ContraceptiveSupplies Financing – The Role of Donors

TERMS OF REFERENCE

July2017

1. Introduction

Countdown 2030 Europe (C2030E) is a consortium of 15 NGOs in twelve European countries working to hold European donor governments and the European Union institutions to account for their policy and funding commitments on sexual and reproductive health (SRH)and family planning (FP). The consortium’s advocacy efforts are supported by several evidence-gathering activities, including a tracking of European donor spending on SRH and FP.The International Planned Parenthood Federation (IPPF) is one of the consortium’s partners.

To strengthen the expertise and advocacy capacity of C2030E oncontraceptivesupplies financing in the context of the current funding shortfall, IPPF, on behalf ofC2030E, is looking to engage a consultant to undertake a reviewand analysis ofEuropean donor governments’ support of contraceptivesupplies financing in low- and middle-incomecountries, within the wider reproductive health supplies financing landscape, and produce a report summarising findings and providing recommendations for further advocacy.

2. Background

Contraceptive funding crisis

The world is facing a contraceptive funding crisis. Funding for contraceptives and other reproductive health supplies falls far short of what is required to meet current needs, and, unless funding levels increase, will become more and more inadequate as demand for contraceptives grows. While the primary responsibility for ensuring access to contraceptives lies with country governments, donors continue to play an important role in the financing of contraceptives in low- and middle-income (LMIs) countries.

In 2014, an estimated total of USD 1.2 billion was spent on contraceptive supplies in 135 LMIs.[1] Of this total amount, donor funding made up 25% (USD 305.5 million), spending by country governments was 17% (USD 202.9 million), and spending by individual users of contraceptives amounted to close to 58% (USD 694.9 million). It is estimated that, if current trajectories of growth in contraceptive use continue, by 2020, the gap between the amount spent on supplies in 2014, and the cost of the volume of supplies users will require, will be USD 322 million.If funding by donors and country governments for supplies does not increase from 2014 levels, this additional cost burden will have to be covered through out-of-pocket expenditures byindividuals.

Recent developments putglobal funding forsupplies, and for wider sexual and reproductive health and rights (SRHR),under even further strain. The reinstatement and expansion of the Global Gag Rule, withholding of US funding to UNFPA through the Kemp-Kasten amendment, and a possible cutting of funding for USAID family planning and reproductive health programmes risk exacerbating the already substantial funding gap.

Development budgets are under pressure also in Europe, yet many European donors remain strongly supportive of SRHR in their development policies and funding. The governments of Belgium, Denmark, the Netherlands and Sweden spearheaded the launch of the She Decides initiative, which at a kick-off conference in March 2017 secured EUR 181 million in pledges. The UK government is one of the core partners of the FP2020 initiative, launched in 2012, which is committed to enabling an additional 120 million women and girls to use contraceptives by 2020.

Donor support for supplies financing

Donors provide support for supplies financing in a variety of ways. UNFPA and USAID are the two largest external procurers of contraceptives for LMI countries. In 2014, UNFPA and USAID provided 42% (USD 128.6 million) and 34% (USD 103.6 million) respectivelyof external procurement of contraceptives.[2]

UNFPA procures commodities using several funding sources, which includes UNFPA Supplies, its thematic programme dedicated to expanding access to family planning, and funds it receives to carry out third party procurement.[3] UNFPA Supplies is largely funded through donor governments, including many European governments.[4]It receives earmarked contributions, which are separate from UNFPA core resources. In recent years, UNFPA Supplieshas been facing a significant funding shortfall due to a decrease in donor contributions and exchange rate fluctuations.

Donors also provide support for supplies financing in the form of direct bilateral support to country governments for the procurement of contraceptives, as well as through funding of INGOs and social marketing groupsand initiatives such as the Global Fund, whichundertake contraceptive procurement.[5] Funding for contraceptive procurement is also provided through loans by the World Bankand projects supported through the Global Financing Facility (GFF) Trust Fund, which are alsofunded through donor contributions.

Several donors have participated in innovative financing partnerships and market-shaping initiatives which have sought to improve contraceptive security. This has included the Pledge Guarantee for Health, the Implant Access Program for the Jadelle® and Implanon® implants, and the Sayana® Press initiative.

At national level, donor support for supplies procurement has been channelled through national public-sector procurement systems, parallel private or UNFPA-managed procurement systems and basket funds set up to support supplies procurement.[6]

3. Scope of work

To strengthen C2030E partners’ understanding, expertise and advocacy capacity on contraceptive supplies financing, the consultant willundertakeareview and analysis of European donor governments’ support of contraceptive supplies financing in low- and middle-income countries, within the wider reproductive health supplies financing landscape, and produce a report summarising findings and providing recommendations for further advocacy.

Development of methodology:

The consultant will be expected to develop amethodology for the review and analysisfor discussion and agreement with C2030E. It is expected that this will include a desk-based review of existing resources, research and other materials on the topic from sources including donor and country governments, UNFPA, INGOs and social marketing groups, think tanks, NGOs and coalitions working in the field of supplies, including the Reproductive Health Supplies Coalition, and other stakeholders engaged on supplies financing, as well asskype/telephoneinterviews and other communicationwith the above or other stakeholders as needed. This mayinclude skype/telephone interviews with stakeholders engaged on supplies financing in 2-3 LMI countries to better grasp trends and realities of supplies financing in these contexts. It may further involve a setting up of a small advisory group of stakeholders engaged on supplies financing to review findings.

Once the methodology has been agreed, the consultant will undertake the review as set out in the methodology.

Development of reportand related materials:

Following the review, it is expected that the consultant will produce a report, which will outline findings of the review, and which should include sections on the following:

  • Current context on supplies financing in LMI countries, including overall trends, the current funding shortfall, including of UNFPA Supplies, different stakeholders involved, relative importance of donors, implications of policy and funding decisions of the new US administration according to latest available data and analysis, and policy context and initiatives (including SDGs, FP2020, She Decides). This may integrate findings from interviews of in-country stakeholders engaged on supplies financing, such as by including 2-3 brief country case examples.
  • Explanation ofprocesses aroundsuppliesprocurementand financing in LMI countries,i.e.procurement processes and structures,procurement from local and regional suppliers vs. global suppliers, commodity price negotiations, commodity prices under different procurement mechanisms, including related challenges.
  • The role of donors in supplies financing and procurement in LMI countries, with a focus on European donors, including:
  • Main donors, funding they provide, and modalities they employ.
  • Description and explanation of the different modalities through which donors provide support for supplies financing and procurement (including direct bilateral support, UNFPA Supplies and third-party procurement, support for INGOs, Global Fund, innovative financing partnerships,forms of support at country level, such as support of public-sector or parallel procurement systems, technical assistance, and any other forms of support).
  • Critical assessment and comparison ofthese different methods, based on findings of the review,highlighting positive and negative elements, efficiency, best practices, and concerns and criticisms.
  • Possibly, two to three case studies; this could, for example, be a more in-depth look at concrete examples of donor support provided, such as examples of bilateral support provided by DFID and/orKfW or another donor agency.
  • Practical recommendations for advocates based on the above findings in relation to the different modalities of donor support.
  • Suggestions for further research.

The consultant would also be expected to develop a shorter version of the above report that should explain findings in more ‘accessible’ language, with the aim of ‘demystifying’ the findings for advocates to use, as well as a two-page briefing that should summarise main findings and recommendations.The consultant will further be expected to provide an annotated bibliography.

The primary target audience of the report, and related materials, are the partners of the C2030E consortium and other civil society advocates working on sexual and reproductive health and rights, including family planning. C2030E will decide at a later point whether to publish the report, and related materials, or whether to keep themas internal documents.

Planning and facilitation of workshop:

The consultant would further be expected to plan and facilitate a 0.5/1-day workshop for C2030E partners and possible other participants, in collaboration with C2030E, to present and discuss findings of the report.

4. Deliverables, and level of effort

  • Development of draft methodology for review and analysis, to be reviewed by C2030E; finalisation of methodology following input received by C2030E (+/- 3 days)
  • Review as outlined in agreed methodology (+/- 11days)
  • Analysis and development of report (around 30 pages), shorter guide (around 8 pages), briefing note (2 pages)and annotated bibliography (+/- 11 days); a draft outline and draft versions of the report,shorter guide and briefing noteare to be shared for review and input by C2030E ahead of finalisation
  • Planning and facilitation of workshop, in collaboration with C2030E (+/- 3days)

Total level of effort:approximately 28working days.

5. Profile of consultant

Essential:

-Substantial knowledge of reproductive health supplies financing and procurement, both regarding donor financing and country contexts

-Understanding ofhealth financing, financing for sexual and reproductive health and rights and broader financing for developmentdiscourse

-Familiarity with donor policies and procedures, particularly of European donors

-Excellent, demonstrated research skills

-Excellent, demonstrated analytical and report writing skills

-Native-level English writing skills

Desirable:

-Previous research work and/or publications on reproductive health supplies financing

-Working knowledge of other European languages

6. Application process

To apply for this consultancy, please send an expression of interest, demonstrating how you meet the above requirements, and briefly detailing how you would plan to carry out this assignment, the estimated duration of the assignment, your times of availability for undertaking the assignment and your daily rate. Your application should also include your CV, including contact details of two referees, a list of previous publications and research work and two writing samples.

Please submityour application to Raffaela Dattler at .

Deadline for submission is Tuesday, 22 August 2017, 5pm GMT.

For more on Countdown 2030 Europe:

For more on the International Planned Parenthood Federation:

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[1] See on these and the following figures, Reproductive Health Supplies Coalition, Global Contraceptive Commodity Gap Analysis 2016, May 2017, available at

[2] See UNFPA, Contraceptives and Condoms for Family Planning and STI & HIV Prevention, External Procurement Support Report, 2014, available at

[3] Ibid.

[4]According to Countdown 2030 Europe’s Trends Analysis 2015-16 of European Donor Support to Sexual and Reproductive Health and Family Planning, the following Countdown country governments contributed to UNFPA Supplies in 2015: UK (EUR 61.3 million), Netherlands (EUR 26.5 million), Denmark (EUR 1.8 million) and Spain (EUR 350,000).

[5] UNFPA, External Procurement Support Report, 2014.

[6] See Center for Global Development, Aligning to 2020 – How the FP2020 Core Partners Can Work Better, Together, available at which provides examples from Kenya, Nigeria and Uganda on pages 24-26.