Strengthening family planning stewardship with a total market approach: Mali, Uganda, and Kenya experiences
| DOI | http://doi.org/10.1002/pad.1840 |
| Author | Sayaka Koseki,Kate Klein,Rob Wood,Cindi R. Cisek |
| Published date | 01 February 2019 |
| Date | 01 February 2019 |
SPECIAL ISSUE ARTICLE
Strengthening family planning stewardship with a total market
approach: Mali, Uganda, and Kenya experiences
Cindi R. Cisek
1
|Kate Klein
1
|Sayaka Koseki
1
|Rob Wood
2
1
Palladium, Washington, D.C.
2
Palladium, Nairobi, Kenya
Correspondence
Cindi R. Cisek, Palladium, 1331 Pennsylvania
Avenue NW, Suite 600, Washington, DC
20004.
Email: cindi.cisek@thepalladiumgroup.com
Funding information
USAID, Grant/Award Number: AID‐OAA‐A‐
10‐00067
Summary
To improve overall market sustainability, governments and their donors are ramping
up efforts to strengthen stewardship in developing country health markets. Key stew-
ardship functions include generating intelligence that enable policymakers, ministerial
leaders, and program managers to develop evidence‐based policies and strategies to
improve the resource management, supply, and use of health products and services.
The total market approach (TMA), an analytic and policy framework, generates market
intelligence and improves evidence‐based decision‐making, and also strengthens
other stewardship functions, such as building and sustaining partnerships, strengthen-
ing tools for implementation, aligning government policy with market interventions,
and ensuring accountability/transparency. TMA evolved in response to the phase
out of donor support for reproductive health (RH) and family planning (FP) programs
and the need to improve coordination among public, private, nongovernmental orga-
nizations, and civil society to achieve greater equity, health impact, and market
sustainability. To assess TMA's role in strengthening the stewardship of RH/FP mar-
kets, this article reviews three countries that applied TMA principles: Mali, Uganda,
and Kenya. It identifies how TMA processes influenced stewardship functions and
assesses to what degree these processes have contributed to concrete actions to
improve market efficiency and sustainability.
KEYWORDS
family planning, Kenya, Mali, stewardship, sustainability, total market approach, Uganda
1|INTRODUCTION
Health markets in emerging and developing countries are often
fragmented and inefficient, resulting in wasted resources, supply gaps,
poor quality, and inequities in use and access. Governments and their
donor partners are ramping up efforts to strengthen the government's
stewardship as a way to improve overall sustainability in the health
sector. Key stewardship functions include generating market intelli-
gence to ensure that policymakers, ministerial leaders, and program
managers can develop the necessary policies, strategies, and plans to
oversee the health sector. The total market approach (TMA), an
analytic and policy framework, supports ministries of health (MOH)
and their partners to address market inefficiencies, improve targeting
of government and donor resources for underserved and vulnerable
populations, and build linkages with the private sector for those who
have the ability to pay. The TMA evolved in response to global‐and
country‐level advocacy in developing country health markets and the
need to improve overall market sustainability, recognizing the MOH
as the lead steward of the national health system.
Reproductive health/family planning (RH/FP) products and ser-
vices, like most health products and services, are offered through a
wide range of public‐and private‐sector actors. In a mixed health care
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This is an open access article under the terms of the Creative Commons Attribution License, which permitsuse, distribution and reproductionin any medium, provided
the original work is properly cited.
© 2018 The Authors Public Administration and Development Published by John Wiley & Sons Ltd
Received: 18 June 2018 Accepted: 7 September 2018
DOI: 10.1002/pad.1840
Public Admin Dev. 2019;39:47–56. wileyonlinelibrary.com/journal/pad 47
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