Existence of a comprehensive reproductive health policy consistent with the ICPD action plan
Recorded evidence of a national reproductive health (RH) policy or strategy that is comprehensive and consistent with the recommendations in the action plan of the 1994 International Conference on Population and Development (ICPD) exists as a stand-alone document or has been integrated into health policies or strategies.
For the policy to be considered comprehensive, it should cover the RH domains included in the ICPD plan, such as family planning, reproductive rights, women’s empowerment and gender equality, male involvement in RH, essential medicines and commodities, sexually transmitted infections (STIs), HIV/AIDS, TB, malaria, maternal health, child health and immunization (UNFPA, 1973).
This indicator is selected from the list of core indicators in the WHO Health System Strengthening (HSS) Handbook. For more background on the process and criteria used in developing the WHO Handbook of Indicators for HSS and for details on this and related indicators, see WHO (2010), USAID (2009), and The Global Fund (2009).
Review of national health policies on RH including reviews of the respective RH domains listed above. The reviewed policies and strategies can be compared to see if they are consistent with the stated goals of the ICPD Programme of Action (UNFPA, 1973).
Review of national health policies or strategies
This indicator measures government support for RH programs and services based on the existence of policies that are both comprehensive and consistent with the ICPD plan of action. The 1994 ICPD in Cairo articulated a vision of the relationships between population, development and individual well-being. At the Conference, 179 governments adopted a 20-year plan of action, including RH and rights in addition to women’s empowerment and gender equality, as the cornerstone of population and development programs. The Millennium Development Goals (MDG) have built upon the ICPD action plan and this indicator can be used to evaluate progress in policies supporting the MDGs: # 3 promote gender equity and empower women: #4 reduce child mortality; #5 improve maternal health; and # 6 combat HIV/AIDS, tuberculosis and malaria.
The WHO Handbook on HSS (WHO, 2010) includes this indicator as a measure of good governance and policy related to maternal health and it serves as one of ten indicators that can be used to calculate a composite governance policy index. The index provides a summary measure of governance quality from a rules-based perspective and assesses whether countries have policies, regulations and strategies in place to promote good leadership and governance in the health sector.
Although a country’s stated policies may capture the intent of the ICPD action plan, if the policies have not been revised for five or more years or have not been costed for implementation, they may not accurately reflect current needs and resources of the country. Evaluators may wish to determine if the policies and plans are current and relevant, and if they have been systematically costed and, optimally, budgeted for implementation. Evidence of comprehensive RH policies does not ensure that the policies have been successfully adopted. Evaluators may also wish to follow up with a complementary output indicator, evidence of RH policies implemented, resources allocated and subsequently used in relation to the same RH policy.
policy, health system strengthening (HSS)
The Global Fund, 2009, Monitoring and Evaluation Toolkit: HIV, Tuberculosis and Malaria and Health Systems Strengthening, https://www.measureevaluation.org/resources/training/capacity-building-resources/m-e-of-hiv-aids-programs-in-india-english/session-1/GFATM%20M_E_Toolkit.pdf
UNFPA, 1995, International Conference on Population and Development – ICPD – Programme of Action, New York: UNFPA. http://www.unfpa.org/public/publications/pid/1973
USAID, 2009, Measuring the Impact of Health Systems Strengthening, A Review of the Literature, Washington, DC: USAID. https://www.researchgate.net/publication/274064201_Measuring_the_Impact_of_Health_Systems_Strengthening_A_Review_of_the_Literature
WHO, 2010, Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies, Geneva: WHO. http://www.who.int/healthinfo/systems/WHO_MBHSS_2010_full_web.pdf