§ Angus RobertsonTo ask the Secretary of State for International Development pursuant to his answer of 14 October 2003, reference 131802, what the delivery strategy for the Contraceptives Supply and Logistics programme in Bolivia was; what(a) local, (b) national, (c) regional and (d) international organisations are involved in this programme; what discussions (i) he, (ii) representatives of his Department and (iii) members of the UK representation in Bolivia have had with 607W representatives of (A) the Government of Bolivia, (B) local communities and (C) the Church with regard to this programme; and if he will make a statement. [133192]
§ Hilary BennThe Contraceptives Supply and Logistics programme supports the Government of Bolivia's National Sexual and Reproductive Health programme by assisting them in the purchase and distribution of contraceptives and by improving the quality of, and demand for, contraceptive services. The programme is managed by UNFPA and the Government of Bolivia with components implemented by CEASS (Central de Abastecimiento de Suministros) and the Population Council.
Regular planning and monitoring meetings are held with the Government of Bolivia and local stakeholders are consulted and involved in programme implementation as is appropriate to each locality. This includes local health defence committees, evangelical churches and the Catholic Church, municipal governments and local non-governmental organisations.
§ Angus RobertsonTo ask the Secretary of State for International Development pursuant to his answer of 14 October 2003,Official Report, columns 70–71W on reproductive health, what the (a) structure, (b) aims and (c) methods of the HIV/AIDS Umbrella Programme in Uganda are; when his Department last assessed the progress of this project; what the main conclusions of this assessment were; what assessment his Department has made of the impact of the Lord's Resistance Army's activities on (i) the reproductive health of the population in Uganda and (ii) the functioning of the HIV/AIDS Umbrella Programme; and if he will make a statement. [133194]
§ Hilary BennThe HIV Umbrella Programme in Uganda has an allocation of £6.2 million for 2002–05. Its purpose is to improve the coordination and monitoring of the Uganda's Strategic HIV/AIDS Framework in support of its Poverty Eradication Action Plan (PEAP). It also aims to improve the Government of Uganda's capacity to take effective action against HIV/AIDS, and supports service delivery and research on HIV/AIDS by civil society organisations.
The programme was last assessed in September 2003. The review concluded that overall the programme's approach was both strategic and effective. However, the review noted that progress in building the Uganda AIDS Commission's (UAC) capacity to coordinate and monitor the National Strategic Response was slower than anticipated. In response to this finding, DFID will he funding an HIV Adviser, to be located in UAC from November 2003, to assist its staff in technical and organisational management issues, and help facilitate the HIV Partnership in Uganda.
Insecurity in Northern Uganda has made access to health services difficult for many and there is some evidence that the Lord's Resistance Army (LRA) has targeted health centres (for drugs) and health workers in their attacks. Anecdotal evidence from NGOs suggests that life in crowded camps encourages earlier sexual activity, leading to a higher teenage pregnancy rate and increased spread of HIV. However, no data is available to date on this point, although a nationwide prevalence survey is due to be carried out at the end of the year.
608WLRA activities are not directly impacting on the functioning of the HIV Umbrella Programme. However, the continuing insecurity in the North is hampering the ability of some of the civil society organisations supported under the programme to scale up their activities.
§ Angus RobertsonTo ask the Secretary of State for International Development pursuant to his Answer of 14 October 2003,Official Report, columns 70–71W on reproductive health, what the (a) structure, (b) aims and (c) methods of the Social Marketing of Contraceptives project in Ethiopia are; when his Department last assessed the progress of this project; what the main conclusions of this assessment were; what the annual cost of the programme has been since its inception; and if he will make a statement. [133195]
§ Hilary BennThe project provides support through DKT International, which is a US based non-governmental organisation registered in Ethiopia, working on nationally led family planning and HIV prevention programmes. They make condoms and contraceptives available to poor people, and high risk groups, at low cost through commercial outlets.
We regularly review their performance, through quarterly project progress reports against agreed targets and visits by DFID advisers. A formal review of their work will be conducted in 2004. We are satisfied with the progress that the project has made so far, and should be able to make a more in depth assessment when the formal review takes place in 2004.
Our support for the project is £2 million over two years.
§ Angus RobertsonTo ask the Secretary of State for International Development pursuant to his Answer of 14 October 2003,Official Report, columns 70–71W on reproductive health, what the (a) structure, (b) aims and (c) methods of the Reproductive Health, Freetown and Newly Accessible Areas in Sierra Leone are; when his Department last assessed the progress of this project; what the main conclusions of this assessment were; what areas of the country are now considered to be accessible; what issues (i) he and (ii) members of his Department have raised with representatives of the Government of Sierra Leone regarding the programme; and if he will make a statement. [133196]
§ Hilary BennAll areas of Sierra Leone are now accessible. The main aims of the project are to provide access to affordable, high quality and innovative sexual and reproductive health (SRH) information and services; to increase awareness of basic health and SRH issues among beneficiary communities; and to increase the capacity of key stakeholders in providing SRH services and developing national health strategy and policy guidelines. The project aims to achieve these objectives through the existing Marie Stopes Sierra Leone centre network (four Reproductive Health Centres, two obstetric hospitals, and two laboratories) and outreach programmes.
We receive quarterly progress reports on the project from Marie Stopes International. Our advisers last visited the project in March 2003. The main conclusion of their assessment was that the project provides high quality services and is reasonably well utilised. More can 609W be done to improve the use of contraceptives, but awareness raising campaigns are addressing this. We have raised with Marie Stopes International the sustainability of the services provided by the project.
DFID health advisers have regularly discussed issues concerning primary health care with the Government of Sierra Leone Ministry of Health and Sanitation. These discussions have not focussed specifically or exclusively on SRH.
§ Angus RobertsonTo ask the Secretary of State for International Development pursuant to his answer of 14 October 2003,Official Report, column 75W on reproductive health, if he will list the activities at country level funded until the end of 2003 what the (a) structure, (b) aims, (c) methods and (d) annual funding need for each of the activities were; how much the UK has (i) pledged and (ii) delivered to each of the activities since January 2001(A) in monetary terms, (B) as a percentage of the funding total and (C) as a percentage of the yearly balance from the one-off UK contribution; and if he will make a statement. [133197]
§ Hilary BennFurther to my previous answer of 14 October 2003,Official Report, column 75W, the whole of the UK's £25 million contribution is used to meet commodity needs in developing countries and for condoms in countries with a high prevalence of HIV. This is a multi-donor programme, worth $96 million. Of this, 45 per cent. has been distributed to Least Developed Countries and 66 per cent. to those in most need of assistance to meet the goals from the landmark International Conference on Population and Development (ICPD). Part of the UK's contribution is being used to support capacity strengthening activities to assist countries to forecast and plan their commodity requirements.
The detailed information requested in the question could only be provided at disproportionate cost. This £25 million one-off contribution is in addition to the UK's core funding to UNFPA (£18 million in 2003). This is disbursed in line with the overall framework for the UK's partnership with UNFPA, set out in the Institutional Strategy Paper (ISP) published in June 2001.
§ Angus RobertsonTo ask the Secretary of State for International Development pursuant to his Answer of 14 October 2003,Official Report, columns 75–76W on reproductive health, what the (a) structure, (b) aims and (c) methods of the Bolivia Post-Abortion Care Project are; what discussions (i) he, (ii) representatives of his Department and (iii) members of the UK representation in Bolivia have had with representatives of (A) the Government of Bolivia, (B) local communities and (C) the Church with regard to this programme; and if he will make a statement. [133199]
Mr. Gareth ThomasThe most recent official statistics from Bolivia (1992) put the maternal mortality rate at 390 for every 100,000 live births. This is one of the highest figures in Latin America and is disproportionately high for a country of the economic status of Bolivia. A key cause of mortality is unwanted pregnancy and subsequently complications resulting from illegal abortion. The aim of the Post Abortion Care (PAC) Services programme is to help Bolivia610W progress towards the Millenium Development Goal of a 75% reduction in maternal mortality by 2015. The approach of the programme is to increase access by poor women experiencing post-abortion complications to high quality, cost-effective Post Abortion Care (PAC) Services under the Basic Health Package. The programme supports the provision of outpatient PAC with manual vacuum aspiration (MVA) services at five tertiary-level hospitals, strengthened training capacity for PAC with MVA at five teaching hospitals, the institutionalisation of PAC training for medical residents, the introduction by Government of Bolivia of the PAC-with-MVA model in secondary-level hospitals in rural areas, and the strengthening of the supply of PAC-with-MVA medical equipment and drugs, for present and future services.
The programme is managed in partnership with the Government of Bolivia and supports its Sexual and Reproductive Health Programme. Local communities are closely involved in discussions on the introduction of PAC with MVA in Secondary level hospitals, and the church is consulted in the context of discussion on national reproductive health strategies.
§ Angus RobertsonTo ask the Secretary of State for International Development pursuant to his answer of 25 September 2003,Official Report, columns 69–70W on Malawi, if he will list each of the reproductive health programmes in Malawi supported by his Department; what review his Department has undertaken of reproductive health programmes supported by his Department in Malawi in 2002–03; and if he will make a statement. [133211]
§ Hilary BennDFID supports the following programmes in Malawi that are concerned in whole or part with reproductive health
The DFID Sexual and Reproductive Health Programme, which supports the National Sexual and Reproductive Health Programme and the National HIV/AIDS Strategic Framework including the National AIDS Commission;The Safe Motherhood Project covering the Southern region;The Integrated Sexual & Reproductive Health Programme which is implemented by Banja la Mtsogolo, a local non-governmental organisation, with a focus on the reproductive health needs of youth, including HIV/AIDS;The National Tuberculosis Programme, which has activities on the TB-HIV link.The Malawi Ministry of Health and Population conducted a joint review of the DFID and Integrated Sexual and Reproductive Health Programmes and the Safe Motherhood Project in November 2002 with DFID and other development partners. The review reported some progress in all activities, but also noted that there were factors beyond the control of the programmes that inhibited progress. These included critical shortage of health personnel, lack of other resources and the rising impact of HIV/AIDS. The international financial institutions and donors including DFID are working with the Malawi Government to address the underlying issues, such as wage policy and macro economic management, that contribute to the problems affecting the health sector.
The National AIDS Commission undertook a joint stakeholder review in March 2003. The review concluded that progress was encouraging. It recommended that the 611W Commission proceed with organisational re-structuring and that donors provide financing through a pooled funding arrangement, instead of through separate individual agreements.
§ Angus RobertsonTo ask the Secretary of State for International Development what the structure, aims and methods of the(a) DFID/Zambia HIV/AIDS Programme approved in June and (b) the Sector Wide Approach Project approved in 2000 are; and if he will make a statement. [133337]
§ Hilary BennThe information is as follows:
(a) DFID/Zambia HIV/AIDS Programme
The DFID HIV/AIDS Multisectoral Programme in Zambia is supporting the national multi-sectoral response to HIV/AIDS, spearheaded by the National AIDS Council. The overall aim of the programme is to reduce HIV transmission and to reduce the socio-economic impact of the disease, in accordance with the Zambia National HIV/AIDS Strategic Framework.
The DFID programme, approved in June 2003, is worth £20 million over six years. The programme has four components: (i) strengthening the capacity of the National AIDS Council; (ii) supporting public sector services such as supplying essential commodities; (iii) supporting the civil society response in behaviour change, impact mitigation and promotion of human rights; and (iv) expanding the private sector response.
(b) Sector Wide Approach to Health
DFID is supporting the health sector in Zambia through the Sector Wide Approach to Health programme. The main implementing partner is the Central Board of Health. The programme aims to improve the health status of all Zambians through increased access to better quality health services.
The DFID programme, approved in July 2000, is worth £20 million over six years. The programme has contributed to a common funding basket, together with other development partners, to enable the sustainable delivery of cost effective basic health services. Other inputs include the provision of drugs and medical supplies, technical assistance for capacity building, and the provision of impregnated bed nets to prevent malaria.
§ Angus RobertsonTo ask the Secretary of State for International Development what the structure, aims and methods of the DF1D Reproductive Health Support Project in Zambia are broken down by projected per annum expenditure for the three year allocated budget approved in 2001 and if he will make a statement. [133338]
§ Hilary BennReproductive health encompasses the services for family planning, contraception and childbearing that make an important contribution to increasing women's choice and opportunity, and to preventing unplanned or unwanted pregnancy. DFID is committed to promoting reproductive health and fighting HIV/AIDS.
612WSince 2001, DFID direct support to reproductive health in Zambia has been through the Reproductive Health Support Project worth £2.9 million. Financial year spending has been:
£ 2001–02 78,839 2002–03 1,221,582 2003–04 11,580,000 1Estimate for the full year The aim of the project is to increase the use of modern methods of family planning and the use of condoms for the prevention of sexually transmitted infections, including HIV. The project is managed by the Central Board of Health, which is the statutory body set up by the Zambian Government to implement health policies. Through this programme, and its forerunner, contraceptive distribution and use have increased.