Strengthening political support and mobilizing resources for family planning in decentralized settings

As countries in Latin America decentralize and integrate their health systems, it is essential to take family planning (FP) and contraceptive security issues into consideration. Presumably, decentralization can provide opportunities for FP/RH in that the act of bringing decisionmaking and funding to local levels can ensure that local needs are met, including improvements in access to and quality of FP/RH. However, decentralization can present challenges. While there is little documentation on the negative effects of decentralization in FP/RH, it can be assumed that government officials at subnational levels often have limited knowledge of FP, face competing priorities for limited funds, and must be convinced of the value and scope of FP interventions.

Well-thought out strategies to ensure that FP/RH is not left aside during decentralization process are needed. We will present practical guidelines for integrating FP/RH into decentralization processes based on cross-country analyses, lessons learned, and interviews with key stakeholders in Bolivia and Mexico where decentralization is well underway. These guidelines will equip policymakers and FP/RH champions with the knowledge, information, and tools necessary to ensure that FP/RH efforts are closely coordinated with and ensconced in decentralization processes and systems. The guidelines address elements of FP/RH including building political commitment, financing, and ensuring access for hard-to-reach populations. Specific strategies such as creating budget line items, promoting meeting unmet need as an approach to achieve MDGs, including FP in social insurance, and influencing resource allocation decisions, will be discussed.