Strengthening family planning stewardship with a total market approach: Mali, Uganda, and Kenya experiences

To improve overall market sustainability, governments and their donors are ramping up efforts to strengthen stewardship in developing country health markets. Key stewardship functions include generating intelligence that enable policymakers, ministerial leaders, and program managers to develop evidence‐based policies and strategies to improve the resource management, supply, and use of health products and services. The total market approach (TMA), an analytic and policy framework, generates market intelligence and improves evidence‐based decision‐making, and also strengthens other stewardship functions, such as building and sustaining partnerships, strengthening tools for implementation, aligning government policy with market interventions, and ensuring accountability/transparency. TMA evolved in response to the phase out of donor support for reproductive health (RH) and family planning (FP) programs and the need to improve coordination among public, private, nongovernmental organizations, and civil society to achieve greater equity, health impact, and market sustainability. To assess TMA's role in strengthening the stewardship of RH/FP markets, this article reviews three countries that applied TMA principles: Mali, Uganda, and Kenya. It identifies how TMA processes influenced stewardship functions and assesses to what degree these processes have contributed to concrete actions to improve market efficiency and sustainability.