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Resources Flow Pilot Project in Tanzania and Ethiopia 2012, Pilot Study

ETHIOPIA, TANZANIA, 2013
Health and Well-Being (HaW)
African Population and Health Research Center
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Identification

IDNO
APHRC-FP2020-1.0
Title
Resources Flow Pilot Project in Tanzania and Ethiopia 2012, Pilot Study
Subtitle
Pilot Study
Country
Name Country code
ETHIOPIA ETH
TANZANIA TNZ
Abstract
For many years, international donors, multilateral corporations, governments and philanthropies have invested heavily in supporting family planning programs in sub-Saharan Africa. Regardless the resources applied to FP, the gap of the needs met is still huge: In response to the need for a revamped family planning agenda, several initiatives have been developed, among them, the Family Planning 2020 (FP2020) Initiative. FP2020 is a global partnership that supports the rights of couples, women and girls to decide, freely, and for themselves, whether, when, and how many children they want to have. The initiative works with governments, civil society, multi-lateral organizations, donors, the private sector, and the research and development community to enable 120 million more women and girls to use contraceptives by 2020.

Given the paucity of information on this expenditure, this pilot study was implemented in Tanzania and Ethiopia. The aim was to ascertain the feasibility of generating quality data on expenditure on family planning from the public and private sectors involved in providing family planning goods and services in the two countries.

Increasing access to family planning (FP) can reduce poverty and hunger, avert maternal and childhood deaths and increase women's empowerment (John Cleland et al., 2006). Effective FP also promotes an economic boom as it ensures a healthier, better educated, and skilled workforce, as well as low dependency ratios (World Health Organisation, United States Agency for International Development, Population Reference Bureau, & Academy for Educational Development, 2008).

For many years, international donors, multilateral corporations, governments and philanthropies have invested heavily in supporting family planning programs in sub-Saharan Africa. Regardless the resources applied to FP, the gap of the needs met is still huge: if unintended pregnancies would drop by 70%, the number would mean a reduction of undesired pregnancies from 74 million to 22 million per year (UNFPA, Guttmacher Institute, 2014). Recently, however, funding for FP has begun to decline leading to reversals in gains already achieved in some developing countries (Barbara O'Hanlon, 2009). In response to the need for a revamped family planning agenda, several initiatives have been developed, among them, the Family Planning 2020 (FP2020) Initiative. FP2020 is a global partnership that supports the rights of couples, women and girls to decide, freely, and for themselves, whether, when, and how many children they want to have. The initiative works with governments, civil society, multi-lateral organizations, donors, the private sector, and the research and development community to enable 120 million more women and girls to use contraceptives by 2020 (FP2020, 2013).

To reach the above-mentioned goal financial information is required to estimate the additional resources needed as well as to find opportunities of an effective and efficient use of the expenditure.The aim is to get clarity on how much is currently spent on family planning and to which components the expenditure go to. Considering the experience in the Resource Flows Project in NIDI, Futures Institute, HPP invited NIDI to develop this study and to identify the major flows of FP funds through a pilot study, which could lead to an enriched tool and more relevant and comprehensive data.

Given the paucity of information on this expenditure, this pilot study was implemented in Tanzania and Ethiopia. The aim was to ascertain the feasibility of generating quality data on expenditure on family planning from the public and private sectors involved in providing family planning goods and services in the two countries. Additionally, estimates on OOPs and the external funding reaching the country with a FP purpose would be prepared. The study was also expected to provide lessons to guide efforts to bring tracking of FP expenditure to scale.

This report presents the various contributions to the study, notably from Futures Institute proposing the content and including the measurement of OOPS; from APHRC performing and reporting the domestic survey in both countries; and from NIDI with the platform for the domestic component, the external resources measurement and the integration of all components. The content includes the following sections: a) Methodology and approach for each area of work: external funding, the domestic survey and OOPS, as well as the quality control and verification process; b) The results on the external funds channeled to FP services in Tanzania and Ethiopia collected by the Resource Flows project; c) Main results of the pilot survey in Tanzania and in Ethiopia, by component: Government, NGO, Corporations, collected and reported by APHRC; d) Family Planning OOPs estimates in both countries, by Futures Institute; e) Summary overview of the experiences and respondent feedback to the domestic survey with a discussion to briefly reflect on the response of the questionnaire and how it served its purpose; f) General discussion and conclusions.

Version

Version Date
2012-12-31
Version Notes
Version 1.0 with datasets and study DOI

Scope

Keywords
Keyword
Capital Investment
Domestic sources
Expenditures
International sources
Own income
Recurrent expenses

Coverage

Geographic Coverage
This survey covered sampled actors in family planning in Ethiopia and Tanzania.
Unit of Analysis
Government departments , corporations, NGOs, Public institutions, insurance companies, local philanthropies and consultants that deal with family planning issues.
Universe
The survey covered sampled government departments , corporations, NGOs, Public institutions, insurance companies, local philanthropies and consultants that deal with family planning issues.

Producers and sponsors

Authoring entity/Primary investigators
Agency Name Affiliation
African Population and Health Research Center APHRC
Producers
Name Affiliation Role
Chimaraoke Izugbara APHRC PI
Erik Beekink Netherlands Interdisciplinary Demographic Institute Co-PI
Michael Mutua APHRC Project Manager
Funding Agency/Sponsor
Name Abbreviation Role
Netherlands Netherlands Interdisciplinary Demographic Institute NIDI NIDI will add specific FP questions to the existing Resource Flow questionnaire in Ethiopia and Tanzania. NIDI will write and provide to HPP the analytical reports of the results of the FP data, the datasets, and recommendations for improving data collection in the future.
Other Identifications/Acknowledgments
Name Role
Futures Institute Developed first field test of the survey
Health Policy Project Provided OOPS data, financial means

Sampling

Sampling Procedure
The first step in implementing the survey was to prelist all known key players in FP financing and provision. From that list was extracted all government, insurance companies, and large corporations to be included. For parsimony, the top 10 NGOs and a simple random sample of the remaining NGOs were included in the sample. The top 10 NGOs and other major players were identified based on the consultant's knowledge of the specific organization's approximate market share of FP involvement in their respective countries and consultative discussion with national FP service provision experts.

Data Collection

Dates of Data Collection (YYYY/MM/DD)
Start date End date Cycle
2013-01-01 2013-12-31 Pilot
Mode of data collection
Face-to-face [f2f]
Supervision
The first step in implementing the survey was to prelist all known key players in FP financing and provision. From that list was extracted all government, insurance companies, and large corporations to be included. For parsimony, the top 10 NGOs and a simple random sample of the remaining NGOs were included in the sample. The top 10 NGOs and other major players were identified based on the consultant’s knowledge of the specific organization’s approximate market share of FP involvement in their respective countries and consultative discussion with national FP service provision experts.



The next step was for the consultant to identify a contact person or respondent from each of the selected organizations or government office. For improved data quantity and quality, a few organizations were selected for further visits with an aim of improving the response rate, as informed by previous experiences in the RF study. The few contact persons were visited and informed beforehand of the planned pilot study. These key contacts were pre-identified as follows; one from the Central MoH, two from any other public sector FP providers or financiers and four key NGOs.



The consultants conducted three visits to each of these seven institutions with the following agenda for each visit:

• At the initial visit, the consultant would go over the questionnaires and the manuals, clarifying issues with the contacts person in these institutions. The consultant would also demonstrate some of the areas of estimation.

• On the second visit, the consultant would check the progress, review the estimations, verify already collected data and agree on finalization schedule for the remaining data.

• On the third/final visit, the consultant would finalize the questionnaire and check the consistency of the data provided so far.



The consultants distributed the questionnaires and manuals, (a detailed and a brief manual) to all identified target institutions either physically or via email after identifying and making contact with the respondents. The consultant followed up by booking an appointment with the respondents, during which the consultant went through the questionnaire with the respondents, identifying any areas that the respondent needed support in, especially the estimation process.
Type of Research Instrument
The questionnaires were structured. There was a question specifically customized for NGOs, corporations, governments, local philanthropies, consultants and insurance companies. They all collected data on general information, sources of income, projects on family planning and expenditures.

Data Processing

Cleaning Operations
After all data were collected, the questionnaires were forwarded to APHRC for entry into an MS Access database developed to capture the data from paper form to soft format. All data were exported to STATA for further management.



Additional to the quality of data developed by AHPRC, NIDI performed a data verification a) comparing the original questionnaires and the entries in the database, b) selected entries and estimations were verified and their impact in the data (e.g. rates, time of transactions); c) suggestion of non- data entry error detection e.g. double count search; and d) a report with specific suggestions was given back to help the improvement of the results.
Other Processing
Other non-data entry errors that could not be verified against the paper questionnaires could be corrected after seeking corrections from the consultant or the respondent. The final clean data were used to produce summary measures such as proportions, summations and averages.

Data access

Contact
Name Affiliation Email
Director of Research APHRC datarequests@aphrc.org
Conditions
All non-APHRC staff seeking to use data generated at the Center must obtain written approval to use the data from the Director of Research. This form is developed to assess applications for data use and facilitate responsible sharing of data with external partners/collaborators/researchers. By entering into this agreement, the undersigned agrees to use these data only for the purpose for which they were obtained and to abide by the conditions outlined below:

1. Data Ownership: The data remain the property of APHRC; any unauthorized reproduction and sharing of the data is strictly prohibited. The user will, therefore, not release nor permit others to use or release the data to any other person without the written authorization from the Center.

2. Purpose: The provided data must be used for the purpose specified in the Data Request Form; any other use not specified in the form must receive additional or separate authorization.

3. Respondent Identifiers: The Center is committed to protecting the identity of the respondents who provide information in its research. All analytical data sets (both qualitative and quantitative) released by the Data Unit MUST are stripped of respondent identifiers to protect the identity of the respondents. By accepting to use APHRC data, the user is pledging that he/she will not, under any circumstance, regenerate the identifiers or permit others to use the data to learn the identity of any individual, household or community included in any data set.

4. Confidentiality pledge: The user will not use nor permit others to use the data to report any information in the data sets that could identify, directly or by inference, individuals or households.

5. Reporting of errors or inconsistencies: The user will promptly notify the Head of the Statistics and Survey Unit any errors discovered in the data as soon as the errors are discovered.

6. Publications resulting from APHRC data: The Center requires external collaborators to work with APHRC staff on all publications resulting from its data. In order to facilitate this, lead authors should send a detailed concept note of the paper (including the background, rationale, data, analytical methods, and preliminary findings) to the Principle Investigator (or Theme Leader) for the project (with a copy to the Director of Research), who will circulate the abstract to concerned researchers for possible expression of interest in participating in the publication as co-authors. Any exception to the involvement of APHRC staff should be approved by the Director of Research, APHRC.

7. Security: The user will take responsibility for the security of the data by ensuring that the data are used and stored in a secure environment where access is password protected. This will ensure that non-authorized people should not have access to the data.

8. Loss of privilege to use data: In the event that APHRC determines that the data user is in violation of the conditions for using the data, or if the user wishes to cancel this agreement, the user will destroy the data files provided to him/her. APHRC retains the right to revoke this agreement or informs publishers to withhold publication of any work based wholly or in part on its data if the conditions for using the data are violated.

9. Acknowledgement: Any work/reports from this data must acknowledge APHRC as the source of these data. For example, the suggested acknowledgement for NUHDSS data is:

"This research uses livelihoods data collected under the longitudinal Nairobi Urban Health and Demographic Surveillance System (NUHDSS) since 2006. The NUHDSS is carried out by the African Population and Health Research Center in two slums settlements (Korogocho and Viwandani) in Nairobi City."

Additionally all funders, the study communities that provided the data, and staff who collected and analyzed or processed the data should be acknowledged.

10. Deposit of Reports/Papers: The user should submit electronic and paper copies of all publications generated using APHRC data to the Policy Engagement and Communications Department, with copies to the Director of Research.

11. Change of contact details: The user will promptly inform the Director of Research of any change in your personal details as contained on this data request form.
Citation requirement
African Population and Health Research Center, Resources Flow Pilot Project in Tanzania and Ethiopia, 2018. Nairobi - Kenya. doi:10.20369/aphrc-050:2018.1.0

Metadata production

Document ID
APHRC-FP2020-1.0
Producers
Name Abbreviation Role
African Population and Health Research Center APHRC Data Producer
Date of Production
2018-03-09
Document version
Version 1.0 (March 2018)