Money Matters: Why We Follow Finance Flows for Population Projects
Population initiatives have stolen the spotlight lately, from Melinda Gates announcing family planning is now her ‘signature issue,’ to the just released international study on material mortality reporting that while childbirth related deaths have been halved since 1990; 250,000 women still die in pregnancy and childbirth each year, and millions more don’t have access to modern contraceptives. However, if we really want to improve access to family planning and reduce the number of women dying in childbirth even further, we need more money to do it. The truth is money matters.
The international community realized this vital fact and that funding for population related projects can be impacted by the sensitive politics surrounding population issues and by increased budget austerity around the globe. As a result, and to improve transparency, tracking progress towards health goals and creating necessary information needed for the improvement of financial strategies and health policies, several resource tracking projects have been initiated. One such project is the ‘Financial Resource Flows for Population Activities’ (RF) project which was born as a joint collaboration between United Nations Population Fund (UNFPA) and the Netherlands Interdisciplinary Demographic Institute (NIDI). To enhance capacity-building especially in developing countries, collaboration with the Indian Institute of Health Management Research (IIHMR) in Jaipur, India, and the African Population and Health Research Centre (APHRC) in Nairobi, Kenya was set up.
The ‘Financial Resource Flows for Population Activities’ (RF) project aims at monitoring the progress achieved by donors and developing countries in implementing the financial resource targets agreed during the ICPD in Cairo in 1994 and UNGASS in 2001.
The project monitors expenditures and future commitments for population programs at the country level, the term “population activities” referring to projects, programmes and activities in the following categories: a) Family planning services; b) Basic reproductive/maternal health services; and c) Basic research, data and population and development policy analysis.
At the core of the RF project’s activities are the donor and domestic surveys. To monitor the money committed and funding actually coming in, financial data on population and AIDS expenditures are collected at the project/program level, including expenditures during the previous year and expected expenditures during the current year and succeeding year. Three donor categories are distinguished: primary donors, intermediate donors and development banks. The domestic survey is a survey among governments and national NGOs.
At APHRC, we implement the Domestic Survey of the project in 46 sub-Saharan Africa countries. Annually, we collect data from government and Non-government organizations dealing with population activities as earlier defined in each country, review the data and enter it in the RF database. In collaboration with NIDI, we also generate and send to the UNFPA country offices ‘feedback reports’ for each country showing some preliminary results for the specific country. These results are also important for country specific reporting in the resource flows context.
How does any of this help us keep the population programs running? Financial Resource Flows data is critical because it provides timely and reliable information on what we have and what we need compared to country, regional and global needs. These data can also help estimate donor contributions in strengthening specific population activities in a country’s health system. In turn the information can be used in sound policy making and planning especially in SSA where data is often unreliable and/or unavailable.
The RF data also serves as a form of capacity strengthening for the National Health Accounts (NHAs). In fact members of the resource project team participated in the preparation of guidelines for reproductive health accounts which resulted in the “Guidelines for producing reproductive health subaccounts within the NHA framework”. Comparing the domestic survey data with the donor survey data gives an indication whether the donor funds are being used where they were intended and helps to keep everyone—donors and country governments—accountable for the funding. For more on the Resource Flows Project, visit www.resourceflows.org.