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Webinar Reading Time: 7 minutes

UHC and Family Planning: Financing Schemes, Innovations, and Integration

Knowledge SUCCESS, FP2030, Population Action International (PAI), and Management Sciences for Health (MSH) have partnered on a three-part collaborative dialogue series on universal health coverage (UHC) and family planning. The series engages participants and speakers to inform a position paper on this timely issue. The paper will be shared at the International Family Planning Conference (ICFP) later this year. Our second conversation, which was held on August 23, focused on financing schemes and innovations for UHC and the integration of family planning.

There’s still time to participate in the conversation! Register for our next session on October 18th.

New to family planning and UHC? Learn more.

The second 90-minute dialogue featured:

  • Moderator: Amy Boldosser-Boesch, Senior Director & Practice Area Lead for Health Policy, Advocacy & Engagement, and Integrated Health Care, Management Sciences for Health (MSH) Secretariat, Civil Society Engagement Mechanism (CSEM), UHC2030
  • Dr. Dieney Fadima Kaba, National Director of Family Health and Nutrition, Ministry of Health and Public Hygiene, Guinea
  • Matt Boxshall, Program Director at ThinkWell
  • Dr. Ben Bellows, Co-founder & Chief Business Officer, Nivi, Inc.

Closing remarks: Nabeeha Kazi Hutchins, President and CEO of PAI

Key Takeaways: 

Are you pressed for time? Here are the key insights from the discussion. 

  • Integration of family planning services requires not only country-level efforts, but community-level engagement, with special consideration for those in the most isolated areas
  • Financing models for UHC and FP must consider who will benefit from the scheme, how to most efficiently use funds, and what schemes will be the most effective on both system-wide and individual levels
  • 1:1 chat-enabled marketplaces can improve the ability of individuals to advocate for themselves and engage in their own health management at all levels of the health system and connect healthcare providers with consumers
  • Technological advancements can improve financing capacity for governments and access to services for individuals

Full Summary: 

Below, we’ve included a comprehensive recap that links to exact segments within the full recordings (available in English or French).

Amy Boldosser-Boesch: Financing family planning and UHC with the goal of leaving no one behind

Watch now: 00:50

Amy Boldosser-Boesch framed the conversation on financing UHC and emphasized the importance of integrating family planning, which requires innovation and effort on the part of both the public and private sectors. (To read the recap of the first conversation, click here.)

  • Webinar objective 1: Analyze and understand the various financing models for UHC and the opportunities for integrating FP
  • Webinar objective 2: Amplify the best practices and programs to expand access to services and how those can prioritize or complement family planning
  • Webinar objective 3: Articulate the role of private-sector engagement in realizing UHC and existing innovations that prioritize FP

Question 1 (for Dr. Dieney Fadima Kaba): Can you describe Guinea’s process of addressing UHC and family planning?

Watch now: 11:20

Dr. Kaba highlighted the three steps Guinea is taking on the path to UHC and the integration of family planning services.

Three important steps on the path towards Guinea’s integration of FP into UHC:

  1. Establishment of UHC at the primary healthcare level
  2. Engagement at the community level, including community healthcare workers and community health centers

Women’s empowerment and family planning awareness campaigns to generate demand and knowledge about FP services

Question 2: What innovative, person-centered financing models can provide sustainable resourcing for family planning?

Watch now: 17:05

Mr. Boxshall emphasized the difficulty of addressing sustainable resourcing for FP, and detailed three considerations to keep in mind when looking for solutions:

  1. Maintain a system-wide perspective
  2. Spend money as efficiently and effectively as possible
  3. Examine who exactly will benefit from a finance scheme

Mr. Boxshall emphasized that countries can only achieve UHC by examining their health systems as a whole. Regarding the second and third points, he highlighted several countries in which insurance schemes barely cover a fifth of the population. The critical problem with these types of insurance schemes is the use of premiums—that is, the price that individuals pay to the insurance company. Countries must focus on who benefits from a particular insurance scheme and whether or not only those who pay premiums can access benefits.

Question 3: What are some of the most innovative tools or approaches that you have seen for ensuring family planning access to those most often left behind?

Watch now: 24:34

Dr. Bellows outlined four hazards to avoid in any innovative process:

  1. Duplication
  2. Fragmentation
  3. Process at the expense of outcomes
  4. Excessive out-of-pocket costs

He noted that the goal of innovation is to create universal tools that focus on delivering high-quality care at low or no cost to beneficiaries. When considering FP integration, programmers must keep the self-care approach in mind. Dr. Bellows explained that 1:1 chat-enabled marketplaces, such as Nivi, can help generate awareness and service uptake as they help connect individuals in the health system with consumers.

Question 4: What is the biggest challenge in moving from policy to implementation, and what is one recommendation you have for removing barriers to implementation?

Watch now: 33:30

Elaborating on her discussion of Guinea’s path to UHC, Dr. Kaba further emphasized the importance of starting with primary healthcare. She noted the importance of using new technology to increase access and awareness in rural areas and to encourage self-care. However, the challenge is creating digital tools that can transmit information to the most isolated users in a language that is accessible to them. Tackling these barriers will require contributions from all levels of government and the community to improve access and ensure no one is left behind.

Question 5: Which countries have successfully integrated family planning services into insurance schemes?

Watch now: 40:56

Mr. Boxshall noted that successful FP integration requires strategic purchasing. The realm of UHC is on the verge of creating a virtuous cycle where purchasing is linked to data in order to improve and optimize spending.

Strategic purchasing involves improving the way we spend money on critical services by directing funds where they are most needed based on data findings.

Mr. Boxshall highlighted several countries that offer important lessons for integrating FP into insurance schemes. Kenya uses a capitation system, in which a doctor or hospital is paid a fixed amount per patient by an insurance association, but access has not increased significantly. Other countries—for example, the Philippines and Indonesia—offer an incentive to providers who ensure a broad method mix.

Question 6: Can you comment on the connection between the private and public sectors?

Watch now: 46:51

Mr. Boxshall highlighted that one of the great advantages of utilizing the private sector in health insurance financing models is that insurance agencies are often better positioned to contract with providers than Ministries of Health.

Solutions to bolster trust and engagement between providers and government:

  • Ensuring that payment is timely and adequate to cover the services provided
  • Automating systems to encourage private providers to engage with public funding

““If financing models can subsidize services supplied by private providers, then the choice and quality of services that consumers can access will increase.””

Matt Boxshall

Question 7: How do you see the integration of self-care into different levels of the healthcare system, especially at the national level of political dialogue? What is at stake?

Watch now: 50:20

Dr. Bellows stressed the need for marketplaces that can generate a financial return as well as a social and public health impact.

  • On the political side: Need for regulatory environments that see digital counseling as favorable and explore the capacity of technological innovations to help Ministries of Health with public health education efforts.
  • On the marketplace side: Need for recognition of the financial investment and return opportunity in the private sector for public health objectives. There is a great opportunity to benefit from a business-to-business consumer model:  services are offered free of charge to consumers, while businesses and governments benefit by buying in.

Question 8: What health financing models have worked for adolescents and young people?

Watch now: 55:11

Dr. Kaba emphasized that to improve contraceptive uptake among youth, access to services must first be improved. Dr. Bellows shared the success of Nivi in reaching young people where they are—online. Tools for digital counseling are finding more users each day.

Guinea’s commitment to increasing financing for family planning services: Guinea has recently included youth in its FP2030 commitment. Since 2018, 50% of FP needs have been financed by the national development budget. In order to reach the level of free service delivery, Guinea has committed to increasing the budget by 10% each year.

Question 9: Ethiopia is using a free-of-charge approach to family planning service integration, but uptake remains low. Are there strategies that you propose to address low uptake?

Watch now: 1:10:28

Dr. Kaba emphasized that in order for communities to accept services, they  must be included in dialogue from the very start. Developing initiatives with input from communities is critical to understanding their needs and desires.

Question 10: Could you talk about financing approaches to ensure that a range of choices and commodities is available?

Watch now: 1:13:26

Mr. Boxshall described several models that address FP costs, with varying levels of efficacy:

  • Option 1 (less effective): Costs are transferred to the district or facility level as part of a reimbursement claim. Responsibility sits with the local government to purchase commodities and distribute them.
  • Option 2 (more effective): Subsidized commodities are used. Formal contracts between an insurance or government agency and a private provider can be an entry point.

““Pay for choice. In a more digital environment, it’s possible to ask consumers questions about how they are allowing their customers choice. Pay for the world we want, not the world we’ve got.””

Dr. Ben Bellows

Closing Remarks: Nabeeha Kazi Hutchins, President and CEO of PAI

Ms. Hutchins emphasized the importance of a collective mission to achieve UHC access for comprehensive sexual and reproductive health. She reiterated an important theme highlighted throughout the conversation: Prioritizing community-based engagement and innovative solutions to financing family planning services with particular consideration of those most in need. This theme is at the core of PAI’s work and its collaborations with peer civil society organizations (CSOs). Currently, PAI is working with local CSOs and youth organizations on a Universal Health Coverage Initiative, and looks forward to sharing with and hearing more from partners at the upcoming International Conference on Family Planning (ICFP).

Want to stay engaged?

  • Tune into Part 3 of the conversation on October 18th! Register here.
  • Look out for the policy paper informed by these conversations to be presented at ICFP.
  • Become an FP2030 commitment maker: within your government or organization, pledge to take specific actions to increase rights-based contraceptive access.

Looking to get involved in the lead-up to the next UHC UN high-level meeting? 

  • Subscribe to the CSEM newsletter for updates on how to participate in the process of refining key asks for the high-level meeting.
  • Participate in the country-level consultations hosted by CSEM to contribute to UHC2030’s State of UHC Commitment Review, which monitors country commitments to UHC. Twenty country consultations will be organized in 2022; those working across different health sectors are encouraged to attend.
  • Add your perspectives to the CESM survey that will be used to inform the country profiles of the State of UHC Commitment Review.
  • Amplify and engage with UHC post-ICFP on World UHC Day in December.
Elizabeth Kayzman

Intern, FP2030

Elizabeth Kayzmanis an intern at FP2030. She assists the organization with communications, administrative tasks, data projects, and partnership engagement. She is currently studying to receive her Bachelor of Science in Neuroscience and Global Health from Duke University.

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