Q&A: Innovation in integration for health gains

WASHINGTON — A renewal of a financing commitment from the Pfizer Foundation represents a significant statement of intent in pushing progress forward in health care access for developing countries. Providing a second round of funding for projects tackling both family planning needs and immunizations, the foundation has simultaneously committed to breaking down barriers women face in their access to health care.

According to the World Health Organization, 214 million women in developing countries who want to avoid pregnancy are not using a modern contraceptive method. This is often due to limited access and awareness. Seeking to change that, the Pfizer Foundation is continuing its support to partners Save the Children, the International Rescue Committee, CARE International, and World Vision, in training health care providers from remote and rural areas, often women themselves, in how to deliver vaccines and talk about family planning opportunities, while also advocating with community leaders.

“We choose our partners carefully because we know that they’re better equipped to implement these types of programs than we would be on our own,” explained Caroline Roan, vice president of corporate responsibility at Pfizer, and president of the Pfizer Foundation. “We use their expertise and understanding of what it’s like for a mother who's coming in to get her child immunized. What are those things that she's dealing with, how can we best use that time while she's waiting to get her child immunized, and will she be open to hearing that information? Those kinds of insights have come from our partners.”

By supporting this two-pronged approach to health — in Benin, Ethiopia, Kenya, Malawi, and Uganda — the Pfizer Foundation aims to cut down the number of trips a woman in a low-income setting needs to make to a health care center for basic services such as contraceptive access and immunizations for her children, and with it, make in-country systems more efficient.

Sitting down with Devex, Roan explained why such an approach is innovative, the gains they’ve seen so far, and how such an approach not only improves health, but gender parity too. Here is the conversation, edited for length and clarity.

Why does access to contraception and immunization remain such a problem in developing countries?

It’s probably not a surprise to the Devex audience that, particularly in low-income countries, family planning services are not readily available because of certain challenges: The overall health care infrastructure is poor, there's poverty, and there's a lack of education and/or awareness about sexual health.

One of the reasons that it’s been so difficult is because there's not a robust, primary health care delivery system in most of these countries and there are a ton of challenges that folks face when trying access these services.

The other thing is that, for the most part, funders have always thought about the delivery of care in a very siloed and parallel approach, instead of looking at the horizontal nature of how a patient or a person in a community is seeking to get health information.

Put that together with social, cultural, and religious norms for a community, and sometimes they prove to be significant barriers for women in understanding what options they have, how to take care of their families, and think through planning for their families.

In that spirit, it's proved to create the perfect storm of barriers for women as they’re seeking to understand family planning options and take care of their young babies in terms of immunization.

In May, the Pfizer Foundation announced a grant recommitment for organizations working to provide integrated family planning and immunization services for underserved women and children. How can this approach better tackle the needs of women and children in developing countries?

Our partners are obviously the experts on the ground, but they're seeking not only to educate women, but also men on family planning, while hopefully reducing the number of visits for a woman seeking health services.

Ideally, you come in, you bring your child for a vaccination — it makes sense that if you had to take a half morning off work to go to that clinic, you could be offered other services. It's much more efficient and we believe that through this work, we’ll be able to demonstrate health system efficiency.

I don't know of any other approach in these low-resource settings that integrates both services so directly, and because of that, and because we've seen such strong uptake by community members, we decided to continue our work in this space at least for another year.

We believe that, ultimately, what we learn about health-seeking behavior with women, and how we understand what we need to do at community level and at provider level, will give important insights to apply to the integration of other health care services.

What are the challenges faced in implementing this approach and how are the Pfizer Foundation and its partners helping to overcome these?

I think, generally speaking, challenges exist at the systems level because systems are not robust enough or comprehensive enough.

We also know that women’s partners are critically important to getting on board with the concept of making good and healthy choices for family planning. We know that we need implement these programs respectfully within the cultural context that families are living. We engage with the community to understand those norms and work with support from community leaders.

How do efforts around family planning fit in with the broader Pfizer women's health portfolio?

First of all, women are really the gatekeepers of health and we know that when women are healthy, their children are healthy, and their communities are healthier. They’re the ones making decisions, they’re the ones caretaking, they're the ones in charge, if you will, for health. For that reason, we see women's health as a key pillar in our ability, as a company, to deliver on the Sustainable Development Goals — and obviously those include good health, but also gender equality and parity for women.

The Pfizer Foundation is a charitable organization established by Pfizer Inc. It is a separate legal entity from Pfizer Inc. with distinct legal restrictions.