FUTURES GROUP LLC

1. FUTURES GROUP LLC TRIANGLE GLOBAL HEALTH CONSORTIUM DECEMBER 2, 2009 Farley R. Cleghorn MD, MPH Chief Technical Officer & SVP

2. FUTURES GROUP ORGANIZATION Futures Group International, LLC Chris LeGrand Chief Executive Officer Business Development Ed Abel Finance & Administration Tim Schur Human Resources Nicole Kamaleson Operations Jamie Hogg Technical Operations Farley Cleghorn, MD, MPH Senior Vice President & Chief Technical Officer Center for Policy & Advocacy Sarah Clark, PhD Vice President Center for Health Systems & Solutions Farley Cleghorn, MD, MPH Acting

3. FUTURES GROUP INTERNATIONAL, LLC Currently active in more than 30 countries Worked in over 100 countries since 1971 GLOBAL PRESENCE

4. FUTURES GROUP INTERNATIONAL, LLC WHAT ARE WE TRYING TO ACHIEVE? WHAT ARE OUR OVERALL GOALS AT FUTURES? TO: • Improve access by the poor/Improve equity in health • Develop & implement sustainable approaches • Enhance local ownership • Deliver Integrated or diagonal solutions • Be evidence based • Be rights based • Adopt a Health Systems approach

5. FUTURES GROUP INTERNATIONAL, LLC What distinguishes us? What do others say about us? • Agile and nimble technical assistance delivery organization • Boutique multi-disciplinary group • Responsive • Not afraid of large amounts of data • Leads with technical offerings • Commitment to local staff • Commitment to sustainability • Population Studies & Family Planning • Sexual & Reproductive Health • Maternal and Child Health • Gender • Infectious Diseases • HIV and AIDS • Malaria • Tuberculosis • Avian Influenza • Other

6. FUTURES GROUP INTERNATIONAL, LLC What are our technical services? • Policy & Advocacy • Policy Development and Implementation • Policy Analysis and Barriers • Legal and Regulatory • Advocacy and Coalition Building • Community Mobilization • Workplace Policy Development • Stigma and Discrimination • Gender Equity Promotion • Research and Strategic Information • Demographic Research • Qualitative Research • Quantitative Research • Operations Research • Surveys • Data Demand and Information Use (DDIU) • Program Monitoring • Program Evaluation • Surveillance • Health Markets & Private Sector Engagement • Public-Private Partnerships • Innovative Financing • Contraceptive Security / Commodities • Health Promotion and Behavior Change Communication • Market Analysis, Segmentation, and Growth • Product Marketing and Distribution • Supply Chain Management Solutions Solutions

7. FUTURES GROUP INTERNATIONAL, LLC What are our technical services? • Modeling and Economic Analysis • Model Development • Model Application: Population and Reproductive Health • Model Application: HIV/AIDS • Economic Analysis • Health Financing • Costing • Resource Mobilization • Resource Allocation • Patient Monitoring and Management/HMIS • HIV Care and Treatment • HMIS Development and Implementation • Program Management • Project Management • Grants Management • Technical Program Design and Implementation • Management of Demand-Led Technical Support Solutions Solutions

8. FUTURES GROUP INTERNATIONAL, LLC What are our technical services? • Strategic Consulting • Donor Coordination and Harmonization • Management Consulting • Strategic Planning • Program and Systems Design • Technical Support/Assistance Solutions Solutions

9. Classic Offering-Projection Modeling for Health Programs • This is how the name Futures was first derived!..\..\Modeling Working Group\Annex - Model Inventory.xls • Started with fertility and contraceptive prevalence • Futures models are part of the basis for UNAIDS HIV epidemic projection by region and country • The Spectrum Suite: • AIDS Impact Model – what are the costs associated with the HIV epidemic in a country? • Current PEPFAR need to cost ART and set targets for treatment • Resource Needs Model and ALLOCATE – what is needed for response and where to put available resources? • RAPID – What are the consequences of high fertility and rapid population growth on development sectors? • GOALS – helping countries to prioritize for greatest impact • Effects of shifting resources from Rx to prevention • Links policymaking and program planning with data analysis

10. CLASSIC OFFERING REDEFINED • From social marketing to total marketing… • Futures was a major implementer of USAID-funded social marketing programs (SOMARC) • Offering has evolved to cover a broad set of private public partnership based health marketing: • PPP • Driving best practice through engagement • Service definition • Market analysis & segmentation • Willingness to pay • Means testing & income analysis • Costing (cost utility, cost benefit & cost effectiveness) • Innovative financing schemes • Voucher systems • Subsidies • Demand generation and behavior change communication

11. SOME RECENT REFINEMENTS OF OFFERINGS Dynamic, and growing… • Patient Monitoring & Management • AIDS Relief HMIS • Sexual & Reproductive Health • Men who have sex with men (MSM) • Technical Support Units (TSU) • India TAST (DFID) • China HIV/AIDS (GF/DFID) • Kenya HAPAC (DFID) • Pro-poor Approaches

12. “NEW” TECHNICAL OFFERINGS

13. AIDS RELIEF DATA SYSTEMS Sound products based on experience in the field – IQCare – IQChart – IQTools – IQGeo – IQReporting – IQShare – IQTrack – IQTraining – Training and Mentoring – Local Experts – DQ & QI – Ownership + Data use Skills transfer Increased Capacity Adaptive Management Improved services Sustainability Best Practices Positive outcomes www.iqstrategy.net

14. IQ STRATEGY • Comprehensive system based on longitudinal medical records • Higher capacity site with greater data demand • High volume site with multiple data entrants • Some computer support preferred • Scaleable, single desktop to large hospital network • Basic system based on WHO registers • Lower capacity site with lesser data demand • High/low volume but only one data entrant • No additional computer support required • Currently multi-language

15. TECHNICAL CENTERS Technical Centers • Center for Policy and Advocacy (CPA) • Center for Health Systems & Solutions (CHSS) • Centers Provide: • Technical Leadership • Project Management • Staff & Performance Management • Professional Development

16. HEALTH SYSTEMS SYSTEM THINKING A Futures Group Perspective?

17. …10 STEPS TO SYSTEM THINKING FOR HEALTH Convene Stakeholders Collectively Brainstorm Conceptualize Effects Adapt and Redesign Intervention Design Determine Indicators Choose Methods Select Design Develop Plan Set Budget Source Funding Evaluation Design System Thinking

18. COMPLEX HEALTH SYSTEMS Poorly accountable, very costly, slow results Function based on the demand and specifics of the country Integrate interventions that can be scaled up Offer sustainable results Make a higher impact because of synergies Health Systems are Complex!

19. …UNLESS YOU STRENGTHEN…

20. FROM HS TOWARDS HSS Action oriented operational framework: What can be done in order to strengthen health systems functions? System-wide actions that reconcile horizontal with vertical disease - specific approaches and offer sustainable diagonal solutions in achieving national goals The challenge of Health System Strengthening from a policy making perspective consists on how to close the gap: • Between the building blocks and real interventions • Between theories and practical results • Between past and the future

21. FUTURES APPROACH TO HSS VERTICAL APPROACH DIAGONAL APPROACH HORIZONTAL APPROACH DISEASE SPECIFIC "strategy in which explicit intervention priorities are used to drive the required improvements into the health system, dealing with more generic HS functional issues…” HEALTH SYSTEM SPECIFIC

22. DISENTAGLING HSS - POSITIONING From additional Inputs to Reform the health system New (mainly non govt) More (Inputs) Better (most govt) Single disease intervention From single disease to cross cutting Health System elements Related diseases/ intervention cluster Cross Cutting Elements Source: Adapted from Berman, Health Nutrition and Population, World Bank, June 2009

23. INTEGRATED HEALTH DELIVERY FRAMEWORK Health System Strengthening: • Health Systems Strengthening 4-point framework • ·         Stewardship • o        Policy • o        Legal Framework • o        Policy Marketing • ·         Resource Use    • o        Health Financing – develop the work we’ve already done in India on ITAP (contracting out public health facilities), Kenya HAPAC (Medium Term Expenditure), HPI (costing) etc into a full health financing offering. • o        HIS – IQCare& IQ Strategy- develop into a broader component of HIS • o        Human Resources • o        Health Management • ·         Health Services • o        Family Medicine • o        Medical Education • o        Pharma • o        Quality Assurance and Improvement • o        EBM • o        HIV/AIDS • o        TB • o        Safe Motherhood • o        Rep health • ·         Population and Community Involvement • o        Community action for health (including BCC, etc) • o        Mobilizing and strengthening civil society

24. HHS RECENT TRENDS - USAID • USAID assistance strengthens health systems across: • Disease-specificprograms • Multiple health areas • The entiresystem Strategic approach basedon evidence and experience to target the mostcritical health systems function needs and elements • The challenges: • Identify and strengthen critical parts of health systems in the local context • Address the major localdrivers of human health • Collaborating with partner country,private sector, and other donors to reach a minimum standard across each core function • Help countries reach functionality in all six core areas

25. ManyTHANKS for Your Attention Siyabonga Asantesana Дякую Dziękuję Ďakujem dhanya-waad go raibhmaith agat bedankt ありがとう شكرًا tesekkürle Спасибо Thank yu 谢谢 Merci köszi tack så mycket Thank you faleminderit hvala Shukriyâ Danke díky kiitos takk Mulţumesc Obrigada nandri anugurihiitosumi Ευχαριστώ Grazie תודה dhanya-waad Muchas gracias köszönöm tack ačiû 너를 감사하십시요 Terima Kasih mange tak aitäh děkuji vam salamat

26. Contributors • Technical staff throughout the organization • 150 US based • 350 international • Jorida Zeneli MSc, Bocconi University, Milan