Suzanna is writing from Nairobi, Kenya, where she is currently meeting with partners on PAI’s RH BudgetWatch project.
The circumstances are challenging:
- Women go to facilities that are stocked out of the type of contraception they depend on to protect them from unplanned pregnancies.
- A contraceptive forecasting system that is transitioning from a “push” system where the central Department of Reproductive Health “pushes” the supplies they estimate facilities need, and a “pull” system where facilities are allowed to make requests for supplies based on their needs.
- Decades of dependence on unpredictable donor funding for contraceptives. Why should government use their own scarce resources when donors can pay for family planning?
- A rigid budget ceiling leaving the Ministry of Health unable to provide sufficient funding for family planning. What about the government’s Abuja commitment to devote 15% of their budget to health?
- Family planning champions in government who have been so frustrated by past budget-making processes that they do not even think it is worthwhile to defend their reproductive health budget.
But there are also exciting opportunities:
- Political momentum around a new constitution guaranteeing the right to health, including reproductive health.
- A new, decentralized political system inspiring hope that government will be more responsive to the people and their needs.
- A parliament with new decision-making power to amend the budget approved by the cabinet.
- A government committed to increased transparency with the Open Data Initiative, e-governance and E-Promise initiatives.
- A growing number of CSOs involved in aid and budget advocacy, and strategic partners like Development Initiatives and the Centre for Economic Governance and AIDS in Africa on hand to provide support.
This is Kenya today. With so many challenges and opportunities, where do advocates trying to make sure that every woman and couple is able to prevent unwanted pregnancies start?
We’ve convened our partners on the RH BudgetWatch project—the Health Rights Advocacy Forum and Pathfinder’s Tanzania country office—to do just this. We’ve asked them to evaluate all the evidence they’ve gathered on budgeting for family planning over the last 18 months of the project and identify the biggest challenges. Now, we’re working with them to decide and plan out the first measurable change they can make to take advantage of the opportunities or overcome the most pressing challenges.
To do this well, they have to know who has the power to make their objective a reality, understand the complex environment around them and their own strengths and weaknesses, and the activities and messengers that can reach their target audience. Then repeat the same steps for each important change they need to make.
It is no easy task. But no one said that changing the world was easy.