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In 1998, the SO2 team leaders, Molly Gingerich and I, assumed
responsibility for determining the status of USAID-funded PAC programs worldwide. We
developed a PAC Activity Matrix which was filled out by seven key CAs: AVSC International,
INTRAH/PRIME, JHPIEGO, Johns Hopkins University Population Communication Services
(JHU/PCS), Pathfinder International, the POLICY Project, and the Population Council. The
matrix had the following 13 program categories:
- Needs assessment
- Start of services
- Policy/advocacy
- Standards/guidelines
- Preservice education
- Inservice training
- Public/private partnerships
- Infection prevention
- Linkage to other FP services
- IEC
- Research
- Program area
- Partners
Over a 3-month period, from October 1998 to January 1999, we collected PAC Activity
Matrix information from the CAs and collated the information by country. In reviewing the
country matrices, however, we realized that they provided only part of the important
information we sought, such as who was working in a given country and the types of
activities being conducted. The matrices did not give us a sense of scale (the size of the
program) or a sense of the strategy driving the PAC activities. In addition, we realized
that the matrix was missing some important program activity categories.
To fill in some of the missing information, we held a series of meetings with key CAs
for one-on-one discussions of their PAC activities. Finally, on 11 January 1999, we held a
PAC CAs’ meeting to present the results of the PAC matrices, and build consensus on
how to move the PAC initiative forward. Attending the meeting were representatives of 10
cooperating agencies, as well as USAID’s PHN Center and Regional Bureaus.
Results of the PAC matrices revealed considerable progress and success in implementing
PAC services worldwide. PAC activities are ongoing in 37 countries with USAID funding in
over 30 of those countries (USAID SO2 Team 1999) (see Table 1). The CAs have also
been successful in leveraging funds from other donors to complement USAID funding or, in
some cases, substitute for it. PAC programs have been integrated into ongoing FP/RH
programs, rather than building costly parallel systems. Currently, a wide range of pilot
projects and program models is in place.
The results also revealed some significant gaps in terms of program, strategy and
scale. We have not yet met existing demand for PAC services in any one country, nor have
we managed to offer the full array of PAC services. We need to be more strategic about
where and how we deliver PAC assistance. By reassessing country selection criteria,
focusing efforts in fewer countries and developing strategic partnerships, we could assist
countries in offering a full array of PAC services in the communities where women live. By
scaling up, countries could finally meet existing demand for PAC services. |
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The conclusions of the PAC CAs’ meeting and PAC Activity Matrix
exercise are as follows:
We need to build a common framework for PAC, building consensus on the
elements of a comprehensive approach to PAC services, including design, implementation and
scale-up. Key elements of the common framework are sustainability and
institutionalization.
We need to be more strategic about where PAC services are implemented,
establishing selection criteria for priority countries and, within countries, working to
decentralize services to the community level where women live.
We need to achieve better coordination of PAC programs, beginning with
joint needs assessment and program design to reduce the "fragmented" aspect of
current PAC programs. By forming strategic partnerships, we can offer the full range of
technical assistance necessary to assist countries in improving access to PAC services as
well as their quality.
- We need to collaborate on common advocacy strategies that focus on missions, country
leaders, other donors and PAC champions. Advocacy efforts should continue to link PAC/FP
programs within the larger RH framework.
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