SEED™ Assessment Guide for Family Planning Programming SEED™ Assessment Guide for Family Planning Programming © 2011 EngenderHealth EngenderHealth 440 Ninth Avenue New York, NY 10001 U.S.A. Telephone: 212-561-8000 Fax: 212-561-8067 e-mail: [email protected] www.engenderhealth.org This publication was made possible through support provided by the F.M. Kirby Foundation. The opinions expressed herein are those of the publisher and do not necessarily reflect the views of the foundation. Cover design, graphic design, and typesetting: Weronika Murray and Tor de Vries Printing: Automated Graphic Systems ISBN 978-1-885063-97-7 Printed in the United States of America. Printed on recycled paper. Suggested citation: EngenderHealth. 2011. The SEED assessment guide for family planning programming. New York. Photo credits: M. Tuschman/EngenderHealth, A. Fiorente/EngenderHealth, C. Svingen/EngenderHealth. ii ContEntS Acknowledgments .................................................................................................................................. iv Acronyms and Abbreviations ................................................................................................................... v Introduction ................................................................................................................................. 2 EngenderHealth’s SEED Programming Model .......................................................................................... 3 How to Use This Assessment Guide......................................................................................................... 6 Key Considerations ............................................................................................................................... 10 Component 1: Supply ................................................................................................................. 12 1. FP is offered through a variety of service delivery modalities. .......................................................... 13 2. Facilities are adequately equipped and staffed to provide quality FP services. ................................. 14 3. Providers and facility staff have the necessary skills to provide quality FP services. ......................... 15 4. Management, supervision, and QA/QI systems are operational. ...................................................... 16 5. A broad mix of FP methods is available ........................................................................................... 18 6. FP services are integrated with other health services. ...................................................................... 19 7. Referral systems are functional where FP methods or services are unavailable ................................. 20 8. The private sector is involved in the provision of FP services. ......................................................... 21 9. FP services are inclusive of youth. ................................................................................................... 22 10. Clients receive high-quality FP counseling ...................................................................................... 23 Component 2: Enabling Environment ......................................................................................... 26 11. The FP program has effective leadership and management .............................................................. 27 12. Supportive laws, policies, and guidelines for FP are operational at all levels. ................................... 28 13. Human and financial resources are available for FP and are allocated effectively .............................. 29 14. Programmatic decision making is evidence-based.. .......................................................................... 30 15. Contraceptive security measures are in place ................................................................................... 32 16. Advocacy efforts support the FP program. ....................................................................................... 33 17. Champions at all levels advocate for FP ........................................................................................... 34 18. Communities are engaged in addressing barriers to FP use .............................................................. 35 19. The FP program works to foster positive social norms and transform gender roles .......................... 36 Component 3: Demand .............................................................................................................. 38 20. The program reduces the cost of FP to increase demand ................................................................. 39 21. An SBCC strategy for FP is in place ................................................................................................. 40 22. Commercial and social marketing are used to create demand .......................................................... 41 23. The FP program utilizes mass media SBCC approaches ................................................................... 42 24. The FP program engages communities and champions in SBCC...................................................... 43 25. The FP program utilizes peer education .......................................................................................... 44 References .................................................................................................................................. 46 Appendix A: Sample outlines for a Desk Review and Final Report ............................................ 54 Appendix B: Key Informant Discussion Guides .......................................................................... 64 Appendix C: Sample Meeting Agendas ...................................................................................... 94 EngenderHealth · The SEED™ Assessment Guide for Familly Planning Programming ACKnowlEDGMEntS EngenderHealth would like to acknowledge the F.M. Kirby Foundation for their generous support of the development of this SEED™ Assessment Guide for Family Planning Programming. This guide was written by Erin K. McGinn, Senior Technical Advisor for Family Planning, and Holly J. Connor, Family Planning Program Associate, both with EngenderHealth. The authors would like to thank several EngenderHealth colleagues for their time and expertise in the development and/or review of this guide: Lynn Bakamjian, Karen Beattie, Ellen Brazier, Jaweer Brown, Dr. Carmela Cordero, Akuba Dolphyne, Betty Farrell, Ashley Jackson, Dr. Roy Jacobstein, Jan Kumar, Nyanda Labor, Andrew Levack, Pierre Moon, Dr. Simon Nchifor, Dr. Isaiah Ndong, Melinda Pavin, Paul Perchal, John Pile, Lori Rolleri, Dr. Joseph Ruminjo, Lynn Van Lith, Marisa Westheimer, Jane Wickstrom, and John Yanulis. They extend thanks to several external colleagues: Jacques Baudouy, Ursula Nadolny, John A. Ross, John W. Townsend, and Dana Vogel. They also appreciate the input received from staff with the ACQUIRE Tanzania Project—in particular, Rehema Kahando, Dr. Joseph Kanama, Faith Kasulwa, Richard Killian, Sarah Kinyaga, Dr. Martha Kisanga, Feddy Mwanga, and Dr. Angelo Sanga, who provided input into early versions of the Key Informant Discussion Guides. The methodology and the Discussion Guides were adapted by the RESPOND Project for use in Burkina Faso, Nigeria, Rwanda, and Togo, and for three program assessments conducted by EngenderHealth and the United Nations Population Fund (UNFPA) in Burkina Faso, Mali, and Senegal; these experiences helped to finalize this Assessment Guide. Michael Klitsch copyedited the final draft of this document and managed the overall publication process; Weronika Murray and Tor de Vries designed and formatted the Assessment Guide. In 2009, EngenderHealth conducted a systematic literature review to identify the best practices in planning, implementation, and assessment of family planning (FP) programs, including searching for FP program models and conceptual frameworks. Most of the literature compiled focused on individual elements of FP programs, with service delivery models (particularly for clinical services) being the most common. Very few documents addressed FP programs in their entirety, from a conceptual and holistic perspective. Two documents of particular note, however, were identified and have influenced the development of this assessment tool: The Family Planning Effort Index: 1999, 2004, and 2009 (Ross & Smith, 2010) is an analysis of national FP programs. The latest in a series of comparable studies that have been conducted seven times from 1972 through 2009, it measures the strength of national FP programs as perceived by knowledgeable observers. Elements of Success in Family Planning Programming (Richey & Salem, 2008) provides an overview of 10 key elements of successful FP programs and includes a useful checklist called “Assessing the Elements of Success in Your Program.” iv EngenderHealth · The SEED™ Assessment Guide for Familly Planning Programming ACRonyMS AnD ABBREvIAtIonS AIDS ............ acquired immune deficiency syndrome CBHW..........community-based health worker CBO .............community-based organization CBS ..............community-based services CHW ............community health worker CIA ..............Central Intelligence Agency (U.S.) CPR ..............contraceptive prevalence rate CS ................contraceptive security DFID ........... Department for International Development (U.K.) DHS .............Demographic and Health Survey FBO..............faith-based