Technical Services » Modeling and Economic Analysis

Futures Group’s modeling and economic analysis services include

  • Model Development
  • Model Application: Population and Reproductive Health
  • Model Application: HIV/AIDS
  • Economic Analysis
  • Health Financing
  • Costing
  • Resource Mobilization
  • Resource Allocation

Model Development

Policy models are designed to answer a number of “what if” questions relevant to organizations ranging from small local providers of primary healthcare to large international development assistance agencies. Futures Group has developed a series of computer models that analyze available data to determine the future consequences of today’s development programs and policies.

Spectrum is a suite of health policy models using easily-learned Windows-based commands. The models project the need for services in family planning and reproductive health, maternal health, and HIV/AIDS. The Spectrum suite consolidates previous models into an integrated package containing the following components:

  • DemProj: Demography. DemProj projects the population for an entire country or region by age and sex based on assumptions about fertility, mortality, and migration. A full set of demographic indicators can be displayed for up to 50 years into the future.
  • FamPlan: Family Planning. FamPlan projects family planning requirements to reach national goals, for example addressing unmet need or achieving desired fertility rates. 
  • AIM: AIDS Impact Model. AIM projects the consequences of the HIV epidemic, including the number of people living with HIV, new infections, and AIDS deaths by age and sex; as well as new cases of tuberculosis and numbers of children orphaned by AIDS.
  • RAPID: Resources for the Awareness of Population Impacts on Development. RAPID projects the social and economic consequences of high fertility and population growth for the labor, education, health, urbanization, environment, and agriculture sectors.
  • PMTCT: Prevention of Mother-to-Child Transmission. PMTCT evaluates the costs and benefits of programs to reduce transmission of HIV from mothers to children.
  • BenCost: Financial Benefits and Costs of Family Planning Programs. The model compares the monetary costs of family planning programs to the monetary benefits in terms of the reduced levels of social services required at lower levels of fertility.
  • CR: Condom Requirements. This model forecasts national condom requirements for both family planning and HIV prevention, focusing on the most-at-risk groups.
  • Safe Motherhood Model. This model improves understanding of how changes in maternal health intervention priorities—investments in one strategy over another—affect program outcomes, by estimating the impacts of different scenarios on the maternal mortality ratio.
  • Allocate. This model examines the linkages and interactions among three main areas of a reproductive health action plan—family planning, safe motherhood, and post-abortion care—to highlight how investments in one area impact key indicators in the other areas.
  • HIV Vaccine. This model explores the impact of potential HIV vaccines on the epidemic.
  • Goals. This model helps countries respond to the HIV/AIDS epidemic by showing how the amount and allocation of funding relates to the achievement of national goals, such as reduced HIV rates.

The Resource Needs Model calculates the funding required for an expanded national response to HIV/AIDS. It contains three sub-models for prevention, care and treatment, and orphan support.

The Workplace Policy Builder helps companies develop their own HIV/AIDS policies through a participatory process.

Model Application: Population and Reproductive Health

Although the benefits of family planning and reproductive health (FP/RH) services have been substantiated and discussed for decades, persuasive evidence-based arguments are still needed to renew high-level commitment among governments and policymakers. The RAPID Model—part of Futures Group’s Spectrum  package, described above— projects the social and economic consequences of high fertility and rapid population growth for the economy, education, health, urbanization, and agriculture. This interactive, user-friendly tool helps in-country stakeholders manipulate data to analyze alternative population scenarios and encourages evidence-based policy dialogue. RAPID presentation materials can be geared toward diverse audiences (e.g., senior decisionmakers, budget planners, and religious leaders), various sectors (e.g., environment, health, education, and economy) and different levels (e.g., national and local), depending on the country context.

For over 20 years—currently under the USAID│Health Policy Initiative (HPI), for example—Futures Group has worked to elevate the status of FP/RH on the political agenda through conducting applications of the RAPID model in more than 40 countries and presenting the findings to key stakeholders and decisionmakers. In Rwanda, Futures Group’s application of RAPID has been a large factor leading to increased political commitment to FP. In 2007, the Minister of Health’s use of data from the RAPID analysis resulted in a presidential-level commitment to family planning and led to the development of a national strategy and the inclusion of FP in Rwanda’s Vision 2020. More recently, RAPID has been used in training sessions for district-level planners to help them develop plans, thus strengthening evidence-based RH policymaking at both local and national levels.

Model Application: HIV/AIDS

Elevating priority issues on the policy agenda is an essential component of the policy process. Recognizing this, Futures Group uses HIV/AIDS projections to illustrate the magnitude of the AIDS epidemic and the demographic, social, and economic consequences of the disease in order to prioritize HIV/AIDS on national policy agendas. These illustrations demonstrate to policymakers the range and magnitude of impacts on other areas of development that may result without effective action. The AIDS Impact Model, known as AIM, is a key tool applied by Futures Group experts to generate projections on the expected number of HIV infections, AIDS cases, and AIDS deaths, as well as the social and demographic impacts of the disease.

In recent years, Futures Group has used AIM projections in Mali to increase public and private sector commitments to HIV/AIDS priorities. Through a decentralization process that divided Mali into hundreds of communes, responses to the AIDS epidemic were divided and weakened. To counterbalance this trend, the Futures Group team trained mayors to use AIM projections to advocate for additional HIV prevention resources in municipal budgets and to raise awareness among locally-elected officials on the urgency of HIV in their communes. Within the private sector, Futures Group presented AIM results to firm managers to spur HIV/AIDS workplace initiatives. After attending a Futures Group-led AIM presentation in 2007, managers of Bramali, a major soft drink company in Mali, drafted and adopted company directives on HIV/AIDS.

Economic Analysis

Sound economic analysis can help countries set priorities, target scarce resources, and reduce waste and inefficiency, thus enhancing their ability to scale up programs and achieve results on important public health initiatives. Futures Group has extensive experience helping policymakers and program managers identify the resources required to mount effective responses to obstacles and maximize investments.

 For example, in August 2009 Futures Group assessed the Nigeria National Health Insurance Scheme (NHIS) and the extent to which the program was providing family planning (FP) services and reaching its target population of potential users. Our team identified a specific need for technical assistance in analyzing the costs of existing NHIS pilot programs in six Nigerian states. Noting these findings, the NHIS Executive Secretary requested that Futures Group analyze the costs and results of funding disbursements from two of the pilot programs. The findings serve as a strong advocacy tool for boosting the effectiveness of FP spending within NHIS programs: with wider dissemination, this information can mobilize broader political commitment and resources for FP in Nigeria overall.

Health Financing

Since financing is essential to the implementation of health policies and programs, it is critical to consider financing mechanisms that will increase access to health services and not impose additional barriers to access among the poor. Futures Group has helped a number of countries identify, test, and implement new and innovative health financing mechanisms.

For example, in Kenya Futures Group’s HPI team assists the Ministry of Health to find solutions to key financial and management problems so that it can respond more effectively to current health needs. Through better resource mobilization and more rational budgeting at all levels, the management of health sector resources is improved. Futures Group also supports the Ministry’s recently established Health Financing Task Force, providing leadership in the development of a long-term, equitable, and efficient approach to financing Kenya’s health services. Our HPI team is providing technical assistance and supporting the inclusion of recommendations into the Health Care Financing Strategy.

Costing

Building in-country capacity is the foundation of Futures Group’s approach to helping prepare action plans and cost estimates. We ensure that targets are realistic, maximizing evidence-based decisionmaking and resource allocation.  For example, Futures Group undertook groundbreaking studies on the impact and human, financial, and commodities requirements for scale up of male circumcision programs in Lesotho, Namibia, Swaziland, and Zambia. As a result, the World Health Organization has recommended that our approach be used as the standard costing methodology on this topic. We have developed a Decision Makers’ Program Planning Tool that enables planners to understand the costs and impacts of male circumcision under different scenarios, taking into account the pace of scale-up, different provider combinations, or targeting specific age groups.

Futures Group’s UNICEF-funded OVC Unit Cost Survey in 23 countries has helped countries develop more realistic strategic plans for orphans and vulnerable children based on current costs and resources. Our staff produced a costing analysis of community-based OVC programs in Rwanda and Zambia and a report for UNAIDS on absorptive capacity, bottlenecks, and out-of-pocket spending related to AIDS.

We are experts in costing national action plans and working with in-country partners to improve resource planning at regional and district levels—a critical next stage as countries increasingly decentralize decisionmaking and healthcare systems. For example, in Indonesia we prepared a costed plan that allowed the National AIDS Commission to set priorities, effectively target resources, and develop a realistic national implementation plan. We also prepared scenarios for 19 high-priority provinces. Through HPI, we assisted Jordan’s Higher Population Council to formulate and cost programs under its Reproductive Health Action Plan 2008–2012, designing a costing system that enabled the council and implementers to estimate the funds needed to implement activities.

Futures Group designed and conducted a unit cost survey among 58 major government and NGO service providers for orphans and vulnerable children (OVC) in five provinces of Cambodia, and  used the results to assist with an OVC action plan and three-year budget.

Resource Mobilization

Successful resource mobilization efforts build the capacity of local groups to design, fund, and implement successful health programs. This capacity building may include training, assistance with proposal writing, and other activities that help make the impact of development efforts sustainable.

For example, Futures Group provided technical and financial assistance through HPI to Kenya’s Network of Religious Leaders Living with and affected by HIV and AIDS, an organization that has been at the frontlines in the fight against stigma and discrimination against people living with HIV/AIDS. After our training on proposal writing and resource mobilization, the network was able to mobilize funds on its own to champion stigma reduction and advocate HIV awareness among religious leaders and their communities.

Through the POLICY project, Futures Group helped Lesotho and South Africa identify, test, and implement innovative new financing mechanisms for family planning and reproductive health services using computer models such as the Goals, Allocate, and Resource Needs models (described above). These cutting-edge tools helped our partners understand and set priorities for effective and efficient resource mobilization and use.

Resource Allocation

Through more effective allocation of limited resources, we can truly expand the impact of efforts to improve health outcomes. By providing local organizations and governments with training and improved information, Futures Group maximizes both the sustainability and effectiveness of our efforts worldwide.

For example, in Peru Futures Group worked to increase efficiency in resource allocation for the JUNTOS project, a conditional cash transfer program for the poorest families in rural and urban communities. Working closely with our HPI team, JUNTOS allocated funds to produce culturally appropriate family planning and reproductive health (FP/RH) communication materials designed by UNFPA for use in health facilities countrywide. This allocation of resources represents an important example of inter-governmental collaboration to ensure that poverty reduction and FP/RH efforts are integrated and resources allocated to maximize impact.

In India, the government conducted a country-wide mapping exercise to ascertain the size and location of the most at-risk populations (MARPs) for HIV infection. Futures Group’s HPI staff examined secondary data, provided monitoring and supervision support, and analyzed the results of the mapping, then shared findings with the Uttar Pradesh State AIDS Control Society (UPSACS), which used the information to scale up its targeted intervention plan. The data revealed that the number of MARPs was higher than expected, which led UPSACS to revise its targets and resource allocation.