Resources Flow Pilot Project in Tanzania and Ethiopia 2012, Pilot Study
For many years, international donors, multilateral corporations, governments and philanthropies have invested heavily in supporting family planning programs in sub-Saharan Africa. Regardless the resources applied to FP, the gap of the needs met is still huge: In response to the need for a revamped family planning agenda, several initiatives have been developed, among them, the Family Planning 2020 (FP2020) Initiative. FP2020 is a global partnership that supports the rights of couples, women and girls to decide, freely, and for themselves, whether, when, and how many children they want to have. The initiative works with governments, civil society, multi-lateral organizations, donors, the private sector, and the research and development community to enable 120 million more women and girls to use contraceptives by 2020.
Given the paucity of information on this expenditure, this pilot study was implemented in Tanzania and Ethiopia. The aim was to ascertain the feasibility of generating quality data on expenditure on family planning from the public and private sectors involved in providing family planning goods and services in the two countries.
Increasing access to family planning (FP) can reduce poverty and hunger, avert maternal and childhood deaths and increase women's empowerment (John Cleland et al., 2006). Effective FP also promotes an economic boom as it ensures a healthier, better educated, and skilled workforce, as well as low dependency ratios (World Health Organisation, United States Agency for International Development, Population Reference Bureau, & Academy for Educational Development, 2008).
For many years, international donors, multilateral corporations, governments and philanthropies have invested heavily in supporting family planning programs in sub-Saharan Africa. Regardless the resources applied to FP, the gap of the needs met is still huge: if unintended pregnancies would drop by 70%, the number would mean a reduction of undesired pregnancies from 74 million to 22 million per year (UNFPA, Guttmacher Institute, 2014). Recently, however, funding for FP has begun to decline leading to reversals in gains already achieved in some developing countries (Barbara O'Hanlon, 2009). In response to the need for a revamped family planning agenda, several initiatives have been developed, among them, the Family Planning 2020 (FP2020) Initiative. FP2020 is a global partnership that supports the rights of couples, women and girls to decide, freely, and for themselves, whether, when, and how many children they want to have. The initiative works with governments, civil society, multi-lateral organizations, donors, the private sector, and the research and development community to enable 120 million more women and girls to use contraceptives by 2020 (FP2020, 2013).
To reach the above-mentioned goal financial information is required to estimate the additional resources needed as well as to find opportunities of an effective and efficient use of the expenditure.The aim is to get clarity on how much is currently spent on family planning and to which components the expenditure go to. Considering the experience in the Resource Flows Project in NIDI, Futures Institute, HPP invited NIDI to develop this study and to identify the major flows of FP funds through a pilot study, which could lead to an enriched tool and more relevant and comprehensive data.
Given the paucity of information on this expenditure, this pilot study was implemented in Tanzania and Ethiopia. The aim was to ascertain the feasibility of generating quality data on expenditure on family planning from the public and private sectors involved in providing family planning goods and services in the two countries. Additionally, estimates on OOPs and the external funding reaching the country with a FP purpose would be prepared. The study was also expected to provide lessons to guide efforts to bring tracking of FP expenditure to scale.
This report presents the various contributions to the study, notably from Futures Institute proposing the content and including the measurement of OOPS; from APHRC performing and reporting the domestic survey in both countries; and from NIDI with the platform for the domestic component, the external resources measurement and the integration of all components. The content includes the following sections: a) Methodology and approach for each area of work: external funding, the domestic survey and OOPS, as well as the quality control and verification process; b) The results on the external funds channeled to FP services in Tanzania and Ethiopia collected by the Resource Flows project; c) Main results of the pilot survey in Tanzania and in Ethiopia, by component: Government, NGO, Corporations, collected and reported by APHRC; d) Family Planning OOPs estimates in both countries, by Futures Institute; e) Summary overview of the experiences and respondent feedback to the domestic survey with a discussion to briefly reflect on the response of the questionnaire and how it served its purpose; f) General discussion and conclusions.
Version 1.0 with datasets and study DOI
This survey covered sampled actors in family planning in Ethiopia and Tanzania.
Unit of Analysis
Government departments , corporations, NGOs, Public institutions, insurance companies, local philanthropies and consultants that deal with family planning issues.
The survey covered sampled government departments , corporations, NGOs, Public institutions, insurance companies, local philanthropies and consultants that deal with family planning issues.
Producers and sponsors
Authoring entity/Primary investigators
African Population and Health Research Center
Netherlands Interdisciplinary Demographic Institute
Netherlands Netherlands Interdisciplinary Demographic Institute
NIDI will add specific FP questions to the existing Resource Flow questionnaire in Ethiopia and Tanzania. NIDI will write and provide to HPP the analytical reports of the results of the FP data, the datasets, and recommendations for improving data collection in the future.
Developed first field test of the survey
Health Policy Project
Provided OOPS data, financial means
The first step in implementing the survey was to prelist all known key players in FP financing and provision. From that list was extracted all government, insurance companies, and large corporations to be included. For parsimony, the top 10 NGOs and a simple random sample of the remaining NGOs were included in the sample. The top 10 NGOs and other major players were identified based on the consultant's knowledge of the specific organization's approximate market share of FP involvement in their respective countries and consultative discussion with national FP service provision experts.
Dates of Data Collection (YYYY/MM/DD)
Mode of data collection
The first step in implementing the survey was to prelist all known key players in FP financing and provision. From that list was extracted all government, insurance companies, and large corporations to be included. For parsimony, the top 10 NGOs and a simple random sample of the remaining NGOs were included in the sample. The top 10 NGOs and other major players were identified based on the consultant’s knowledge of the specific organization’s approximate market share of FP involvement in their respective countries and consultative discussion with national FP service provision experts.
The next step was for the consultant to identify a contact person or respondent from each of the selected organizations or government office. For improved data quantity and quality, a few organizations were selected for further visits with an aim of improving the response rate, as informed by previous experiences in the RF study. The few contact persons were visited and informed beforehand of the planned pilot study. These key contacts were pre-identified as follows; one from the Central MoH, two from any other public sector FP providers or financiers and four key NGOs.
The consultants conducted three visits to each of these seven institutions with the following agenda for each visit:
• At the initial visit, the consultant would go over the questionnaires and the manuals, clarifying issues with the contacts person in these institutions. The consultant would also demonstrate some of the areas of estimation.
• On the second visit, the consultant would check the progress, review the estimations, verify already collected data and agree on finalization schedule for the remaining data.
• On the third/final visit, the consultant would finalize the questionnaire and check the consistency of the data provided so far.
The consultants distributed the questionnaires and manuals, (a detailed and a brief manual) to all identified target institutions either physically or via email after identifying and making contact with the respondents. The consultant followed up by booking an appointment with the respondents, during which the consultant went through the questionnaire with the respondents, identifying any areas that the respondent needed support in, especially the estimation process.
Type of Research Instrument
The questionnaires were structured. There was a question specifically customized for NGOs, corporations, governments, local philanthropies, consultants and insurance companies. They all collected data on general information, sources of income, projects on family planning and expenditures.
After all data were collected, the questionnaires were forwarded to APHRC for entry into an MS Access database developed to capture the data from paper form to soft format. All data were exported to STATA for further management.
Additional to the quality of data developed by AHPRC, NIDI performed a data verification a) comparing the original questionnaires and the entries in the database, b) selected entries and estimations were verified and their impact in the data (e.g. rates, time of transactions); c) suggestion of non- data entry error detection e.g. double count search; and d) a report with specific suggestions was given back to help the improvement of the results.
Other non-data entry errors that could not be verified against the paper questionnaires could be corrected after seeking corrections from the consultant or the respondent. The final clean data were used to produce summary measures such as proportions, summations and averages.
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African Population and Health Research Center, Resources Flow Pilot Project in Tanzania and Ethiopia, 2018. Nairobi - Kenya. doi:10.20369/aphrc-050:2018.1.0
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