CANADA

CANADA POPULATION AND REPRODUCTIVE HEALTH ASSISTANCE OVERALL ASSESSMENT

After declining steeply in the early 1990s, Canadian population assistance levels have stabilized, but not recovered. Current levels of population assistance are only about a quarter of the level needed for Canada to contribute its fair share of the ICPD year 2000 goals for donor assistance. Given continuing deep cuts in overall development aid, it is unclear whether recently initiated advocacy efforts can help restore–let alone increase–funding for population and reproductive health.

At the policy level, Canada appears to be giving increased priority to reproductive health. A new health strategy adopted by the Canadian aid agency includes a strong emphasis on women’s and reproductive health. However, work on a population and reproductive health strategy expected to clarify program priorities and future directions has been suspended. Unless levels of population assistance increase, Canada will likely be a donor of declining importance in the international population field.

Canada channels over half of its population assistance bilaterally. Despite its limited technical expertise, Canada is an effective donor in population and reproductive health, largely because it allocates a significant proportion of bilateral funds to cofinancing of multilateral projects.

1 Development Assistance: Policy and Funding

Canada’s development assistance has been declining since 1991. Early in the decade, a lack of high-level political support led to cuts in the foreign aid budget. More recently, economic problems have made it difficult to reverse this trend. While still low historically, 1997 Canadian development assistance increased to $2.1 billion, up from $1.8 billion in 1996. In 1997, Canada ranked 9th out of 21 major donor countries in terms of total aid volume. Canadian aid represented 0.36 percent of GNP, slightly less than the average for the donor community.

Despite recent negative trends, Canada’s role as a donor nation remains an important part of its international identity. There is strong public support for humanitarian and emergency aid, although support for long-term development aid may be weaker in the current economic context. Canada also holds a unique position within the donor community as a member of the following inter-governmental groups: the British Commonwealth, La Francophonie, and the Group of Seven major economic powers.

Official Canadian development policy identifies basic human needs (including family planning) and women in development as priority program areas. Other priorities include infrastructure services, human rights, democracy and good governance, private sector development and the environment.

Canadian development assistance is managed by the Canadian International Development Agency (CIDA), which administers 75 to 80 percent of bilateral and multilateral development assistance funds. The Department of Finance, which handles contributions to the World Bank and International Monetary Fund, and the Department of Foreign Affairs and Trade manage smaller portions of the aid budget. As part of a decentralization initiative, CIDA has also delegated limited authority to approve projects to Canadian embassies overseas. Following a series of management reviews and reorganizations during the 1990s, CIDA has recently taken a more "results-based" approach. In response to cuts in the development assistance budget, it has also concentrated its activities in fewer countries.

2 The Policy Environment for International Population Assistance

In 1996, CIDA released a policy document entitled Strategy for Health which assigns high priority to women’s health and reproductive health programs. The health policy aims to address problems of poverty and population growth through health projects focusing on women, and also supports access to health services as a human right. The strategy frames the problem of rapid population growth as an impediment to economic growth in developing countries, and also sees reduction of high unmet need for family planning as a prerequisite to arresting the spread of HIV/AIDS and other sexually transmitted diseases (STDs).

Other than these broad policy statements, there is no detailed population strategy to guide CIDA programming in this area. Recognizing this gap, CIDA embarked on an internal consultation process to develop a population, reproductive health and sustainable development strategy. As of mid-1998, however, work on this strategy had been suspended.

On the policy front, the establishment of Action Canada for Population and Development has given advocacy for population assistance a boost. This new NGO, set up in 1997 with the assistance of the Planned Parenthood Association of Canada, aims to promote Canadian fulfillment of its ICPD commitments. The Conservation Council in Ontario is another NGO with a history of involvement in advocacy for Canadian population assistance.

3 Trends in Funding for Population Assistance

Overall Funding Levels:

Canadian population assistance declined along with development assistance levels during the 1990s. Funding fell to a low in 1994 of $22.8 million a year, down from a high of $43 million in 1990. CIDA population staff and external advocates have worked hard to maintain core population and family planning assistance in the $20 to $25 million range in recent years, even as CIDA’s overall aid budget has continued to shrink.

Following the Cairo conference, Canada reported spending about $37 million annually in 1995 and 1996 on population assistance defined more broadly to include maternal health and AIDS activities. Canada would have to increase its allocations almost four-fold to reach its fair share of the year 2000 goal for donor assistance to population programs, based on Canada’s proportional share of total donor country GNP.

Multilateral Funding:

Canada’s annual contribution to UNFPA peaked in 1994 at $10.1 million, and has since fallen, amounting in 1997 to $6.5 million. Canada provides additional multi-bilateral funding to UNFPA to finance the costs of Canadian junior professional staff on loan to UNFPA, as well as the purchase of Canadian contraceptives. In 1996, Canada also funded UNAIDS at $3 million, including both a core contribution and cofinancing of a multi-bilateral breastfeeding and AIDS project in Zimbabwe. The WHO human reproduction research program receives a modest annual contribution from Canada, amounting in 1996 to about $300,000.

Bilateral Funding:

Canada increased the bilateral share of its population assistance from one-fifth of the total in 1992 to over half in 1996. Bilateral funds are concentrated in Asia and Africa, which in 1996 received the bulk of overall reproductive health funding.

Funding for NGOs:

Canada supports numerous NGOs working in the international family planning and reproductive health arena. In 1996, CIDA disbursed about $4.4 million through its "partnership branch" to international NGOs such as IPPF, the Population Council, the International Council on Management of Population Programs, the Planned Parenthood Federation of Canada and various other health and development NGOs. In 1996, support to family planning NGOs amounted to about $3.7 million; funding for NGOs working in other areas of reproductive health, including HIV/AIDS, totaled about $684,000.

The Canadian government cut support to IPPF by almost 50 percent between 1988 and 1997. Contributions to IPPF, historically the major recipient of Canada’s population assistance through the NGO channel, fell from over $6 million in 1994 to $368,000 in 1995. These funding cuts resulted from a new policy announced in 1994 by the Ministry of Foreign Affairs and Trade, limiting eligibility for Canadian support to international NGOs based in Canada. At the time, CIDA proposed to partly offset these cuts by increasing direct support to national family planning associations affiliated with IPPF, particularly in the Africa region. Despite protests by advocacy groups, CIDA has only partially restored its core support to IPPF, to about $3.3 million in 1996.

Geographic Priorities and Areas of Program Emphasis:

The Canadian bilateral population program is concentrated in Asia; its most substantial activity–in terms of both funding and length of involvement–is cofinancing of the World Bank’s Bangladesh Health and Population Project (BHPP). The project is implemented by the Bangladesh government and local NGOs with the support of a consortium of donors under the World Bank’s leadership. Canada has been a large donor to this project since its inception in the early 1970s. CIDA resources currently support the purchase of oral contraceptives, the strengthening of management information systems, formulation of a master plan for human resources development in the health sector, and services provided by local NGOs.

Canada also supports smaller projects focusing on other aspects of reproductive health in China (maternal and child health) and Indonesia (safe motherhood). In Africa, Canada has recently supported regional family planning projects in Southern African, West Africa and the Sahel, as well as country-specific projects in Egypt, Eritrea, Malawi, Tanzania and Zimbabwe. In Latin America, Canada cofinances a small multi-bilateral project with UNFPA in Haiti, and other reproductive health programs emphasizing safe motherhood and STD/HIV prevention in Peru and Bolivia, as well as on a region-wide basis.

5 Technical Capacity

Staffing:

Critics of Canadian population assistance cite the dearth of expertise in CIDA as a major constraint to effective bilateral programming in the sector. In 1997, CIDA hired a new reproductive health expert, increasing total senior technical staff in this area to three. Five other staff within CIDA work on broader health issues, which may include some aspects of reproductive health.

Technical Expertise of Collaborating Institutions:

Although Canada is home to numerous NGOs involved in international development, few of these NGOs focus specifically on population and reproductive health issues. The International Development Research Center, a government-affiliated think tank previously active in this area, has reduced its involvement in population research activities during the 1990s, leaving the population research niche largely unfilled in Canada. CIDA meets the technical needs of its bilateral program from in-house sources or through individual consultants, supplemented in some cases by experts from Canadian universities.