Assessing public and private sector contributions in reproductive health financing and utilization for six sub-Saharan African countries

Nguyen, Ha; Snider, Jeremy; Ravishankar, Nirmala; Magvanjav, Oyunbileg

doi:10.1016/s0968-8080(11)37561-1

Cited by 24 publications

(27 citation statements)

References 6 publications

(7 reference statements)

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“…This assessment provides a baseline for tracking FP funds at the county level. This study joins other studies arguing for more local-level information about FP 7 to add to estimates of RH financing at the national level 29 and for more comprehensive budget analysis for FP 30 . The participatory approach facilitated the acceptance of the findings and increased the likelihood that recommendations will be adopted.…”

Section: Discussionsupporting

confidence: 71%

“…This reliance on donors suggests a need to advocate for greater national and county government contribution toward the FP program. International donors have figured heavily in national sources for RH 29 . In the present study, an increase in funding from the Government of Kenya was observed at the county level.…”

Section: Discussionmentioning

confidence: 99%

“…Government spending was only captured for FP methods and commodities expenditures and for employees' salaries designated for -reproductive health.‖ Additional government contributions not captured include infrastructure (buildings, administration of buildings) and staff time for supervision of health care; thus, the government's financial commitment to FP is underestimated. Clients' out-of-pocket expenditure for FP commodities was beyond the scope of this study, but future studies should include this component, which has been examined at the national level 29 .…”

Section: Strengths and Limitationsmentioning

confidence: 99%

See 2 more Smart Citations

Changing Face of Family Planning Funding in Kenya: A Cross-Sectional Survey of Two Urban Counties

Keyonzo¹,

Korir

Abilla

et al. 2017

Afr J Reprod Health

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As international development partners reduce funding for family planning (FP) programs, the need to estimate the financial resources devoted to FP is becoming increasingly important both at all levels. This cross-sectional assessment examined the FP financing sources, agents, and expenditures in two counties of Kenya for fiscal years 2010/2011 and 2011/2012 to guide local decision-making on financial allocations. Data were collected through a participatory process. This involved stakeholder interviews, review of financial records and service statistics, and a survey of facilities offering FP services. Financing sources and agents were identified, and source amounts calculated. Types of FP provider organizations and the amounts spent by expenditure categories were identified. Overall, five financing sources and seven agents for FP were identified. Total two-year expenditures were KSh 307.8 M (US$ 3.62 M). The government's share of funding rose from 12% to 21% over the two years (p=0.029). In 2010/2011, the largest expense categories were administration, commodities, and labor; however, spending on commodities increased by 47% (p=0.042). This study provides local managers with FP financing and expenditure information for use in budget allocation decision-making. These analyses can be done routinely and replicated in other local counties or countries in a context of devolution. (Afr J Reprod Health 2017; 21[4]: 24-32).

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

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Changing Face of Family Planning Funding in Kenya: A Cross-Sectional Survey of Two Urban Counties

Keyonzo¹,

Korir

Abilla

et al. 2017

Afr J Reprod Health

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“…Little is known about contraceptive use among HIV positive women entering HIV care in Uganda, a country in which access to reproductive health care is limited [27]. Entry into HIV care may represent an opportune time to assess women's fertility plans and intervene to prevent unintended pregnancies and reduce MTCT of HIV.…”

Section: Introductionmentioning

confidence: 99%

Contraceptive Use and Associated Factors among Women Enrolling into HIV Care in Southwestern Uganda

Muyindike

Fatch

Steinfield

et al. 2012

Infectious Diseases in Obstetrics and Gynecology

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Background. Preventing unintended pregnancies among women living with HIV is an important component of prevention of mother-to-child HIV transmission (PMTCT), yet few data exist on contraceptive use among women entering HIV care. Methods. This was a retrospective study of electronic medical records from the initial HIV clinic visits of 826 sexually active, nonpregnant, 18–49-year old women in southwestern Uganda in 2009. We examined whether contraceptive use was associated with HIV status disclosure to one's spouse. Results. The proportion reporting use of contraception was 27.8%. The most common method used was injectable hormones (51.7%), followed by condoms (29.6%), and oral contraceptives (8.7%). In multivariable analysis, the odds of contraceptive use were significantly higher among women reporting secondary education, higher income, three or more children, and younger age. There were no significant independent associations between contraceptive use and HIV status disclosure to spouse. Discussion. Contraceptive use among HIV-positive females enrolling into HIV care in southwestern Uganda was low. Our results suggest that increased emphasis should be given to increase the contraception uptake for all women especially those with lower education and income. HIV clinics may be prime sites for contraception education and service delivery integration.

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“…However, even when financial and geographic barriers have been removed, acceptability (Govender & Penn-Kekana, 2008;Tilahun et al, 2012;Tylee, Haller, Graham, Churchill, & Sanci, 2007) and quality-of-care (Ahmed & Khan, 2011;Limwattananon, Tangcharoensathien, & Sirilak, 2011;Nguyen, Snider, Ravishankar, & Magvanjav, 2011;Ravindran & Nair, 2012) challenges can persist. SRH services, particularly those that are contested, are often the site where quality-of-care remains a challenge (Wood & Jewkes, 2006).…”

Section: Introductionmentioning

confidence: 99%

Sexual and reproductive health and rights in changing health systems

2015

Reproductive Health Matters

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Sexual and reproductive health and rights (SRHR) are centrally important to health. However, there have been significant shortcomings in implementing SRHR to date. In the context of health systems reform and universal health coverage/care (UHC), this paper explores the following questions. What do these changes in health systems thinking mean for SRHR and gender equity in health in the context of renewed calls for increased investments in the health of women and girls? Can SRHR be integrated usefully into the call for UHC, and if so how? Can health systems reforms address the continuing sexual and reproductive ill health and violations of sexual and reproductive rights (SRR)? Conversely, can the attention to individual human rights that is intrinsic to the SRHR agenda and its continuing concerns about equality, quality and accountability provide impetus for strengthening the health system? The paper argues that achieving equity on the UHC path will require a combination of system improvements and services that benefit all, together with special attention to those whose needs are great and who are likely to fall behind in the politics of choice and voice (i.e., progressive universalism paying particular attention to gender inequalities).Keywords: sexual and reproductive health and rights; universal health coverage/care; quality of care; accountability; equity Introduction Sexual and reproductive health and rights (SRHR) are centrally important to health outcomes in all countries. Sex and reproduction define unique and specific health needs for girls and women over the entire life course. Whether, how and to what extent these health needs are met by the health system depends on the extent to which girls' and women's human rights are respected, protected and fulfilled. Throughout the life course, the sexual and reproductive rights (SRR) of girls and women -to bodily autonomy and integrity, to choice in relation to sexuality and reproduction, to freedom from coercion, discrimination and violence or fear of violence, to safety, satisfaction and pleasureprofoundly shape their physical and mental health and well-being.

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Assessing public and private sector contributions in reproductive health financing and utilization for six sub-Saharan African countries

Cited by 24 publications

References 6 publications

Changing Face of Family Planning Funding in Kenya: A Cross-Sectional Survey of Two Urban Counties

Changing Face of Family Planning Funding in Kenya: A Cross-Sectional Survey of Two Urban Counties

Contraceptive Use and Associated Factors among Women Enrolling into HIV Care in Southwestern Uganda

Sexual and reproductive health and rights in changing health systems

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