPF

Year Total Requirement

(US $)

Commitment

(US $)

Funding Gap

(US $)

2007 6.0 1.8(DFID $0.7m, USAID $1.1m)

4.2

2008 6.5 0.2(DFID)

6.3

2009 7.7 0 7.7

2010 8.1 0 8.1

2011 8.3 0 8.3

TOTAL $36.6 $2.0 $34.6

2007-2011 Funding requirements, commitments and Gap

Challenges of New IDA

• Potential Competition for funds with other programmes – Health funds– Commodities– Programme Activities, overwhelmed & understaffed

• Assessing funds outside the Health fund– E.g. DFID funds for condoms with Ghana AIDS Commission

• Inadequate Transparency from donors– Unpredictable donor funding - “Withdrawal” plan (general and

commodity specific)– Funds with unknown “conditionalities” – e.g. will not/ canot be

used to purchase certain commodities.– Dealings with other partners sometimes not known to

programme staff.• Lack of funding for RH/FP from new funding initiatives

e.g. Global fund

Ghana’s “Be Safe” Male Condom DFID supported male condoms for public and social marketing programme from 2002-2006.

Opportunity to change/beautify foil of male condoms.

Public sector with PPAG –introduced new foil “Be Safe” with family planning and STI/HIV logos denoting dual protection, to replace plain white “No Logo” condoms previously donated by USAID

Have had to go back to “No Logo” from USAID as a stop-gap measure to forestall shortage while new procurement arrangements for are being made to re-instate “Be Safe”

Female Condom mostly supported by Government procurement

Responses to challenges

• ICC/CS proactive in addressing problems e.g. “No Logo” condoms from USAID as a stop gap measure for “Be Safe” male condoms.

• Strengthen Advocacy role of ICC/CS• Increased “ring-fencing” of funds for

procurement of contraceptives in MOH budget• Source funding to implement strategy on CS• Financial Sustainability plan for CS drafted• Implement “Road Map” for Repositioning of

Family Planning (Multi sectoral response)

Lessons and insights for the future• Confirm donor commitments• Identify new partners (International and local)• Raise profile of Family Planning

– Need for dedicated and sustained fund for RH Commodities– Advocate for FP through collaborating with the MOH/GAC/NPC as one voice for

funds outside of the MoH budget – Create a contraceptive development fund within the MoH

• National Health Insurance– Cover all FP commodities and condom for STI and HIV prevention– Improve the NHIS to eliminate the ‘cash and carry’ system as a health financing

mechanism • Need for Increased transparency and dialogue between donors and local

counterparts (including programme level)• Need for integration of RH/FP with HIV/AIDS• Advocate for multi donor budget support • Need for gradual withdrawal of funding from traditional donors• Diversification of funding sources• Self procurement• Monitoring and Evaluation

Thank you for your attention

Presented by

Dr. Gloria Quansah Asare

Ghana