No Product, No Program: Financing, Procurement and Distribution of Reproductive Health Supplies
Contraceptive security exists when every person is able to choose, obtain, and use quality contraceptives and condoms for family planning and protection from sexually transmitted infections, including HIV. Contraceptive security is complicated, necessitating work in information and education, demand generation, research, service delivery, securing supportive national policies and/or individuals or groups willing to advocate for favorable policies, finance, forecasting and logistics, human and organizational capacity, donor coordination, and private sector involvement.
USAID is a world leader in developing viable contraceptive logistic systems encompassing product procurement, policy, finance, and forecasting skills and support, all of which contribute to making contraceptive security a reality.
The success of USAID’s family planning programs, continued growth in the number of men and women reaching reproductive age, and the growing response to curb the HIV/AIDS pandemic have led to an increased demand for contraceptives and condoms worldwide. Maintaining a strong supply system is crucial. When supply chains do not keep pace with growing numbers of customers or when supplies run out, clients can’t get contraceptives and new customers cannot be served. Confidence in the program fades and people may stop asking for services.
How USAID Programs Help
Logistics support ensured an effective supply system in Bangladesh. In the mid-1970s, the contraceptive prevalence rate in Bangladesh was approximately 7 percent and the average number of births per woman was 7. With improvements in contraceptive logistics and the launch of subsidized sales, supply methods expanded and awareness of contraceptives grew. Increasing access through doorstep delivery and social marketing, expanding choice of methods, and other programs led to an increase in contraceptive prevalence to 50 percent. The average number of children is now 3.4 per family.
Vigilance from production to delivery to the consumer is required. To achieve contraceptive security, USAID programs include competitive procurement; clear, comprehensive product specifications; routine testing during manufacture; a distribution system that tracks expiration dates; and good storage and handling practices. Procedures for forecasting need and distributing quantities of supplies are required at all levels and are made widely known.
USAID works with the private sector, which is important to program sustainability. For-profit private sector companies and non-governmental organizations in developing countries can help increase access to affordably priced commercial reproductive health care, products, and programs. By encouraging those who can pay for commodities to do so, public-sector resources can be made available to serve poor and hard-to-reach communities.
Supportive national policies are crucial. These policies must encourage private sector participation, multiple supply outlets, quality assurance, and government and civil society advocacy. However, both the subsidized and non-subsidized supply chains need policy support. The public sector needs support in such areas as resource allocation, staff, training, budget/credit concerns, facilities, vehicles, and more. Equally important is the elimination of barriers, such as price controls, tariffs, and other impediments.
National government support in Turkey and Morocco. The Government of Turkey recognized that once USAID assistance phased out, it would need to guarantee supplies. The advocacy efforts of in-country organizations raised public awareness about the need for government commitment to purchase contraceptives. Turkey received its final donated supplies from USAID in 2000 and the Ministry of Health secured and maintained its allocation for contraceptives in its budget to ensure reliable funding despite political changes and economic shocks. In Morocco, USAID encouraged the Government of Morocco to begin purchasing contraceptives when USAID began to phase out. By 2000, the GOM had taken full control of contraceptives in its budget and has maintained this commitment to this day.
Global coordination and advocacy. USAID is working with other donors and concerned groups to design a system that would facilitate donor coordination among the world’s largest providers of contraceptives. The RH Interchange is creating a common procurement management information system for contraceptive and condom programs. Additionally, USAID created a Commodity Promotion Fund to ensure availability of condoms in countries with a high prevalence of HIV/AIDS.
Prepared June 2004
Related Technical Areas
|
