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					LOGO Bayer East Africa Ltd. / DHL                                                                gtz            Deutsche Gesellschaft für

                                                                                                 Technische Zusammenarbeit (GTZ) GmbH

                                                 PROJECT PROPOSAL


1. Data Sheet
                                                       Status:       In preparation                                         Date: 22.05.11
                                                       Duration:     01.08.2009 – 31.07.2011

GTZ Co-ordinator (PPP)                                 Klaus Hornetz

Address and Description of Partner Companies and its Economic Activities in the Partner Country

Bayer Schering Pharma, Bayer East Africa Limited, Thika Rd. P.O.Box 30321, 00100 GPO Nairobi, Kenya
Contact: Mr. Frans J. Labuschagne, Managing Director, Country Division Head
         Tel. +254 2 8560667-74, Fax +254 2 8561636, Mobile +254-733249736
         E-Mail: frans.labuschagne@@bayerhealthcare.com, Internet: http://www.bayerhealthcare.com

Description of the Company Bayer Schering Pharma:
Sales in 2008: EUR 10.704 billion, Headquarter: Berlin (Germany)
     Bayer Schering Pharma is concentrating on four strategic business units: Diagnostic Imaging, General Medicine,
         Specialty Medicine, and Women’s Healthcare.

DHL, DHL Express, DHL House, Witu Road off Lusaka Road, P.O.Box 67577 – 00200, Nairobi Kenya
Contact: Mr. Cyrus Chege, Direct Channel Manager, +254 20 6925100/120 E-Mail: cyrus.chege@dhl.com
         Mr. Larence Yumba, National Sales Manager, Tel. +254 20 6925100/120, E-Mail: Lawrence.yumbya@dhl.com,
         Internet: http://www.dhl.co.ke

Description of the Company DHL:
DHL is a Deutsche Post DHL brand. The group generated revenues of more than 63 bn euros in 2007.
DHL is a global market leader of the international express and logistics industry, specializing in providing innovative and
customized solutions from a single source. Its international network links more than 220 countries and territories worldwide.
Some 300,000 employees are dedicated to providing fast and reliable services that exceed customers.


Short Description of the Project
Support district government to increase knowledge on and use of modern contraceptives in two rural districts of
Kenya in order to reduce unmet need of contraception


PPP-Criteria

Are all PPP Criteria fulfilled?         yes



Costs
Total costs
                                    Total Contribution of the Private Partners                       186.675                                €
                                    Total Public Contribution                                        173.500                                €
                                    Total Contribution of Others

                                    Total Volume of the Project                                   360.175 €                             100 %

Type of Promotion
                                    Contribution Contract with PPP Partners          186.675 €                                       51,83 %

                                    Public Consultancy with:                         173.500 €                                       48,17 %




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LOGO Bayer East Africa Ltd. / DHL                                                       gtz            Deutsche Gesellschaft für

                                                                                        Technische Zusammenarbeit (GTZ) GmbH

                                           PROJECT PROPOSAL


2. Description of the project

Background and problem analysis from the point of view of developing politics and the private
sector

Reproductive choice is a human right, but it cannot be exercised without access to relevant information and high-
quality services. To enable individuals exercise this right, the need for family planning, safer and healthier
pregnancy and childbirth (safe motherhood), and the prevention of sexually transmitted infections (STIs), including
HIV/AIDS has to be covered. In this respect it is important to make needed services of high quality and relevant
information available. Short-term and long-term contraceptives, available through a well functioning supply chain
management, are cornerstones of this approach.
The Kenya Demographic Health Survey (KDHS) 2003 shows a large and even increasing, unmet need for family
planning. Whereas 95% of all women know at least one contraceptive method, only 74 % know about female
sterilization, 67% have heard of the IUD, and 63% have heard of implants (KDHS 2003). 23% of all women (32% of
married women) use a modern contraceptive, 2.9% using sterilisation, 1.6% an IUD, and 1.2% using implants.

Between 1998 and 2003, use of female sterilization and IUD has decreased, and use of implants has only increased
slightly. Whereas urban and rural women use sterilization to roughly equal proportions, use of IUD and implants is
considerably lower among rural women: (2.4% versus 1.9% for IUD and 2.6% versus 1.4% for implants).

With a contraceptive prevalence for modern methods among married women of 21%, Nyanza province is far below
the national average of 31.5%. Use of IUD and implants is exceptionally low. The unmet need for family planning is
high at national level, and highest in Nyanza and Western Provinces: among the currently married women in
Nyanza Province 21% would like to postpone the next pregnancy, but are not using contraceptives, and 14% would
like to limit their family size, resulting in an overall unmet need for family planning of around one third of all married
women. In Western Province, an unmet need for spacing (19%) and for limiting family size (13%), results in again
one third of married women needing, but not using, a contraceptive method.

IUDs and implants are important elements of the method mix in particular in rural areas, as women may want to
space pregnancies, but are not in frequent contact with a health facility. However, use of IUDs and implants is low in
rural areas. This may result from a lack of information, difficulties in accessing services due to information, distance,
cost, unavailability of trained providers or equipment of health facilities to offer the services or unaivailability of
contraceptives due to difficulties within the supply chain management.
.


Short description of the project

In a first step, a desk study will be carried out to collect all relevant existing information on the level of knowledge
women and men in Nyanza and Western Provinces have on contraceptives methods, their expressed need for
long-term contraception, and on information regarding the availability of services offered in the 2 focal districts of
German Development Cooperation (GDC) in Nyanza and Western Provinces. Furthermore the study will collect
existing information on training content, quality level of family health training and on professional experiences of
reproductive health staff.

Based on the findings of this desk study, on-the-job training and communication strategies (Information Education
Communication – IEC - campaigns) to overcome barriers to contraceptive use will be developed. Depending on the
study findings, this includes:
- Refresher and/or on-the-job training concept for providers in the provision of long-term contraceptives, including
    implants and IUD.
- Strategy to include private family health providers into training concept
- Strategy to link with existing projects
- IEC activities in cooperation with communities and NGOs / FBOs to increase knowledge on contraceptive
    methods within the target group and to inform them about available services.


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LOGO Bayer East Africa Ltd. / DHL                                                      gtz            Deutsche Gesellschaft für

                                                                                       Technische Zusammenarbeit (GTZ) GmbH

                                          PROJECT PROPOSAL


Furthermore it is expected to identify strengths and weaknesses of the contraceptive supply chain management in
the target area. These survey results will be used to support the targeted districts to review their M+E system and to
link them with the PPP project contraceptive supply chain concept.

The training and communication strategies will be discussed with PHMTs (Provincial Health Management Team),
DHMTs (District Health Management Team) and all relevant stakeholders – including NGOs / FBOs - in the two
focal districts for GDC support in Nyanza (Gucha or Bondo) and Western (Butere or Vihiga) provinces. Based on
workshop results and existing guidelines for family planning providers, on-the-job training curriculum and handbook
will be amended. Needed IEC materials for communication campaigns will also be amended. In a next step human
resources capacity building by training TOTs (Training of Trainers) of the two districts followed by on-the-job training
will be implemented.

The two districts will be supported to improve the quality of health facilities through strategies which contain not only
human resource capacity building and availability of long-term contraceptives but also innovative supervisory
activities and discussion (implementation) on performance oriented reward systems. Furthermore IEC campaigns
will be conducted in cooperation with NGOs / FBOs and communities (link to community strategy) to increase the
demand.

Results of the first project phase will be used to review training & communication strategies and tools. District
governments will be encouraged and enabled to integrate activities into their annual operational plan. At the end of
the project it is planned to conduct a consumer satisfaction survey and share lessons learned with interested
partners.


Impacts and Effects of the PPP-Programme on Development

The project enables Bayer Schering Ltd. and DHL to support district governments to increase the knowledge on
contraceptives among the rural population and to reduce their unmet needs of contraceptives. The PPP project
promotes the quality of family health providers in the target area by developing strategies and tools which support
district governments to increase the service providers personnel’s knowledge on long-term contraceptive methods,
their contraindication, their advantages and disadvantages related to the women’s needs. Tools designed by the
Bayer Schering – DHL - GTZ PPP project will help providers to develop adequate strategies to meet the client’s
needs. Local civil society organisations (NGOs / FBOs) will be involved in IEC activities on community level to
increase the demand and acceptance of family planning methods. Furthermore it is expected that the government
acknowledge the opportunity to oursource transport of contraceptives and the district health management teams will
receive a model on how to improve the supply chain management in the districts. It is envisaged to transfer the
experiences made within the PPP project to other Kenyan provinces and districts. The project contributes thus to
MDG 5, the improvement of maternal health.




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LOGO Bayer East Africa Ltd. / DHL                                                      gtz            Deutsche Gesellschaft für

                                                                                       Technische Zusammenarbeit (GTZ) GmbH

                                          PROJECT PROPOSAL

ANNEX:

PROJECT PLANNING MATRIX

Project Objective
        Support district government to increase knowledge on and use of modern contraceptives in rural areas of
         Kenya in order to reduce unmet need of modern contraception
Indicators
     A small-scale desk survey is carried out presenting relevant information on the level of information women
        and men have on contraceptives methods, their expressed need for long-term contraception and on
        information regarding the availability of services offered in the two focal districts of German Development
        Cooperation (GDC) in Nyanza and Western Provinces.
     Based on survey results, on-the-job training strategy, curriculum and handbook to overcome barriers to
        long-term contraceptive use is developed in close cooperation with the government (PHMTs and DHMTs),
        service providers and relevant stakeholders.
     Communication strategies / IEC campaigns and IEC materials to increase knowledge on contraceptive use
        and service providers are developed in cooperation with the communities and local NGOs/FBOs.
     Contraceptive supply chain management M&E system is developed and functional in the focus area.
     On-the-job Training and communication strategies to overcome barriers to contraceptive use with focus on
        long-term contraceptive use are integrated into the AOPs of the two focal districts.
     Increased usage of long-term contraceptives (50 %) in focal districts.
     80 % of family planning customers evaluate services positive (various criteria).

Results, indicators and activities
Result 1:
   A small-scale desk survey has been carried out and the following strategy proposals to overcome
   barriers to long-term contraceptive use have been developed: On-the-job training strategy / IEC
   campaign or communication strategy/ contraceptive supply chain strategy
Indicators:
        1.1 A baseline survey document has been formulated which provides the following information of the focal
            districts:
            - List of all governmental, non-governmental and private contraceptive suppliers and projects
            - List of community based NGOs / FBOs active in relevant IEC campaigns and activities
            - Analysis of unmet contraceptive needs / availability of family planning services and its quality /
              availability of contraceptive methods (contraceptives, needed supplies)
            - Opportunities to cooperate with existing projects and services (4 weeks after project start)
        1.2 Strengths and weaknesses of the contraceptive supply chain management are described. (4 weeks
            after project start)
        1.3 Based on survey results the project design has been reviewed and training / communication strategy
            and contraceptive supply chain strategy proposals have been developed.
            (6 weeks after project start)
Activities:
1.1 Conduct a desk survey in order to identify needs, gaps and opportunities of contraceptive use – long-term
    methods in particular - in the 2 focal districts. Include information of all existing governmental, non-
    governmental and private contraceptive supplierers and projects into the survey. Furthermore include
    information of all NGOs / FBOs which are experienced to conduct family planning oriented IEC campaigns
1.2 Conduct a SWOT analysis as part of the desk survey to identify
    - strengths and weaknesses of the contraceptive supply chain management in the two districts
    - opportunities to cooperate with existing projects and services.
1.3 - Analyse the results of the baseline survey in cooperation with PHMTs and DHMTs.
    - Based on survey results develop training strategy to improve long-term contraceptive use, availability and
      quality of services.
    - Based on survey results develop communication strategy / IEC campaigns to increase demand and usage of long-term
      contraceptives.
    - Based on survey results review contractive supply chain design of the PPP project proposal.
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LOGO Bayer East Africa Ltd. / DHL                                                     gtz            Deutsche Gesellschaft für

                                                                                      Technische Zusammenarbeit (GTZ) GmbH

                                          PROJECT PROPOSAL


Result 2:
   A 1 day workshop has been carried out in each district to introduce and discuss strategies to overcome
   barriers to contraceptive use in close cooperation with the government (PHMTs and DHMTs),
   representatives of service providers, regional health training centres, identified NGOs / FBOs and other
   relevant stakeholders.
Indicator:
        2.1 District governments and stakeholders agreed on training strategy and tools to improve quality of
            family health service providers (8 weeks after project start)
        2.2 District governments and stakeholders agreed on communication strategy and use of IEC materials to
            improve knowledge on long-term contraceptives and family health services (8 weeks after project
            start)
        2.3 District governments and stakeholders agreed on contraceptive supply chain strategy (8 weeks after
            project start)
        2.4 Modes of cooperation between different stakeholders / projects / organisations and health facilities is
            well defined (e.g. MoU)(10 weeks after project start)
        2.5 Plan of Operation and M&E system developed (3 month after project start)
Activities:
2.1 – 2.3 Organise and conduct a 1 day workshop with all relevant stakeholders to introduce survey results and
          strategy proposals, to discuss and agree on the way forward.
2.4 Develop modes of cooperation with identified stakeholder / projects / organisations / health facilities with respect
    to - demand orientied community activities (community strategy / IEC campaign)
        - on-the-job training of health personnel (Training Centre / District Public Health Nurse / training strategy)
        - supply chain management of contraceptives (warehouse management, logistics, order and delivery)
2.5 - Develop plan of operation with participating partners
    - Develop M&E System for the project activities
.

Result 3:
    Contraceptive supply chain management system is in place and supported by DHL, long-term
    contraceptives are provided by Bayer Schering
Indicators:
        3.1 The following parts of the supply chain management system are implemented:
            Procurement / Order Processing / Warehouse Management / Logistic Tracking / Custormer
            Management / Costing / Push + Pull Factors (10 weeks after project start)
        3.2 Requested long-term contraceptives (Implants + pill) are available in the target districts

Activities:
3.1 Implement the supply chain management system based on survey results and workshop agreement
3.2 Provide long-term contraceptives by using push and pull factors.


Result 4:
   Supported by Bayer Schering / DHL training and communication strategies accompanied by tools have
   been developed based on survey and workshop results,
Indicators:
        4.1 Training strategy, curriculum and handbook, to overcome barriers to contraceptive use is developed in
            close cooperation with stakeholders including PHMTs / DHMTs and regional health training centres. (3
            month after project start)
        4.2 NGOs / FBOs conducting IEC campaigns are identified in cooperation with communities (3 month)
        4.3 Communication strategies and IEC materials to increase knowledge on contraceptive use and service
            providers are developed in cooperation with stakeholders. (5 month after project start)
        4.4 Health Facilities participating in project activities are identified (MoU) (4 month)
Activities:
4.1. Finalize on-the-job training strategy (curriculum and handbook for service provider personnel and TOTs) based
     on workshop results in cooperation with regional health training centres.

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LOGO Bayer East Africa Ltd. / DHL                                                     gtz            Deutsche Gesellschaft für

                                                                                      Technische Zusammenarbeit (GTZ) GmbH

                                          PROJECT PROPOSAL


4.2 Assess and identify local NGOs /FBOs in cooperation with communities.
4.3 - Finalize design of communication strategy / campaign in cooperation with communities.
    - Adopt relevant IEC materials for target group and service provider professionals
4.4 Assess and identify Health Facilities interested to participate in project activities and develop a MoU

Result 5.
   TOT workshop supported by Bayer Schering has been conducted to enable capacity building and
   quality improvement of service providers in the target districts
Indicators
     5.1 Each district has 6 trained TOTs who are in the position to conduct on the job training of health service
         personnel on reproductive and family health issues (4 month after project start)
     5.2 Reviewed TOT training curriculum and handbook has been handed over to regional health training centres.
         (project end)
Activities
5.1 Ensure cooperation with local training organisation
5.2 Conduct TOT training workshop (5 days) for trainers of target districts.
5.3 Evaluate and review training materials and handbook
5.4 Introduce TOT training curriculum and handbook to regional health training centres and relevant governmental
    authorities.

Result 6.
    On-the-job training of service provider personnel has been implemented and conducted in the two
    districts followed by implementation of innovative supervision
Indicator
     6.1 TOT trainers conduct on-the-job training as planned (ongoing)
     6.2 Supportive supervision and round table discussions (supervision tool) are implemented
     6.2 In line with Kenyan training guidlines trained reproductive and family health service provider personnel
         have relevant knowledge on long-term contraceptives and on clients’ needs. (project end)
     6.3 Reviewed training strategy has been introduced to relevant governmental authorities in target regions.
         (project end)
Activities
6.1 Start discussion on performance oriented reward system and implement pilot reward system
6.2 District TOTs provide on the job training for family health provider personnel.
6.3 Review on-the-job training strategy
6.4 Implement and conduct supervisory activities (supportive supervision, round table discussions)
6.5 Introduce training and communication strategy to relevant governmental authorities in all target regions.
6.6 Evaluate outcome of project activities and conduct consumer survey

Result 7.
    IEC Campaigns (related to community strategy) have been conducted by local NGOs / FBOs in
    cooperation with communities.

Indicators
     7.1 Target group has relevant knowledge on contraceptives including long-term contraceptives and family
         health service providers. (project end)
     7.2 IEC campaigns and communication strategy has been introduced to relevant governmental authorities in
         target regions. (project end)
Activities
7.1 NGOs/CBOs conduct communication campaigns on family planning, contraceptive use (focus on long-term
    contrateptives).
7.2 NGOs / FBOs review their IEC campaigns and communication strategy and document results.




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LOGO Bayer East Africa Ltd. / DHL                                                  gtz            Deutsche Gesellschaft für

                                                                                   Technische Zusammenarbeit (GTZ) GmbH

                                         PROJECT PROPOSAL


Result 8.
    Workshop has been carried out to introduce evaluation survey and reviewed strategies to
    stakeholders and interested partners
Indicators
     8.1 Training strategy, communication strategy and contraceptive supply chain strategy are introduced to
         partners and published (project end)
     8.2 Training and IEC community activities are integrated in AOP X (project end)
Activities
8.1 Conduct survey to evaluate project activities (see activity 6.6)
8.2 Conduct 1 day workshop to introduce and discuss evaluation results and the 3 strategies to all partners
8.3 Publish documents (web site and hard copies)




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