When public health officials make decisions, they are faced with competing demands on financial resources, conflicting interests, and the imperative to meet national health goals. Decision-makers need tools to help them establish a healthy market, particularly in resource-constrained settings. SHOPS Plus found this to be the case in in a recent activity in Tanzania, where their ultimate goal was to engage all the actors in Tanzania’s health market, public and private, to ensure proper targeting of investments and meet the health needs of all Tanzanians.
SHOPS Plus in Tanzania leverages and unlocks the potential of private sector to accelerate progress towards Tanzania’s health outcomes. While working with the Tanzania Ministry of Health, Community Development, Gender, Elderly, and Children to increase access to family planning, we realized that stakeholders at the local and regional levels were not aware of data on the contributions of the public and private sectors when it came to looking at the sources of family planning commodities.
This made it easy for private providers to be sidelined, because there was little understanding of what or how they were contributing to the market. Stakeholders were not thinking about what an absent or diminished private sector market would mean. There was no consideration of how a change in supply patterns or public-sector availability might affect the overall market.
We saw the need for evidence to prompt action. As the saying goes, a picture is worth a thousand words. We used the Family Planning Market Analyzer, a tool that enables data visualization and gives decision-makers a view of the family planning market and what could happen with different scenarios. Created by SHOPS Plus, the tool combines data from The DHS Program’s and Family Planning 2020’s projections of modern contraceptive use. It projects changes based on three scenarios: shifts in method mix, source mix, and both method and source mix. These projections show how many women will be affected by a given change and how that change will influence the overall picture. They also explore the implications of such changes for both public and private providers.
Using the tool shifted our conversations. We moved from talking theoretically about what would happen if the supply of a given family planning method changed to looking at projections based on data. Now, our conversations were grounded in actual numbers. Using the tool’s built-in visualizations provided a clear and simple way to communicate the results.
Working with government stakeholders, we wanted to model market situations based on anticipated changes in user source patterns and demand patterns. Using the Family Planning Market Analyzer to study the 2017 market in Tanzania, we were able to see what might happen if the private sector faced an imminent shortage of injectables, the most popular family planning method in the country.
This situation arose from the history of Tanzania’s private injectables market, which for a very long time was dependent on a single socially marketed brand. Due to reduced support for subsidies, the supply of this socially marketed brand was declining. We knew that this would result in a shift in sourcing for the one in three injectable users who obtained their method from the private sector.
To spur action, we demonstrated what would happen if these clients shifted to the public sector.
Analysis revealed that there would be an increase of 428,000 women going to the public sector for their injectables. This very dramatic increase over three years is shown by the bars below, drawn from the Family Planning Market Analyzer. This caught the attention of our government stakeholders in addition to implementing partners and market actors such as social marketing organizations, social enterprises, and pharmaceutical distributors.
We then worked with the Ministry to examine the situation from the flip side: Was our public sector ready to absorb 428,000 additional clients?
Bear in mind that this would translate to over 1,000,000 additional visits, since injectable users visit a facility multiple times a year. Our stakeholders agreed that our public sector would not have the human resource capacity or the commodities to absorb this anticipated shift.
The Family Planning Market Analyzer helped us move from theory to numbers. Thanks to these scenarios, for the first time, public stakeholders in Tanzania were asking questions about how to achieve a market that is efficient, equitable, and sustainable.
We needed to ensure that private-sector users continued to be served by the private sector, and, where needed, continued to have access to a subsidized affordable product. After reviewing the market projections, the government of Tanzania was willing to support development of the private sector’s capacity to absorb anticipated future increases in contraceptive users as a result of an increase in the modern contraceptive rate.
The Family Planning Market Analyzer helped us generate scenarios that prompted action. This injectables example illustrates the need to support the private sector to ensure market entry by new private-sector brands. The government heeded the call of the data and, in fact, has put in place measures to support increased involvement of private family planning market actors in commodity quantification and programming—taking into account health commodities distributed through the private sector and populations served by the private market.
Achieving a goal of all women having affordable access to a range of contraceptive methods takes careful coordination and planning. The Family Planning Market Analyzer is a tool to help make this a reality. Stakeholders in other countries can easily access this free online tool, which is pre-loaded with data for over 50 countries. They will find information about the current state of their family planning markets and be able to explore a range of scenarios to help inform discussions about the future role of both the public and private sectors.