The fourth International Conference on Family Planning (ICFP) on January 25-28, 2016, in Nusa Dua, Indonesia calls for “Global Commitments, Local Actions.” The conference is co-hosted by the Bill and Melinda Gates Institute for Population and Reproductive Health at Johns Hopkins Bloomberg School of Public Health and the National Population and Family Planning Board of Indonesia (BKKBN).
In October 2014, I shared the experience of Nepal’s long term impact of the Leadership Development Program (LDP), The LDP, originally developed by the LMG Project’s lead partner Management Sciences for Health (MSH), empowers teams to face local health service delivery challenges and to achieve results by utilizing hands-on leadership, management, and governance practices. In Nepal, almost ten years after original implementation, the LDP was still being used widely by local organizations on their own, enabling local teams to overcome challenges to achieve results. Most notably, hundreds of communities have been able to use the LDP process and plans to access millions of rupees from the government of Nepal to implement their community development priorities.
Talk about impact and sustainability! Pretty cool, right? Well, here’s another story of impact.
Here at the ICFP, I was speaking to a visitor to the LMG Project’s poster on the south-to-south exchange between Afghanistan and Peru about their community-based programs. Amos Simpano, Director of Clinical Services at Family Health Options Kenya (FHOK), was particularly interested because FHOK has a long and proud history of community based programs.
Coincidence Alert! I knew FHOK well in its earlier incarnation as the Family Planning Association of Kenya (FPAK), the leading NGO in family planning in Kenya. In the 1990s, when I worked in Nairobi with MSH’s Family Planning Management Development Project, 1990-1995 (FMPD-I), FPAK was one of our major client organizations. FPMD had worked closely with FPAK to strengthen their management systems, helping them establish their first comprehensive finance and information systems and computerizing them, developing strategic plans, and supporting a resource mobilization strategy that enabled them to move from rented office space to their own building. Among other things, FPMD also organized a south-to-south exchange with Bangladesh so FPAK could learn about a simple client mapping tool for their Community Based Distribution (CBD) volunteers – long before this could be done on computers.
In the 1990s, there were multiple effective CBD programs in Kenya, and FPAK’s stood out as the most widespread and successful. The intractable problem facing FPAK and all these programs was sustainability. While the volunteers were enormously dedicated, engaged, and effective, counting on unpaid labor was not the basis for a long-term family planning program. But who would pay for it? And when the donors turned their attention away from funding family planning and community volunteers to tackle the HIV/AIDS crisis, the CBD programs were diminished.
Flash forward to the conversation this week at ICFP. Amos and I had a fabulous catch-up about the repositioning of family planning in Kenya – great news indeed. Then, he mentioned that he and his team from Siaya in western Kenya had participated in MSH’s LDP through the Leadership, Management, and Sustainability Project, 2010-2015 (LMS). Their challenge was making the community family planning program sustainable. Using the LDP, they advocated to the county of Siaya for inclusion of the costs of the community health workers’ salaries in the county budget. So, they are no longer volunteers, but paid employees of the county. The sustainability challenge of the 1990s has been resolved, thanks to the LDP.
Don’t you just love these true stories? Do we think leadership and management have an important role in family planning and other health programs? Just ask Amos and FHOK.