For many family planning clients in low- and middle-income countries, particularly those in remote areas, traveling to the nearest health clinic for contraceptive services is a long, inconvenient, expensive, and even risky journey. To arrive at the clinic only to find her preferred contraceptive method is out of stock can have devastating consequences for a woman.
Continue reading to learn about contraceptive security:
“No product, no program!” was a saying made popular by the USAID-funded DELIVER PROJECT. Systems thinking is essential so that all actors in the health system—health workers, delivery drivers, information management specialists—have the resources and tools they need to ensure that reproductive health commodities are available when clients need them. These tools include forecasting, procurement, distribution, and other decision support resources. Over the past decade, advocacy and donor investments have lead to major advancements in contractive security. Countries are seeing the fruit from these investments and initiatives.
Looking ahead, the importance of public-private partnerships will continue to play an important role, allowing the health sector to capitalize on successful business models and leverage the resources of logistics companies such as FEDEX and DHL. Advancements in technology, especially mHealth, and the opportunities for enhanced data collection and use will facilitate faster, more accurate information to support all levels of the supply chain system. And with a growing number of trained supply chain managers, the capacity to do more and do it better, especially integrating commodity procurement to break down health sector silos, will allow improved health services at all levels of the health system. This may include integrating HIV and family planning commodity procurement and delivery.
Contraceptive security depends on many stakeholders and systems. Harnessing generation, capture, synthesis, and sharing of the growing supply chain knowledge base will further enhance and grow successful reproductive health commodity programs and service delivery. Robust knowledge management can ensure collective sharing and use of information in a timely and responsive manner.
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A successful family planning program guarantees access to a variety of high quality contraceptives so that clients can access their preferred methods when they need them. Efficient and effective supply chain management ensures commodities are procured, distributed, and monitored to allow an uninterrupted supply of contraceptives.
- Contraceptive security requires six rights: the right goods, in the right quantities, in the right condition, delivered to the right place, at the right time, for the right cost.
- A well-trained and supported health workforce of supply chain managers is needed to ensure commodities are procured, delivered, and stocked.
- Knowledge management can help health systems turn knowledge into action to improve client access to family planning commodities.
Contraceptive security: Every person is able to choose, obtain, and use quality contraceptives and other essential reproductive health products whenever they need them.
Forecasting: Estimating the quantity of a commodity that clients will consume
Procurement: The acquisition of contraceptive supplies from an external source
Stockout: A situation in which there is zero quantity of a particular commodity on a facility’s shelf on a day that the facility is open
Supply Chain Management: The design, planning, execution, control, and monitoring of supply chain activities to create value, build a competitive infrastructure, leverage worldwide logistics, match supply with demand, and measure performance
The Global Health eLearning Center offers a course, Logistics for Health Commodities, that provides learners with a wide range of logistics principles and practices and highlights each function of the logistics cycle, including assessing stock status, inventory control, and monitoring and evaluation.
Study up on the rationale for improving access to family planning and learn about the latest program guidance for offering reliable contraceptive services:
The Global Health: Science and Practice Journal also contains a wealth of peer-reviewed research on topics relevant to contraceptive security.
Read some of the latest research and commentary on public health supply chain systems:
- Arney L, Yadav P, Miller R, Wilkerson T. Strategic contracting practices to improve procurement of health commodities. Glob Health Sci Pract. 2014;2(3):295-306. Practices such as flexible, pre-established framework agreements can improve timeliness and cost of procurement and help improve commodity security. Addressing legislative barriers and building technical capacity in contract management may facilitate the use of such practices.
- Bornbusch A, Dickens T, Hart C, Wright C. A stewardship approach to shaping the future of public health supply chain systems. Glob Health Sci Pract. 2014;2(4):403-409. Guiding Principles: (1) Governments should see themselves as stewards of supply chains, providing vision, guidance, and oversight, not necessarily as operators of supply chains. (2) Governments should not be afraid to leverage the multiple supply chain actors and diverse options available; these can be woven into a coherent, integrated system, providing flexibility and reducing risk. (3) Governments will need new skills in leadership, regulation, market research, contract design, oversight of outsourced providers, financial analysis, and alliance-building.
Read the latest evidence on ensuring contraceptive security in diverse settings:
- Cunningham M, Bock A, Brown N, Sacher S, Hatch B, Inglis A, et al. Estimating contraceptive prevalence using logistics data for short-acting methods: analysis across 30 countries. Glob Health Sci Pract. 2015;3(3):462-481. Three models showed strong correlation between public-sector logistics data for injectables, oral contraceptives, and condoms and their prevalence rates, demonstrating that current logistics data can provide useful prevalence estimates when timely survey data are unavailable.
- Daff BM, Seck C, Belkhayat H, Sutton P. Informed push distribution of contraceptives in Senegal reduces stockouts and improves quality of family planning services. Glob Health Sci Pract. 2014;2(2):245-252. Dedicated logisticians restocked contraceptives monthly at facilities to maintain defined minimum stock levels, freeing up clinic staff. High stockout rates were virtually eliminated. Also, quality and timely data on contraceptives distributed allowed for better program management.
The High Impact Practices in Family Planning (HIPs) team at USAID has developed briefs that synthesize the evidence and provide recommendations on how to implement selected HIPs.
- Financing Commodities and Services: Essential for meeting family planning needs (2014; PDF, 703KB) aims to help countries advance toward contraceptive security, focusing primarily on increasing funds for procurement. This brief also provides commentary on engaging the private sector to support a “total market approach” that serves individuals from all socioeconomic classes.
- Drug Shops and Pharmacies: Sources for family planning commodities and information (2013; PDF, 796KB) describes the importance of these outlets for distributing commodities and information and outlines key issues for planning and implementing programs to support pharmacy and drug shop staff.
- Supply Chain Management: Investing in contraceptive security and strengthening health systems (2012; PDF, 695KB) describes the importance and impact of strengthening supply chain management (SCM) and provides examples of critical implementation elements. The brief highlights why SCM of contraceptives and related products, such as the equipment, instruments, and supplies required to provide long-acting and permanent methods (LA/ PMs), is critical to the effective operation of family planning programs.