Total Market Approaches - Total Market Approach Stewardship Capacity Assessment Report

Publication date: 2015

Total Market Approach Stewardship Capacity Assessment Report Reproductive Health Supplies Coalition Inovation Grant V 1.0 Contract # NOD.1841- 705888-GRT July 2015 Prepared for: Reproductive Health Supplies Coalition C/o PATH - 2201 Westlake Avenue, Suite 200, Seattle, WA 98121 Submitted by: Abt Associates 4550 Montgomery Avenue Suite 800 North Bethesda, MD 20814 CONTENTS Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. i Acknowledgments . ii Acronyms . iii 1. Background . 1 1.1 Objectives . 1 2. Assessment methodology . 2 2.1 Design stage . 2 2.2 Review stage . 2 2.3 Field testing . 3 2.3.1 Key informant selection. 3 2.3.2 Field test data collection . 3 3. Findings from the field testing. 5 4. Assessment redesign . 7 5. Additional findings . 8 6. Recommendations and next steps . 9 7. Annex 1: Field test evaluation tool (v2.0) . 11 8. Annex 2: Contact list . 22 ACKNOWLEDGMENTS Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. ii Acknowledgments Abt Associates is grateful to the staff of the Ministries of Health and National Medical Stores in Malawi and Tanzania for graciously participating in this assessment; to local representatives of PSI, Marie Stopes International, John Snow International, the United Nations Population Fund, and members of the RHSC Market Development Approaches Working Group, for providing critical input into the revisions of the tool and indicator. The author of this report extends special thanks to Dr. Timothy Kachule and Dr. Emmanuel Malangalila from the Strengthening Health Outcomes through the Private Sector (SHOPS) project for helping identify and secure meetings with key stakeholders in Malawi and Tanzania. ACKNOWLEDGMENTS Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. iii Acronyms FP/RH Family planning / reproductive health HIV/AIDS Human immunodeficiency virus, acquired immunodeficiency syndrome JSI John Snow, Inc. M&E Monitoring and evaluation MDA Market Development Approaches MOH Ministry of Health MSI Marie Stopes International NGO Non-governmental organization PSI Population Services International RHSC Reproductive Health Supplies Coalition SHOPS Strengthening Health Outcomes through the Private Sector TMA Total Market Approach TMASCT Total Market Approach Stewardship Capacity Tool UNFPA United Nations Population Fund USAID United States Agency for International Development BACKGROUND Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 1 1. Background 1.1 Objectives Despite increased support for Total Market Approaches that leverage the public, NGO and commercial sectors to meet the need for health products and services, government-led TMAs are rare. This activity is in response to a need identified by the Reproductive health Supplies Coalition (RHSC) to assist governments in playing a stewardship role in the implementation of TMAs. The stewardship role of the government involves collecting and analyzing data, engaging other sectors, regulating the quality of Family Planning and Reproductive Health (FP/RH) supplies, and monitoring progress along TMA indicators. This would enable the public sector to ensure commodity security and equity, and improve the targeting of subsidies. With the proper indicators, tool and implementation strategy, efforts to build capacity for TMAs within the public health sector can be measured and lead to evidence-based policies and programs. In April 2015, the Reproductive Health Supplies Coalition (RHSC) awarded an Innovation grant to Abt Associates to develop and test a tool to assess the capacity of a government to steward a TMA for FP/RH commodities. The Total Market Approach Stewardship Capacity Tool (TMASCT) was developed in three stages, including a design stage, a stakeholder engagement and field-testing stage, and a revision stage. This report describes the methodology used to develop the tool, and presents the findings of the field testing and subsequent revisions to the tool and indicators. ASSESSMENT METHODOLOGY Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 2 2. Assessment methodology 2.1 Design stage The TMASCT was developed to assess a government’s ability to steward a TMA and is intended for use by an external evaluator, hired by the government, donor or technical assistance organization. Users of the tool would be able to generate scores, Excel tables and charts to be used in assessment reports. The tool was conceived as an Access database with the capability to aggregate remotely- collected data from different countries. The initial version of the tool was organized around three main responsibilities of stewardship capacity: market understanding, ability to act, and willingness to act. These categories were broken up into characteristics that could be measured to estimate stewardship capacity, as illustrated below. Responsibility Market Understanding Ability to Act Willingness to Act Components Data Collection Mandate Communication Data Management Human Resources Plan Data Dissemination Legal Framework Regulate Data Quality Reliable Funding Governance Data Use Partners Need Perception Experience Primary indicators were then developed to measure each component of stewardship capacity. Next, secondary and tertiary indicators were created to determine the existence of the component, how to measure it, and whether the government is actually undertaking the activities required to lead a TMA. The assessment tool was designed in an Excel document to facilitate the production of tables and charts that could be included in a report of analysis and recommendations. The detail contained in the tertiary indicators can be used to guide specific capacity building interventions. 2.2 Review stage The second stage of the tool development was a review of the initial design and indicators by members of the RHSC Market Development Approaches Working Group contributing to this effort. The definition of stewardship capacity and the scope of responsibilities received positive feedback from the working group members, but the number of criteria and indicators included in the tool was deemed overwhelming. Indicators would have to be proxies, limited to just a few for each component. ASSESSMENT METHODOLOGY Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 3 Next, a more limited version of the tool was created using primary indicators that best capture key responsibilities to measure for each component. This refined list of indicators was then vetted by local stakeholders to complete the review stage. 2.3 Field testing The objective of the field testing was to assess the feasibility and usefulness of the proposed tool. An Abt Monitoring and Evaluation specialist (referred to as the Assessor) conducted interviews of government officials in Malawi and Tanzania with responsibility in the areas of regulation, policy development, and commodity management. For an external perspective, the Assessor met with representatives of NGOs and donor agencies including Marie Stopes International (MSI), PSI, John Snow International (JSI), the United Nations Population Fund (NFPA) and the United States Agency for International development (USAID). 2.3.1 Key informant selection The primary focus of the field testing was the public health sector. Informants were selected from areas of the MOH most likely to be involved in a TMA, such as FP/RH program officers, Commodities Procurement officers, Health Information System officers, and drug regulatory agency officers. The Assessor worked with a local Abt representative in each country to identify informants, and private sector organizations facilitated meetings with site office representatives. Securing appointments at the Ministry of Health in both countries was complicated by the need to obtain authorizations from ministry gatekeepers to access key informants. Although the objective of the assessment was described in formal letters of introduction, miscommunications occurred and delayed responses from potential informants. The use of an anonymous Likert scale in the collection tool, however, greatly facilitated participation and no informant contacted declined to be interviewed. Another significant challenge was the difficulty of securing interviews in the public sector within the 5 days allotted for the assessment. Last-minute conflicts caused cancellations by two informants that could not be rescheduled. Some informants had limited decision-making authority or knowledge of MOH bureaucracy, but nevertheless provided valuable insight, particularly into potential data sources. Every effort was made to meet with private sector stakeholders, though priority was given to securing appointments with public sector informants. 2.3.2 Field test data collection The Assessor tested the proposed list of indicators using a questionnaire (ANNEX A) based on a Likert scale. By asking individuals to agree or disagree with statements describing the proposed indicators, the Assessor intended to trigger questions and discussion that would shine some light on the likely interpretation of indicators. Informants were asked to indicate, on a scale of 1-5, whether they agreed that a specific indicator was useful and feasible, using the following criteria:  Relevance: The indicator provides information related to the government’s ability to steward a TMA. This first measure of usefulness helps eliminate indicators that are not direct measures of government stewardship capacity. ASSESSMENT METHODOLOGY Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 4  Importance: The indicator is necessary to measure the government’s stewardship ability. This second measure of usefulness helps eliminate indicators that are not critical to measuring a government’s ability to steward a TMA.  Easy to measure: The indicator can be easily measured consistently and accurately. This is the first measure of feasibility, likely to trigger discussion of data sources and expectations of quality.  Easy to achieve: The indicator will be easy to achieve. This is the second measure of feasibility, intended to encourage a frank discussion of the government’s ability to achieve the indicator and discuss potential challenges. FINDINGS FROM THE FIELD TESTING Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 5 3. Findings from the field testing The objective of the field assessment was to test the feasibility and usefulness of the indicators and tool, and identifying areas that may need to be improved through technical assistance. The two countries selected for the field testing were Malawi and Tanzania. The following findings were common to both countries:  The Total Market Approach concept is not well understood in the public sector. A TMA was defined for the purpose of this assessment as a “strategic and analytical approach to leverage the comparative advantages of different sectors in meeting the family planning commodity needs of the population”. Stewardship was defined as leading and coordinating a TMA strategy among different sectors. While the operational definition and benefits of a TMA triggered discussions at the beginning of each meeting, the definition chosen for the assessment was deemed acceptable by all informants. Private sector informants were more likely to provide a concise definition of a TMA and to have thought about the issue, than respondents in the public sector.  There was no consensus on how easily stewardship capacity could be measured. Some informants stated that indicators would be easy to measure but subsequently acknowledged that data sources might not exist, or that the data might be infrequently collected or unreliable. Because of the possible confusion between expectations and reality, the tool now requires identifying actual data sources for assessment measurements.  Several informants felt that commercial sales data would be difficult to obtain. Private companies have an incentive to underreport sales to reduce their tax liability, therefore commercial sales data may not be reliable or complete. The indicator is sufficiently critical to be included in the tool, but it may have to be replaced by a demand-side proxy (such as a market share indicator using population-based sourcing data). One informant suggested that a national health insurance scheme may be able to require and collect pricing data and saw TMAs as a way to promote a national insurance program.  Respondents had different perceptions of the government’s stewardship capacity. Public sector informants generally believed that the government was capable of leading a TMA but private sector stakeholders were politely skeptical. Informants in both sectors suggested that the government would need to fulfil its own responsibilities in the area of FP commodity supply in order to be perceived as capable of leading a TMA. Although perceptions of capacity are useful qualitative information to include in the assessment report, a decision was made to use only objective indicators of capacity in order to keep the tool simple.  Respondents recommended additional indicator for customer satisfaction and M&E. The tool originally addressed customer satisfaction under a “communication” category but this was not intuitive to most informants. Customer satisfaction was elevated and moved to “data collection and analysis”. Informants in both countries and in both sectors, but primarily the private sector, also recommended the inclusion of monitoring & evaluation indicators. Monitoring and evaluation has been retained as a component in the final version of the tool.  TMA stewardship capacity is seen as predicated on the ability to conduct studies. Several informants in both countries and sectors believed that research capacity is lacking in the public sector. Government employees are typically not trained to undertake in-depth, complex research, FINDINGS FROM THE FIELD TESTING Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 6 and little funding is available to build this capacity outside of the government’s HMIS and Statistics offices. This indicator however was seen as valuable because improvements in research capacity might be realistic and possible in the short term.  Several public sector informants suggested that the tool be used for self-assessments. This finding contributed to the decision to develop a questionnaire and report template to consistently and correctly guide data collection, analysis, and reporting. The tool would need precise directions or a training program to ensure correct and consistent use. The report template is intended to streamline analysis and reporting so more people could use the tool, for informal and formal assessments and produce reports that would be easily understood. ASSESSMENT REDESIGN Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 7 4. Assessment tool redesign The assessment tool retained most of its original design after the field testing but significant changes were made to the indicators. A questionnaire and a report template were created to help assessors correctly score indicators and analyze results. The scope of the assessment was narrowed to a single government agency because a TMA is more effective if it is led and managed by a single entity rather than through shared responsibility among several agencies. An exception would be the market regulation aspect of the government’s stewardship responsibility (particularly the enforcement of product registration and quality standards) which is typically assumed by a dedicated regulatory agency. Finally, the responsibilities and components were reorganized to reflect the key stewardship responsibilities of the government in leading a TMA. Responsibility Policy & Dialogue Regulation Data Collection and Analysis Components Mandate Regulation Data Collection Sufficient Funding Sources Sufficient Funding Sources Data Analysis Recognized Need Legal Framework Data Management Dialogue Data Quality Monitoring & Evaluation Data Dissemination Human Resources Data Use Drawing from the feedback obtained from informants, the Abt Assessor revised indicators and selected more appropriate measurements. These changes gave more importance to the availability and quality of data and aimed to address concerns about subjectivity; allow precise data definitions to be generalizable; and avoid scores based on opinions that cannot be compared. The original design included a data definitions manual describing assessment procedures for consistent reporting but this approach was found to be too confusing. The manual was replaced by a questionnaire using precise criteria for each indicator to ensure that the assessment is based on objective scores. Finally, the tool was adapted to synthesize results from the questionnaire. These changes, together with the accompanying report template, should facilitate data analysis and generate actionable assessment results. ADDITIONAL FINDINGS Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 8 5. Additional findings In the course of the field testing, informants shared opinions with the Assessor that drifted beyond the tool and indicators, but constitute useful information for future TMA initiatives.  Informants overwhelmingly accepted the concept of a government-led TMA to meet the population’s needs for family planning commodities, despite occasional doubts in both countries about the government’s current ability to lead. There were no strong differences between feedback from the private and public sector, suggesting that building capacity in the government to lead TMAs would be a worthwhile endeavor.  At least one informant suggested that an NGO could be empowered by the government to fill the TMA coordination role, as is the case in Malawi.  Informants from both sectors repeatedly referenced government HIV/AIDS programs as having better data sources and stewardship capacity than FP programs. Replicating successful HIV/AIDS systems and approaches may be relevant to building stewardship capacity for family planning.  Several informants mentioned the need to incentivize the commercial sector to participate in TMAs. When pressed for suggestions, more than one respondent suggested tying licensing to the submission of provider data but no concrete strategies for incentivizing the submission of commercial sales data.  Several informants from both sectors were concerned about the availability of funding for the assessment and follow-on activities. Governments have limited resources and may not be able to take on additional responsibilities based on the findings of the assessment. It seems as if the government itself might need to be incentivized to improve its stewardship capacity, for example with technical assistance in research and private sector engagement.  Some public sector informants expressed frustration about “earmarked” funding and felt that the need to compromise on priorities can undermine a government’s overall stewardship capacity. ADDITIONAL FINDINGS Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 9 6. Recommendations and next steps The tool is submitted with high expectations for its success. The recommendations below are intended to ensure  Allow enough time for the assessment and plan for delays and schedule changes. The Abt Assessor spent five working days in each country but found it challenging to manage delays and cancellations while ensuring that external stakeholders were included in the field-testing. It is recommended that the actual stewardship capacity assessment be conducted over a 2-week period, in order to allow enough time for interviews and the verification of data sources.  The scope of the assessment should be focused on a single agency. Requests from country informants and external contributors to simplify the tool required that we narrow the scope of the assessment to a single government entity (referred to as Agency). The tool should be used to assess government stewardship capacity following the pre-selection of the most likely implementing agency  Build consensus on the definition of TMA. The definition used for this activity was acceptable. The effectiveness of the assessment may be limited if a different definition of TMA is used. There were no significant alternative definitions presented in the review or field test of the indicators but this may change. Any variation of the definition would require a review and possible modifications of the indicators.  Ensure enabling conditions for government leadership of TMAs. Clear communication about the purpose of the assessment and some advocacy may be necessary to ensure collaboration from government managers. Beyond ensuring the successful completion of the assessment (which may involve training if used for self-assessment), prior engagement of the agency to be assessed will greatly facilitate subsequent plans to build its capacity. A road map based on the findings of the assessment could support targeted capacity building, with the caveat that a single assessment may not be deep enough to address all shortcomings.  Identify a mitigation strategy when commercial sales data is not available. A TMA can still be effective without precise commercial data as long as multi sector engagement is effective and sustained. Assessing the ability and willingness of the government to fulfill a coordination role is the key element of determining its stewardship capacity. To estimate commercial market share and sales growth, population-based data may be used in lieu of actual sales.  Consider the possibility of mixed responsibilities between the public and private sectors. Although the government still bears a regulatory responsibility, another entity might better fulfill the coordination role. The tool can easily be adapted to identify and test the capacity of the entity best suited for this function.  Pilot and improve the tool. The field testing of the assessment tool and indicators was acceptable to stakeholders because it focused on validating a process. It may be more difficult to obtain buy-in for an actual assessment of government capacity; therefore we recommend that a pilot assessment be conducted before using the tool widely. Future evaluators should be encouraged to provide feedback on the tool, after the pilot phase to allow for further improvements. For example, it indicators can continue to be updated to reflect the most accurate ADDITIONAL FINDINGS Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 10 measure of a governments ability to steward a TMA. One of the main benefits of the field testing of the tool was to make sure that indicators would be easy to understand and useful for decision- making. Additional guidance can be provided by the creator of the tool, should users experience difficulties applying the indicators and tool.  It is possible to centralize results from countries willing to share. The Excel document can be converted into an Access database and assessors can remotely upload results to a comprehensive database maintained by a global organization (such as UNFPA). Results could be shared and tracked over time if capacity building interventions are implemented and an agency is reassessed. Also, management by a single source could ensure greater supervision to ensure consistent scoring and viability of results. ANNEX 1: FIELD TEST EVALUATION TOOL Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 11 7. Annex 1: Field test evaluation tool (v2.0) Primary Indicators of a Government’s ability to steward a TMA Fill in using the Likert scale score: 1. Strongly disagree 2. Disagree 3. Neither agree nor disagree 4. Agree 5. Strongly agree Note observations and comments. Note data sources for indicators. MARKET UNDERSTANDING TASK PRIMARY INDICATOR SECONDARY INDICATOR Data Collection The government FP commodity agencies manage data collection Relevant Important Easy to measure Easy to achieve The government FP commodity agencies manage data collection Relevant Important Easy to measure Easy to achieve The commercial sector produces FP commodity data available to the government for use Relevant Important Easy to measure Easy to achieve The commercial sector produces FP commodity data available to the government for use Relevant Important Easy to measure Easy to achieve NGOs produces FP commodity Relevant Important Easy to Easy to NGOs produces FP commodity Relevant Important Easy to Easy to ANNEX 1: FIELD TEST EVALUATION TOOL Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 12 data available to the government for use measure achieve data available to the government for use measure achieve The government receives all the supply data it needs to steward a FP commodity programs Relevant Important Easy to measure Easy to achieve The government receives all the supply data it needs to run its FP commodity programs Relevant Important Easy to measure Easy to achieve Logistics Management system produces useful data Relevant Important Easy to measure Easy to achieve Information Systems generate relevant FP commodity data Relevant Important Easy to measure Easy to achieve HIS is a consistent and accurate source of FP commodity data Relevant Important Easy to measure Easy to achieve The FP agencies use other government Information Systems to monitor FP commodity activities Relevant Important Easy to measure Easy to achieve FP agencies understand the staffing situation for government FP commodities activities Relevant Important Easy to measure Easy to achieve ANNEX 1: FIELD TEST EVALUATION TOOL Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 13 Government data is used by other stakeholders: Partners, the commercial sector and NGOs provide unique data Relevant Important Easy to measure Easy to achieve The government leverages other data sources to understand the FP commodities situation Relevant Important Easy to measure Easy to achieve The FP needs of all population segments is understood Relevant Important Easy to measure Easy to achieve The FP commodity needs of all population segments is understood Relevant Important Easy to measure Easy to achieve Price data are available Relevant Important Easy to measure Easy to achieve Commercial Sector price data are available Relevant Important Easy to measure Easy to achieve NGO price data are available Relevant Important Easy to measure Easy to achieve The government receives all the demand data it needs to run its FP commodity programs Relevant Important Easy to measure Easy to achieve The government receives all the demand data it needs to run its FP commodity programs Relevant Important Easy to measure Easy to achieve Sales data are Relevant Important Easy to Easy Commercial Sector sales Relevant Important Easy to Easy ANNEX 1: FIELD TEST EVALUATION TOOL Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 14 available measure to achieve data are available measure to achieve NGO sales data are available Relevant Important Easy to measure Easy to achieve Data Dissemination FP Commodity data is disseminated Relevant Important Easy to measure Easy to achieve FP Commodity data is disseminated Relevant Important Easy to measure Easy to achieve Data Management FP Commodity data is managed appropriately for use to steward a TMA Relevant Important Easy to measure Easy to achieve FP Commodity data is managed appropriately for use to steward a TMA Relevant Important Easy to measure Easy to achieve The government can conduct in- depth research into FP commodities Relevant Important Easy to measure Easy to achieve The government can conduct in- depth research into FP commodities Relevant Important Easy to measure Easy to achieve Data Quality Standards of Data Quality are known and maintained to accurately steward a TMA Relevant Important Easy to measure Easy to achieve Standards of Data Quality are known and maintained to accurately steward a TMA Relevant Important Easy to measure Easy to achieve Data Use The FP Commodities market organization data system is understood Relevant Important Easy to measure Easy to achieve The FP Commodities market organization is understood Relevant Important Easy to measure Easy to achieve FP Commodity data is used for evidence-based decision making Relevant Important Easy to measure Easy to achieve Data is used by government FP agencies/agenc y agencies to Relevant Important Easy to measure Easy to achieve ANNEX 1: FIELD TEST EVALUATION TOOL Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 15 to steward a TMA make FP commodity decisions The Planning agency uses demand data to supply facilities with RH/FP commodities Relevant Important Easy to measure Easy to achieve Data is used by actors to make FP commodity decisions Relevant Important Easy to measure Easy to achieve Market Understanding Additional Notes Additional Tasks? Additional Indicators? Additional Notes ANNEX 1: FIELD TEST EVALUATION TOOL Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 16 ABILITY TO ACT TASK PRIMARY INDICATOR SECONDARY INDICATOR HR Human Resources are effectively managed for the government FP commodity agencies to enable stewardship of a TMA HR Relevant Important Easy to measure Easy to achieve Human Resources are effectively managed for the government FP commodity agencies to enable stewardship of a TMA Relevant Important Easy to measure Easy to achieve Legal Laws facilitate management of a TMA Relevant Important Easy to measure Easy to achieve Laws facilitate management of a TMA Relevant Important Easy to measure Easy to achieve Sanctions enforce the rule of law to support management of a TMA Mandate The Government has the responsibility to plan, regulate and fulfill the FP commodity needs of the population Relevant Important Easy to measure Easy to achieve The government regulates the FP market Relevant Important Easy to measure Easy to achieve The government can coordinate planning, regulation, and fulfillment of supply and demand of FP Commodities Relevant Important Easy to measure Easy to achieve The government has a mission statement or clear objectives regarding family Relevant Important Easy to measure Easy to achieve ANNEX 1: FIELD TEST EVALUATION TOOL Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 17 planning commodities The government has instituted a clear organizational structure for the management of FP commodities Relevant Important Easy to measure Easy to achieve FP government entities are audited or reviewed regularly Relevant Important Easy to measure Easy to achieve Partners Partners can be leveraged to steward an FP Commodity TMA Relevant Important Easy to measure Easy to achieve The government has a defined relationship with actors in the FP commodity market Relevant Important Easy to measure Easy to achieve FP Commodity partners and players are known to the government Relevant Important Easy to measure Easy to achieve There are no gaps in coverage for FP commodities Relevant Important Easy to measure Easy to achieve The government can effectively leverage the commercial sector, NGOs and partners to most effectively and efficiently meet the FP needs of the population Relevant Important Easy to measure Easy to achieve Physical Assets Mgmt Government agencies possess the necessary physical assets to steward an Relevant Important Easy to measure Easy to achieve Government agencies possess the necessary physical assets to steward FP Commodity activities Relevant Important Easy to measure Easy to achieve ANNEX 1: FIELD TEST EVALUATION TOOL Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 18 FP Commodity TMA Reliable Funding Sources The FP commodity agency/agencie s receive reliable and sufficient funding to fulfill tasks related to stewarding a TMA Relevant Important Easy to measure Easy to achieve The FP commodity agency/agencies and governing bodies receive regular and reliable funding Relevant Important Easy to measure Easy to achieve The FP commodity agency/agencies and governing bodies are authorized to manage their own financial situation Relevant Important Easy to measure Easy to achieve Ability to Act Additional Notes Additional Tasks? Additional Indicators? Additional Notes ANNEX 1: FIELD TEST EVALUATION TOOL Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 19 WILLINGNESS TO ACT TASK PRIMARY INDICATOR SECONDARY INDICATOR Communication The government can effectively communicate to steward a TMA Relevant Important Easy to measure Easy to achieve The Govt communicates effectively with private sector FP Commodity actors Relevant Important Easy to measure Easy to achieve The Government effectively communicates with community organizations Relevant Important Easy to measure Easy to achieve The Community level can engage the government to meet FP commodity needs Relevant Important Easy to measure Easy to achieve Individuals can engage the government to meet FP needs Relevant Important Easy to measure Easy to achieve Cultural or community leaders who talk about FP commodities are engaged as partners Relevant Important Easy to measure Easy to achieve The Government communicates effectively with NGOs involved in FP Commodities Relevant Important Easy to measure Easy to achieve There is a formal mechanism by which the government can solicit feedback from Relevant Important Easy to measure Easy to achieve ANNEX 1: FIELD TEST EVALUATION TOOL Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 20 donor partners The government arranges meetings that can facilitate stewardship of a TMA Relevant Important Easy to measure Easy to achieve Experience The government has experience relevant to managing a cross-sector approach Relevant Important Easy to measure Easy to achieve The government has participated in a total market approach in the past Relevant Important Easy to measure Easy to achieve The government has participated in a PPP Relevant Important Easy to measure Easy to achieve Fulfill The government fulfills its own FP commodity responsibilitie s to support a TMA Relevant Important Easy to measure Easy to achieve There is a functional supply chain management agency Relevant Important Easy to measure Easy to achieve There is a functional agency to manage FP commodity logistics Relevant Important Easy to measure Easy to achieve There is a functional agency to ensure contraceptive security Relevant Important Easy to measure Easy to achieve There is a functional agency to educate the population on family planning methods Relevant Important Easy to measure Easy to achieve Governance The government actively pursues good governance policies to facilitate a TMA Relevant Important Easy to measure Easy to achieve The government actively pursues good governance policies to facilitate a TMA Relevant Important Easy to measure Easy to achieve ANNEX 1: FIELD TEST EVALUATION TOOL Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 21 Need A need for a TMA has been recognized Relevant Important Easy to measure Easy to achieve A need for a TMA has been recognized Relevant Important Easy to measure Easy to achieve Perception The government is perceived to be capable of coordinating a TMA Relevant Important Easy to measure Easy to achieve The government is perceived to be capable of coordinating a TMA Relevant Important Easy to measure Easy to achieve Partners are perceived to be willing to cooperate Relevant Important Easy to measure Easy to achieve Plan The Government conducts planning to meet the FP commodity needs of the population Relevant Important Easy to measure Easy to achieve There is a functional Planning Agency for FP commodities Relevant Important Easy to measure Easy to achieve The Planning Agency can activate the workforce to meet FP commodity planning needs Relevant Important Easy to measure Easy to achieve Regulate The Government regulates the FP commodity market to meet the needs of the population Relevant Important Easy to measure Easy to achieve The Regulating Agency can activate the workforce to meet FP commodity regulation needs Relevant Important Easy to measure Easy to achieve There is a Functional Regulatory agency for FP commodities Relevant Important Easy to measure Easy to achieve Willingness to Act Additional Notes Additional Tasks? Additional Indicators? Additional Notes ANNEX 2: CONTACT LIST Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 22 8. Annex 2: Contact list Malawi Public Sector Godfrey Kadewele, CEO/Director, Pharmacy, Medicines and Poisons board; gkadds@gmail.com Jean Momkabu, Family Planning Service Delivery Coordinator, Reproductive Health Directorate; makaika@gmail.com Roy Makaika, Logistics Officer, Reproductive Health Directorate; makaika@gmail.com Private Sector Mary Mittochi, Director of Health Services Operations, MSI Malawi; mary.mittochi@banja.org.mw Carol Bakasa, Director of Reproductive Health, Population Services International; cbakasa@psimalawi.org Joseph Kawanga, M&E Manager, SSDI-Systems Project; Jacob_Kawonga@SSDI-Systems.org Timothy Kachule, Chief of Party, Strengthening Health Outcomes through the Private Sector; tkachule@gmail.com Donors Milika Mdala, Reproductive Health Commodities Sec/FP Specialist, United Nations Population Fund; mdala@unfpa.org Tanzania Public Sector Dr. Deo Mtasiwa, Deputy Permanent Secretary, Prime Minister’s Office- Office Regional Administration and Local Government; dmtasiwa@hotmail.com Dr. Hiza Moris, Family Planning Coordinator, Ministry of Health and Social Welfare; MOHSW Box 9083 Dar-es-Salaam, Tanzania, Mobile +255754308223 Cosmos Mwaifiani, Director General, Medical Stores Direct, Tanzania, cmwaifiani@msd.or.tz Edward Terry, Director of Customer Service, Medical Stores Direct, Tanzania eterry@msd.or.tz Claude Kumalija, Head of the Health Management Information System, Ministry of Health and Social Welfare, MOHSW Box 9083 Dar-es-Salaam, Tanzania, Mobile +255754308223 Edwin Ninda (in substitution for Phillip Mpango, Executive Secretary), Principal Economist, President's Office, Planning Commission; pmpango@yahoo.com Erudi Iasia (in substitution for Phillip Mpango, Executive Secretary), Economist, President's Office, Planning Commission ; pmpango@yahoo.com ANNEX 2: CONTACT LIST Abt Associates The Total Market Approach Stewardship Capacity Assessment Trip Report ▌pg. 23 Hakima Chengula (in substitution for Phillip Mpango, Executive Secretary), Statistician, President's Office, Planning Commission; pmpango@yahoo.com Julius Edward (in substitution for Phillip Mpango, Executive Secretary), Environmental Officer, President's Office, Planning Commission; pmpango@yahoo.com Private Sector Dr. Emmanuel Malangalila Chief of Party, Strengthening Health Outcomes through the Private Sector; Emmanuel_Malangalila@shopsproject.com Ssanyu Nyinondi, FO Country Director for Public health Procurement, SMS Deliver, John Snow International, snyinondi@tz.pfscm.org Lilian Baby Ebomelana, Assistant to the FO Deputy Country Director for Public Health Procurement, SMS Deliver, John Snow International; snyinondi@tz.pfscm.org Mwemezi MN. Ngemera, Director - Health Systems & Management, Marie Stopes Tanzania; mngemera@mst.or.tz Donors Lulu Msungi, Supply Chain Management Specialist, USAID/ Tanzania, lmsangi@usaid.gov

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