Transcript Foundation PowerPoint Template

Voluntary, Rights-based
Family Planning Framework:
How to Apply to Programs
Module 2: Application
Agenda
 Opening Remarks—[name, title]
 Overview of Workshop and Process
 Sessions:
• Step 1: Consider the Country Context
• Step 2: Assess the Program and Set Priorities
• Sept 3: Formulate Recommended Actions
• Step 4: Link Actions to Outputs and Outcomes/Indicators
• Step 5: Identify Potential Partners
• Step 6: Assess and Strengthen Program Accountability
• Step 7: Create a One-Year Action Plan
Facilitator: [name, title]
Objectives:
1. Assess and prioritize program needs and inform
recommended actions
2. Identify monitoring indicators to explicitly track rightsbased activities, outputs, and outcomes
3. Identify strategic partners to supplement or
complement planned action
4. Strengthen accountability protocols and mechanisms
MAJOR OUTPUT: One-Year Action Plan to strengthen the
FP Program’s capacity to respect, protect, and fulfill
human rights
Step 1:
Consider country
context
Step 2:
Assess Program
& Set Priorities
Step 3:
Formulate
Recommended
Actions
Step 4:
Link to Outputs
& Outcomes
and Develop
Indicators
Overview of Process
July 18, 2015
Step 5:
Identify
Potential
Partners
Step 6:
Assess and
Strengthen
Program
Accountability
Step 7:
Create One-Year
Acton Plan
© 2013 Bill & Melinda Gates Foundation
|
4
Framework for Voluntary Family Planning Programs that Respect, Protect, and Fulfill Human Rights
INPUTS & ACTIVITIES
POLICY LEVEL
A. Develop/revise/implement policies to respect/protect/fulfill rights and eliminate policies
that create unnecessary barriers to access (All Rs)*
B. Develop/revise/implement policies to ensure contraceptive security, including access to
a range of methods and service modalities, including public, private, and NGO (R2)
C. Create processes and an environment that supports the participation of diverse
stakeholders (e.g. policymakers, advocacy groups, community members) (R2/R3)
D. Support and actively participate in monitoring and accountability processes, including
commitments to international treaties (All Rs)
E. Guarantee financing options to maximize access, equity, nondiscrimination, and quality
in all settings (R2/R3)
OUTPUTS
Illustrative
•
 Available (adequate number of
service delivery points, equitably
distributed)
 Accessible (affordable and
equitable; free from
discrimination; no missed
opportunities for service
provision)
 Acceptable (respectful of
medical ethics, culturally
appropriate, and clients’ views are
valued)
 Highest quality (scientifically and
medically appropriate and of good
quality (e.g., full, free, and
informed decisions; a broad
choice of methods continuously
available; accurate, unbiased, and
comprehensive information;
technical competence; highquality client-provider
interactions; follow-up and
continuity mechanisms; and
appropriate constellation of
services)
COUNTRY CONTEXT
Assess to inform interventions
SERVICE LEVEL
A. Inform and counsel all clients in high-quality interactions that ensure accurate, unbiased,
and comprehensible information and protect clients’ dignity, confidentiality, and privacy
and refer to other SRH services (All Rs)
B. Ensure high-quality care through effective training and supervision and performance
improvement and recognize providers for respecting clients and their rights (All Rs)
C. Ensure equitable service access for all, including disadvantaged, marginalized,
discriminated against, and hard-to-reach populations, through various service models
(including integrated, mobile, and/or youth-friendly services) and effective referral to
other SRH services (All Rs)
D. Routinely provide a wide choice of methods and ensure proper removal services,
supported by sufficient supply, necessary equipment, and infrastructure (R2)
E. Establish and maintain effective monitoring and accountability systems with community
input; strengthen HMIS and QA/QI processes (All Rs)
•
COMMUNITY LEVEL
A. Engage diverse groups in participatory program development and implementation
processes (R2/R3)
B. Build/strengthen community capacity in monitoring and accountability and ensure
robust means of redress for violations of rights (R2/R3)
C. Empower and mobilize the community to advocate for reproductive health funding and
an improved country context and enabling environment for FP access and use (All Rs)
D. Transform gender norms and power imbalances and reduce community-, family-, and
partner-level barriers that prevent access to and use of FP (R3)
E. Support healthy transitions from adolescence to adulthood (All Rs)
INDIVIDUAL LEVEL
A. Increase access to information on reproductive rights, contraceptive choices (All Rs)
B. Empower, through education and training about reproductive health, self-esteem, rights,
life-skills, and interpersonal communication (R1/R2)
C. Foster demand for high-quality services and supplies through IEC/BCC and empower
individuals to demand their rights be respected, protected, and fulfilled (R2)
Family planning services are
Accountability systems are in
place, which effectively expose any
vulnerabilities, and alleged or
confirmed rights violations and
issues are dealt with in a significant,
timely, and respectful manner
•
Communities actively participate
in program design, monitoring,
accountability, and quality
improvement
• Community norms support the
health and rights of married and
unmarried women, men, and young
people and their use of family
planning
OUTCOMES
IMPACT
Illustrative
Decreased
• Women, men,
and young
people decide for
themselves—
free from
discrimination,
coercion, and
violence—
whether, when,
and how many
children to have
and have access
to the means to
do so
• Trust in FP
programs is
increased
• Universal access
to FP is achieved
• Equity in service
provision and use
is increased
• Availability of a
broad range of
contraceptive
methods is
sustainable
• Women get
methods they
want without
barriers or
coercion
• FP needs are
met; demand is
satisfied
• Unintended
pregnancies
• Maternal/infant
deaths
• Unsafe abortions
• Adolescent
fertility rate
• Total fertility rate
Increased
• Agency to achieve
reproductive
intentions
throughout the
lifecycle
• Well-being of
individuals,
families,
communities, and
countries
* Reproductive rights:
R1: reproductive selfdetermination
R2: access to sexual and
reproductive health
services, commodities,
information, and
education
R3: equality and nondiscrimination
(“All Rs” indicates that all
rights are encompassed)
• Agency of individuals is increased
to enable them to make and act on
reproductive health decisions
Citation: Hardee, K., et al. 2013. Voluntary Family Planning Programs that Respect, Protect, and Fulfill Human Rights: A Conceptual Framework. Washington, DC: Futures Group.
August 2013
STEP 1
Consider Country Context
Step 1:
Consider country
context
Objective
 Consider the country context and the factors
that have the potential to affect FP and
human rights outcomes
Some are beyond your control; some may
be amendable to change.
Are there opportunities for collaboration
across disciplines and sectors?
STEP 2
Assess Program and Set Priorities
Step 2:
Assess Program
& Set Priorities
Objectives
 Assess the FP program effort at the
policy, service, community, and individual
levels and identify
• Strengths to capitalize on
• Weaknesses or gaps that should be addressed
 Set priorities for action
STEP 3
Formulate Recommended Actions
Step 3:
Formulate
Recommended
Actions
Objectives
 Formulate recommended actions to address
each of the priority issues identified
 Identify who would be responsible for
implementing each action
STEP 4
Link Actions to Outputs and Outcomes
and Develop Monitoring Indicators
Step 4:
Link to Outputs &
Outcomes and
Develop
Indicators
Objectives
 Connect proposed priority actions to
desired outputs and outcomes
 Propose indicators (and data sources)
to measure progress
Step 4:
Link to Outputs &
Outcomes and
Develop
Indicators
“What gets measured, gets
done!”
 We need to ask the right questions:
• Are we doing the rights things?
• Are we doing them right?
 Measurement is needed for:
• AAAQ
• Extent to which programs protect full, free, and informed
choice
• Discrimination or coercion
• Promotion of individual agency
• Respect of individual dignity
 Requires appropriate data sources, quality data
collection, and management and dissemination
Step 4:
Link to Outputs &
Outcomes and
Develop
Indicators
What makes M&E rightsfocused?
 Participation—as a means and an end
 Robust measurement of outcomes and processes
(not just outputs)
 Supports accountability of stakeholders
 Focus on marginalized/vulnerable groups
 Goals and targets informed by human rights
principles
Move beyond traditional measures (CYP, CPR) to
measures that emphasize AAAQ and equity
Step 4:
Link to Outputs &
Outcomes and
Develop
Indicators
Relevant constructs to apply




Participation
Accountability
Nondiscrimination
Empowerment




Availability
Accessibility
Acceptability
Quality
Activities
Structural indicators
Process indicators
Outputs
Output indicators
Outcome/Impact
 Fulfillment of rights
Outcome indicators
 Self-determination
Impact indicators
 Equality and nondiscrimination
Step 4:
Link to Outputs &
Outcomes and
Develop
Indicators
Considerations: Data
collection and use
 Accountability
• What mechanisms are in place?
• Who is responsible for analysis? For the process?
• Who will use the data?
 Scope and Feasibility
• Program levels? (policy, service, community, individual)
• Will data be needed for outputs at each level? Feasible?
• Are indicators to measure human rights activities,
processes, or outcomes?
 Timing and methods
• Is there a plan to ensure timely data collection?
Step 4:
Link to Outputs &
Outcomes and
Develop
Indicators
Other considerations
 Program monitoring is important:
• Informs learning
• Promotes strategic, evidence-based decision making
• Used to document and share results
• Necessary for accountability
 However, only as useful to the extent reliable
data can be collected, analyzed, and used!
• Holistic framework will generate many indicators—select
final indicators strategically
STEP 5
Identify Potential Partners
Step 5:
Identify
Potential
Partners
Objective
 Identify potential partners to support the
actions proposed in prior steps
Step 5:
Identify
Potential
Partners
Need to partner across sectors,
service modes, and disciplines
RIGHTS
EDUCATION
Public sector
Facility-based
services
Private
commercial
sector
Community-based
services
NGOs
Social marketing
HEALTH
Checkpoints for Choice, EngenderHealth, 2014
Step 5:
Identify
Potential
Partners
Partner considerations
 Primary areas of competence?
• How do they complement and add value?
 New or existing partner?
 Current focus areas?
• Level of health system, content, geography, groups
served?
 Current interest or engagement in advancing
human rights?
 Capacity and/or readiness to partner?
 Resources available to support partnering?
 Absorptive capacity?
• What additional support might be needed?
Partnership principles and
effective practices
Step 5:
Identify
Potential
Partners





Shared purpose and vision
Values to govern working together
Explicit, shared expectations
Perceived benefit to all parties
Mechanisms for decision making, problem solving,
and conflict resolution
 Agreements about credit sharing
 Commitments to the partnership and to followthrough
 Effective management: joint planning, ongoing
communication, realistic timeframes, openness to
resolving issues
Step 5:
Identify
Potential
Partners
Beyond the workshop—
next steps for partnering
 Further vet and explore the desirability and
feasibility of partnering with specific groups
 Determine whether formal or informal
partnerships are desired
 Negotiate based on good partnership principles
and effective partnering practices
STEP 6
Assess and Strengthen Program
Accountability
Step 6:
Assess and
Strengthen
Program
Accountability
Objective
 Identify actions that FP programs or
projects can take to strengthen
accountability regarding their
responsibilities to respect, protect, and
fulfill human rights, including how to
identify and manage problems with
voluntarism
Step 6:
Assess and
Strengthen
Program
Accountability
What is accountability?
 Duty bearers are accountable to rights-holders
for respecting, protecting, and fulfilling human
rights
• Rights holders = individuals and groups with valid
claims
•
Duty bearers = state and non-state actors with
obligations to fulfill human rights, including programs,
projects, and service providers
 Monitoring is an essential component to hold
programs responsible for how services are
delivered in accord with human rights
principles (e.g., AAAQ and PANEL)
Step 6:
Assess and
Strengthen
Program
Accountability
How to know if your program may have
a problem with voluntarism and human
rights
Use routine data to keep an eye on
 Method mix
 Availability of commodities and supplies
 Client characteristics
 Timing and number of requests for removals of providerdependent methods
 Provider attitudes and behaviors toward clients
 Reports or rumors of voluntarism abuse
Investigate any alleged violations or worrisome signs; act swiftly
to take corrective action and institute safeguards if needed
July 18, 2015
© 2013 Bill & Melinda Gates Foundation
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Step 6:
Assess and
Strengthen
Program
Accountability
Monitoring is not enough—What else
needs to be in place?
 Voluntarism safeguards
• Human rights literacy training
• Counseling
• Client feedback mechanisms
 Protocols for investigating and addressing
problems
 Processes for corrective action
• Be clear about responsibilities
• Address the particular problem
• Apply lessons to prevent recurrence
 Redress mechanism for affected individuals
Step 6:
Assess and
Strengthen
Program
Accountability
Promoting accountability at all
levels: Examples of tools
 Policy Level
• “Sexual and Reproductive Health and Human Rights:
A Tool for Examining Laws, Regulations and Policies”
—WHO, 2010
 Service Level
• Use of social audits to increase empowerment and
access to RH services among youth—IPPF
 Community Level
• Community scorecards and community health
committees, CARE/Malawi, India—Center for Health and
Social Justice
•
Site Walk-Through Approach—EngenderHealth
Reference: Voluntary Rights-based FP Framework, A Sytematic Review of Tools, 2013
STEP 7
Create a One-Year Action Plan
Step 7:
Create One-Year
Acton Plan
Objective
 Create a one-year action plan for carrying
out the recommended actions to address
priority needs
Step 7:
Create One-Year
Acton Plan
Action Plan Follow-up
Considerations
 The action plan is just the beginning!
 Important follow-up steps:
• Incorporate into existing program plans or initiate
new plans and budgets
•
•
•
•
Update M&E plans
Assess, engage, and negotiate with new partners
Advocate for additional resources, as needed
Coordinate about priority issues that need other
groups’ attention and action
Final Reflection on the Road Ahead
 What was the most
important thing you
learned?
 What is the one thing you
will change? Do
differently?