Applying lessons learned from the Usaid family planning graduation experience to the Gavi graduation process

Bibliographic Data

ID11490405
AuthorsAngela K Shen (0000-0003-3761-0016, 1 Bureau for Global Health, US Agency for International Development, Washington, DC, USA, 2US Department of Health and Human Services, Washington, DC, USA, 3Office of Population and Reproductive Health, US Agency for International Development, Washington, DC, USA, 4Office of Country Support, US Agency for International Development, Washington, DC, USA and 5Office of Health Infectious Disease and Nutrition, US Agency for International Development, Washington, DC, USA, corresponding author), Marguerite M Farrell (1 Bureau for Global Health, US Agency for International Development, Washington, DC, USA, 2US Department of Health and Human Services, Washington, DC, USA, 3Office of Population and Reproductive Health, US Agency for International Development, Washington, DC, USA, 4Office of Country Support, US Agency for International Development, Washington, DC, USA and 5Office of Health Infectious Disease and Nutrition, US Agency for International Development, Washington, DC, USA), Marguerite Farrell (United States Agency for International Development), Mary F Vandenbroucke (1 Bureau for Global Health, US Agency for International Development, Washington, DC, USA, 2US Department of Health and Human Services, Washington, DC, USA, 3Office of Population and Reproductive Health, US Agency for International Development, Washington, DC, USA, 4Office of Country Support, US Agency for International Development, Washington, DC, USA and 5Office of Health Infectious Disease and Nutrition, US Agency for International Development, Washington, DC, USA), Elizabeth Fox (0000-0001-5384-3755, 1 Bureau for Global Health, US Agency for International Development, Washington, DC, USA, 2US Department of Health and Human Services, Washington, DC, USA, 3Office of Population and Reproductive Health, US Agency for International Development, Washington, DC, USA, 4Office of Country Support, US Agency for International Development, Washington, DC, USA and 5Office of Health Infectious Disease and Nutrition, US Agency for International Development, Washington, DC, USA), Elizabeth L Fox (0000-0003-1599-6069, United States Agency for International Development), Ariel Pablos-Méndez (0000-0002-4494-1713, 1 Bureau for Global Health, US Agency for International Development, Washington, DC, USA, 2US Department of Health and Human Services, Washington, DC, USA, 3Office of Population and Reproductive Health, US Agency for International Development, Washington, DC, USA, 4Office of Country Support, US Agency for International Development, Washington, DC, USA and 5Office of Health Infectious Disease and Nutrition, US Agency for International Development, Washington, DC, USA)
Year2015
Volume30
Issue6
Pages687-695
Publication date2015-07-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Policy and Planning (JOURNAL)
Journal identifiersISSN: 0268-1080 • E-ISSN: 1460-2237
PublisherOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czu045
PMID24974106
OpenAlexW2122767570
LanguageEN
Citations received5
References cited3

As low income countries experience economic transition, characterized by rapid economic growth and increased government spending potential in health, they have increased fiscal space to support and sustain more of their own health programmes, decreasing need for donor development assistance. Phase out of external funds should be systematic and efforts towards this end should concentrate on government commitments towards country ownership and self-sustainability. The 2006 US Agency for International Development (USAID) family planning (FP) graduation strategy is one such example of a systematic phase-out approach. Triggers for graduation were based on pre-determined criteria and programme indicators. In 2011 the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunizations) which primarily supports financing of new vaccines, established a graduation policy process. Countries whose gross national income per capita exceeds $1570 incrementally increase their co-financing of new vaccines over a 5-year period until they are no longer eligible to apply for new GAVI funding, although previously awarded support will continue. This article compares and contrasts the USAID and GAVI processes to apply lessons learned from the USAID FP graduation experience to the GAVI process. The findings of the review are 3-fold: (1) FP graduation plans served an important purpose by focusing on strategic needs across six graduation plan foci, facilitating graduation with pre-determined financial and technical benchmarks, (2) USAID sought to assure contraceptive security prior to graduation, phasing out of contraceptive donations first before phasing out from technical assistance in other programme areas and (3) USAID sought to sustain political support to assure financing of products and programmes continue after graduation. Improving sustainability more broadly beyond vaccine financing provides a more comprehensive approach to graduation. The USAID FP experience provides a window into understanding one approach to graduation from donor assistance. The process itself—involving transparent country-level partners well in advance of graduation—appears a valuable lesson towards success

Agency (philosophy) · Business · Economic growth · Economics · Government (linguistics) · Graduation (instrument) · International development · Political science · Sociology · Child Nutrition and Water Access · Global Maternal and Child Health · Poverty, Education, and Child Welfare