Strengthening a Total Market Approach

Photo © Richard Lord

The total market approach (TMA) is defined as a coordinated means of serving all clients in a country—from those requiring free services to those willing and able to pay—to maximize access, equity, and sustainability. Central to this approach is the notion that health providers and suppliers from all three sectors—public, nonprofit, and commercial—leverage their comparative advantages to reach different types of clients with a range of family planning product and service options. A TMA helps expand the market for health products by better targeting free or subsidized products, reducing inefficiencies and overlap, and creating room for the private sector to increase its provision of health commodities. Central to a TMA is a strong focus on coordination, partnership, and alignment of all related activities among key actors in the total market. Optimal delivery of family planning products and services occurs when the needs and capabilities of the different sectors are aligned under government stewardship. This is because the government has the regulatory, financing, and health program authority to convene stakeholders and support implementation. Also, transforming and expanding the government’s role from service provider to supporter of the total family planning market contributes to program quality, affordability, and accessibility, and may help direct limited public resources to benefit poor and vulnerable families.

The Evidence Project is working to enhance equitable and sustained access to family planning services in Uganda by maximizing the country’s readiness to implement a total market initiative (TMI) and to meet its FP2020 commitments. The first phase of the project will be the conducting of an in-depth landscape analysis of the total market for family planning in Uganda. The goal is to inform the design and lay the groundwork for a future TMI in the country. At the same time, this work in Uganda will be used to inform the development of enhanced landscaping guidance to support TMIs across different country contexts. The Evidence Project will produce a clear and easy-to-follow tool describing how to conduct a total market landscape analysis. This tool will be developed in consultation with in-country partners and stakeholders from the Reproductive Health Supplies Coalition (RHSC) Market Development Approaches Working Group (MDAWG).