(May 2007) The philanthropic sector plays a vital role in supporting family planning and reproductive health funding, and provided $326 million in grants for population activities in 2004. The overwhelming majority of these funds come from a handful of U.S. foundations, and in recent years these institutions have recognized the need to hold themselves more accountable regarding the effectiveness of the work that they support.

During a PRB Discuss Online, Sara Seims, director of the Population Program at the William and Flora Hewlett Foundation, answered participants’ questions about the ways in which many foundations are determining how best to work with developing country governments, civil society organizations, local communities and other stakeholders, as well as with other funders.

Thank you for taking part in this PRB online discussion. If there is a question you would like Dr. Seims to answer, please e-mail her at: sseims@hewlett.org.

May 22, 2007 12:45 PM EST

Transcript of Questions and Answers

Sandra: What can be done to ensure that funds earmarked for family planning and reproductive health services actually make it to the end users?
Sara Seims: Philanthropies have the same challenges of ensuring that our funds reach the end users as all other donors. For those philanthropies with a field office the job is much easier in that they can stay closer to the project. For the rest, we must rely on seeking measurable and firm indicators from the grantee before the proposal is approved, trusting the grantee to ensure that the funds reach those in need, and in visiting the project and gathering whatever informatin that we can to ensure that end users do indeed receive the maximum benefit.

William H. Johnson: Although philanthropic organizations are more interested in measuring effectiveness, the indicators are often unique to each organization, not always transparent, and often do not sum across organizations to a higher level purpose in a significant way. Does this suggest the need for more collaboration across philanthropic organizations regarding cooperation for common objective(s)?
Sara Seims: Philanthropies face the same challenges with coordination as do bilateral and multilateral donors. We each have independent Boards which set strategy and direction, and different areas of emphasis. That being said, coordination among philanthropies has much improved in recent years. For example, the Funders’ Network organizes bi-annual meetings of all pop/FPRH foundations, every year or so the presidents of the major international pop/FPRH philanthropies meet and on a very regular basis foundations working in the same countries or on the same priorities communicate. There is always more that can be done to relieve the reporting burden from the grantee but I believe that the bi- and multi-laterals, which give the bulk of the funds, should set a good example first with perhaps USAID leading the way.

William H. Johnson: In the USAID cooperating agency community, many well designed activities are operational but underfunded. WHy doesn’t the philanthropic community consider utilizing the existing capacity in some of these underfunded projects to maximize marginal return on investment. Why re-invent the wheel if you can simply add some missing spokes?
Sara Seims: The Hewlett Foundation provides core support to many USAID cooperating agencies which are allowed to use these funds as they see fit. Other major foundations also provide funds to many CAs not necessarily to supplement shortfalls in USAID funds, but certainly to support complementary activities particularly those not permissible with USAID money.

Nicholas Kaufmann: Does the philanthropy sector regard working with men and boys in family planning and reproductive health a priority? If not, why not, and how can it be made a priority?
Sara Seims: Many philanthropies recognize the importance of working with men and boys as do the grantees. The Hewlett Foundation usually provides core support and this enables the grantees to allocate the funds as they see fit and thus we leave it up to the organizations to enhance their work with men and boys if they want to. Most, if not all, of the major FPRH organizations such as IPPF, work with men and boys and certainly the HIV/AIDS pandemic has underscored the vital nature of providing services and counselling to all.

Rachna Maheshwari: In most democratic developing nations one of the best ways to promote family planning methods and reproductive health care is by spreading awareness about these issues. Can corporate philanthrophy in the form of financing and intiating public service advertisements which reach people through mass media (i.e. television, radio,print media and the internet)be useful?
Sara Seims: In the United States corporate philanthropy, private media and private sector public relations and advertising firms help finance PSAs and often devote a great deal of time in ensuring that these are of high quality for their intended audiences. MTV and other networks have shown considerable commitment to improving FPRH either through PSAs or including relevant materials in their programs. Even if the corporate philanthropic sector is not particularly well strong in a developing nation, civil society groups can themselves make contact with many of these same organizations and media to seek their help in improving FPRH.

Rahat Bari Tooheen: Philanthropy can achieve this goal through upholding human rights all over the world. How can philanthropy address the gap in achievement of universal human rights, when human rights are being continuously violated globally, despite several national/international initiatives?
Sara Seims: Several philanthropies, including the Hewlett Foundation, provide support to civil society organizations that enhance human rights and fight corruption. Looking at the websites of the major philanthropies will provide more detail of this work.

Adekola Olalekan: There are some very influencial Philanthropy groups in developing countries. However, they often have cultural affiliations not in support of Family Planning and Reproductive Health. What is the best way to deal with such organisations, as it seems even educating their leadership is not working.
Sara Seims: If a philanthropy does not want to support FPRH and educating their leadership doesn’t do the trick, the best tactic may be to try and engage other philanthropies that are more open and more interested.

John Rohe: Which factor bears most prominently in lowering fertility:

1. industrialization,

2. affluence,

3. access to birth control,

4. gender equity,

5. separation of church and state,

6. wealth,

7. other?
Sara Seims: This is a very important question and one that is difficult to answer. The East Asian countries achieved lower fertility as they were making birth control more available, educating their children and expanding their economies. It is generally believed that all of these factors worked together to create a virtuous circle and helped these nations break through the ‘poverty trap’. In other countries, such as Bangladesh, fertility rates have gone down a great deal in the absence of dramatic economic development but with a broad effort to expand family planning. In any event, access to good quality voluntary birth control and reproductive health services will always be helpful. In sub-Saharan Africa the situation is more complicated but as the continent rapidly urbanizes we can anticipate a significant change in the number of children that women and men want to have and thus an increase in the demand for contraception.

Adekola Olalekan: Hi Sara, Is there a database of philanthropy (groups or individuals) involved in reproductive health? If there is none, will it not be nice to have one to serve as a platform where these orgnaisations can learn from each other (mistakes, successes, etc).
Sara Seims: You will find lots of information at: www.fundersnet.org/news/docs/funding_analysis_2007. Also Population Action International will be able to help you with your data needs.

Adrienne Allison: What is being done by US philanthropies to encourage similarly focused philanthropies in developing countries such as India to support national or local family planning programs?
Sara Seims: Hallo Adrienne, Several well established US foundations are interested in strengthening the philanthropic sector in other countries but are still figuring out how to do this. The American University of Cairo has established a center for philanthropy and is working hard to encourage foundations in the Arab world to support women’s health and other worthy causes. The Hewlett Foundation is supporting their efforts as are other US foundations. I am not aware of a similar institution for India. The large Indian diaspora in the U.S could perhaps be contacted for advice on this point. Sara

Kakaire Kirunda: Do you think the philanthropy sector should tie new funding to good results from previous funding? Several organisations continue to receive funding despite poor performance.
Sara Seims: Foundations are increasingly interested in working with their grantees to establish clear goals and measurable ways of evaluating outputs, outcomes and impact. We hope that these efforts will be helpful to our partners and will improve overall performance. Foundations are also willing to, at times, make highly risky investments that could take several years to yield results but no philanthropy wants to keep throwing good money after bad. We all want to see that the grantee is prepared to learn from experiences and make necessary changes.

Dr. Yamini Sarwal: What are your views on decentralization of fiscal powers so that the funds provided by the philanthropic sector are utilized appropriately and without logistic delays?
Sara Seims: Getting funds to grantees in a timely manner is of great importance to the philanthropic sector. Because philanthropies usually have very few staff, they often need to work through intermediaries with the hope being that in the long run this will be better for the grantee and in fact speed things up. Giving money directly to a non-US charity requires, according to US law, expanded reporting requirements and this may be burdensome to the grantee and may also result in some delay. Your question is a good one and we know that there are bureaucratic hurdles that must be overcome for rapid decentralization of financial matters but most philanthropies are committed to empowering the grantee on the ground and are working to do a better job.

Rachna Maheshwari: To what extent can philanthrophic organizations involved in promoting women’s rights and gender equity help?
Sara Seims: Many of the philanthropies that support reproductive health also promote women’s rights and gender equity since we know that the two go hand-in-hand. Fortunately, most foundation websites list the grants that they make and the grantee is also identified and often the website includes a brief description of the grants so that you will be able to see for yourself that commitment to support RH often goes together with broader areas of empowering women.

William H. Johnson: Given the increased significance of the philanthropic funding targeted for PRH, especially the Bill & Melinda Gates “Buffet ted” reserves, why doesn’t the philanthropic community increase it’s capacity for strategic planning, implementation, monitoring and evaluation by more effective use of short term technical assistance (one of the 5 recommmendations of the UK All Party Parliamentarians Report). The increase in financial resources in the philanthropic community seems to outpaced capcity to program, and some view the strategic planning as insular.
Sara Seims: The philanthropic community relies very heavily on outside expertise to guide its strategies and to help with implementation and M&E. Short term TA does not do justice to the collaboration that foundations have with these experts. Some foundations are fortunate enough to have local field offices and these tend to be very well integrated within their communities and work closely with FPRH leaders in the countries. You are quite right in stating that foundations tend to be short staffed so in addition to using the services of experts, we also use intermediaries from time to time – similar to USAID.

William H. Johnson: Can you provide the breakout by philanthropic organization of the $326 million in grants for population in 2004? What are the defining parameters for population versus reproductive health?
Sara Seims: You will find most of what you need by checking on: http://www.fundersnet.org/news/docs/funding_analysis_2007 and by contacting PAI

Pushpanjali Swain: Who are the philanthropic group in developing world? Are they NGOs or Charitable hospitals or both? How to bring them into the folder of reproductive health and family welfare programme? Where philanthropic group intervention would be most appropriate to tackle the reproductive problems in developing countries?
Sara Seims: As far as I know there is no listing of philanthropic organizations in the developing world. Philanthropies have their own funds and thus are different from NGOs and charities that implement work and usually are in need of funds. There may be rich individuals in developing countries who are interested in establishing their own philanthropies or who may be willing to fund NGOs, hospitals and other worthy causes but most likely you will need to identify them through local sources.

William H. Johnson: US philanthropic organizations now seem more interested in working directly with beneficiaries. Given the staff limitations of such organizations, how realistic is this approach?
Sara Seims: Given the small staffs of most foundations, it is a challenge to figure out how to work effectively with beneficiaries. Foundations with local offices do a much better job. For the rest of us, we often have to rely on sporadic site visits and trusted local consultants. Since many foundations work on policy dialogue, this involves fewer beneficiaries and it is easier to establish a good direct relationship. FOr service delivery work with many providers and even larger numbers of clients, it is more difficult to establish direct relationships without a local presence.

Mathias: Hi Sara. What can you tell us about philantropy activities in this regard in latin America?
Sara Seims: To find out more about philanthropic reproductive health activities in Latin America, I suggest that you contact NGOs in the region and find out which foundations support their work. You can also go on the websites of the major foundations to see if any have a particular interest in Latin America as a region or in particular countries within Latin America.

Paul: There was earlier mention of “human” rights, but shouldn’t we really be talking about women’s rights? In matters of FPRH, the female population of the world needs a louder voice.
Sara Seims: I agree with you that women need a louder voice and since women make up about half of the world’s population, it may not be useful to distinguish women’s rights from human rights.

Solomon Van Kanei: The issue of delayed referrals are a sure problem for those trained and untrained Traditional Birth Attendants around the world who serve in especially difficult terrains. What can the Philantropists do to help these people cultivate the culture of prompt referral when necessary?
Sara Seims: Those foundations that are engaged in safe motherhood initiatives often include grants to train TBAs since they are aware of the important problem that you raise. These philanthropies make grants to organizations such as Family Care International and Columbia University’s School of Public Health as well as to UNFPA and WHO. I suggest that you visit the websites of these organizations to find out more about the specific work that is being done to combat delayed referrals.

Gasoni jeannette: Hello Dr. Seim I am from Burundi a country of subsaharian Africa. I am a demographer and I am for the moment coordinator of the component Population and development of the ministry for planning financed by UNFPA. Our work relates to the sensitizing the rural population to known the reproductive health , we distribute contraceptives and we make the data-gathering on some aspects of maternal and children health. So I’d like to know if we can collaborate with you because we often miss financing for our activities. I thanks you
Sara Seims: Dear Dr. Gasoni, Your question is an excellent one in that it points out that there are some types of activities, such as nationwide distribution of contraceptives or delivering health services, that are best supported by public funders rather than philanthropies. Normally, foundations do not view overall systems improvement as their strength nor do many have sufficient funds for this purpose. To raise money for your important work, I suggest that you visit the embassies of the donor countries (European countries and the EU, Japan) in Burundi since they often have development staff and budgets that might be able to help you. UNFPA might also be able to provide good advice to you in terms of raising funds. Good luck. Sara

Miriam Ruiz: Many funders are not engaging in RHSR anymore. Why is this trend happening? There is a discussion on the need to protect gains in the field.
Sara Seims: Some foundations originally began supporting family planning because of fear of overpopulation. As fertility rates have declined around the world, with the exception of sub-Saharan Africa, some of these philanthropies no longer saw any point in supporting work in this area. As you probably know, RHSR is a controversial subject and the MDGs do not have a specific goal on this topic. However, since RHSR is inextricably linked to the achievements of most, if not all, of the MDGs especially those relating to poverty alleviation, women’s health and status, and HIV/AIDS, other funders recognise the important of continuing work in RHSR. To protect the gains in the field, activities that can concretely demonstrate the importance of RHSR to the achievement of the MDGs is very important.