ASSESSMENT OF ADVANCE AFRICA AND THE CATALYST CONSORTIUM Laurel Cobb Gerard Bowers Nina Frankel Maria Mamlouk November 2004 Submitted by: LTG Associates, Inc. Social & Scientific Systems, Inc. Submitted to: The United States Agency for International Development Under USAID Contract No. HRN–C–00–00–00007–00 This document is available in printed or online versions (POPTECH Publication Number 2004– 169–033). To review and/or obtain a document online, see the POPTECH web site at www.poptechproject.com. Documents are also available through the Development Experience Clearinghouse (www.dec.org). Assessment of Advance Africa and the CATALYST Consortium was made possible through support provided by the United States Agency for International Development (USAID) under the terms of Contract Number HRN–C–00–00–00007–00, POPTECH Assignment Number 2004–169. The opinions expressed herein are those of the authors and do not necessarily reflect the views of USAID. ACKNOWLEDGMENTS The assessment team would like to express its gratitude to all those who were so supportive of the team’s work: Bruce Carlson, David Barmettler, and Anne Shinn at POPTECH, who handled the technical planning and logistics for this assessment with great care; Maureen Norton and Kellie Stewart at USAID who have been unfailingly helpful; the leadership and staff of the Advance Africa team—and especially to Advance Africa staff in Arlington, Harare, and Maputo; and the leadership and staff of CATALYST, and especially to staff in Washington, Cairo, and Lima. ACRONYMS ADAR Asociación para el Desarrollo Amazónico Rural (Peru) AED Academy for Educational Development AGROVIDA Asociación de Promoción Agraria y Defensa de la Vida ANE Bureau for Asia and the Near East (USAID) APHA American Public Health Association APROPO Apoyo a Programas de Población (Peruvian NGO) ASPEFAM Asociación Peruana de Facultades de Medicina (Peruvian Association of Faculties and Schools of Medicine) ASPEFEEN Asociación Peruana de Facultades y Escuelas de Enfermería (Association of Faculties and Schools of Nurses) ASPEFOBST Asociación Peruana de Escuelas y Facultades de Obstetricia (Peruvian Association of Faculties and Schools of Midwives) BCC Behavior change communication CA Cooperating agency CAFME Commission for the Accreditation of Faculties and Schools of Medicine (Peru) CAFS Centre for African Family Studies CBD Community-based distribution CCP Central Contraceptive Procurement CDC Centers for Disease Control and Prevention CEDPA Centre for Development and Population Activities CHAPPL Caring for HIV and AIDS, Prevention and Positive Living initiative (CDC) CRS Catholic Relief Services CSI Clinical Services Improvement Project (Egypt) CTO Cognizant technical officer CYP Couple year of protection D&C Dilation and curettage DHS Demographic and Health Survey DOMCCP Diocese of Mutare Community Care Program DRC Democratic Republic of Congo DTT Deloitte Touche Tohmatsu EFPA Egyptian Family Planning Association FAWE Forum for African Women Educationalists FAWEMO Forum for African Women Educationalists/Mozambique FAWEZI Forum for African Women Educationalists/Zimbabwe FEMAP Mexican Federation of Private Associations for Health and Community FGC Female genital cutting FHI Family Health International FON Obstetric and Neonatal Functions (software) FP Family planning FY Fiscal year GH/PRH/SDI Bureau for Global Health, Office of Population and Reproductive Health, Service Delivery Improvement Division HIV/AIDS Human immunodeficiency virus/acquired immune deficiency syndrome HKI Helen Keller International HPN Office of Health, Population and Nutrition (USAID/Zimbabwe) HSDS Health Services Delivery and Support Program (JHU) IEC Information, education, and communication IMCI Integrated management of childhood illness INPPARES Instituto Peruano de Paternidad Responsable (International Planned Parenthood Federation affiliate, Peru) IQC Indefinite quantity contract IPPF/WHR International Planned Parenthood Federation/Western Hemisphere Region IR Intermediate Result IUD Intrauterine device IWG Integration Working Group JHU Johns Hopkins University JHU/HCP Johns Hopkins University/Health Communications Project JSI John Snow, Inc. KAP Knowledge, attitudes, and practices MAQ Maximizing Access and Quality Initiative MCA Millennium Challenge Account MCDI Medical Care Development International (Mozambique) MCH Maternal and child health MINSA Ministerio de Salud MIS Management information system MMR Movimiento Manuela Ramos MOH Ministry of Health MOH&CW Ministry of Health and Child Welfare (Zimbabwe) MOH/CH Ministry of Health, Division of Community Health (Mozambique) MOHP Ministry of Health and Population (Egypt) MSH Management Sciences for Health MTCT Mother-to-child transmission NGO Nongovernmental organization OBSI Optimal Birth Spacing Initiative PAC Postabortion care PAHO Pan American Health Organization PHC Primary health care PHRplus Partners for Health Reformplus Project PMIS Performance monitoring and improvement system PMTCT Prevention of mother-to-child transmission PSI Population Services International PVO Private voluntary organization REDSO Regional Economic Development Services Office (USAID) RFA Request for application RFP Request for proposal RH Reproductive health RUDO Rural Unity for Development Organization SAAJ Serviço de Saúde Amigo do Adolescente e Jovem SANRU III Santé Rural III project SCF/UK Save the Children/United Kingdom SO Strategic Objective STD Sexually transmitted disease STI Sexually transmitted infection STRIVE Support to Replicable, Innovative, Village/Community-level Efforts program (CRS) TAHSEEN Tahseen Sihitna Bi Tanzeem Usritna (CATALYST/Egypt) UNAIDS Joint United Nations Programme on HIV/AIDS UNDP United Nations Development Programme UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund USAID United States Agency for International Development USAID/GH Bureau for Global Health (USAID) VCT Voluntary counseling and testing WAHO West African Health Organization WHO World Health Organization WHO/AFRO World Health Organization/Africa Regional Office ZDHS Zimbabwe Demographic and Health Survey ZNFPC Zimbabwe National Family Planning Council CONTENTS Page Executive Summary.........................................................................................................i I. Background .........................................................................................................1 Bureau for Global Health Strategic Objectives ....................................................1 Program Description .............................................................................................2 Methodology.........................................................................................................4 II. IR 1: Increased Access to and Improved Quality of FP/RH Clinical and Nonclinical Programs .......................................................................................6 Findings for Advance Africa ................................................................................6 Findings for CATALYST...................................................................................10 Conclusions and Recommendations on IR 1 ......................................................16 III. IR 2: Increased Capacity for Informed FP/RH Decision-Making Among Clients and Communities ...............................................................................18 Findings for Advance Africa ..............................................................................18 Findings for CATALYST...................................................................................21 Conclusions and Recommendations ...................................................................25 IV. IR 3: Increased Capacity of Public and Private Sectors To Sustain Quality FP/RH Service Delivery Programs: CATALYST Consortium ....27 Conclusions and Recommendations ...................................................................28 V. IR 3: Improved Awareness of the Importance of the Health Benefits of FP Among African Policymakers: Advance Africa.................................30 Repositioning Family Planning...........................................................................30 Conclusions and Recommendations ...................................................................32 VI. IR 4: Scaled-Up and Improved FP/RH Service Delivery Programs Through Technical Collaboration With Other Agency/Donor/ Foundation Programs: CATALYST............................................................33 Scaling Up Programs ..........................................................................................33 Expansion Through Networking.........................................................................34 Conclusions and Recommendations ...................................................................34 VII. Crosscutting Issues............................................................................................36 Best Practices......................................................................................................36 Gender.................................................................................................................41 Conclusions and Recommendations ...................................................................43 VIII. Systems and Management................................................................................45 Human Resource Management...........................................................................45