Contraceptive Security Indicators 2009

Publication date: 2009

Introduction Contraceptive Security Indicators 2009 Introduction and Purpose: This activity highlights a comprehensive set of indicators that can be used to monitor contraceptive security (CS) for programmatic and advocacy purposes. The CS Indicators were developed to reflect key aspects of contraceptive security to help in-country stakeholders monitor and evaluate their country’s CS status. This dataset presents CS indicators for 36 countries and builds upon the Strategic Pathway to Reproductive Health Commodity Security (SPARHCS) framework. Worksheets: This dataset presents data by country and also provides two summary sheets of data of all surveyed countries together. All worksheets contain grouping so that all indicators can be displayed by clicking "2" in the upper lefthand corner and a summary of key indicators are displayed by clicking "1". - The individual country worksheets contain additional information about the indicator responses in the "comments" column. - The first summary worksheet contains all country's responses. - The second summary worksheet provides the option to filter the data by various categories. (It contains all country's responses as well.) We encourage readers with questions, corrections or more information on the countries concerned, or information on additional countries, to contact the USAID | DELIVER PROJECT. We also invite suggestions for improving the indicators and methodology. Click below to jump to the following data sheets: Individual countries: Afghanistan Albania Armenia Azerbaijan Bangladesh Bolivia DRC Dominican Republic El Salvador Ethiopia Georgia Ghana Guatemala Haiti India Kenya Liberia Madagascar Malawi Mali Mozambique Nepal Nicaragua Nigeria Pakistan Paraguay Philippines Russia Rwanda Senegal Tanzania Uganda Ukraine Yemen Zambia Zimbabwe Summary sheets: All countries, grouped All countries, filtered & grouped Data Sources: The indicators were designed with the intention that they could be routinely captured with accessible and relatively objective information either through key informants or a literature review of existing local documents. Country respondents were mainly USAID mission and USAID | DELIVER PROJECT staff. Indicator questions were constructed so that a range of respondents could answer them easily with as little background research as possible. While every effort was made to verify the data provided, mainly through crosschecking with country informants, the data are contingent upon the knowledge of the respondents. Data was collected and crosschecked between January and August 2009. Topics: Indicator questions cover the following topics: -- Public Sector Finance for Procurement—extent of funding for contraceptives; funding sources; existence of a government budget line-item for contraceptives, and information about the procurement mechanism. - Commodities—range of contraceptive methods offered in public facilities and social marketing or NGO facilities, respectively. - Policies—existence of a national contraceptive security strategy; existence of policies limiting or expanding access to family planning; inclusion of contraceptives on the National Essential Medicine List (NEML), and inclusion of contraceptive security concepts in the Poverty Reduction Strategy Paper (PRSP). - Coordination and Leadership—existence of a national committee that works on contraceptive security and types of organizations represented therein; frequency of committee meetings; legal status of the committee, and existence of a contraceptive security “champion”. - Supply Chain—existence of essential logistics data items on information system reports; whether forecasts are updated annually and incorporated into budget planning; whether correct amounts are obtained at the appropriate time; whether physical inventories are conducted annually at storage facilities; existence of product quality complaint procedures; occurrence of visual quality insurance inspections at storage facilities, and stockout data. Additional Information: For more information on the background, purpose, methodology, findings, and considerations, please refer to CS Indicators paper - USAID | DELIVER PROJECT, Task Order 1. 2010. Measuring Contraceptive Security Indicators in 36 Countries. Arlington, Va.: USAID | DELIVER PROJECT, Task Order 1. The paper can be found on the USAID | DELIVER PROJECT website at http://deliver.jsi.com or directly at http://deliver.jsi.com/dlvr_content/resources/allpubs/guidelines/CS_Indicators36.pdf. This spreadsheet can be cited as: USAID | DELIVER PROJECT. Contraceptive Security Indicators Data 2009. Available at http://deliver.jsi.com/dlvr_content/resources/allpubs/factsheets/CS_Indicators_Data_2009.xls. Paraguay Afghanistan Albania Armenia Azerbaijan Bangladesh Bolivia DRC Dominican Republic El Salvador Ethiopia Georgia Ghana Guatemala Haiti India Kenya Liberia Madagascar Malawi Mali Mozambique Nepal Nicaragua Nigeria Pakistan Philippines Russia Rwanda Senegal Tanzania Uganda Ukraine Yemen Zambia Zimbabwe All countries, grouped All countries, filtered & grouped All Countries, Grouped Notes: Click on "1" in the top lefthand corner to see just the main questions and "2" to see all of the questions. Please refer to country worksheets for additional comments on indicators. To jump to the Introduction sheet, click here. Contraceptive Security Indicator Questions 2009 Afghanistan Albania Armenia Azerbaijan Bangladesh Bolivia Democratic Republic of Congo Dominican Republic El Salvador Ethiopia Georgia Ghana Guatemala Haiti India Kenya Liberia Madagascar Malawi Mali Mozambique Nepal Nicaragua Nigeria Pakistan Paraguay Philippines Russia Rwanda Senegal Tanzania Uganda Ukraine Yemen Zambia Zimbabwe Leadership and Coordination L1. Is there a national committee that works on contraceptive security? No Yes No Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes L1. Is there a national committee that works on contraceptive security? L1a. What is the name of the committee? N/A RH Committee/Contraceptive Security Working Group N/A National Strategy Development Working Group Logistics Coordination Forum Comite Nacional de Disponibilidad Asegurada de Insumos Anticonceptivos N/A Comité para la Disponibilidad Asegurada de Insumos Anticonceptivos (DAIA) Comité para la Disponibilidad Asegurada de Insumos Anticonceptivos (DAIA) Family Planning Technical Working Group National RH Committee ICC/CS-INTERCOORDINATING COMMITTEE FOR CONTRACEPTION National Contraceptive Security Commission National Committee on Reproductive Health Supply and Social Marketing Division of Ministry of Health and Family Welfare FP Logistics Committee. N/A "Partners Reproductive Health/Family Planning Committee" seconded by a sub-committee which is the "Family Planning Logistics Committee". Reproductive Health Technical Working Group Commission de Suivi de la Mise en Oeuvre du Plan d'Action à long terme pour la Contraception Sécurisée au Mali Reproductive Health Commodity Security Task Force (RH-CS Task Force) Reproductive Health Commodities Security Working Group (also known as Contraceptive and Essential Commodities Security Working Group) Comité para la Disponibilidad Asegurada de Insumos Anticonceptivos (DAIA) Reproductive Health Commodity Security Stakeholders' Committee RHCS Committee DAIA Committee Contraceptive Self-Reliance (CSR) Technical Working Group N/A Family Planning Logistics Committee Meeting Comité Nationale de Securisation des Produits Contraceptifs Reproductive and Child Health Section Reproductive Health Commodity Security Committee National committee for implementation of the State Program Reproductive Health of the Nation up to 2015 (SPRHN). Reproductive Health Technical Group with sub committee for CS Reproductive Health Commodity Security Committee Reproductive Health Commodity Security Committee L1a. What is the name of the committee? L2. Are the following organizations represented on the committee? L2. Are the following organizations represented on the committee? L2a. Are social marketing organizations on the committee? N/A Yes N/A No Yes Yes N/A Yes Yes Yes No Yes Yes Yes No Yes N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes N/A Yes Yes Yes Yes No Yes Yes Yes L2a. Are social marketing organizations on the committee? L2ai. Names of social marketing organizations on the committee N/A NESMARK N/A N/A Social Marketing Company (SMC) PROSALUD N/A PROFAMILIA ADS DKT Ethiopia N/A AED/GSCP PASMO (Pan American Social Marketing Organization) PSI N/A PSI N/A PSI PSI Centrale d'Achat des Génériques (C.A.G.), PSI PSI Nepal CRS Company PASMO Society for Family Health Greenstar PSI Paraguay DKT Philippines, Family Planning Organization of the Philippines, League of Municipalities N/A PSI Agence pour le Développement de Marketing Social (ADEMAS) - USAID Implementing Partner (IP) TMARC (AED), PSI AFFORD/UHMG (Uganda Health Marketing Group), PSI, MSI Uganda N/A Marie Stopes Society for Family Health PSI L2ai. Names of social marketing organizations on the committee L2b. Are NGO's on the committee? (e.g. service delivery, advocacy, Planned Parenthood affiliate, Marie Stopes affiliate) N/A Yes N/A Yes YES Yes N/A Yes No Yes Yes Yes Yes Yes No No N/A Yes No Yes Yes Yes Yes Yes Yes Yes Yes N/A Yes Yes Yes Yes Yes Yes Yes Yes L2b. Are NGO's on the committee? (e.g. service delivery, advocacy, Planned Parenthood affiliate, Marie Stopes affiliate) L2bi. Names of NGOs on the committee N/A The Albanian Center for Population and Development/IPPF affiliate N/A Local NGOs: The National Reproductive Health Office, Heydar Aliyev Foundation, Gender and Development Association, Ombudsman FPAB CIES N/A ADOPLAFAM, MUDE, 30 more institutions N/A IPAS, DKT, EngenderHealth, Family Guidance Association of Ethiopia (FGAE), Pathfinder, IntraHealth, Marie Stopes International, World Vision, CARE, Save the Children JSI PPAG,MSI APROFAM (Pro-Family Association--IPPF affliate) JHPIEGO, MSH, PSI N/A N/A N/A FISA (IPPF affiliate), MSI (Marie Stopes M/car), SAF-FJKM, SALFA, Religious platforms (leader), AMIT and OSTIE (Inter-Health Organization), etc. N/A Groupe Pivot Santé et Population, AMPPF (IPPF affiliate) Forte Saúde (funded by USAID), AMODEFA (IPPF affiliate) Family Planning Association of Nepal PROFAMILIA Planned Parenthood Federation of Nigeria (also Association of Reproductive & Family Health*, Adolescent Health Program*, Federation of Moslem Women*) Pop Council, PAIMAN CEPEP (Centro Paraguayo de Estudios de Poblacion)- IPPF affiliate Philippine NGO Council, Family Planning Organization of the Philippines, Cooperative Movement for Encouraging NSV (non-scalpel vasectomy), League of Provinces, League of Cities, League of Municipalities, Union of Local Authorities of the Philippines N/A ARBEF Association Sénégalaise pour le Bien-Etre Familial (ASBEF) - IPPF affiliate, IntraHealth (USAID IP), CCF & consortium (USAID IP) John Snow Inc., EngenderHealth, UMATI (IPPF), Marie Stopes Reproductive Health Uganda, MSI, FHI All-Ukrainian Federation of Young Doctors, All-Ukrainian Women's Society, National Medical Academy for Postgraduate Education, & Academy of Medical Science Marie Stopes, German Development Bank Planned Parenthood Association (PPAZ), Marie Stopes International, USAID | DELIVER PROJECT Population Services Zimbabwe (Marie Stopes affiliate) L2bi. Names of NGOs on the committee L2c. Are commercial sector organizations on the committee? (e.g. pharmacy associations, manufacturers) N/A Yes N/A No No No N/A No No No No Yes No Yes No No N/A Yes No Yes No No No Yes No No Yes N/A Yes No Yes No No No No No L2c. Are commercial sector organizations on the committee? (e.g. pharmacy associations, manufacturers) L2ci. Names of commercial sector organizations on the committee N/A Schering N/A N/A N/A N/A N/A N/A N/A N/A N/A BAYER-SCHERING,PHARMACEUTICAL SOCIETY OF GHANA. N/A Ad Hoc N/A N/A N/A ORGANON, AMEL (private physician's association) N/A Centrale d'Achat des Génériques (C.A.G.) N/A N/A N/A Pharmaceutical Society of Nigeria N/A N/A Philippine Chamber of Commerce and Industry, Drugstores Association of the Philippines N/A Associations of private pharmacists and physicians N/A World Wide Movers (Agility's local rep) N/A N/A N/A N/A N/A L2ci. Names of commercial sector organizations on the committee L2d. Are donors on the committee? N/A Yes N/A Yes Yes Yes N/A Yes Yes Yes Yes Yes Yes Yes No Yes N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes N/A Yes Yes Yes Yes Yes Yes Yes Yes L2d. Are donors on the committee? L2di. Names of donors on the committee N/A USAID N/A EU, USAID, USAID-funded ACQUIRE project WB, CIDA, KfW, DFID,USAID USAID N/A USAID USAID, UNFPA UNFPA, USAID USAID, UNFPA, UNICEF, WHO USAID,UNFPA,DFID,RNE,JICA USAID (unofficial, invited by Commission to participate) USAID, Canadian Embassy, Global Fund N/A USAID, GTZ, KfW, WB, UNFPA N/A USAID, UNFPA, WORLD BANK, GTZ, JICA, EU USAID USAID, UNFPA, KFW USAID, UNFPA, DFID (will join the group) USAID, KfW, DFID, World Bank USAID USAID, CIDA, (also DFID*) USAID USAID, UNFPA USAID, UNFPA N/A UNFPA, GTZ/KfW, USAID, GFATM USAID, JICA, KfW, UNFPA USAID USAID, UNFPA USAID, through Together for Health (TfH) and Maternal and Infant Health (MIHP) projects RNE, World Bank, USAID USAID, DFID, HSSP USAID, DFID, UNFPA L2di. Names of donors on the committee L2e. Are UN agencies on the committee? N/A Yes N/A Yes Yes Yes N/A Yes Yes Yes Yes Yes Yes Yes No Yes N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes N/A Yes Yes Yes Yes Yes Yes Yes Yes L2e. Are UN agencies on the committee? L2ei. Names of UN agencies on the committee N/A UNFPA, WHO, UNICEF N/A UNFPA, WHO UNFPA UNFPA N/A UNFPA UNFPA UNFPA, UNICEF UNFPA, UNICEF, WHO UNFPA,UNAIDS UNFPA (unofficial, invited by Commission to participate) UNFPA, WHO/PAHO, UNICEF N/A UNFPA N/A WHO, UNICEF, UNAIDS UNFPA UNFPA UNFPA, WHO UNFPA, UNICEF UNFPA UNFPA UNFPA UNFPA, OPS (PAHO in English) WHO N/A UNFPA WHO, UNFPA UNFPA UNFPA UNFPA UNFPA, WHO WHO, UNFPA UNFPA L2ei. Names of UN agencies on the committee L2f. Are Ministry of Health units on the committee? (e.g. logistics, RH, FP, MCH units) N/A Yes N/A Yes Yes Yes N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes N/A Yes Yes Yes Yes Yes Yes Yes Yes L2f. Are Ministry of Health units on the committee? (e.g. logistics, RH, FP, MCH units) L2fi. Names of Ministry of Health units on the committee N/A RH department, Institute of Public Health, Juridical Office, Pharmaceutical Directorate, Statistics Department N/A Organization of Health Service Department of MOH & Center of Innovation and Procurement of MOH Directorate General of Family Planning (DGFP) Unidad de Servicios de Salud y calidad, Unidad de Medicamentos N/A Ministry of Health (SESPAS), MCH, FP MoH, MCH, FP Family Health Department Not available PROCUREMENT&SUPPLIES DIRECTORATE,GHS DIRECTORATE,FHD ETC National Reproductive Health Program DSF, Ministry of Women Affair Supply and Social Marketing Division of Ministry of Health and Family Welfare Family Planning, Division of RH N/A Family Planning Directorate RH, Pharmacy, HIV/AIDS Direction Nationale de la Santé, Direction de la Pharmacie et du Médicament, Pharmacie Populaire du Mali (PPM) RH/FP program Family Health Division, Logisitcs Management Division, Child Health Division, National Center for AIDS and STD Control, Ministry of Health, National Planning Commission Ministry of Health (MCH, FP) Family Health Department, FMOH, (also RH unit*, HIV/AIDS unit*, Planning Department*, Ministry of Women's Affairs*) MoPW, MoH RH, PH, Logistics DOH: National Center for Disease Prevention and Control (includes FP and HIV/AIDS), Bureau of Local Health Development, Bureau of International Health Coordination, Health Policy Development and Planning Bureau, National Drug Program, Center of Health Development Region 4A and National Capital Region; DOH attached agencies: Bureau of Food and Drugs, Population Commission, Philippine Health Insurance Corp (PhilHealth).; Local Government Unit (LGU): Pangasinan Provincial Population Office N/A Maternal and Child Health Task Force and Pharmacy Task Force Division de la Santé de la Reproduction (FP/RH/MCH Division), Division de la Lutte Contre le SIDA (HIV/AIDS Division), Direction de la Pharmacie et du Medicament, Laboratoire Nationale de Controle RCHS, NACP Reproductive Health Division MCH Department/RH Division & Financial and Economic Department RH and FP directories Reproductive Health Unit, MoH RH unit of the Ministrry of Health & Child Welfare (MOHCW, the Zimbabwe National Family Planning Council (ZNFPC), Medicines Control Authority of Zimbabwe (MCAZ) L2fi. Names of Ministry of Health units on the committee L2g. Is the Central Medical Store or Central Warehouse on the committee? N/A No N/A No Yes Yes N/A No No No No Yes Yes Yes No Yes N/A Yes No Yes Yes Yes No Yes No Yes Yes N/A Yes Yes Yes Yes No Yes Yes Yes L2g. Is the Central Medical Store or Central Warehouse on the committee? L2gi. Names of Central Medical Store or Central Warehouse on the committee N/A N/A N/A N/A CWH of DGFP CEASS (parastatal), but does not participate N/A N/A N/A N/A N/A CMS Not available PROMESS N/A Kenya Medical Supplies Agency (KEMSA) N/A SALAMA N/A Pharmacie Populaire du Mali (PPM) CMAM Central Warehouse, Teku N/A Central Contraceptives Warehouse N/A Central Warehouse DOH Materials Management Service N/A CAMERWA Pharmacie Nationale de l'Approvissionment (PNA) MSD National Medical Stores N/A at the MOPHP Medical Stores Limited NatPharm L2gi. Names of Central Medical Store or Central Warehouse on the committee L2h. Is the Ministry of Finance on the committee? N/A No N/A No No No N/A No No No No Yes Yes No No No N/A Yes No No No Yes No Yes No No No N/A No No No Yes No Yes No No L2h. Is the Ministry of Finance on the committee? L3. How many times did the committee meet during the last year? (0, 1-3, 3-5, or 6+) N/A 1-3 times N/A 3-5 times 1-3 times 1-3 times N/A 6 or more times 6 or more times 1-3 times 6 or more times 1-3 times 6 or more times 6 or more times 3-5 times 1-3 times N/A 1-3 times 1-3 times 1-3 times 6 or more times 1-3 times 6 or more times 1-3 times 1-3 times 6 or more times 3-5 times N/A 1-3 times 1-3 times 3-5 times 6 or more times 1-3 times 3-5 times 1-3 times 1-3 times L3. How many times did the committee meet during the last year? (0, 1-3, 3-5, or 6+) L4. Does the committee have legal status? N/A Yes N/A Yes Yes No N/A Yes No No Yes Yes Yes No Yes No N/A No No Yes Yes Yes Yes Yes Yes No Yes N/A Yes No No No Yes Yes No Yes L4. Does the committee have legal status? L5. Is there a contraceptive security "champion"? No No Not available No Yes No Not available Yes Yes No No Yes Yes No Yes No No No No No No Yes Yes Yes No Yes Yes No No No No Yes No Yes No Yes L5. Is there a contraceptive security "champion"? Finance and Procurement (Capital) Finance and Procurement (Capital) F1. Is there a government budget line item for the procurement of contraceptives? No Yes No No Yes No Yes No No Yes No No No Yes Yes Not available No Yes No Yes Yes Yes No No Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes No F1. Is there a government budget line item for the procurement of contraceptives? F2. Were government funds spent on contraceptives in the most recent complete fiscal year? (including internally generated funds, World Bank credits or loans, basket funds, or other government funds) No Yes No No Yes Yes Yes Yes Yes Yes No Yes No No Yes Not available No Yes Yes No No Yes Yes No Yes Yes Yes No Yes No Yes Yes Yes Yes Yes No F2. Were government funds spent on contraceptives in the most recent complete fiscal year? (including internally generated funds, World Bank credits or loans, basket funds, or other government funds) F2a. Time period of funding N/A January 2008-December 2008 Not available N/A FY 2007-2008 Not available any year 2008 2008 July 2007-June 2008 Not available 2007 Jan-Dec 2008 October 2007-September 2008 April 2008-March 2009 Not available 2008 2008 October 2007-September 2008 Not available 2008 2008 2008 2008 July 08-June 09 2008 Approximately April 2008 to approximately March 2009 2008 Not available July 2007-June 2008 July 07-June 08 2008 2008 2008 2008 F2a. Time period of funding F2b. Did the government spend internally generated funds (for example, from public sector sources or taxes) for contraceptive procurement? No Yes No No No Yes No Yes Yes Yes No No No No Yes Not available No Yes No No No Yes Yes No Yes Yes Yes No Yes No Yes Yes Yes No Yes No F2b. Did the government spend internally generated funds (for example, from public sector sources or taxes) for contraceptive procurement? F2bi. What was the amount of internally generated funds spent on contraceptive procurement? (in US$) $0 $63,900 $0 $0 $0 Not available $0 $700,000 $680,000 $910,000 $0 $0 $0 $0 $99,250,000 Not available $0 $127,788 $0 $0 $0 $1,688,000 $150,000 $0 MOPW: Pakistani Rs. 225 million (GoP funds) approx. $3 mi. MOH: Not available $539,537 Not available $0 $500,000 $0 $870,000 $280,000 $225,000 $0 $275,000 $0 F2bi. What was the amount of internally generated funds spent on contraceptive procurement? (in US$) F2c. Did the government spend World Bank credits or loans for contraceptive procurement? No No No No Yes No Yes No No No No Yes No No No Not available No No No No No Yes No No No No No No No No No No Yes Yes No No F2c. Did the government spend World Bank credits or loans for contraceptive procurement? F2ci. What was the amount of World Bank credits or loans spent on contraceptive procurement? (in US$) $0 $0 $0 $0 $34,540,000 $0 Not available $0 $0 $0 $0 $1,000,000 $0 $0 $0 Not available $0 $0 $0 $0 $0 $422,000 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $200,000 $2,500,000 $0 $0 F2ci. What was the amount of World Bank credits or loans spent on contraceptive procurement? (in US$) F2d. Did the government spend basket funds for contraceptive procurement? No No No No No No Yes No No Yes No Yes No No No Not available No No Yes No No No Yes No No No No No Yes No Yes No No Yes No No F2d. Did the government spend basket funds for contraceptive procurement? F2di. What was the amount of basket funds spent on contraceptive procurement? (in US$) $0 $0 $0 $0 $0 $0 Not available $0 $0 $11,900,000 $0 $300,000 $0 $0 $0 Not available $0 $0 $1,620,000 $0 $0 $0 $441,665 $0 $0 $0 $0 $0 $1,278,600 $0 $870,000 $0 $0 $723,613 $0 $0 F2di. What was the amount of basket funds spent on contraceptive procurement? (in US$) F2e. Did the government spend other funding sources for contraceptive procurement? (Including only funds given to the government used for contraceptive procurement. This does NOT include contraceptive supplies donated to the government (so for example, NOT from USAID).) No No No No No No No No No No No No No No No Not available No No No No No Yes No No No No No No No No No No No No Yes No F2e. Did the government spend other funding sources for contraceptive procurement? (Including only funds given to the government used for contraceptive procurement. This does NOT include contraceptive supplies donated to the government (so for example, NOT from USAID).) F2ei. Specify source of other government funding N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Not available N/A N/A N/A N/A N/A KfW N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A DFID N/A F2ei. Specify source of other government funding F2eii. What was the amount of other government funds spent on contraceptive procurement? (in US$) $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 Not available $0 $0 $0 $0 $0 $94,806 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $275,000 $0 F2eii. What was the amount of other government funds spent on contraceptive procurement? (in US$) F2f. In total, how much funding did the government spend on contraceptive procurement (including internally generated funds, World Bank credits or loans, basket funds, and other government funds)? (in US$) $0 $63,900 $0 $0 $34,540,000 Not available Not available $700,000 $680,000 $12,810,000 $0 $1,300,000 $0 $0 $99,250,000 Not available $0 $127,788 $1,620,000 $0 $0 $2,204,806 $591,665 $0 Not available $539,537 Not available $0 $1,778,600 $0 $1,740,000 $280,000 $425,000 $3,223,613 $550,000 $0 F2f. In total, how much funding did the government spend on contraceptive procurement (including internally generated funds, World Bank credits or loans, basket funds, and other government funds)? (in US$) F3. What was the total amount of non-government funds spent on contraceptive procurement? (in US$) (This includes contraceptive supplies donated directly to the government, procured by donors (e.g. USAID). This is actual supplies donated, not funds. How much were these supplies worth?) Not Available $42,600 Not available Not available $12,930,000 Not available Not available $396,884 $229,866 $9,000,000 Not available $5,640,000 $545,473 $3,100,000 $0 Not available $1,427,844 $3,164,462 $5,397,180 $1,000,000 $3,410,437 $214,300 $1,010,321 $1,250,629 Not available $251,257 Not available Not available $2,878,191 Not available $1,000,000 $1,657,172 $160,000 Not available $3,131,530 $8,808,638 F3. What was the total amount of non-government funds spent on contraceptive procurement? (in US$) (This includes contraceptive supplies donated directly to the government, procured by donors (e.g. USAID). This is actual supplies donated, not funds. How much were these supplies worth?) F4. Of the total amount of financing spent on public sector contraceptives for the most recent complete fiscal year, what percent was covered by government funding (including internally generated funds, World Bank credits or loans, basket funds, and other government funds)? (F2f./(F2f.+F3.) (in US$) Not Available 60% Not available 0% 73% Not available Not available 64% 75% 59% N/A 19% 0% 0% 100% Not available 0% 4% 23% 0% N/A 91% 37% 0% Not available 68% Not available 0% 38% 0% 64% 14% 73% Not available 15% 0% F4. Of the total amount of financing spent on public sector contraceptives for the most recent complete fiscal year, what percent was covered by government funding (including internally generated funds, World Bank credits or loans, basket funds, and other government funds)? (F2f./(F2f.+F3.) (in US$) F4a. Specify data source (e.g. Contraceptive Procurement Table (CPT), National Health Account (NHA), Reproductive Health Account (RHA), etc.) N/A UNFPA and MoH records N/A N/A DGFP Not available Not available SESPAS and RHI Graduation Plan CPT N/A CPT (Country Needs) Not available N/A Ministry of Health and Family Welfare, Government of India Not available RHI and CPT report Data base MoH/DPF/SSPSR = National Health Account CPT, NHA Contraceptive Procurement Tables (CPTs) CPT and PipeLine database Annual Forecast/FHD/LMD Ministry of Health and Newvern UNFPA and other records Not available CPT Not available N/A CPT (PipeLine Annual Costs by Supplier) CPT RCHS CPT and PipeLine reports State Program "Reproductive Health of the Nation until 2015” (SPRHN) contraceptive forecasting calculations/estimates made by the Ministry of Health Deputy Minister and RHInterchange CPT, Pipeline Database, MOH PipeLine Shipment Summary (for non-govt spending) F4a. Specify data source (e.g. Contraceptive Procurement Table (CPT), National Health Account (NHA), Reproductive Health Account (RHA), etc.) F5. Which entity does procurement: government or other? N/A Other N/A N/A Government N/A Government Other Other Government and Other N/A Government and Other Other N/A Government Government and Other N/A Government Government N/A N/A Government Government and Other N/A Other Other Government N/A Other N/A Government Government Government Other Government N/A F5. Which entity does procurement: government or other? F5a. Specify government entity that does procurement (e.g. Central Medical Store, MOH logistics unit, MOH procurement unit, etc.) N/A N/A N/A N/A DGFP N/A FEDECAME N/A N/A Pharmaceutical Fund & Supply Agency (PFSA) N/A Procurement Unit N/A N/A Supply and Social Marketing Division of Government of India KEMSA N/A SALAMA (Central Medical Stores) Central Medical Stores N/A N/A Logistics Management Division/MoHP Essential Drugs Unit (for condoms) N/A N/A N/A Local Government Unit’s General Property and Supplies Office N/A N/A N/A MSD National Medical Stores Ministry of Health at central level in Kiyv and Oblast Health Administrations N/A MoH Procurement Unit N/A F5a. Specify government entity that does procurement (e.g. Central Medical Store, MOH logistics unit, MOH procurement unit, etc.) F5ai. Is this procurement entity a parastatal? N/A N/A N/A N/A No N/A Yes N/A N/A No N/A Yes N/A N/A No Yes N/A Yes No N/A N/A Yes No N/A N/A N/A No N/A N/A N/A Yes Yes Yes N/A No N/A F5ai. Is this procurement entity a parastatal? F5b. Specify non-government entity that does procurement (e.g. third-party agent such as UNFPA or Crown Agents, or private entity) N/A UNFPA N/A N/A N/A N/A N/A UNFPA UNFPA UNFPA N/A Crown Agents and UNFPA UNFPA N/A N/A UNFPA N/A N/A N/A N/A N/A N/A UNFPA N/A UNFPA UNFPA N/A N/A UNFPA N/A N/A N/A N/A UNFPA N/A N/A F5b. Specify non-government entity that does procurement (e.g. third-party agent such as UNFPA or Crown Agents, or private entity) F6. Comments about government procurement and financing Not Available Albania’s National Contraceptive Security Strategy has established a key goal to realize contraceptive independence by 2010. Currently, UNFPA is the only donor providing contraceptives in Albania for the public sector. Since 2005, the MoH has contributed to financing a share of contraceptives, incrementally increasing its share each year (by adding 20%). As 2010 approaches UNFPA financial contribution will decrease and its role will be limited only as the procurement agent for the MoH. Family planning programs started developing in Azerbaijan in 1996 with support from international organizations such as UNFPA, USAID, and others. Technically equipped family planning centers were set up and supplied with contraceptives. However, donor support with the provision of contraceptives was stopped in 2004. It is currently providing in limited amounts by EU through UNFPA. The National RH Strategy (approved in February 2008) has a goal to include contraceptives (intrauterine devices, oral contraceptives) into the list of main medicines. DGFP, under MOHFW, procures all FP-RH commodities, using WB credit money, through open bidding following Govt. and IDA procurement guidelines. Bangladesh funding supports not just public sector but NGO too (who get supplies from the public sector) By law, each Municipality is supposed to dedicate 10% of its budget for health ("Fondo de co-participacion tributaria municipal"). However, usually the percentage is significantly lower. Contraceptive commodities are included in the Maternal and Child Health public insurance, which should be covered by part of this amount (calculated in each municipality by number of inhabitants). Since 2007 contraceptive commodities are supposed to be included in municipal budgets, however there is not information available regarding how much was actually spent on contraceptive commodities, because each municipality does its own purchase of pharmaceutics and commodities. No national procurement, last contraceptive commodities supplied to the Ministry of Health donated by UNFPA (with JICA funds). USAID's Social Marketing Program is currently the major contraceptive commodity supplier for the country. All government-procured contraceptives are funded by donors. Back in 2004/2005 and before the Federal MOH, it was the regions which started to procure contraceptives with their annual budget. The Federal level did not finance contraceptives until 2006 or 2007. Proucurement Unit has most recently started doing this for Ghana (for condoms). The price obtained was good. 15% of Alcoholic Beverages Tax is supposed to be allocated to Contraceptive Security but it is difficult to ensure these funds are indeed used to purchase contraceptives or fund the reproductive health program. Government has not paid UNFPA for 2007 and 2008 shipments (as of Feb 2009). 1. A line item for commodities including vaccines, contraceptives and contraception related supplies is included in the MOH budget. The National budget is not yet ratified by the Haitian Parliament. 2. So far, the Government has been mainly coordinating the forecasting, procurement and distribution of contraceptives with the donors to ensure the complete coverage of the country need of contraceptives. Indian Government is self suffficient in contraceptive logistics and supplies and has a strong public sector distribution network and Social Marketing program. The government procures through open tendering with specifications that call for commodities of international quality standards. Some development agencies also procure independently. The government's contributions began in 2006. The budget allocated is worth US$100,000 per year. All contraceptives with GoP funds are procured through UNFPA. However, this will change as the GoP would like to procure contraceptives through its own unit in the future (through the MoPW (M and S Unit)). The line item for procurement of contraceptives is at the LGU level. LGUs fund and procure their contraceptive requirements. Prices of contraceptives, even for the same contraceptive method and brand, are not uniform across LGUs. Therefore, computing the total amount in Pesos of LGU procured contraceptives as a percentage of the total amount in Pesos of total contraceptive requirement may not be the best indicator to measure the country's contraceptive security. Computing total quantity procured as a percentage of total required quantity is a better indicator. Currently, there is no systematic data that provides report on LGU procurements. While the DOH does not have a specific line item for procurement of contraceptives, the Government Appropriations Act of 2008 has an earmark in the DOH budget of US$43,478,260 (PhP2 Billion) for contraceptives and related training and other costs. US$26,087,000 (PhP1.2 Billion) of this earmark is for contraceptives and downloaded to the LGUs to facilitate LGU procurement of contraceptives. PhilHealth enrolment is another mechanism for LGU financing of contraceptives. When an LGU enrols its constituents (indigent constituents) with PhilHealth, it is indirectly financing its contraceptive requirements, through: a) the enrolled constituent can avail of the PhilHealth benefit packages that cover the costs of some contraceptive methods (as described previously in this survey); and/or (b) using part of the capitation fund received from PhilHealth (for enrollments made) to procure contraceptives. USAID/Philippines, through the Health Policy Development Project assisted the DOH to conduct a rapid assessment survey on 2007 LGU (local government unit) procurements covering all provinces and cities (N: 122). The result of the survey showed that 55% of the LGUs (N: 67) procured contraceptives at or above the level of donated contraceptives they used to receive before the phase out of USAID's donation. The remaining 45% (N: 55) did not procure. In 2004, the DOH issued the guidelines on the management of the donated commodities under the Contraceptive Self-Reliance Strategy which includes the guidelines and schedule for phasing out of contraceptive donations at the national and local level. The LGUs were divided into three batches, the first being the richest LGUs and the last being the poorest LGUs. It should be noted that while the last shipment of USAID donated contraceptives (excluding IUDs) was in September 2007, the last DOH shipment to the third batch of LGUs to be phased out was in the quarter October-December 2008. The Russian federal government stopped its federal family planning program back in 1998 including the procurement of contraceptives. However, some regions and municipalities provide limited contraceptives (both in range and number) to vulnerable groups of population mostly under mandatory health insurance programs and small donations from pharmaceutical firms. However, a range of modern contraceptive methods are widely available through pharmacies, including in the public health care facilities for a fee/purchase. Even though FP is not included in the provision of health services, some USAID target regions cover/reimburse FP counseling under the regional mandatory health insurance plans. UNFPA was the procurement agent for the contraceptives purchased with the government funding (own budget and basket funds). For the first time, this year (2009) the government is asking CAMERWA (MOH procurement unit) to buy contraceptives on their behalf with GFATM funds. It has been reported that for the last 3 years, funding was allocated to the Central Medical Stores, but was returned to Treasury unspent. Last year this was reportedly 45 million Fcfa (about $90,000). When funding is available, the Pharmacie National de l'Approvissionment does the procurement. Total need for the fiscal year was estimated at $6.6 million - $1 million to be provided by USAID, $5.6 million to be provided by GOT and Basket funds. USAID provided their $1 million contribution in Lofemenal and IUDs. Of the GOT/Basket requirement, only $1.74 million materialized (half of this was internally generated, half basket). The rest remained an uncovered gap. Whereas the government provides some funds for contraceptive procurement, the amount allocated has not increased over the years. Also, there is pressure to procure other RH commodities using the same funds, which could potentially reduce the amount available for contraceptives. The quarterly release of funds hinders bulk procurement. The RH division is forced to wait for the money to accumulate, and sometimes loses the money if they are unable to use it by the end of the financial year. The lead time for the NMS that does the procurement on behalf of MOH is also long, sometimes up to one year. Since its start, the USAID funded project “Together for Health” (TfH, 2005-2010), implemented by JSI, worked closely with MOH and other governmental and non-governmental counterparts to develop the State Program "Reproductive Health of the Nation until 2015” (SPRHN) approved by the Cabinet of Ministers in December 2006. The SPRHN includes line items for procurement of contraceptives from National and Local government budgets. Since 2008 National and Local Governments have been partially mobilizing the budgeted resources to procure contraceptives. The bulk of financial resources for procurement of contraceptives has been coming from local government budgets. Regardless the start was an optimistic one, currently it looks like due to the budget cuts in government health expenditures the SPRHN will have its funding dramatically reduced for 2009 and 2010. Therefore, even though the line item in the state budget for contraceptive procurement will remain, future funding is very uncertain. While the budget line for the procurement of Reproductive Health (RH) commodities exists, the funds are usually not adequate. Procurement of contraceptives competes with procurement of other non-contraceptive RH commodities. The procurement experience in 2008 was characterised by delays of up to 2 months and 6 months. F6. Comments about government procurement and financing Commodities Commodities C1. Are the following contraceptive methods dispensed in public sector facilities? C1. Are the following contraceptive methods dispensed in public sector facilities? C1a. Combined oral hormonal pills dispensed in public sector facilities? Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes C1a. Combined oral hormonal pills dispensed in public sector facilities? C1b. Progestin-only oral hormonal pills dispensed in public sector facilities? Yes Yes Yes No No No Yes Yes No Yes Yes Yes No Yes No Yes Yes Yes Yes Yes Yes No No Yes Yes No Yes Yes Yes Yes Yes Yes No Yes Yes Yes C1b. Progestin-only oral hormonal pills dispensed in public sector facilities? C1c. Hormonal injections dispensed in public sector facilities? Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes C1c. Hormonal injections dispensed in public sector facilities? C1d. Hormonal implants dispensed in public sector facilities? No No No No Yes No Yes Yes Yes Yes No Yes Yes Yes No Yes No Yes Yes Yes No Yes No Yes Yes No No No Yes Yes Yes Yes No Yes Yes Yes C1d. Hormonal implants dispensed in public sector facilities? C1e. Intrauterine devices (IUDs) dispensed in public sector facilities? Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No C1e. Intrauterine devices (IUDs) dispensed in public sector facilities? C1f. Male condoms dispensed in public sector facilities? Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes C1f. Male condoms dispensed in public sector facilities? C1g. Female condoms dispensed in public sector facilities? No No No No No No Yes No No No Yes Yes No Yes No Yes Yes Yes Yes No No No No Yes No No No Yes Yes Yes Yes No No Yes Yes Yes C1g. Female condoms dispensed in public sector facilities? C1h. Emergency contraceptive oral hormonal pills dispensed in public sector facilities? No Yes Yes No Not available No No No No Yes Yes Yes Yes No Yes Yes No No No Yes No No No No Yes Yes No Yes No Yes No Yes No Yes Yes No C1h. Emergency contraceptive oral hormonal pills dispensed in public sector facilities? C1i. Other contraceptive dispensed in public sector facilities? (See question C3 for name.) Not available Not available Not available No Not available No Yes Not available Not available Not available No Yes No Yes No No No Yes Not available Yes Not available Not available Not available Not available Not available No Not available Yes Yes Yes Yes Not available Yes Not available Not available Not available C1i. Other contraceptive dispensed in public sector facilities? (See question C3 for name.) C2. Are the following contraceptive methods dispensed in social marketing or NGO facilities? C2. Are the following contraceptive methods dispensed in social marketing or NGO facilities? C2a. Combined oral hormonal pills dispensed in social marketing or NGO facilities? Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes No Yes Yes No C2a. Combined oral hormonal pills dispensed in social marketing or NGO facilities? C2b. Progestin-only oral hormonal pills dispensed in social marketing or NGO facilities? Yes No No No No No Yes No No Yes Yes Yes No Yes Yes Yes Yes No Yes Yes No No No Yes Yes No Yes No Yes No Yes Yes No Yes No No C2b. Progestin-only oral hormonal pills dispensed in social marketing or NGO facilities? C2c. Hormonal injections dispensed in social marketing or NGO facilities? Yes Yes No No Yes Yes Yes Yes No Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes No Yes No Yes No No Yes No Yes No Yes C2c. Hormonal injections dispensed in social marketing or NGO facilities? C2d. Hormonal implants dispensed in social marketing or NGO facilities? No No No No No No Yes Yes Yes No but it's under registration No Yes Yes Yes No Yes Yes No Yes Yes No Yes No Yes No No No No Yes Yes No Yes No Yes No Yes C2d. Hormonal implants dispensed in social marketing or NGO facilities? C2e. Intrauterine devices (IUDs) dispensed in social marketing or NGO facilities? Yes Yes No Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes No Yes Yes Yes Yes Only the IPPF affiliates No No Yes Yes Yes Yes No Yes No Yes C2e. Intrauterine devices (IUDs) dispensed in social marketing or NGO facilities? C2f. Male condoms dispensed in social marketing or NGO facilities? Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes C2f. Male condoms dispensed in social marketing or NGO facilities? C2g. Female condoms dispensed in social marketing or NGO facilities? No No No No No Yes Yes No No No No Yes Yes Yes Yes No Yes No Yes Yes Yes No No Yes No No No No Yes Yes Yes No No Yes Yes Yes C2g. Female condoms dispensed in social marketing or NGO facilities? C2h. Emergency contraceptive oral hormonal pills dispensed in social marketing or NGO facilities? No Yes No No No Yes No Yes No Yes No Yes Yes No Yes Yes Not available No No Yes No Yes No Yes No Yes No No Yes No No Yes No Yes No Yes C2h. Emergency contraceptive oral hormonal pills dispensed in social marketing or NGO facilities? C2i. Other contraceptive dispensed in social marketing or NGO facilities? (See question C3 for name.) Not available Not available No No Not available Yes Yes Not available Not available Yes No Yes Yes Yes Yes Yes Not available No Not available No Not available Not available Not available Not available Not available Not available Not available No Yes Yes Yes Not available No Not available Not available Not available C2i. Other contraceptive dispensed in social marketing or NGO facilities? (See question C3 for name.) C3. What is the name of the "other" contraceptive(s) dispensed in public sector, social marketing, or NGO facilities (referred to in question C1i and/or C2i)? N/A N/A Not available N/A N/A Standar Days Method Collier (Standard Days Method) Not available Not available Not available N/A Vaginal foaming tablets Patch, foam, jelly, spermicide Cycle beads, surgical contraceptives (Tubal ligation, vasectomy) Standard Days Method (NGOs) Spermicide N/A Cycle Beads Not available vaginal foaming tablets, CycleBeads Not available Not available Not available Not available Not available Not available Not available contraceptive patch Evra (by Jancenn Cilag) and vaginal ring Novaring (by Organon) Cycle Beads Standard Days Method (Cyclebeads) Vasectomy and tubal ligation Not available Vaginal ring, patch, hormonal IUD, and spermicides. Not available Not available Not available C3. What is the name of the "other" contraceptive(s) dispensed in public sector, social marketing, or NGO facilities (referred to in question C1i and/or C2i)? Policy (Commitment) Policy (Commitment) P1. Is there a contraceptive security or reproductive health commodity security strategy or is contraceptive security explicitly included in a country strategy? No Yes Yes Yes Yes Yes Yes No No No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes No Yes Yes No Yes Yes No Yes No Yes No Yes P1. Is there a contraceptive security or reproductive health commodity security strategy or is contraceptive security explicitly included in a country strategy? P1a. Strategy name N/A Contraceptive Security Strategy National Strategy, Program and Actions Timeframe on Reproductive Health Improvement National Reproductive Health Strategy 20 Point CS Strategy SUMI Public Insurance for Mother and Children PLAN STRATEGIQUE DE LA SECURISATION DES PRODUITS DE SANTE DE LA REPRODUCTION DE LA REPUBLIQUE DEMOCRATIQUE DU CONGO    N/A N/A N/A National Reproductive Health Strategy THE GHANA NATIONAL CONTRACEPTION SECURITY STRATEGY Operational Plan for Contraceptive Security Plan d'Action pour la Sécurisation des Intrants de Santé de la Reproduction (Action Plan for Reproductive Health Commodities Security) National Population Policy 2000 National Contraceptive Commodity Security Strategy National Reproductive Health Commodity Security Strategy and Operational Plan Contraceptives Strategy, RHCS Strategy Reproductive Health Commodity Security Strategy Plan pour la Contraception Sécurisée au Mali N/A National Reproductive Health Commodity Security (RHCS) Strategy Estrategia DAIA Nigeria National Reproductive Health Strategic Framework and Plan N/A Plan Estategico DAIA, Paraguay National Family Planning Policy and others N/A RHCS Strategy (draft) Programme National de Développement Sanitaire (PNDS) and Strategie Nationale de Securisation de Produits Contraceptifs (National Contraceptive Security Strategy) N/A FP Advocacy Strategy N/A Reproductive Health Commodity Security framework N/A Not available P1a. Strategy name P1b. Years strategy covers N/A 2003-2010 2007-2015 2008-2015 Future Years 2007 - present 2008-2012 N/A N/A N/A 2005-2015 2004-2010 2008-2009 5 years (June 2007) 2000-2016 2007-2012 2008-2012 2007-2012, 2008-2012 2006-2010 2002-2011 N/A 2007-2011 2009-2011 2002-2007 N/A 2006-2010 still in effect N/A 11/2008-12/2012 2009-2014 and 2007-2011 N/A 2005-2010 N/A Not available N/A Not available P1b. Years strategy covers P1c. Is the strategy formally approved by the Ministry? N/A Yes Yes Yes Yes Yes Yes N/A N/A N/A Yes Yes Yes Yes Yes Yes No Yes No Yes N/A Yes Yes Yes N/A Yes Yes N/A No Yes N/A Yes N/A Yes N/A Yes P1c. Is the strategy formally approved by the Ministry? P1d. Is the contraceptive security strategy being implemented? N/A Yes Yes Yes Yes Yes No N/A N/A N/A No Yes Yes Yes Yes No No Yes No Yes N/A Yes Yes Yes N/A Yes Yes N/A No Yes N/A Yes N/A No N/A Yes P1d. Is the contraceptive security strategy being implemented? P2. Are there policies that affect the ability of the private sector (commercial sector or NGOs) to provide contraceptives? (e.g. price controls, distribution limitations, taxes/duties, advertising bans) No Yes Yes Yes No Yes No No No Yes No No No Yes No Yes No No Yes Yes Yes No No No No Yes Yes Yes Yes Yes Yes No Yes No Yes No P2. Are there policies that affect the ability of the private sector (commercial sector or NGOs) to provide contraceptives? (e.g. price controls, distribution limitations, taxes/duties, advertising bans) P2a. Policy description N/A Price control, VAT (condoms, IUD), Custom Tax_ 2% for all methods There are advertising ban policies. In particular, contraceptive pills and spermicides are not among "over the counter" medicines and cannot be advertised. For the advertisement of other contraceptivves the permission from MOH is required. taxed in same way as other drugs - 18% Efforts are made to allow to import quality contraceptives duty free by commercial/private sector. (Private sector (SMC) does not pay any duty for contraceptives.) Taxes The problem in DRC is the absence of such policies. Where they exist, these policies are not enforced. As a result, a lot of dangerous, substandard, or ineffective products are sold through the private sector, resulting in unwanted pregnancies, poor RH, and increased maternal mortality. N/A N/A Taxes and duties on contraceptives N/A N/A N/A Official authorities intervene through taxation (when applicable) of commercial brands. N/A Not available N/A N/A The largest NGO in Malawi is BLM, an affiliate of MSI. Because of a US policy provision, BLM is not able to access the relatively cheaper commodities available through the government system. The "Schema Directeur d'Approvisionnement des Produits Contraceptifs" determines the methods that should be distributed in the private sector (social marketing). These products are injectables, Duofem (emergency contraceptive), and condoms. Bottlenecks with Registration process for drugs, especially for private sector. Fortunately the donation (contraceptives and condom) distributed through the public sector are not concerned because it does not need to be registered. N/A N/A N/A N/A Contraceptives are charged with taxes & duties. Taxes/duties. Donated commodities, socially marketed commodities and commercially marketed contraceptives are subject to taxes and duties. Taxes/duties on donated contraceptives consigned to the Department of Health (such as those donated by USAID) are shouldered by the Government of the Philippines through automatic appropriations of the Department of Budget Management. Taxes/duties of socially marketed contraceptives consigned to the Department of Health are paid by the Department of Health. Taxes/duties on socially marketed contraceptives that are not consigned to the Department of Health are paid by the organizations (NGOs) marketing those contraceptives. Taxes/duties on commercially marketed contraceptives are paid by the manufacturer, importer or trader. Pharmacy Law. This law bans brand advertising of ethical/regulated drugs. Hormonal contraceptives (oral pills, injectables and hormonal IUDs) are classified as ethical/regulated drugs, therefore, brand advertising is banned. Copper T IUDs are classified as medical device and registered as unregulated product and not subject to the same restrictions. There is no prohibition on brand advertising of Copper T IUDs. The pharmacy law also prohibits dispensing of ethical/regulated drugs without prescription. It's illegal to advertise a specific contraceptive brand as well as any other prescription drug in mass media (e.g., no ads on TV or popular public journals, newspapers). Private pharmaceutical companies can promote specific brands in professional health care literature and faciliites. However, public campaigns on contraception in general are allowed. The policy on free distribution of contraceptives in the public sector and the subsidy of products in the social marketing limit the ability for the private commercial sector to provide contraceptives To access contraceptives (namely OCs) in the private sector, a prescription is required. There are also advertising bans for the commercial sector - only generic advertising is permitted. The Union Monetaire Ouest Africain also imposes additional regional duties on medical products. OCs cannot be sold in chemist shops, only Type 1 pharmacies. Brand-specific advertizing for OCs is not allowed since they are considered a prescription-only product. N/A All contraceptives in Ukraine, excluding condoms, should be prescribed by doctors, and can be distributed through health facilities. Only ObGyn's are allowed to insert IUDs. Contraceptives are taxed in the same way as all other drugs. Advertising for contraceptives as well as for other prescribed drugs is neither permitted in mass-media nor through direct marketing. While all of these policies might be considered significant barriers, they are seen as normal commercial practices often in line with WHO and European regulations. The contraceptive manufacturers operating in Ukraine indicate that the incapacity to conduct direct advertising for contraceptives to doctors and clients is a significantr barrier for contraceptive provision in the country. N/A 1. Advertising ban 2. Distribution restricted through pharmacies and private clinics except for condoms which can also be sold in grocery and drug stores stores. N/A P2a. Policy description P3. Do policies or regulations exist that restrict who can dispense or sell particular contraceptive methods? Yes Yes Yes Yes No Yes No No No No Yes Yes No Yes Yes Yes No No Yes No Yes No No Yes No No Yes Yes No Yes Yes Yes Yes No Yes Yes P3. Do policies or regulations exist that restrict who can dispense or sell particular contraceptive methods? P3a. Name of contraceptive method 1 Injectables IUDs Condoms Pills N/A Oral contraceptive pills N/A N/A N/A N/A IUDs Injectables N/A Surgical contraceptives Injectables Implants N/A N/A IUDs, Implants, Injectables N/A IUDs N/A N/A Injectables N/A N/A Oral contraceptive pills Contraceptives N/A Oral contraceptive pills Oral contraceptive pills Injectables Hormonal contraceptives (orals, injectables, ring, patch, etc.) N/A Hormonal contraceptives Injectables P3a. Name of contraceptive method 1 P3ai. Description of public sector restriction regarding who is allowed to dispense or sell method 1 Community health workers are not authorized to give IC to people. Only OB/GYNs can provide PoliClinics can dispense. Lower-level facilities (ambulatory, health post) cannot dispense contraceptives because of lack of appropriate personnel and unfeasibility of delivering the contraceptives to each facility There are only a very limited number of pills available through public health facilities for very poor and rural women. Only pharmacies are allowed to sell contraceptives and only OB/GYNs can prescribe them. All contraceptives in Azerbaijan, excluding condoms, should be prescribed by gynecologists. N/A Distribution at health facilities and by health personnel N/A N/A N/A N/A Only OB/GYN and Reproductologists can dispense TYPE OF STAFF e.g., no community health workers N/A Can only be provided by physicians or nurses under special considerations approved by the Ministry of Health Not available through the public sector service delivery points. Only at the health facility by trained personnel N/A N/A Only trained health workers. N/A Enfermeira Elementar e Enfermeiro Basico (category of Nurse with low level of qualification) cannot insert IUD. Only the “Enfermeiro SMI” ("Saúde Materna e Infantil" = Maternal and Child Health) who received training can insert IUD. (refer to the Norms and Standards Guidelines ). N/A N/A Only providers qualified to inject can provide this service N/A N/A Only trained health workers are allowed to dispense. Dispensing without prescription is not allowed. However, since public facilities are headed by doctors who supervise all health workers in the facilities, prescriptions are easy to obtain. However, in practice, OCPs can be obtained without prescription from pharmacies/drugstores. Only pharmacies are allowed to sell contraceptives and only OB/GYNs can prescribe them. (Only condoms are non-prescriptive items.) (Although other contraceptives are prescription drugs, they are universally available over the counter in Russian pharmacies. This contradiction is noted but it does exist.) N/A Must be dispensed by doctors, nurses or midwives. (USAID has a pilot demonstration project on the initial offer of pills at the community level) N/A N/A Only governmental clinics can dispense free products or prescribe them for purchase in governmental pharmacies, based on prescription. N/A Restricted to trained health care providers to dispense following counseling CBDs cannot dispense long term methods P3ai. Description of public sector restriction regarding who is allowed to dispense or sell method 1 P3aii. Description of private sector restriction regarding who is allowed to dispense or sell method 1 N/A Drug Store N/A Only pharmacies are allowed to sell contraceptives and only OB/GYNs can prescribe them N/A Distribution at health facilities and by health personnel N/A N/A N/A N/A Only OB/GYN and Reproductologists can dispense N/A N/A Can be provided by physicians Qualified Private sector medical professionals are permitted to use injectable contraceptives N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Only trained health service providers are allowed to dispense. Service providers other than physicians, such as midwives, cannot dispense without a prescription. However, most midwives, and all PHilHealth accredited midwives have back-up physicians who write the prescriptions. Only pharmacies are allowed to sell contraceptives and only OB/GYNs can prescribe them. Only condoms are non-prescriptive items. N/A On the books, there is a prohibition on counseling for, prescribing and dispensing contraceptives in the same private facility. (A private sector doctor can write a prescription and counsel, but cannot provide the contraceptive. However, in practice this may not always be abided by in pharmacies. Pharmacies and ADDOs (Accreditied Drug Dispensing Outlets) The National Drug Policy does not allow drug shops to dispense injectables including Depo-Provera Private sector physicians can prescribe contraceptives. Licensed private pharmacies can sell them based on prescription. N/A Restricted to Chemists, pharmacies and private clinics to sell and dispense. Only registered nurses and doctors can dispense. P3aii. Description of private sector restriction regarding who is allowed to dispense or sell method 1 P3b. Name of contraceptive method 2 N/A Orals and Injectables Pills, IUDs, and other IUD N/A Injectables N/A N/A N/A N/A N/A Implants N/A Injectables Progestin-only pills IUDs N/A N/A Oral contraceptive pills N/A N/A N/A N/A Implants N/A N/A Injectables N/A N/A Injectables IUDs and Implants N/A N/A N/A IUDs Implants P3b. Name of contraceptive method 2 P3bi. Description of public sector restriction regarding who is allowed to dispense or sell method 2 N/A Not available Policlinics can dispense. Only OB/GYNs can prescribe and dispense all methods, including pills and insert IUDs. FDs provide FP counseling and dispense all contraceptives except hormonal pills and IUD insertion. Nurses can only refer for FP counseling and dispense condoms. Only pharmacies are allowed to sell contraceptives and only OB/GYNs can prescribe and insert them. N/A Distribution and sells only at health facility and/or pharmacy N/A N/A N/A N/A N/A TYPE OF STAFF e.g., no community health workers N/A Cannot be provided by Community Health Agents to date; however, discussions are underway to approve use by Community Health Agents Not available through the public sector service delivery points. Only at the health facility by trained personnel N/A N/A Only trained health workers. N/A N/A N/A N/A Only trained providers can provide this service. N/A N/A Only trained health workers are allowed to dispense. Dispensing without prescription is not allowed. However, since public facilities are headed by doctors who supervise all health workers in the facilities, prescriptions are easy to obtain. However, in practice, injectables can be obtained without prescription from pharmacies / drugstores. N/A N/A Doctors, nurses and midwives only restricted to Public Health Nurse of higher grade MOH staff N/A N/A N/A Restricted to trained health care providers to insert following counseling Only clinical offices and doctors can dispense P3bi. Description of public sector restriction regarding who is allowed to dispense or sell method 2 P3bii. Description of private sector restriction regarding who is allowed to dispense or sell method 2 N/A Drug Store Can be sold in pharmacies Only pharmacies are allowed to sell contraceptives and only OB/GYNs can prescribe them. N/A Distribution and sells only at health facility and/or pharmacy N/A N/A N/A N/A N/A CHEMICAL SELLERS ARE RESTRICTED N/A N/A Available through private practitioners and pharmacies. N/A N/A N/A Can only be prescribed by authozied prescribers and dispensed in registered outlets maned by pharmaceutical personnel N/A N/A N/A N/A N/A N/A N/A Only trained health service providers are allowed to dispense. Service providers other than physicians, such as midwives, cannot dispense without a prescription. However, most midwives, and all PHilHealth (Phil. Health Insurance Corp) accredited midwives have back-up physicians who write the prescriptions. N/A N/A Not sold in the private sector yet (USAID now has an MOU with Pfizer for the social marketing of Depo-provera in the private sector - project will commence this year) but the prohibition described earlier (on counseling for, prescribing and dispensing contraceptives in the same private facility) will have particular implications on the provision of hormonal injectables through private clinics. N/A N/A N/A N/A Restricted to private clinics Only doctors can dispense. P3bii. Description of private sector restriction regarding who is allowed to dispense or sell method 2 P3c. Name of contraceptive method 3 N/A N/A N/A N/A N/A IUDs N/A N/A N/A N/A N/A IUDs N/A Oral contraceptive pills N/A N/A N/A N/A N/A N/A N/A N/A N/A IUDs N/A N/A IUDs N/A N/A N/A N/A N/A N/A N/A Implants IUDs P3c. Name of contraceptive method 3 P3ci. Description of public sector restriction regarding who is allowed to dispense or sell method 3 N/A N/A N/A N/A N/A Sells and insertion at the facility where a doctor is present and performs the insertion. N/A N/A N/A N/A N/A TYPE OF STAFF e.g., no community health workers N/A Available for sale at pharmacies N/A N/A N/A N/A N/A N/A N/A N/A N/A Only trained providers can provide this service. N/A N/A Only trained health workers are allowed to dispense. Dispensing of hormonal IUD without prescription is not allowed. However, since public facilities are headed by doctors who supervise all health workers in the facilities, prescriptions are easy to obtain. Barangay Health Station (the lowest level of public health facility) health service providers do not dispense IUDs. N/A N/A N/A N/A N/A N/A N/A Restricted to trained health care providers to provide following counseling Non-doctors cannot P3ci. Description of public sector restriction regarding who is allowed to dispense or sell method 3 P3cii. Description of private sector restriction regarding who is allowed to dispense or sell method 3 N/A N/A N/A N/A N/A Sells and insertion at the facility where a doctor is present and performs the insertion. N/A N/A N/A N/A N/A CHEMICAL SELLERS ARE RESTRICTED N/A Available for sale at pharmacies N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Only trained health service providers are allowed to dispense. Service providers other than physicians, such as midwives, cannot dispense without a prescription. However, most midwives, and all PHilHealth (Phil. Health Insurance Corp) accredited midwives have back-up physicians who write the prescriptions. N/A N/A N/A N/A N/A N/A N/A Restricted to private clinics Only doctors can dispense. P3cii. Description of private sector restriction regarding who is allowed to dispense or sell method 3 P4. Does the country have laws, regulations, or policies that make it difficult for the following sub-populations to access effective family planning services? P4. Does the country have laws, regulations, or policies that make it difficult for the following sub-populations to access effective family planning services? P4a. Laws/regulations/policies limiting access to family planning services for women? No No No No No No No No No No No No No No No No No No No No No No No No No No No No No No No No No No No No P4a. Laws/regulations/policies limiting access to family planning services for women? P4b. Laws/regulations/policies limiting access to family planning services for unmarried women? No No No No Yes No No No No No No No No No No No No No No No No No No No Yes No No No No No No No No No No No P4b. Laws/regulations/policies limiting access to family planning services for unmarried women? P4c. Laws/regulations/policies limiting access to family planning for young people? No No No No Yes No No No No No No Yes No No No No No No No No No No No No Yes No No No No No No No No No No No P4c. Laws/regulations/policies limiting access to family planning for young people? P4d. Other laws/regulations/policies limiting access to family planning services? Not available Not available Not available No Not available Not available No No No No No Not available No No No No Not available Not available Not available No Not available No No No Not available Not available No No Not available No Not available No Not available Not available No P4d. Other laws/regulations/policies limiting access to family planning services? P4di. Specification of other policies limiting access Not available Not available Not available N/A Not available Not available N/A N/A N/A N/A N/A Not available N/A No N/A N/A Not available Not available Not available N/A Not available N/A N/A N/A Not available Not available N/A N/A Not available N/A Not available N/A Not available Not available N/A P4di. Specification of other policies limiting access P4e. Description of the rules or policies limiting access Not available Not available Not available N/A Traditionally family planning methods are not encouraged for young or unmarried population Not available N/A N/A N/A N/A N/A lack of provision of commodities to under 18-year olds N/A No N/A N/A Not available Not available Not available N/A Not available N/A N/A N/A Staff are not to provide a device to young/unmarried people. Not available N/A N/A Not available N/A Not available N/A Not available Not available N/A P4e. Description of the rules or policies limiting access P5. Are any family planning commodities subject to duties, import taxes, or other fees? No Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes No Yes Not available No No Yes Yes Yes Yes No No Yes Yes Yes Yes Yes No Yes Yes No No No P5. Are any family planning commodities subject to duties, import taxes, or other fees? P5a. If yes, for which methods and for which sector (public, NGO, commercial sector) are there duties, taxes, or fees? N/A Public Sector: 1) VAT for condoms and IUDs 2) Custom Taxes for all methods Commercial Sector and NGOs 1) Price controls 2) VAT (condoms, IUD) 3) Custom Tax(all methods) In commercial sector any method is subject to VAT. all contraceptive commodities are subject to import taxes for commercial sector. All imported items (GOB pays but social marketing does not) Methods provided by the commercial sector (profit) All methods and all sectors although the commercial sector is much more heavily taxed than the humanitarian sector NGO and commercial sector NGO and commercial sector N/A Commercial Sector COMMODITIES FOR PRIVATE SECTOR All products -- the Ministry of health benefits from a tax exemption agreement signed with the U.N. System Official authorities intervene through taxation of contraceptives (especially condoms and pills) imported by the private sector for profit purposes. N/A All commodities imported into the country attract an import declaration fee. Not available N/A N/A All products brought into the country are taxed, but USAID donated contraceptives are tax exempt. Commercial sector, for importation of medicines including contraceptives Commercial Sector NGO and commercial sector N/A N/A All methods for the private sector. All methods for all sectors. (See Question 21) However, if an NGO has obtained tax exemption, payment of taxes and duties may be waived. for all methods and all sectors. For all methods in the public sector: MOH pays storage and distribution fees to the central warehouse CAMERWA All methods in the private sector. N/A Drugs are generally duty free, but a verification fee of 2% is applied by the National Drug Authority to all drug imports (including contraceptives) for the public, NGO and commercial sectors. (The prospective importer pays the fee and provides a copy of the Profoma invoice to NDA which "verifies" that the medicine to be imported is registered and hence allowed to be imported in Uganda. The NDA then provides import authorization if satisfied.) All methods N/A N/A N/A P5a. If yes, for which methods and for which sector (public, NGO, commercial sector) are there duties, taxes, or fees? P5b. How much are the duties, taxes, or fees? N/A VAT: 20%, Custom Taxes 2%, 20% VAT 0.18 ~10% 18.5% (IVA, IT, IUE) An administrative tax of 6% and a few administrative fees 18% (VAT) 13% (VAT) N/A 1) If The commodity (Pills, IUD, etc) is humanitarian aid it is not subject to any taxation or fee except 60GEL for documentation. 2) If the commodity is commercial (intended to be sold) it is subject to taxation and here are the fees: - Registration in drug agency - 2500 GEL - Custom tax 18%from the total price (gross, including transportation) - Custom fee - 60 EU. - After sale Revenue Tax 10% from revenue ~10% Duties 5%, VAT (Value Added Tax) 12%. (Total 17%) Not available N/A 2.25% of invoice value. Waiver is requested per shipment and easily granted against a letter of donation. Not available N/A N/A 2.5% tax Not available 1% tax is charged for commercial sector. There is no tax for contraceptives for Public sector and Social Marketing sector. 15% (VAT) N/A N/A Not available Customs duties on condoms and hormonal contraceptives is 3% of total value. Customs duties on Copper T IUDs is 15% of total value. All contraceptives are subject to 12% Value Added Tax (VAT). However, if an NGO has obtained tax exemption, payment of taxes and duties may be waived. 10% custom/import duties, 10% VAT 9% of the product value 20% duties and 18% TVA for IUD only. 2,7% for all goods entering in UEMOA (Taxe Commun à l'Importation) areas. N/A 2% FOB Value FP commodities sold in the commercial sector are taxed the same way as other drugs (custom taxation, VAT, etc…). The donated FP commodities are free from any duties and fees, if they are brought as humanitarian assistance to Ukraine and provided they are registered in the country. N/A N/A N/A P5b. How much are the duties, taxes, or fees? P6. Are there charges to the client in the public sector for family planning services or commodities? P6. Are there charges to the client in the public sector for family planning services or commodities? P6a. Charges to client in public sector for family planning services? No No No Yes No Yes&No Yes No No Yes No Yes No Yes No No Yes No No Yes No No No No No No Yes&No No No Yes No No No No No No P6a. Charges to client in public sector for family planning services? P6b. Charges to client in public sector for family planning commodities? No No No Yes Yes Yes&No Yes No No No No Yes No No No No Yes No No Yes No No No Yes Yes No Yes&No Yes No Yes No No No No No No P6b. Charges to client in public sector for family planning commodities? P6c. If there are any charges, are there exemptions for those who cannot afford to pay? N/A N/A N/A Yes Yes Yes No N/A N/A Yes N/A No N/A Yes N/A N/A Not available N/A N/A No N/A N/A N/A No Yes N/A Yes&No No N/A Yes N/A N/A N/A N/A N/A N/A P6c. If there are any charges, are there exemptions for those who cannot afford to pay? P6ci. Description of exemptions N/A N/A N/A There is very limited number of contraceptives available free of charge (UNFPA donated) for very poor women Only condoms are sold at a very minimal price. Those who cannot pay are given free. SUMI (Universal Mother and Infant Health Insurance Law) covers both costs for the client. In Bolivia, there are 3 sources of funding: programs, local government, and income generation. Under income generation, public sector pharmacies sell drugs and contraceptives, but under programs and local govt, they are provided free. N/A N/A N/A Waiver system but applies to <5% of population N/A N/A N/A Anyone who needs and asks for contraception services but cannot afford or pay for them should be provided with the requested services. N/A N/A Not available N/A N/A N/A N/A N/A N/A N/A Government can exempt when people cannot afford to pay due to their economic status. N/A Because of devolution, LGUs craft their own policies. Policies are not uniform across LGUs. In general, services in public sector facilities are provided for free but there are some LGUs that have fee for service policies in some of their facilities. In general, commodities in public sector facilities are provided for free but there are some who charge at full or subsidized prices. Only a few LGUs have policies on client segmentation. While this is the case, other funding mechanisms for paying of contraceptives are available to public sector clients. If the client is a PhilHealth member, the client can avail of three PhilHealth benefit packages: (1) Maternity Care Package for normal deliveries that includes the first cycle of oral contraceptives and the first dose of injectable postpartum; (2) IUD Package; and (3) Voluntary Surgical Sterilization Package for bilateral tubal ligation and vasectomy. A significant number of LGUs have enrolled their poor constituents with PhilHealth. N/A N/A At the District level, there are local mechanisms for indigent clients. N/A N/A Although there are no official charges to the client for FP services and/or contraceptives in public sector, there is a "culture" of under the table payment for any health services in Ukraine including FP services. Payments vary depending on the place of client's residency (urban/rural), the facility accessed (rayon/small city/oblast capital), client's income and the official rank of a health provider (FD, FP doctor, Ob-Gyn, professor). IUD insertion is considered to be a higher level service, and additional payment is expected. N/A N/A In theory all MOHCW institutions offer these commodities and services for free, although that may have changed in the course of the recent financial crisis. Local authority health facilities,i.e. municipal & city, charge for the services. (the local authority clinics, e.g., those owned by the city of Harare and Bulaway and other smaller minicipalities are under ddifferent management and rules than the central government MOHCW owned and operated clinics.) P6ci. Description of exemptions P7. Information in country's Poverty Reduction Strategy Paper (PRSP) P7. Information in country's Poverty Reduction Strategy Paper (PRSP) P7a. Year of Poverty Reduction Strategy Paper (PRSP) (most recent actual PRSP on IMF's site (not progress or summary report)) 2008 2008 2008 2003 2005 2001 N/A N/A N/A 2007 2003 2005 N/A 2008 N/A 2005 2008 2007 2007 2008 2007 2003 2005 2004 2004 N/A N/A N/A 2008 2007 2006 2005 2001-2009 2002 2007 N/A P7a. Year of Poverty Reduction Strategy Paper (PRSP) (most recent actual PRSP on IMF's site (not progress or summary report)) P7b. Is family planning or reproductive health a priority in the PRSP? Yes No Yes Yes Yes No N/A N/A N/A Yes No Yes N/A Yes N/A No No Yes No No Yes Yes Yes No Yes N/A N/A N/A Yes Yes Yes Yes No Yes No N/A P7b. Is family planning or reproductive health a priority in the PRSP? P7c. Is contraceptive security included in PRSP? No No No Yes No No N/A N/A N/A Yes No No N/A No N/A No No Yes No No No No No No Yes N/A N/A N/A Yes No No No No No No N/A P7c. Is contraceptive security included in PRSP? P7d. Is contraceptive prevalence rate (CPR) included as an indicator in the PRSP? Yes No No No Yes No N/A N/A N/A Yes No No N/A Yes N/A Yes Yes Yes Yes No No Yes No No Yes N/A N/A N/A Yes No No No No No No N/A P7d. Is contraceptive prevalence rate (CPR) included as an indicator in the PRSP? P7e. Are supply indicators included in the PRSP? No No No No No No N/A N/A N/A No No No N/A No N/A No No No No No No No No No Yes N/A N/A N/A No No No No No No No N/A P7e. Are supply indicators included in the PRSP? P7f. Notes about the PRSP Not available Not available Document not available on IMF's website. Document not available on IMF's website. Document not available on IMF's website. Document not available on IMF's website. Document not available on IMF's website. Document not available on IMF's website. Document not available on IMF's website. Document not available on IMF's website. USAID & partners have been trying to incorporate CPR and FP as key areas for inclusion in the PRSP. Seems to only be in Ukrainian, not in English too. In Ukrainian at http://zakon.nau.ua/doc/?code=637/2001. Not available on IMF's website. Document not available on IMF's website. P7f. Notes about the PRSP P8. Inclusion of contraceptives in country's National Essential Medicine List (NEML) P8. Inclusion of contraceptives in country's National Essential Medicine List (NEML) P8a. Year of National Essential Medicine List (NEML) 2007 2009 Not available Not available Not available 2003 2007 2007 2006 2004 N/A reviewed in early 2008-to early 2009 Not available Likely 2007 or 2008 2003 2003 Not available 2008 1998 2004 2007 2009 Not available 2003 2003 2002 2008 Not available 2005 2003 2007 2007 2009 2001 2004 2006 P8a. Year of National Essential Medicine List (NEML) P8b. Is a combined oral hormonal pill included on the NEML? Yes Yes Yes No Yes Yes Yes Yes Yes Yes No Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Not available Yes Yes Yes Yes Yes Yes Yes Yes P8b. Is a combined oral hormonal pill included on the NEML? P8c. Is a progestin-only oral hormonal pill included on the NEML? Yes Yes Yes No No No Yes Yes No Yes No Yes No No No Yes Yes Yes Yes Yes Yes No No Yes Yes No Yes Not available Yes Yes Yes Yes Yes Yes Yes Yes P8c. Is a progestin-only oral hormonal pill included on the NEML? P8d. Is a hormonal injection included on the NEML? Yes No No No No Yes Yes Yes Yes Yes No Yes Yes No No Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Not available Yes Yes Yes Yes Yes No Yes Yes P8d. Is a hormonal injection included on the NEML? P8e. Is a hormonal implant included on the NEML? No No No No No No No No No Yes No Yes No Yes No No No Yes Yes Yes No Yes No Yes No No No Not available Yes Yes Yes Yes No (not registered) No Yes Yes P8e. Is a hormonal implant included on the NEML? P8f. Is an IUD included on the NEML? Yes Yes No No No No Yes Yes Yes Yes No Yes Yes No Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Not available Yes Yes Yes No No Yes Yes Yes P8f. Is an IUD included on the NEML? P8g. Is a male condom included on the NEML? Yes No Yes No Yes No Yes Yes Yes Yes No Yes Yes No Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Not available Yes Yes Yes No No Yes Yes Yes P8g. Is a male condom included on the NEML? P8h. Is a female condom included on the NEML? No No No No No No No Yes No Yes No Yes No No No No Yes Yes No Yes Yes No No Yes No No No Not available Yes No Yes No No No Yes Yes P8h. Is a female condom included on the NEML? P8i. Is an emergency contraceptive oral hormonal pill included on the NEML? No Yes No No No No No No Yes not confirmed - list is under revision since 2007 and comments have been made to incorporate emergency contraceptives No Yes No No Yes No No No No No No Yes No No Yes Yes No Not available No No No No Yes No Yes Yes P8i. Is an emergency contraceptive oral hormonal pill included on the NEML? P8j. Is any other contraceptive included on the NEML? No Not available Yes No Not available No Not available Yes Not available Yes No Not available No No No No No Yes Not available Yes Not available Not available Not available Not available Yes Not available No Not available Not available Yes Not available Not available No Yes Not available Not available P8j. Is any other contraceptive included on the NEML? P8ji. Name of other contraceptive on NEML? N/A Not available diaphragms with spermicide N/A Not available N/A Not available Cycle beads and vaginal spermicides Not available diaphragms with spermicide N/A Not available N/A N/A N/A N/A N/A VFTs Not available spermicide Not available Not available Not available Not available spermicide, diaphragms Not available N/A Not available N/A spermicide Not available Not available N/A spermicide Not available Not available P8ji. Name of other contraceptive on NEML? P8k. Notes about the NEML Not available Reviewed registered drug list and was told contraceptives not on reimbursable drug list either. Since the registered drug list is not separated into categories, it is possible that a contraceptive listed here was included on the list for a different purpose. In addition, there could be more contraceptives that were inadvertently overlooked. There are plans to include combined oral contraceptives and IUDs in the list soon and to include injectables in the future (the National Essential Drug List is revised every two years). The next revision of the NEML will be in 2010. No legally approved essential drug list exists at the national level, however most insurance companies have their own lists. Neither the list of generics prepared as the national essential drug list (draft, which includes just 200 drugs), nor any of the essential drug lists elaborated by the insurance companies contain any kind of contraceptive. (Two years ago, under one of the Word Bank funded programs, the essential drug list was drafted but was never approved by the MoH or Parliament.) This is based on the departmental list since the latest NEML is still being revised. Instead of from a National Essential Medicine List, this was from "The Basic package of Health and Social Welfare Services," Ministry of Health and Social Welfare Some are in the Medical Supplies List instead of the NEML. P8k. Notes about the NEML Supply Chain (Capacity) Supply Chain (Capacity) S1. Do information system reports at all levels of the system show inventory balance (stock on hand)? Yes Yes Yes No Yes No Not available Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes No Yes Yes Yes Yes Yes Yes Not available Yes Yes Yes No No No Yes Not available S1. Do information system reports at all levels of the system show inventory balance (stock on hand)? S2. Do information system reports at all levels of the system show quantity dispensed or issued during a specified reporting period? Yes Yes Yes No Yes No Not available Yes Yes No Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes No Yes Yes Not available Yes Yes Yes Yes Yes Yes Yes Not available S2. Do information system reports at all levels of the system show quantity dispensed or issued during a specified reporting period? S3. Do information system reports at all levels of the system show losses and adjustments? Yes Yes No No Yes No Not available Yes Yes Yes, but not adequate Yes Yes Yes No No Yes No No Yes Yes No Yes Yes No No Yes No Not available Yes Yes Yes No No No Yes Not available S3. Do information system reports at all levels of the system show losses and adjustments? S4. Do information system reports at all levels of the system show quantities received? Yes Yes Yes No Yes No Not available Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes No Yes Yes Yes No Yes Yes Not available Yes Yes Yes No Yes Yes Yes Not available S4. Do information system reports at all levels of the system show quantities received? S5. Are forecasts updated at least annually? Yes Yes No No No No Not available Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes No Not available Yes Yes Yes Yes Yes Yes Yes Not available S5. Are forecasts updated at least annually? S6. Are forecasts costed out and incorporated into budget planning by the MOH and/or donors? Yes Yes No No No No Not available Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes No Not available Yes Yes Yes Yes Yes Yes Yes Not available S6. Are forecasts costed out and incorporated into budget planning by the MOH and/or donors? S7. Does the program actively monitor/manage the coordination of procurement plans among suppliers/donors? No Yes No No Yes No Not available Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes No No Yes Yes Not available Yes Yes Yes Yes Yes Yes Yes Not available S7. Does the program actively monitor/manage the coordination of procurement plans among suppliers/donors? S8. Are the correct amounts of all products generally procured and obtained at the appropriate time at all levels? Yes Yes Yes No Yes Not available Not available No No No Yes No Yes No Yes No No No Yes No Yes Yes Yes Yes No Yes No Not available Yes Yes No Yes No No No Not available S8. Are the correct amounts of all products generally procured and obtained at the appropriate time at all levels? S9. Does the program conduct at least one physical inventory of all products every year at storage facilities at all levels? Yes Yes Yes No No No Not available Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes No No Yes Yes Yes No No No Not available Yes No Yes Yes No Yes Yes Not available S9. Does the program conduct at least one physical inventory of all products every year at storage facilities at all levels? S10. Is there a procedure for recording complaints about product quality at all levels? Yes No No No Yes No Not available No Yes No No No Yes No Yes Yes No Yes No No No Yes Yes Yes No No Not available Not available No Yes Yes Yes No No No Not available S10. Is there a procedure for recording complaints about product quality at all levels? S11. Are visual quality assurance inspections of products conducted at the storage facility at all levels? Yes Yes No No Yes Not available Not available Yes Yes Yes Yes Yes Yes No No Yes No Yes Yes Yes No Yes Yes Yes No No Yes Not available Yes Yes to an extent Yes Yes Yes No Yes Not available S11. Are visual quality assurance inspections of products conducted at the storage facility at all levels? S12. Was a stockout reported in the Procurement Planning and Monitoring Report (PPMR) in the last year for the following products? S12. Was a stockout reported in the Procurement Planning and Monitoring Report (PPMR) in the last year for the following products? S12a. Combined oral hormonal pills reported stocked out in the PPMR? N/A N/A N/A N/A No N/A N/A Yes No No N/A Yes N/A N/A N/A Yes N/A N/A No N/A Yes N/A No N/A N/A Yes N/A N/A Yes N/A No No N/A N/A Yes N/A S12a. Combined oral hormonal pills reported stocked out in the PPMR? S12b. Progestin-only oral hormonal pills reported stocked out in the PPMR? N/A N/A N/A N/A N/A N/A N/A No N/A No N/A Yes N/A N/A N/A Yes N/A N/A No N/A No N/A N/A N/A N/A N/A N/A No N/A No No N/A N/A No N/A S12b. Progestin-only oral hormonal pills reported stocked out in the PPMR? S12c. Hormonal injections reported stocked out in the PPMR? N/A N/A N/A N/A No N/A N/A Yes Yes No N/A Yes N/A N/A N/A Yes N/A N/A No N/A No N/A N/A N/A N/A No N/A N/A No N/A No No N/A N/A No N/A S12c. Hormonal injections reported stocked out in the PPMR? S12d. Hormonal implants reported stocked out in the PPMR? N/A N/A N/A N/A No N/A N/A N/A N/A No N/A No N/A N/A N/A Yes N/A N/A Yes N/A N/A N/A N/A N/A N/A N/A N/A N/A No N/A No No N/A N/A No N/A S12d. Hormonal implants reported stocked out in the PPMR? S12e. Intrauterine devices (IUDs) reported stocked out in the PPMR? N/A N/A N/A N/A No N/A N/A No Yes No N/A No N/A N/A N/A Yes N/A N/A No N/A No N/A No N/A N/A No N/A N/A No N/A No No N/A N/A No N/A S12e. Intrauterine devices (IUDs) reported stocked out in the PPMR? S12f. Male condoms reported stocked out in the PPMR? N/A N/A N/A N/A No N/A N/A Yes No No N/A Yes N/A N/A N/A No N/A N/A No N/A No N/A Yes N/A N/A Yes N/A N/A No N/A No No N/A N/A No N/A S12f. Male condoms reported stocked out in the PPMR? S12g. Female condoms reported stocked out in the PPMR? N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A No N/A N/A N/A Yes N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Yes N/A Yes No N/A N/A No N/A S12g. Female condoms reported stocked out in the PPMR? S12h. Emergency contraceptive oral hormonal pills reported stocked out in the PPMR? N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A No N/A N/A N/A Yes N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Yes N/A No Yes N/A N/A Yes N/A S12h. Emergency contraceptive oral hormonal pills reported stocked out in the PPMR? S12i. Levels of the system covered in the PPMR N/A N/A N/A N/A Entire system (warehouses & service delivery points) N/A N/A Central Central Central N/A Central N/A N/A N/A Central N/A N/A Central (three regional stores) N/A No N/A Central N/A N/A Central N/A N/A Central and district N/A Central and zonal Central N/A N/A Central N/A S12i. Levels of the system covered in the PPMR S12j. Time period of PPMR's reviewed N/A N/A N/A N/A January 2008-December 2008 N/A N/A 2008-2009 January 2008-December 2008 No N/A January 2008-December 2008 N/A N/A N/A 2008-2009 N/A N/A 2008-2009 N/A January 2008-December 2008 N/A January 2008-December 2008 N/A N/A January 2008-December 2008 N/A N/A January 2008-December 2008 N/A January 2008-December 2008 January 2008-December 2008 N/A N/A 2008-2009 N/A S12j. Time period of PPMR's reviewed Comments about contraceptive security The Government of Albania has committed itself to providing 100% financing for contraceptive procurement in the public sector by 2010. In the near-term and in subsequent years, however, the number of users is expected to grow substantially and the method mix accessed by users continues to change. From what source (i.e., public, social marketing, and commercial sector) those users will access supplies, prices, and potential changes to the contraceptive method mix should be examined and an action plan should be developed to address these issues and to continue to ensuring the contraceptive security in Albania There is a need to improve contraceptive security through efficient distribution of publicly procured FP methods. In addition, it is important that Government be able to secure at least some part of contraceptive needs in the country by state funds. The National Reproductive Health Strategy approved by MOH in February 2008 includes contraceptive security (CS) as one of the national priorities. CS is included in the draft RH Law which is still under Parliament debate right now. However, contraceptive security is a serious issue in Azerbaijan. Only the private sector sells contraceptives. Contraceptives are not available through public health care. Only a limited number of COCs and IUDs are provided by the National RH Office. Contraceptives are not included in the Essential Drug List yet. The aim of Bangladesh FP program is to ensure availability of right contraceptives in adequate quantity, as well as services for permanent and longterm methods (PLTMs), to all the current and potential users free of cost, excepting Condom for which a token price is charged from those who can afford to pay. The current national health policies are not prioritizing FH/RH. Current assumption of authorities is that by including contraceptive commodities under the Public Insurance program, the problem is solved. But not all municipalities know/understand their responsibility and there is no national procurement system, so USAID continues to be the major supplier. There's no budget line item for contraceptive procurement. There's no budget line item for contraceptive procurement HIGH AGENDA ITEM DUE TO ADVOCACY DONE BY THE ICC/CS PARTNERS Government involvement in Reproductive Health Commodities Security has improved during the last years. However, more improvement in terms of coordination, financing and supervision is still needed. India is a Contraceptive Secure Country and most of the contraceptives are locally available. Family Planning commodities and services are avaialble for free in India through the public sector. There is concerted effort from all stakeholders to ensure commodity security in Kenya. Money generated by the sale of contraceptives was used to support transportation costs between central and district level. Since July 2007, a free contraceptive policy is in place. That policy could likely affect the logistics system as district pharmacies might be more reluctant in using their money to pay for the transportation costs of contraceptives. Therefore, it has been suggested to government to reallocate the current "contraceptives procurement budget line" into "contraceptive transportation costs". On question 18, all contraceptives are available through BLM, an MSI affiliate NGO. Male and Female condoms are also available through PSI's Social Marketing Initiative. Logistics Management Information System (LMIS) is weak. Need to train people in the system. USAID | DELIVER PROJECT assisted CMAM/MOH to update the SOPs for managing the supply chain and is planning to train people in all the provinces during this year 2009. - Warehouse space not sufficient at the central level- Transport problem to distribute products from the central to the provinces- Cash flow problem within the MOH--à Accessibility of SWAP Funds (commodity Funds) for contraceptive purchase is a big issue within the MOH.- Policy challenges (MOH wants a Global Health Commodity Security strategy plan including, RH, HIV, Malaria, Laboratory and materials/equipments rather than one exclusively on Contraceptives or RH commodity security Donor contribution for contraceptive commodities have been decreasing. The MoHP's share in contraceptives is increasing each year. MoHP is planning to procure 100% of contraceptives in the coming year, 2009/10. LMD is strengthening the supply and inventory management in the district and health facilities level. There's no budget line item for contraceptive procurement The FMOH is in the process of developing the next five year strategy plan. Pakistan is making all out effort to ensure contraceptive security eventhough it finds it difficult due to the financial crunch. Development of national contraceptive strategy is a priority of the MoPW in 2009. 1) Contraceptive Security vs. Contraceptive Self-Reliance. The Philippines addresses Contraceptive Security in the context of eliminating unmet need for family planning given the phase out of USAID contraceptive donation. This requires broadening the definition to include the support systems for the implementation of the family planning program and addressing issues of sustainability. Hence, the DOH has embarked on Contraceptive Self-Reliance, rather than Contraceptive Security. This strategy includes, in addition to government financing and procurement of commodity based contraceptive methods (pills, injectables, IUDs, condoms, and others) promotion and financing of other methods (bilateral tubal ligation, vasectomy, lactational amenorrhea, natural family planning, and others), expanding distribution coverage, and mobilizing private sector resources in the provision of family planning services and commodities. This approach to Contraceptive Security may have contributed to maintaining the Contraceptive Prevalence Rate in the Philippines steady despite USAID's phase out of contraceptive donation. And since the Government's objective is to ensure the country's self-sufficiency in the provision of family planning services and commodities, the prospect for sustainability is high even without external contraceptive donations. 2) Protecting the Poor. The poor should be protected in the process of achieving Contraceptive Self-Reliance. The issue of targeting financing and provision for the poor is not just an issue of commitment and willingness to fund. It also involves many operational issues such as determining who are poor and entitled to free services, how the non-poor should be served, and how will these issues be handled by local health systems that are supposed to be for everyone in the community. Contraception in Russia is a sensitive topic due to the demographic crisis and other reasons such as traditionally negative perception of hormonal contraception among policy makers, professionals and general population. 1) Currently there is a parallel distribution for essential drugs, contraceptive commodities and condoms. Though contraceptives now form part of the essential drug list, they are not distributed by the Pharmacie Nationale de l'Approvissionment (PNA). In the recent MOH Annual meeting, a clear directive was given for integration. 2) It was recently reported that for 3 consecutive years, funds have been earmarked in the national budget for the purchase of contraceptives. However, these funds have been returned to the Treasury by the Pharmacie Nationale de l'Approvissionment (PNA) (a reported 45 million Fcfa (about $90,000)). This issue has been raised and was also discussed at the Annual MOH Meeting. 3) There needs to be better coordination with UN partners in the National Contraceptive Security Committee on the development of contraceptive procurement tables. The main challenges to Contraceptive Security in Uganda currently include limited government financing for contraceptive procurement, ineffective coordination and weakness in the supply chain. The country is the final stages of developing a Reproductive Health Commodity Security Strategy to guide all partners in addressing the current challenges to CS in a coordinated and holistic way. The overall Contraceptive Security in Ukraine is improving as can be seen through this survey or by looking at the latest 2007 Demographic Health Survey data that shows increase in the use of modern methods over the last eight years. However, there are still many issues that need to be addressed in the future, i.e., improvement of the government procurement process that secures public funding for FP programs and commodities; expansion of method mix; and better integration of FP with STI and HIV/AIDS services. Currently the US government is the only supporter of the Government of Ukraine's efforts to improve availability of affordable contraceptives. With USAID's assistance, the MOH have made important steps forward in the procurement process. However, due to a limited number of international partners and because of the current financial crisis future improvements in this area are questionable. The government funding for FP/RH in Ukraine as well as other health programs has been drastically reduced in 2009. In addition, inflation of the past years is pushing up the private sector contraceptive prices to levels which are not affordable by many people in Ukraine. USAID-supported TfH project played an active role in moving forward the CS agenda at the political and operational levels. Through an innovative public-private partnership that involved, in addition to MOH, a number of contraceptive manufacturers, TfH is working closely with the government of Ukraine to implement a range of activities aimed at expanding the contraceptive market. Comments about contraceptive security Notes: N/A = not applicable, Not available = data not available To jump to the Introduction sheet, click here. All Countries, Filtered & Group Notes: Click on "1" in the top lefthand corner to see just the main questions and "2" to see all of the questions. Please refer to country worksheets for additional comments on indicators. To jump to the Introduction sheet, click here. Contraceptive Security Indicators 2009 Country Leadership and Coordination L1. Is there a national committee that works on contraceptive security? L1a. What is the name of the committee? L2. Are the following organizations represented on the committee? L2a.Are social marketing organizations on the committee? L2ai. Names of social marketing organizations on the committee L2b. Are NGOs on the committee? (e.g. service delivery, advocacy, Planned Parenthood afiliate, Marie Stopes afiliate) L2bi. Names of NGOs on the committee L2c. Are commercial sector organizations on the committee? (e.g. pharmacy associations, manufacturers) L2ci. Names of commercial sector organizations on the committee L2d. Are donors on the committee? L2di. Names of donors on the committee L2e. Are UN agencies on the committee? L2ei. Names of UN agencies on the committee L2f. Are Ministry of Health units on the committee? (e.g. logistics, RH, FP, MCH units) L2fi. Names of Ministry of Health units on the committee L2g. Is the Central Medical Store or Central Warehouse on the committee? L2gi. Names of Central Medical Store or Central Warehouse on the committee L2h. Is the Ministry of Finance on the committee? L3. How many times did the committee meet during the last year? (0, 1-3, 3-5, or 6+) L4. Does committee have legal status? L5. Is there a Contraceptive Security "champion"? Finance and Procurement (Capital) F1. Is there a government budget line item for the procurement of contraceptives? F2. Were government funds spent on contraceptives in the most recent complete fiscal year? (including internally generated funds, World Bank credits or loans, basket funds, or other government funds) F2a. Time period of funding (should be the same for all sources of funds) F2b. Did the government spend internally generated funds (for example, from public sector sources or taxes) for contraceptive procurement? F2bi. What was the amount of internally generated funds spent on contraceptive procurement? (in US$) F2c. Did the government spend World Bank credits or loans for contraceptive procurement? F2ci. What was the amount of World Bank credits or loans spent on contraceptive procurement? (in US$) F2d. Did the government spend basket funds for contraceptive procurement? F2di. What was the amount of basket funds spent on contraceptive procurement? (in US$) F2e. Did the government spend other funding sources for contraceptive procurement? (Including only funds given to the government used for contraceptive procurement. This does NOT include contraceptive supplies donated to the government (so for example NO F2ei. Specify source of other government funding F2eii. What was the amount of other government funds spent on contraceptive procurement? (in US$) F2f. In total, how much funding did the government spend on contraceptive procurement (including internally generated funds, World Bank credits or loans, basket funds, and other government funds)? (in US$) F3. Total amount of non-government funds spent - This includes contraceptive supplies donated directly to the government, procured by donors (e.g. from USAID). This is actual supplies donated, not funds. How much were these supplies worth?: US$ F4. Of the total amount of financing spent on public sector contraceptives for the most recent complete fiscal year, what percent was covered by government funding (including internally generated funds, World Bank credits or loans, basket funds, etc.)?: 14e./(14e+14f): % F4a. Specify data source (e.g. Contraceptive Procurement Table (CPT), National Health Account (NHA), Reproductive Health Account (RHA), etc.) F5. Which entity does procurement: government or other? F5a. Specify government entity that does procurement (e.g. Central Medical Store, MOH logistics unit, MOH procurement unit, etc.) F5ai. Is this procurement entity a parastatal? F5b. Specify non-government entity that does procurement (e.g. third-party agent such as UNFPA or Crown Agents, or private entity) F6. Comments about government procurement and financing Commodities C1. Are the following contraceptive methods dispensed in public sector facilities? C1a. Combined oral hormonal pills dispensed in public sector facilities? C1b. Progestin-only oral hormonal pills dispensed in public sector facilities? C1c. Hormonal injections dispensed in public sector facilities? C1d. Hormonal implants dispensed in public sector facilities? C1e. Intrauterine devices (IUDs) dispensed in public sector facilities? C1f. Male condoms dispensed in public sector facilities? C1g. Female condoms dispensed in public sector facilities? C1h. Emergency contraceptive oral hormonal pills dispensed in public sector facilities? C1i. Other contraceptives dispensed in public sector facilities? (See question C3 for name) C2. Are the following contraceptive methods dispensed in social marketing or NGO facilities? C2a. Combined oral hormonal pills dispensed in social marketing or NGO facilities? C2b. Progestin-only oral hormonal pills dispensed in social marketing or NGO facilities? C2c. Hormonal injections dispensed in social marketing or NGO facilities? C2d. Hormonal implants dispensed in social marketing or NGO facilities? C2e. Intrauterine devices (IUDs) dispensed in social marketing or NGO facilities? C2f. Male condoms dispensed in social marketing or NGO facilities? C2g. Female condoms dispensed in social marketing or NGO facilities? C2h. Emergency contraceptive oral hormonal pills dispensed in social marketing or NGO facilities? C2i. Other contraceptives dispensed in social marketing or NGO facilities? (See questions C3 for name) C3. What is the name of the "other" contraceptive(s) dispensed in public sector, social marketing, or NGO facilities (referred to in question C1i and/or C2i)? Policy (Commitment) P1. Is there a contraceptive security or reproductive health commodity security strategy or is contraceptive security explicitly included in a country strategy? P1a. Strategy name P1b. Years strategy covers P1c. Is the strategy formally approved by the Ministry? P1d. Is the contraceptive security strategy being implemented? P2. Are there policies that affect the ability of the private sector (commercial sector or NGOs) to provide contraceptives? (e.g. price controls, distribution limitiations, taxes/duties, advertising bans) P2a. Policy description P3. Do policies or regulations exist that restrict who can dispense or sell particular contraceptive methods? P3a. Name of contraceptive method 1 P3ai. Description of public sector restriction regarding who is allowed to dispense or sell method 1 P3aii. Description of private sector restriction regarding who is allowed to dispense or sell method 1 P3b. Name of contraceptive method 2 P3bi. Description of public sector restriction regarding who is allowed to dispense or sell method 2 P3bii. Description of private sector restriction regarding who is allowed to dispense or sell method 2 P3c. Name of contraceptive method 3 P3ci. Description of public sector restriction regarding who is allowed to dispense or sell method 3 P3cii. Description of private sector restriction regarding who is allowed to dispense or sell method 3 P4. Does the country have laws, regulations, or policies that make it difficult for the following sub-populations to access effective family planning services? P4a. Laws/regulations/policies limiting access to family planning services for women? P4b. Laws/regulations/policies limiting access to family planning services for unmarried women? P4c. Laws/regulations/policies limiting access to family planning for young people? P4d. Other laws/regulations/policies limiting access to family planning services: Y/N P4di. Specification of other policies limiting access P4e. Description of the rules or policies limiting access P5. Are any family planning commodities subject to duties, import taxes, or other fees? P5a. If yes, for which methods and for which sector (public, NGO, commercial sector) are there duties, taxes, or fees? P5b. How much are the duties, taxes, or fees? P6. Are there charges to the client in the public sector for family planning services or commodities? P6a. Charges to client in public sector for family planning services? P6b. Charges to client in public sector for family planning commodities? P6c. If there are any charges, are there exemptions for those who cannot afford to pay? P6ci. Description of exemptions P7. Information in country's Poverty Reduction Strtegy Paper (PRSP) P7a. Year of Poverty Reduction Strategy Paper (PRSP) (most recent actual PRSP on IMF's site (not progress or summary report)) P7b. Is family planning or reproductive health a priority in the PRSP? P7c. Is contraceptive security included in the PRSP? P7d. Is contraceptive prevalence rate (CPR) included as an indicator in the PRSP? P7e. Are supply indicators included in the PRSP? P7f. Notes about the PRSP P8. Inclusion of contraceptives in country's National Essential Medicine List (NEML) P8a. Year of National Essential Medicine List (NEML) P8b. Is a combined oral hormonal pill included on the NEML? P8c. Is a progestin-only oral hormonal pill included on the NEML? P8d. Is a hormonal injection included on the NEML? P8e. Is a hormonal implant included on the NEML? P8f. Is an IUD included on the NEML? P8g. Is a male condom included on the NEML? P8h. Is a female condom included on the NEML? P8i. Is an emergency contraceptive oral hormonal pill included on the NEML? P8j. Is any other contraceptive included on the NEML? P8ji. Name of other contraceptive on NEML P8k. Notes about the NEML Supply Chain (Capacity) S1. Do information system reports at all levels of the system show inventory balance (stock on hand)? S2. Do information system reports at all levels of the system show quantity dispensed or issued during a specified reporting period? S3. Do information system reports at all levels of the system show losses and adjustments? S4. Do information system reports at all levels of the system show quantities received? S5. Are forecasts updated at least annually? S6. Are forecasts costed out and incorporated into budget planning by the MOH and/or donors? S7. Does the program actively monitor/manage the coordination of procurement plans among suppliers/donors? S8. Are the correct amounts of all products generally procured and obtained at the appropriate time at all levels? S9. Does the program conduct at least one physical inventory of all products every year at storage facilities at all levels? S10. Is there a procedure for recording complaints about product quality at all levels? S11. Are visual quality assurance inspections of products conducted at the storage facility at all levels? S12. Was a stockout reported in the Procurement Planning and Monitoring Report (PPMR) in the last year for the following products? S12a. Combined oral hormonal pills reported stocked out in the PPMR? S12b. Progestin-only oral hormonal pills reported stocked out in the PPMR? S12c. Hormonal injections reported stocked out in the PPMR? S12d. Hormonal implants reported stocked out in the PPMR? S12e. Intrauterine devices (IUDs) reported stocked out in the PPMR? S12f. Male condoms reported stocked out in the PPMR? S12g. Female condoms reported stocked out in the PPMR? S12h. Emergency contraceptive oral hormonal pills reported stocked out in the PPMR? S12i. Levels of the system covered in the PPMR S12j. Time period of PPMR's reviewed Comments about contraceptive security Region Afghanistan No N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No N/A No 0.0 No 0.0 No 0.0 No N/A 0.0 0.0 Not Available Not Available N/A N/A N/A N/A N/A Not Available Yes Yes Yes No Yes Yes No No Not available Yes Yes Yes No Yes Yes No No Not available N/A No N/A N/A N/A N/A No N/A Yes Injectables Community health workers are not authorized to give IC to people. N/A N/A N/A N/A N/A N/A N/A No No No Not available Not available Not available No N/A N/A No No N/A N/A 2008 Yes No Yes No Not available 2007 Yes Yes Yes No Yes Yes No No No N/A Not available Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Europe and Asia Albania Yes RH Committee/Contraceptive Security Working Group Yes NESMARK Yes The Albanian Center for Population and Development/IPPF affiliate Yes Schering Yes USAID Yes UNFPA, WHO, UNICEF Yes RH department, Institute of Public Health, Juridical Office, Pharmaceutical Directorate, Statistics Department No N/A No 1-3 times Yes No Yes Yes January 2008-December 2008 Yes $63,900 No 0.0 No 0.0 No N/A 0.0 $63,900 $42,600 60% UNFPA and MoH records Other N/A N/A UNFPA Albania’s National Contraceptive Security Strategy has established a key goal to realize contraceptive independence by 2010. Currently, UNFPA is the only donor providing contraceptives in Albania for the public sector. Since 2005, the MoH has contributed to financing a share of contraceptives, incrementally increasing its share each year (by adding 20%). As 2010 approaches UNFPA financial contribution will decrease and its role will be limited only as the procurement agent for the MoH. Yes Yes Yes No Yes Yes No Yes Not available Yes No Yes No Yes Yes No Yes Not available N/A Yes Contraceptive Security Strategy 2003-2010 Yes Yes Yes Price control, VAT (condoms, IUD), Custom Tax_ 2% for all methods Yes IUDs Only OB/GYNs can provide Drug Store Orals and Injectables Not available Drug Store N/A N/A N/A No No No Not available Not available Not available Yes Public Sector: 1) VAT for condoms and IUDs 2) Custom Taxes for all methods Commercial Sector and NGOs 1) Price controls 2) VAT (condoms, IUD) 3) Custom Tax(all methods) VAT: 20%, Custom Taxes 2%, No No N/A N/A 2008 No No No No Not available 2009 Yes Yes No No Yes No No Yes Not available Not available Reviewed registered drug list and was told contraceptives not on reimbursable drug list either. Since the registered drug list is not separated into categories, it is possible that a contraceptive listed here was included on the list for a different purpose. In addition, there could be more contraceptives that were inadvertently overlooked. Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A The Government of Albania has committed itself to providing 100% financing for contraceptive procurement in the public sector by 2010. In the near-term and in subsequent years, however, the number of users is expected to grow substantially and the method mix accessed by users continues to change. From what source (i.e., public, social marketing, and commercial sector) those users will access supplies, prices, and potential changes to the contraceptive method mix should be examined and an action plan should be developed to address these issues and to continue to ensuring the contraceptive security in Albania Europe and Asia Armenia No N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Not available No No Not available No 0.0 No 0.0 No 0.0 No N/A 0.0 0.0 Not available Not available N/A N/A N/A N/A N/A Yes Yes Yes No Yes Yes No Yes Not available No No No No No Yes No No No Not available Yes National Strategy, Program and Actions Timeframe on Reproductive Health Improvement 2007-2015 Yes Yes Yes There are advertising ban policies. In particular, contraceptive pills and spermicides are not among "over the counter" medicines and cannot be advertised. For the advertisement of other contraceptivves the permission from MOH is required. Yes Condoms PoliClinics can dispense. Lower-level facilities (ambulatory, health post) cannot dispense contraceptives because of lack of appropriate personnel and unfeasibility of delivering the contraceptives to each facility N/A Pills, IUDs, and other Policlinics can dispense. Only OB/GYNs can prescribe and dispense all methods, including pills and insert IUDs. FDs provide FP counseling and dispense all contraceptives except hormonal pills and IUD insertion. Nurses can only refer for FP counseling and dispense condoms. Can be sold in pharmacies N/A N/A N/A No No No Not available Not available Not available Yes In commercial sector any method is subject to VAT. 20% VAT No No N/A N/A 2008 Yes No No No Not available Yes Yes No No No Yes No No Yes diaphragms with spermicide Yes Yes No Yes No No No Yes Yes No No N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A There is a need to improve contraceptive security through efficient distribution of publicly procured FP methods. In addition, it is important that Government be able to secure at least some part of contraceptive needs in the country by state funds. Europe and Asia Azerbaijan Yes National Strategy Development Working Group No N/A Yes Local NGOs: The National Reproductive Health Office, Heydar Aliyev Foundation, Gender and Development Association, Ombudsman No N/A Yes EU, USAID, USAID-funded ACQUIRE project Yes UNFPA, WHO Yes Organization of Health Service Department of MOH & Center of Innovation and Procurement of MOH No N/A No 3-5 times Yes No No No N/A No 0.0 No 0.0 No 0.0 No N/A 0.0 0.0 Not available 0% N/A N/A N/A N/A N/A Family planning programs started developing in Azerbaijan in 1996 with support from international organizations such as UNFPA, USAID, and others. Technically equipped family planning centers were set up and supplied with contraceptives. However, donor support with the provision of contraceptives was stopped in 2004. It is currently providing in limited amounts by EU through UNFPA. The National RH Strategy (approved in February 2008) has a goal to include contraceptives (intrauterine devices, oral contraceptives) into the list of main medicines. Yes No No No Yes No No No No Yes No No No Yes Yes No No No N/A Yes National Reproductive Health Strategy 2008-2015 Yes Yes Yes taxed in same way as other drugs - 18% Yes Pills There are only a very limited number of pills available through public health facilities for very poor and rural women. Only pharmacies are allowed to sell contraceptives and only OB/GYNs can prescribe them. All contraceptives in Azerbaijan, excluding condoms, should be prescribed by gynecologists. Only pharmacies are allowed to sell contraceptives and only OB/GYNs can prescribe them IUD Only pharmacies are allowed to sell contraceptives and only OB/GYNs can prescribe and insert them. Only pharmacies are allowed to sell contraceptives and only OB/GYNs can prescribe them. N/A N/A N/A No No No No N/A N/A Yes all contraceptive commodities are subject to import taxes for commercial sector. 0.18 Yes Yes Yes There is very limited number of contraceptives available free of charge (UNFPA donated) for very poor women 2003 Yes Yes No No Not available No No No No No No No No No N/A There are plans to include combined oral contraceptives and IUDs in the list soon and to include injectables in the future (the National Essential Drug List is revised every two years). The next revision of the NEML will be in 2010. No No No No No No No No No No No N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A The National Reproductive Health Strategy approved by MOH in February 2008 includes contraceptive security (CS) as one of the national priorities. CS is included in the draft RH Law which is still under Parliament debate right now. However, contraceptive security is a serious issue in Azerbaijan. Only the private sector sells contraceptives. Contraceptives are not available through public health care. Only a limited number of COCs and IUDs are provided by the National RH Office. Contraceptives are not included in the Essential Drug List yet. Europe and Asia Bangladesh Yes Logistics Coordination Forum Yes Social Marketing Company (SMC) YES FPAB No N/A Yes WB, CIDA, KfW, DFID,USAID Yes UNFPA Yes Directorate General of Family Planning (DGFP) Yes CWH of DGFP No 1-3 times Yes Yes Yes Yes FY 2007-2008 No 0.0 Yes $34,540,000 No 0.0 No N/A 0.0 $34,540,000 $12,930,000 73% DGFP Government DGFP No N/A DGFP, under MOHFW, procures all FP-RH commodities, using WB credit money, through open bidding following Govt. and IDA procurement guidelines. Bangladesh funding supports not just public sector but NGO too (who get supplies from the public sector) Yes No Yes Yes Yes Yes No Not available Not available Yes No Yes No No Yes No No Not available N/A Yes 20 Point CS Strategy Future Years Yes Yes No Efforts are made to allow to import quality contraceptives duty free by commercial/private sector. (Private sector (SMC) does not pay any duty for contraceptives.) No N/A N/A N/A N/A N/A N/A N/A N/A N/A No Yes Yes Not available Not available Traditionally family planning methods are not encouraged for young or unmarried population Yes All imported items (GOB pays but social marketing does not) ~10% No Yes Yes Only condoms are sold at a very minimal price. Those who cannot pay are given free. 2005 Yes No Yes No Not available Yes No No No No Yes No No Not available Not available Yes Yes Yes Yes No No Yes Yes No Yes Yes No N/A No No No No N/A N/A Entire system (warehouses & service delivery points) January 2008-December 2008 The aim of Bangladesh FP program is to ensure availability of right contraceptives in adequate quantity, as well as services for permanent and longterm methods (PLTMs), to all the current and potential users free of cost, excepting Condom for which a token price is charged from those who can afford to pay. Europe and Asia Bolivia Yes Comite Nacional de Disponibilidad Asegurada de Insumos Anticonceptivos Yes PROSALUD Yes CIES No N/A Yes USAID Yes UNFPA Yes Unidad de Servicios de Salud y calidad, Unidad de Medicamentos Yes CEASS (parastatal), but does not participate No 1-3 times No No No Yes Not available Yes Not available No 0.0 No 0.0 No N/A 0.0 Not available Not available Not available Not available N/A N/A N/A N/A By law, each Municipality is supposed to dedicate 10% of its budget for health ("Fondo de co-participacion tributaria municipal"). However, usually the percentage is significantly lower. Contraceptive commodities are included in the Maternal and Child Health public insurance, which should be covered by part of this amount (calculated in each municipality by number of inhabitants). Since 2007 contraceptive commodities are supposed to be included in municipal budgets, however there is not information available regarding how much was actually spent on contraceptive commodities, because each municipality does its own purchase of pharmaceutics and commodities. No national procurement, last contraceptive commodities supplied to the Ministry of Health donated by UNFPA (with JICA funds). USAID's Social Marketing Program is currently the major contraceptive commodity supplier for the country. Yes No Yes No Yes Yes No No No Yes No Yes No Yes Yes Yes Yes Yes Standar Days Method Yes SUMI Public Insurance for Mother and Children 2007 - present Yes Yes Yes Taxes Yes Oral contraceptive pills Distribution at health facilities and by health personnel Distribution at health facilities and by health personnel Injectables Distribution and sells only at health facility and/or pharmacy Distribution and sells only at health facility and/or pharmacy IUDs Sells and insertion at the facility where a doctor is present and performs the insertion. Sells and insertion at the facility where a doctor is present and performs the insertion. No No No Not available Not available Not available Yes Methods provided by the commercial sector (profit) 18.5% (IVA, IT, IUE) Yes&No Yes&No Yes SUMI (Universal Mother and Infant Health Insurance Law) covers both costs for the client. In Bolivia, there are 3 sources of funding: programs, local government, and income generation. Under income generation, public sector pharmacies sell drugs and contraceptives, but under programs and local govt, they are provided free. 2001 No No No No 2003 Yes No Yes No No No No No No N/A No No No No No No No Not available No No Not available N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A The current national health policies are not prioritizing FH/RH. Current assumption of authorities is that by including contraceptive commodities under the Public Insurance program, the problem is solved. But not all municipalities know/understand their responsibility and there is no national procurement system, so USAID continues to be the major supplier. LAC Democratic Republic of Congo No N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Not available Yes Yes any year No 0.0 Yes Not available Yes Not available No N/A 0.0 Not available Not available Not available Not available Government FEDECAME Yes N/A All government-procured contraceptives are funded by donors. Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes No Yes Collier (Standard Days Method) Yes PLAN STRATEGIQUE DE LA SECURISATION DES PRODUITS DE SANTE DE LA REPRODUCTION DE LA REPUBLIQUE DEMOCRATIQUE DU CONGO    2008-2012 Yes No No The problem in DRC is the absence of such policies. Where they exist, these policies are not enforced. As a result, a lot of dangerous, substandard, or ineffective products are sold through the private sector, resulting in unwanted pregnancies, poor RH, and increased maternal mortality. No N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No No N/A N/A Yes All methods and all sectors although the commercial sector is much more heavily taxed than the humanitarian sector An administrative tax of 6% and a few administrative fees Yes Yes No N/A N/A N/A N/A N/A N/A Document not available on IMF's website. 2007 Yes Yes Yes No Yes Yes No No Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Africa Dominican Republic Yes Comité para la Disponibilidad Asegurada de Insumos Anticonceptivos (DAIA) Yes PROFAMILIA Yes ADOPLAFAM, MUDE, 30 more institutions No N/A Yes USAID Yes UNFPA Yes Ministry of Health (SESPAS), MCH, FP No N/A No 6 or more times Yes Yes No Yes 2008 Yes $700,000 No 0.0 No 0.0 No N/A 0.0 $700,000 $396,884 64% SESPAS and RHI Other N/A N/A UNFPA Yes Yes Yes Yes Yes Yes No No Not available Yes No Yes Yes Yes Yes No Yes Not available Not available No N/A N/A N/A N/A No N/A No N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No No N/A N/A Yes NGO and commercial sector 18% (VAT) No No N/A N/A N/A N/A N/A N/A N/A Document not available on IMF's website. 2007 Yes Yes Yes No Yes Yes Yes No Yes Cycle beads and vaginal spermicides Yes Yes Yes Yes Yes Yes Yes No Yes No Yes Yes No Yes N/A No Yes N/A N/A Central 2008-2009 There's no budget line item for contraceptive procurement. LAC El Salvador Yes Comité para la Disponibilidad Asegurada de Insumos Anticonceptivos (DAIA) Yes ADS No N/A No N/A Yes USAID, UNFPA Yes UNFPA Yes MoH, MCH, FP No N/A No 6 or more times No Yes No Yes 2008 Yes $680,000 No 0.0 No 0.0 No N/A 0.0 $680,000 $229,866 75% Graduation Plan Other N/A N/A UNFPA Yes No Yes Yes Yes Yes No No Not available Yes No No Yes Yes Yes No No Not available Not available No N/A N/A N/A N/A No N/A No N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No No N/A N/A Yes NGO and commercial sector 13% (VAT) No No N/A N/A N/A N/A N/A N/A N/A Document not available on IMF's website. 2006 Yes No Yes No Yes Yes No Yes Not available Not available Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes No N/A Yes N/A Yes No N/A N/A Central January 2008-December 2008 There's no budget line item for contraceptive procurement LAC Ethiopia Yes Family Planning Technical Working Group Yes DKT Ethiopia Yes IPAS, DKT, EngenderHealth, Family Guidance Association of Ethiopia (FGAE), Pathfinder, IntraHealth, Marie Stopes International, World Vision, CARE, Save the Children No N/A Yes UNFPA, USAID Yes UNFPA, UNICEF Yes Family Health Department No N/A No 1-3 times No No Yes Yes July 2007-June 2008 Yes $910,000 No 0.0 Yes $11,900,000 No N/A 0.0 $12,810,000 $9,000,000 59% CPT Government and Other Pharmaceutical Fund & Supply Agency (PFSA) No UNFPA Back in 2004/2005 and before the Federal MOH, it was the regions which started to procure contraceptives with their annual budget. The Federal level did not finance contraceptives until 2006 or 2007. Yes Yes Yes Yes Yes Yes No Yes Not available Yes Yes Yes No but it's under registration Yes Yes No Yes Yes Not available No N/A N/A N/A N/A Yes Taxes and duties on contraceptives No N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No No N/A N/A No N/A N/A Yes No Yes Waiver system but applies to <5% of population 2007 Yes Yes Yes No 2004 Yes Yes Yes Yes Yes Yes Yes not confirmed - list is under revision since 2007 and comments have been made to incorporate emergency contraceptives Yes diaphragms with spermicide Yes No Yes, but not adequate Yes Yes Yes Yes No Yes No Yes No No No No No No N/A N/A Central No Africa Georgia Yes National RH Committee No N/A Yes JSI No N/A Yes USAID, UNFPA, UNICEF, WHO Yes UNFPA, UNICEF, WHO Yes Not available No N/A No 6 or more times Yes No No No Not available No 0.0 No 0.0 No 0.0 No N/A 0.0 0.0 Not available N/A N/A N/A N/A N/A N/A Yes Yes Yes No Yes Yes Yes Yes No Yes Yes No No Yes Yes No No No N/A Yes National Reproductive Health Strategy 2005-2015 Yes No No N/A Yes IUDs Only OB/GYN and Reproductologists can dispense Only OB/GYN and Reproductologists can dispense N/A N/A N/A N/A N/A N/A No No No No N/A N/A Yes Commercial Sector 1) If The commodity (Pills, IUD, etc) is humanitarian aid it is not subject to any taxation or fee except 60GEL for documentation. 2) If the commodity is commercial (intended to be sold) it is subject to taxation and here are the fees: - Registration in drug agency - 2500 GEL - Custom tax 18%from the total price (gross, including transportation) - Custom fee - 60 EU. - After sale Revenue Tax 10% from revenue No No N/A N/A 2003 No No No No N/A No No No No No No No No No N/A No legally approved essential drug list exists at the national level, however most insurance companies have their own lists. Neither the list of generics prepared as the national essential drug list (draft, which includes just 200 drugs), nor any of the essential drug lists elaborated by the insurance companies contain any kind of contraceptive. (Two years ago, under one of the Word Bank funded programs, the essential drug list was drafted but was never approved by the MoH or Parliament.) Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Europe and Asia Ghana Yes ICC/CS-INTERCOORDINATING COMMITTEE FOR CONTRACEPTION Yes AED/GSCP Yes PPAG,MSI Yes BAYER-SCHERING,PHARMACEUTICAL SOCIETY OF GHANA. Yes USAID,UNFPA,DFID,RNE,JICA Yes UNFPA,UNAIDS Yes PROCUREMENT&SUPPLIES DIRECTORATE,GHS DIRECTORATE,FHD ETC Yes CMS Yes 1-3 times Yes Yes No Yes 2007 No 0.0 Yes $1,000,000 Yes $300,000 No N/A 0.0 $1,300,000 $5,640,000 19% CPT (Country Needs) Government and Other Procurement Unit Yes Crown Agents and UNFPA Proucurement Unit has most recently started doing this for Ghana (for condoms). The price obtained was good. Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Vaginal foaming tablets Yes THE GHANA NATIONAL CONTRACEPTION SECURITY STRATEGY 2004-2010 Yes Yes No N/A Yes Injectables TYPE OF STAFF e.g., no community health workers N/A Implants TYPE OF STAFF e.g., no community health workers CHEMICAL SELLERS ARE RESTRICTED IUDs TYPE OF STAFF e.g., no community health workers CHEMICAL SELLERS ARE RESTRICTED No No Yes Not available Not available lack of provision of commodities to under 18-year olds Yes COMMODITIES FOR PRIVATE SECTOR ~10% Yes Yes No N/A 2005 Yes No No No reviewed in early 2008-to early 2009 Yes Yes Yes Yes Yes Yes Yes Yes Not available Not available Yes Yes Yes Yes Yes Yes Yes No Yes No Yes Yes Yes Yes No No Yes No No Central January 2008-December 2008 HIGH AGENDA ITEM DUE TO ADVOCACY DONE BY THE ICC/CS PARTNERS Africa Guatemala Yes National Contraceptive Security Commission Yes PASMO (Pan American Social Marketing Organization) Yes APROFAM (Pro-Family Association--IPPF affliate) No N/A Yes USAID (unofficial, invited by Commission to participate) Yes UNFPA (unofficial, invited by Commission to participate) Yes National Reproductive Health Program Yes Not available Yes 6 or more times Yes Yes No No Jan-Dec 2008 No 0.0 No 0.0 No 0.0 No N/A 0.0 0.0 $545,473 0% Not available Other N/A N/A UNFPA 15% of Alcoholic Beverages Tax is supposed to be allocated to Contraceptive Security but it is difficult to ensure these funds are indeed used to purchase contraceptives or fund the reproductive health program. Government has not paid UNFPA for 2007 and 2008 shipments (as of Feb 2009). Yes No Yes Yes Yes Yes No Yes No Yes No Yes Yes Yes Yes Yes Yes Yes Patch, foam, jelly, spermicide Yes Operational Plan for Contraceptive Security 2008-2009 Yes Yes No N/A No N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No No N/A N/A Yes All products -- the Ministry of health benefits from a tax exemption agreement signed with the U.N. System Duties 5%, VAT (Value Added Tax) 12%. (Total 17%) No No N/A N/A N/A N/A N/A N/A N/A Document not available on IMF's website. Not available Yes No Yes No Yes Yes No No No N/A This is based on the departmental list since the latest NEML is still being revised. Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A LAC Haiti Yes National Committee on Reproductive Health Yes PSI Yes JHPIEGO, MSH, PSI Yes Ad Hoc Yes USAID, Canadian Embassy, Global Fund Yes UNFPA, WHO/PAHO, UNICEF Yes DSF, Ministry of Women Affair Yes PROMESS No 6 or more times No No Yes No October 2007-September 2008 No 0.0 No 0.0 No 0.0 No N/A 0.0 0.0 $3,100,000 0% N/A N/A N/A N/A N/A 1. A line item for commodities including vaccines, contraceptives and contraception related supplies is included in the MOH budget. The National budget is not yet ratified by the Haitian Parliament. 2. So far, the Government has been mainly coordinating the forecasting, procurement and distribution of contraceptives with the donors to ensure the complete coverage of the country need of contraceptives. Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes No Yes Cycle beads, surgical contraceptives (Tubal ligation, vasectomy) Yes Plan d'Action pour la Sécurisation des Intrants de Santé de la Reproduction (Action Plan for Reproductive Health Commodities Security) 5 years (June 2007) Yes Yes Yes Official authorities intervene through taxation (when applicable) of commercial brands. Yes Surgical contraceptives Can only be provided by physicians or nurses under special considerations approved by the Ministry of Health Can be provided by physicians Injectables Cannot be provided by Community Health Agents to date; however, discussions are underway to approve use by Community Health Agents N/A Oral contraceptive pills Available for sale at pharmacies Available for sale at pharmacies No No No No No No Yes Official authorities intervene through taxation of contraceptives (especially condoms and pills) imported by the private sector for profit purposes. Not available Yes No Yes Anyone who needs and asks for contraception services but cannot afford or pay for them should be provided with the requested services. 2008 Yes No Yes No Likely 2007 or 2008 No No No Yes No No No No No N/A Yes Yes No Yes Yes Yes Yes No Yes No No N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Government involvement in Reproductive Health Commodities Security has improved during the last years. However, more improvement in terms of coordination, financing and supervision is still needed. LAC India Yes Supply and Social Marketing Division of Ministry of Health and Family Welfare No N/A No N/A No N/A No N/A No N/A Yes Supply and Social Marketing Division of Ministry of Health and Family Welfare No N/A No 3-5 times Yes Yes Yes Yes April 2008-March 2009 Yes $99,250,000 No 0.0 No 0.0 No N/A 0.0 $99,250,000 0.0 100% Ministry of Health and Family Welfare, Government of India Government Supply and Social Marketing Division of Government of India No N/A Indian Government is self suffficient in contraceptive logistics and supplies and has a strong public sector distribution network and Social Marketing program. Yes No No No Yes Yes No Yes No Yes Yes Yes No Yes Yes Yes Yes Yes Standard Days Method (NGOs) Yes National Population Policy 2000 2000-2016 Yes Yes No N/A Yes Injectables Not available through the public sector service delivery points. Qualified Private sector medical professionals are permitted to use injectable contraceptives Progestin-only pills Not available through the public sector service delivery points. Available through private practitioners and pharmacies. N/A N/A N/A No No No No N/A N/A No N/A N/A No No N/A N/A N/A N/A N/A N/A N/A Document not available on IMF's website. 2003 Yes No No No Yes Yes No Yes No N/A Yes Yes No Yes Yes Yes Yes Yes Yes Yes No N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A India is a Contraceptive Secure Country and most of the contraceptives are locally available. Family Planning commodities and services are avaialble for free in India through the public sector. Europe and Asia Kenya Yes FP Logistics Committee. Yes PSI No N/A No N/A Yes USAID, GTZ, KfW, WB, UNFPA Yes UNFPA Yes Family Planning, Division of RH Yes Kenya Medical Supplies Agency (KEMSA) No 1-3 times No No Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Government and Other KEMSA Yes UNFPA The government procures through open tendering with specifications that call for commodities of international quality standards. Some development agencies also procure independently. Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes No Yes Yes Spermicide Yes National Contraceptive Commodity Security Strategy 2007-2012 Yes No Yes Not available Yes Implants Only at the health facility by trained personnel N/A IUDs Only at the health facility by trained personnel N/A N/A N/A N/A No No No No N/A N/A Yes All commodities imported into the country attract an import declaration fee. 2.25% of invoice value. Waiver is requested per shipment and easily granted against a letter of donation. No No N/A N/A 2005 No No Yes No 2003 Yes Yes Yes No No No No No No N/A Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Central 2008-2009 There is concerted effort from all stakeholders to ensure commodity security in Kenya. Africa Liberia No N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No 2008 No 0.0 No 0.0 No 0.0 No N/A 0.0 0.0 $1,427,844 0% RHI and CPT report N/A N/A N/A N/A Yes Yes Yes No Yes Yes Yes No No Yes Yes Yes Yes Yes Yes Yes Not available Not available N/A Yes National Reproductive Health Commodity Security Strategy and Operational Plan 2008-2012 No No No N/A No N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No Not available Not available Not available Not available Not available Not available Yes Yes Not available Not available 2008 No No Yes No Not available Yes Yes Yes No Yes Yes Yes No No N/A Instead of from a National Essential Medicine List, this was from "The Basic package of Health and Social Welfare Services," Ministry of Health and Social Welfare No No No No No No No No No No No N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Africa Madagascar Yes "Partners Reproductive Health/Family Planning Committee" seconded by a sub-committee which is the "Family Planning Logistics Committee". Yes PSI Yes FISA (IPPF affiliate), MSI (Marie Stopes M/car), SAF-FJKM, SALFA, Religious platforms (leader), AMIT and OSTIE (Inter-Health Organization), etc. Yes ORGANON, AMEL (private physician's association) Yes USAID, UNFPA, WORLD BANK, GTZ, JICA, EU Yes WHO, UNICEF, UNAIDS Yes Family Planning Directorate Yes SALAMA Yes 1-3 times No No Yes Yes 2008 Yes $127,788 No 0.0 No 0.0 No N/A 0.0 $127,788 $3,164,462 4% Data base MoH/DPF/SSPSR = National Health Account Government SALAMA (Central Medical Stores) Yes N/A The government's contributions began in 2006. The budget allocated is worth US$100,000 per year. Yes Yes Yes Yes Yes Yes Yes No Yes Yes No Yes No No Yes No No No Cycle Beads Yes Contraceptives Strategy, RHCS Strategy 2007-2012, 2008-2012 Yes Yes No N/A No N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No Not available Not available Not available No N/A N/A No No N/A N/A 2007 Yes Yes Yes No 2008 Yes Yes Yes Yes Yes Yes Yes No Yes VFTs Yes Yes No Yes Yes Yes Yes No Yes Yes Yes N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Money generated by the sale of contraceptives was used to support transportation costs between central and district level. Since July 2007, a free contraceptive policy is in place. That policy could likely affect the logistics system as district pharmacies might be more reluctant in using their money to pay for the transportation costs of contraceptives. Therefore, it has been suggested to government to reallocate the current "contraceptives procurement budget line" into "contraceptive transportation costs". Africa Malawi Yes Reproductive Health Technical Working Group Yes PSI No N/A No N/A Yes USAID Yes UNFPA Yes RH, Pharmacy, HIV/AIDS No N/A No 1-3 times No No No Yes October 2007-September 2008 No 0.0 No 0.0 Yes $1,620,000 No N/A 0.0 $1,620,000 $5,397,180 23% CPT, NHA Government Central Medical Stores No N/A Yes Yes Yes Yes Yes Yes Yes No Not available Yes Yes Yes Yes Yes Yes Yes No Not available Not available Yes Reproductive Health Commodity Security Strategy 2006-2010 No No Yes The largest NGO in Malawi is BLM, an affiliate of MSI. Because of a US policy provision, BLM is not able to access the relatively cheaper commodities available through the government system. Yes IUDs, Implants, Injectables Only trained health workers. N/A Oral contraceptive pills Only trained health workers. Can only be prescribed by authozied prescribers and dispensed in registered outlets maned by pharmaceutical personnel N/A N/A N/A No No No Not available Not available Not available No N/A N/A No No N/A N/A 2007 No No Yes No 1998 Yes Yes Yes Yes Yes Yes No No Not available Not available Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes No No No Yes No No N/A N/A Central (three regional stores) 2008-2009 On question 18, all contraceptives are available through BLM, an MSI affiliate NGO. Male and Female condoms are also available through PSI's Social Marketing Initiative. Africa Mali Yes Commission de Suivi de la Mise en Oeuvre du Plan d'Action à long terme pour la Contraception Sécurisée au Mali Yes Centrale d'Achat des Génériques (C.A.G.), PSI Yes Groupe Pivot Santé et Population, AMPPF (IPPF affiliate) Yes Centrale d'Achat des Génériques (C.A.G.) Yes USAID, UNFPA, KFW Yes UNFPA Yes Direction Nationale de la Santé, Direction de la Pharmacie et du Médicament, Pharmacie Populaire du Mali (PPM) Yes Pharmacie Populaire du Mali (PPM) No 1-3 times Yes No Yes No Not available No 0.0 No 0.0 No 0.0 No N/A 0.0 0.0 $1,000,000 0% Contraceptive Procurement Tables (CPTs) N/A N/A N/A N/A Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No vaginal foaming tablets, CycleBeads Yes Plan pour la Contraception Sécurisée au Mali 2002-2011 Yes Yes Yes The "Schema Directeur d'Approvisionnement des Produits Contraceptifs" determines the methods that should be distributed in the private sector (social marketing). These products are injectables, Duofem (emergency contraceptive), and condoms. No N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No No N/A N/A Yes All products brought into the country are taxed, but USAID donated contraceptives are tax exempt. 2.5% tax Yes Yes No N/A 2008 No No No No 2004 Yes Yes Yes Yes Yes Yes Yes No Yes spermicide Yes Yes Yes Yes Yes Yes Yes No No No Yes N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Africa Mozambique Yes Reproductive Health Commodity Security Task Force (RH-CS Task Force) Yes PSI Yes Forte Saúde (funded by USAID), AMODEFA (IPPF affiliate) No N/A Yes USAID, UNFPA, DFID (will join the group) Yes UNFPA, WHO Yes RH/FP program Yes CMAM No 6 or more times Yes No Yes No 2008 No 0.0 No 0.0 No 0.0 No N/A 0.0 0.0 $3,410,437 N/A CPT and PipeLine database N/A N/A N/A N/A Yes Yes Yes No Yes Yes No No Not available No No No No No Yes Yes No Not available Not available No N/A N/A N/A N/A Yes Bottlenecks with Registration process for drugs, especially for private sector. Fortunately the donation (contraceptives and condom) distributed through the public sector are not concerned because it does not need to be registered. Yes IUDs Enfermeira Elementar e Enfermeiro Basico (category of Nurse with low level of qualification) cannot insert IUD. Only the “Enfermeiro SMI” ("Saúde Materna e Infantil" = Maternal and Child Health) who received training can insert IUD. (refer to the Norms and Standards Guidelines ). N/A N/A N/A N/A N/A N/A N/A No No No Not available Not available Not available Yes Commercial sector, for importation of medicines including contraceptives Not available No No N/A N/A 2007 Yes No No No 2007 Yes Yes Yes No Yes Yes Yes No Not available Not available No Yes No No Yes Yes Yes Yes No No No Yes No No N/A No No N/A N/A No January 2008-December 2008 Logistics Management Information System (LMIS) is weak. Need to train people in the system. USAID | DELIVER PROJECT assisted CMAM/MOH to update the SOPs for managing the supply chain and is planning to train people in all the provinces during this year 2009. - Warehouse space not sufficient at the central level- Transport problem to distribute products from the central to the provinces- Cash flow problem within the MOH--à Accessibility of SWAP Funds (commodity Funds) for contraceptive purchase is a big issue within the MOH.- Policy challenges (MOH wants a Global Health Commodity Security strategy plan including, RH, HIV, Malaria, Laboratory and materials/equipments rather than one exclusively on Contraceptives or RH commodity security Africa Nepal Yes Reproductive Health Commodities Security Working Group (also known as Contraceptive and Essential Commodities Security Working Group) Yes Nepal CRS Company Yes Family Planning Association of Nepal No N/A Yes USAID, KfW, DFID, World Bank Yes UNFPA, UNICEF Yes Family Health Division, Logisitcs Management Division, Child Health Division, National Center for AIDS and STD Control, Ministry of Health, National Planning Commission Yes Central Warehouse, Teku Yes 1-3 times Yes Yes Yes Yes 2008 Yes $1,688,000 Yes $422,000 No 0.0 Yes KfW $94,806 $2,204,806 $214,300 91% Annual Forecast/FHD/LMD Government Logistics Management Division/MoHP Yes N/A Yes No Yes Yes Yes Yes No No Not available Yes No Yes Yes Yes Yes No Yes Not available Not available Yes National Reproductive Health Commodity Security (RHCS) Strategy 2007-2011 Yes Yes No N/A No N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No No N/A N/A Yes Commercial Sector 1% tax is charged for commercial sector. There is no tax for contraceptives for Public sector and Social Marketing sector. No No N/A N/A 2003 Yes No Yes No 2009 Yes No Yes Yes Yes Yes No Yes Not available Not available Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Donor contribution for contraceptive commodities have been decreasing. The MoHP's share in contraceptives is increasing each year. MoHP is planning to procure 100% of contraceptives in the coming year, 2009/10. LMD is strengthening the supply and inventory management in the district and health facilities level. Europe and Asia Nicaragua Yes Comité para la Disponibilidad Asegurada de Insumos Anticonceptivos (DAIA) Yes PASMO Yes PROFAMILIA No N/A Yes USAID Yes UNFPA Yes Ministry of Health (MCH, FP) No N/A No 6 or more times Yes Yes No Yes 2008 Yes $150,000 No 0.0 Yes $441,665 No N/A 0.0 $591,665 $1,010,321 37% Ministry of Health and Newvern Government and Other Essential Drugs Unit (for condoms) No UNFPA Yes No Yes No Yes Yes No No Not available Yes No Yes No Yes Yes No No Not available Not available Yes Estrategia DAIA 2009-2011 Yes Yes No N/A No N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No No N/A N/A Yes NGO and commercial sector 15% (VAT) No No N/A N/A 2005 Yes No No No Not available Yes No Yes No Yes Yes No No Not available Not available Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No N/A Yes N/A No Yes N/A N/A Central January 2008-December 2008 There's no budget line item for contraceptive procurement LAC Nigeria Yes Reproductive Health Commodity Security Stakeholders' Committee Yes Society for Family Health Yes Planned Parenthood Federation of Nigeria (also Association of Reproductive & Family Health*, Adolescent Health Program*, Federation of Moslem Women*) Yes Pharmaceutical Society of Nigeria Yes USAID, CIDA, (also DFID*) Yes UNFPA Yes Family Health Department, FMOH, (also RH unit*, HIV/AIDS unit*, Planning Department*, Ministry of Women's Affairs*) Yes Central Contraceptives Warehouse Yes 1-3 times Yes Yes No No 2008 No 0.0 No 0.0 No 0.0 No N/A 0.0 0.0 $1,250,629 0% UNFPA and other records N/A N/A N/A N/A Yes Yes Yes Yes Yes Yes Yes No Not available Yes Yes Yes Yes Yes Yes Yes Yes Not available Not available Yes Nigeria National Reproductive Health Strategic Framework and Plan 2002-2007 Yes Yes No N/A Yes Injectables Only providers qualified to inject can provide this service N/A Implants Only trained providers can provide this service. N/A IUDs Only trained providers can provide this service. N/A No No No No N/A N/A No N/A N/A No Yes No N/A 2004 No No No No 2003 Yes Yes Yes Yes Yes Yes Yes No Not available Not available Yes Yes No Yes Yes Yes No Yes Yes Yes Yes N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A The FMOH is in the process of developing the next five year strategy plan. Africa Pakistan Yes RHCS Committee Yes Greenstar Yes Pop Council, PAIMAN No N/A Yes USAID Yes UNFPA Yes MoPW, MoH No N/A No 1-3 times Yes No Yes Yes July 08-June 09 Yes MOPW: Pakistani Rs. 225 million (GoP funds) approx. $3 mi. MOH: Not available No 0.0 No 0.0 No N/A 0.0 Not available Not available Not available Not available Other N/A N/A UNFPA All contraceptives with GoP funds are procured through UNFPA. However, this will change as the GoP would like to procure contraceptives through its own unit in the future (through the MoPW (M and S Unit)). Yes Yes Yes Yes Yes Yes No Yes Not available Yes Yes Yes No Yes Yes No No Not available Not available No N/A N/A N/A N/A No N/A No N/A N/A N/A N/A N/A N/A N/A N/A N/A No Yes Yes Not available Not available Staff are not to provide a device to young/unmarried people. No N/A N/A No Yes Yes Government can exempt when people cannot afford to pay due to their economic status. 2004 Yes Yes Yes Yes 2003 Yes Yes No No Yes Yes No Yes Yes spermicide, diaphragms Yes No No No Yes Yes No No No No No N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Pakistan is making all out effort to ensure contraceptive security eventhough it finds it difficult due to the financial crunch. Development of national contraceptive strategy is a priority of the MoPW in 2009. Europe and Asia Paraguay Yes DAIA Committee Yes PSI Paraguay Yes CEPEP (Centro Paraguayo de Estudios de Poblacion)- IPPF affiliate No N/A Yes USAID, UNFPA Yes UNFPA, OPS (PAHO in English) Yes RH, PH, Logistics Yes Central Warehouse No 6 or more times No Yes Yes Yes 2008 Yes $539,537 No 0.0 No 0.0 No N/A 0.0 $539,537 $251,257 68% CPT Other N/A N/A UNFPA Yes No Yes No Yes Yes No Yes No Yes No No No Only the IPPF affiliates Yes No Yes Not available Not available Yes Plan Estategico DAIA, Paraguay 2006-2010 Yes Yes Yes Contraceptives are charged with taxes & duties. No N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No Not available Not available Not available Yes All methods for the private sector. Not available No No N/A N/A N/A N/A N/A N/A N/A Document not available on IMF's website. 2002 Yes No Yes No Yes Yes No Yes Not available Not available Some are in the Medical Supplies List instead of the NEML. Yes Yes Yes Yes Yes Yes Yes Yes No No No Yes N/A No N/A No Yes N/A N/A Central January 2008-December 2008 LAC Philippines Yes Contraceptive Self-Reliance (CSR) Technical Working Group Yes DKT Philippines, Family Planning Organization of the Philippines, League of Municipalities Yes Philippine NGO Council, Family Planning Organization of the Philippines, Cooperative Movement for Encouraging NSV (non-scalpel vasectomy), League of Provinces, League of Cities, League of Municipalities, Union of Local Authorities of the Philippines Yes Philippine Chamber of Commerce and Industry, Drugstores Association of the Philippines Yes USAID, UNFPA Yes WHO Yes DOH: National Center for Disease Prevention and Control (includes FP and HIV/AIDS), Bureau of Local Health Development, Bureau of International Health Coordination, Health Policy Development and Planning Bureau, National Drug Program, Center of Health Development Region 4A and National Capital Region; DOH attached agencies: Bureau of Food and Drugs, Population Commission, Philippine Health Insurance Corp (PhilHealth).; Local Government Unit (LGU): Pangasinan Provincial Population Office Yes DOH Materials Management Service No 3-5 times Yes Yes Yes Yes Approximately April 2008 to approximately March 2009 Yes Not available No 0.0 No 0.0 No N/A 0.0 Not available Not available Not available Not available Government Local Government Unit’s General Property and Supplies Office No N/A The line item for procurement of contraceptives is at the LGU level. LGUs fund and procure their contraceptive requirements. Prices of contraceptives, even for the same contraceptive method and brand, are not uniform across LGUs. Therefore, computing the total amount in Pesos of LGU procured contraceptives as a percentage of the total amount in Pesos of total contraceptive requirement may not be the best indicator to measure the country's contraceptive security. Computing total quantity procured as a percentage of total required quantity is a better indicator. Currently, there is no systematic data that provides report on LGU procurements. While the DOH does not have a specific line item for procurement of contraceptives, the Government Appropriations Act of 2008 has an earmark in the DOH budget of US$43,478,260 (PhP2 Billion) for contraceptives and related training and other costs. US$26,087,000 (PhP1.2 Billion) of this earmark is for contraceptives and downloaded to the LGUs to facilitate LGU procurement of contraceptives. PhilHealth enrolment is another mechanism for LGU financing of contraceptives. When an LGU enrols its constituents (indigent constituents) with PhilHealth, it is indirectly financing its contraceptive requirements, through: a) the enrolled constituent can avail of the PhilHealth benefit packages that cover the costs of some contraceptive methods (as described previously in this survey); and/or (b) using part of the capitation fund received from PhilHealth (for enrollments made) to procure contraceptives. USAID/Philippines, through the Health Policy Development Project assisted the DOH to conduct a rapid assessment survey on 2007 LGU (local government unit) procurements covering all provinces and cities (N: 122). The result of the survey showed that 55% of the LGUs (N: 67) procured contraceptives at or above the level of donated contraceptives they used to receive before the phase out of USAID's donation. The remaining 45% (N: 55) did not procure. In 2004, the DOH issued the guidelines on the management of the donated commodities under the Contraceptive Self-Reliance Strategy which includes the guidelines and schedule for phasing out of contraceptive donations at the national and local level. The LGUs were divided into three batches, the first being the richest LGUs and the last being the poorest LGUs. It should be noted that while the last shipment of USAID donated contraceptives (excluding IUDs) was in September 2007, the last DOH shipment to the third batch of LGUs to be phased out was in the quarter October-December 2008. Yes Yes Yes No Yes Yes No No Not available Yes Yes Yes No No Yes No No Not available Not available Yes National Family Planning Policy and others still in effect Yes Yes Yes Taxes/duties. Donated commodities, socially marketed commodities and commercially marketed contraceptives are subject to taxes and duties. Taxes/duties on donated contraceptives consigned to the Department of Health (such as those donated by USAID) are shouldered by the Government of the Philippines through automatic appropriations of the Department of Budget Management. Taxes/duties of socially marketed contraceptives consigned to the Department of Health are paid by the Department of Health. Taxes/duties on socially marketed contraceptives that are not consigned to the Department of Health are paid by the organizations (NGOs) marketing those contraceptives. Taxes/duties on commercially marketed contraceptives are paid by the manufacturer, importer or trader. Pharmacy Law. This law bans brand advertising of ethical/regulated drugs. Hormonal contraceptives (oral pills, injectables and hormonal IUDs) are classified as ethical/regulated drugs, therefore, brand advertising is banned. Copper T IUDs are classified as medical device and registered as unregulated product and not subject to the same restrictions. There is no prohibition on brand advertising of Copper T IUDs. The pharmacy law also prohibits dispensing of ethical/regulated drugs without prescription. Yes Oral contraceptive pills Only trained health workers are allowed to dispense. Dispensing without prescription is not allowed. However, since public facilities are headed by doctors who supervise all health workers in the facilities, prescriptions are easy to obtain. However, in practice, OCPs can be obtained without prescription from pharmacies/drugstores. Only trained health service providers are allowed to dispense. Service providers other than physicians, such as midwives, cannot dispense without a prescription. However, most midwives, and all PHilHealth accredited midwives have back-up physicians who write the prescriptions. Injectables Only trained health workers are allowed to dispense. Dispensing without prescription is not allowed. However, since public facilities are headed by doctors who supervise all health workers in the facilities, prescriptions are easy to obtain. However, in practice, injectables can be obtained without prescription from pharmacies / drugstores. Only trained health service providers are allowed to dispense. Service providers other than physicians, such as midwives, cannot dispense without a prescription. However, most midwives, and all PHilHealth (Phil. Health Insurance Corp) accredited midwives have back-up physicians who write the prescriptions. IUDs Only trained health workers are allowed to dispense. Dispensing of hormonal IUD without prescription is not allowed. However, since public facilities are headed by doctors who supervise all health workers in the facilities, prescriptions are easy to obtain. Barangay Health Station (the lowest level of public health facility) health service providers do not dispense IUDs. Only trained health service providers are allowed to dispense. Service providers other than physicians, such as midwives, cannot dispense without a prescription. However, most midwives, and all PHilHealth (Phil. Health Insurance Corp) accredited midwives have back-up physicians who write the prescriptions. No No No No N/A N/A Yes All methods for all sectors. (See Question 21) However, if an NGO has obtained tax exemption, payment of taxes and duties may be waived. Customs duties on condoms and hormonal contraceptives is 3% of total value. Customs duties on Copper T IUDs is 15% of total value. All contraceptives are subject to 12% Value Added Tax (VAT). However, if an NGO has obtained tax exemption, payment of taxes and duties may be waived. Yes&No Yes&No Yes&No Because of devolution, LGUs craft their own policies. Policies are not uniform across LGUs. In general, services in public sector facilities are provided for free but there are some LGUs that have fee for service policies in some of their facilities. In general, commodities in public sector facilities are provided for free but there are some who charge at full or subsidized prices. Only a few LGUs have policies on client segmentation. While this is the case, other funding mechanisms for paying of contraceptives are available to public sector clients. If the client is a PhilHealth member, the client can avail of three PhilHealth benefit packages: (1) Maternity Care Package for normal deliveries that includes the first cycle of oral contraceptives and the first dose of injectable postpartum; (2) IUD Package; and (3) Voluntary Surgical Sterilization Package for bilateral tubal ligation and vasectomy. A significant number of LGUs have enrolled their poor constituents with PhilHealth. N/A N/A N/A N/A N/A Document not available on IMF's website. 2008 Yes Yes Yes No No No No No No N/A Yes Yes No Yes No No Yes No No Not available Yes N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 1) Contraceptive Security vs. Contraceptive Self-Reliance. The Philippines addresses Contraceptive Security in the context of eliminating unmet need for family planning given the phase out of USAID contraceptive donation. This requires broadening the definition to include the support systems for the implementation of the family planning program and addressing issues of sustainability. Hence, the DOH has embarked on Contraceptive Self-Reliance, rather than Contraceptive Security. This strategy includes, in addition to government financing and procurement of commodity based contraceptive methods (pills, injectables, IUDs, condoms, and others) promotion and financing of other methods (bilateral tubal ligation, vasectomy, lactational amenorrhea, natural family planning, and others), expanding distribution coverage, and mobilizing private sector resources in the provision of family planning services and commodities. This approach to Contraceptive Security may have contributed to maintaining the Contraceptive Prevalence Rate in the Philippines steady despite USAID's phase out of contraceptive donation. And since the Government's objective is to ensure the country's self-sufficiency in the provision of family planning services and commodities, the prospect for sustainability is high even without external contraceptive donations. 2) Protecting the Poor. The poor should be protected in the process of achieving Contraceptive Self-Reliance. The issue of targeting financing and provision for the poor is not just an issue of commitment and willingness to fund. It also involves many operational issues such as determining who are poor and entitled to free services, how the non-poor should be served, and how will these issues be handled by local health systems that are supposed to be for everyone in the community. Europe and Asia Russia No N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No No 0.0 No 0.0 No 0.0 No N/A 0.0 0.0 Not available 0% N/A N/A N/A N/A N/A The Russian federal government stopped its federal family planning program back in 1998 including the procurement of contraceptives. However, some regions and municipalities provide limited contraceptives (both in range and number) to vulnerable groups of population mostly under mandatory health insurance programs and small donations from pharmaceutical firms. However, a range of modern contraceptive methods are widely available through pharmacies, including in the public health care facilities for a fee/purchase. Even though FP is not included in the provision of health services, some USAID target regions cover/reimburse FP counseling under the regional mandatory health insurance plans. Yes Yes Yes No Yes Yes Yes Yes Yes No No No No No Yes No No No contraceptive patch Evra (by Jancenn Cilag) and vaginal ring Novaring (by Organon) No N/A N/A N/A N/A Yes It's illegal to advertise a specific contraceptive brand as well as any other prescription drug in mass media (e.g., no ads on TV or popular public journals, newspapers). Private pharmaceutical companies can promote specific brands in professional health care literature and faciliites. However, public campaigns on contraception in general are allowed. Yes Contraceptives Only pharmacies are allowed to sell contraceptives and only OB/GYNs can prescribe them. (Only condoms are non-prescriptive items.) (Although other contraceptives are prescription drugs, they are universally available over the counter in Russian pharmacies. This contradiction is noted but it does exist.) Only pharmacies are allowed to sell contraceptives and only OB/GYNs can prescribe them. Only condoms are non-prescriptive items. N/A N/A N/A N/A N/A N/A No No No Yes for all methods and all sectors. 10% custom/import duties, 10% VAT No Yes No N/A N/A N/A N/A N/A N/A Document not available on IMF's website. Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Contraception in Russia is a sensitive topic due to the demographic crisis and other reasons such as traditionally negative perception of hormonal contraception among policy makers, professionals and general population. Europe and Asia Rwanda Yes Family Planning Logistics Committee Meeting Yes PSI Yes ARBEF Yes Associations of private pharmacists and physicians Yes UNFPA, GTZ/KfW, USAID, GFATM Yes UNFPA Yes Maternal and Child Health Task Force and Pharmacy Task Force Yes CAMERWA No 1-3 times Yes No Yes Yes 2008 Yes $500,000 No 0.0 Yes $1,278,600 No N/A 0.0 $1,778,600 $2,878,191 38% CPT (PipeLine Annual Costs by Supplier) Other N/A N/A UNFPA UNFPA was the procurement agent for the contraceptives purchased with the government funding (own budget and basket funds). For the first time, this year (2009) the government is asking CAMERWA (MOH procurement unit) to buy contraceptives on their behalf with GFATM funds. Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Cycle Beads Yes RHCS Strategy (draft) 11/2008-12/2012 No No Yes The policy on free distribution of contraceptives in the public sector and the subsidy of products in the social marketing limit the ability for the private commercial sector to provide contraceptives No N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No No N/A N/A Yes For all methods in the public sector: MOH pays storage and distribution fees to the central warehouse CAMERWA 9% of the product value No No N/A N/A 2008 Yes Yes Yes No 2005 Yes Yes Yes Yes Yes Yes Yes No Not available N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes No No No No No Yes Yes Central and district January 2008-December 2008 Africa Senegal Yes Comité Nationale de Securisation des Produits Contraceptifs Yes Agence pour le Développement de Marketing Social (ADEMAS) - USAID Implementing Partner (IP) Yes Association Sénégalaise pour le Bien-Etre Familial (ASBEF) - IPPF affiliate, IntraHealth (USAID IP), CCF & consortium (USAID IP) No N/A Yes USAID, JICA, KfW, UNFPA Yes WHO, UNFPA Yes Division de la Santé de la Reproduction (FP/RH/MCH Division), Division de la Lutte Contre le SIDA (HIV/AIDS Division), Direction de la Pharmacie et du Medicament, Laboratoire Nationale de Controle Yes Pharmacie Nationale de l'Approvissionment (PNA) No 1-3 times No No Yes No Not available No 0.0 No 0.0 No 0.0 No N/A 0.0 0.0 Not available 0% CPT N/A N/A N/A N/A It has been reported that for the last 3 years, funding was allocated to the Central Medical Stores, but was returned to Treasury unspent. Last year this was reportedly 45 million Fcfa (about $90,000). When funding is available, the Pharmacie National de l'Approvissionment does the procurement. Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No Yes Yes Yes Yes No Yes Standard Days Method (Cyclebeads) Yes Programme National de Développement Sanitaire (PNDS) and Strategie Nationale de Securisation de Produits Contraceptifs (National Contraceptive Security Strategy) 2009-2014 and 2007-2011 Yes Yes Yes To access contraceptives (namely OCs) in the private sector, a prescription is required. There are also advertising bans for the commercial sector - only generic advertising is permitted. The Union Monetaire Ouest Africain also imposes additional regional duties on medical products. Yes Oral contraceptive pills Must be dispensed by doctors, nurses or midwives. (USAID has a pilot demonstration project on the initial offer of pills at the community level) On the books, there is a prohibition on counseling for, prescribing and dispensing contraceptives in the same private facility. (A private sector doctor can write a prescription and counsel, but cannot provide the contraceptive. However, in practice this may not always be abided by in pharmacies. Injectables Doctors, nurses and midwives only Not sold in the private sector yet (USAID now has an MOU with Pfizer for the social marketing of Depo-provera in the private sector - project will commence this year) but the prohibition described earlier (on counseling for, prescribing and dispensing contraceptives in the same private facility) will have particular implications on the provision of hormonal injectables through private clinics. N/A N/A N/A No No No Not available Not available Not available Yes All methods in the private sector. 20% duties and 18% TVA for IUD only. 2,7% for all goods entering in UEMOA (Taxe Commun à l'Importation) areas. Yes Yes Yes At the District level, there are local mechanisms for indigent clients. 2007 Yes No No No USAID & partners have been trying to incorporate CPR and FP as key areas for inclusion in the PRSP. 2003 Yes Yes Yes Yes Yes Yes No No Yes spermicide Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes to an extent N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 1) Currently there is a parallel distribution for essential drugs, contraceptive commodities and condoms. Though contraceptives now form part of the essential drug list, they are not distributed by the Pharmacie Nationale de l'Approvissionment (PNA). In the recent MOH Annual meeting, a clear directive was given for integration. 2) It was recently reported that for 3 consecutive years, funds have been earmarked in the national budget for the purchase of contraceptives. However, these funds have been returned to the Treasury by the Pharmacie Nationale de l'Approvissionment (PNA) (a reported 45 million Fcfa (about $90,000)). This issue has been raised and was also discussed at the Annual MOH Meeting. 3) There needs to be better coordination with UN partners in the National Contraceptive Security Committee on the development of contraceptive procurement tables. Africa Tanzania Yes Reproductive and Child Health Section Yes TMARC (AED), PSI Yes John Snow Inc., EngenderHealth, UMATI (IPPF), Marie Stopes Yes World Wide Movers (Agility's local rep) Yes USAID Yes UNFPA Yes RCHS, NACP Yes MSD No 3-5 times No No Yes Yes July 2007-June 2008 Yes $870,000 No 0.0 Yes $870,000 No N/A 0.0 $1,740,000 $1,000,000 64% RCHS Government MSD Yes N/A Total need for the fiscal year was estimated at $6.6 million - $1 million to be provided by USAID, $5.6 million to be provided by GOT and Basket funds. USAID provided their $1 million contribution in Lofemenal and IUDs. Of the GOT/Basket requirement, only $1.74 million materialized (half of this was internally generated, half basket). The rest remained an uncovered gap. Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes No No Yes Yes Yes No Yes Vasectomy and tubal ligation No N/A N/A N/A N/A Yes OCs cannot be sold in chemist shops, only Type 1 pharmacies. Brand-specific advertizing for OCs is not allowed since they are considered a prescription-only product. Yes Oral contraceptive pills N/A Pharmacies and ADDOs (Accreditied Drug Dispensing Outlets) IUDs and Implants restricted to Public Health Nurse of higher grade MOH staff N/A N/A N/A N/A No No No No N/A N/A No N/A N/A No No N/A N/A 2006 Yes No No No 2007 Yes Yes Yes Yes Yes Yes Yes No Not available Not available Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes No No No No No No Yes No Central and zonal January 2008-December 2008 Africa Uganda Yes Reproductive Health Commodity Security Committee Yes AFFORD/UHMG (Uganda Health Marketing Group), PSI, MSI Uganda Yes Reproductive Health Uganda, MSI, FHI No N/A Yes USAID, UNFPA Yes UNFPA Yes Reproductive Health Division Yes National Medical Stores Yes 6 or more times No Yes Yes Yes July 07-June 08 Yes $280,000 No 0.0 No 0.0 No N/A 0.0 $280,000 $1,657,172 14% CPT and PipeLine reports Government National Medical Stores Yes N/A Whereas the government provides some funds for contraceptive procurement, the amount allocated has not increased over the years. Also, there is pressure to procure other RH commodities using the same funds, which could potentially reduce the amount available for contraceptives. The quarterly release of funds hinders bulk procurement. The RH division is forced to wait for the money to accumulate, and sometimes loses the money if they are unable to use it by the end of the financial year. The lead time for the NMS that does the procurement on behalf of MOH is also long, sometimes up to one year. Yes Yes Yes Yes Yes Yes No Yes Not available Yes Yes Yes Yes Yes Yes No Yes Not available Not available Yes FP Advocacy Strategy 2005-2010 Yes Yes No N/A Yes Injectables N/A The National Drug Policy does not allow drug shops to dispense injectables including Depo-Provera N/A N/A N/A N/A N/A N/A No No No Not available Not available Not available Yes Drugs are generally duty free, but a verification fee of 2% is applied by the National Drug Authority to all drug imports (including contraceptives) for the public, NGO and commercial sectors. (The prospective importer pays the fee and provides a copy of the Profoma invoice to NDA which "verifies" that the medicine to be imported is registered and hence allowed to be imported in Uganda. The NDA then provides import authorization if satisfied.) 2% FOB Value No No N/A N/A 2005 Yes No No No 2007 Yes Yes Yes Yes No No No No Not available Not available No Yes No No Yes Yes Yes Yes Yes Yes Yes No No No No No No No Yes Central January 2008-December 2008 The main challenges to Contraceptive Security in Uganda currently include limited government financing for contraceptive procurement, ineffective coordination and weakness in the supply chain. The country is the final stages of developing a Reproductive Health Commodity Security Strategy to guide all partners in addressing the current challenges to CS in a coordinated and holistic way. Africa Ukraine Yes National committee for implementation of the State Program Reproductive Health of the Nation up to 2015 (SPRHN). No N/A Yes All-Ukrainian Federation of Young Doctors, All-Ukrainian Women's Society, National Medical Academy for Postgraduate Education, & Academy of Medical Science No N/A Yes USAID, through Together for Health (TfH) and Maternal and Infant Health (MIHP) projects Yes UNFPA Yes MCH Department/RH Division & Financial and Economic Department No N/A No 1-3 times Yes No Yes Yes 2008 Yes $225,000 Yes $200,000 No 0.0 No N/A 0.0 $425,000 $160,000 73% State Program "Reproductive Health of the Nation until 2015” (SPRHN) contraceptive forecasting calculations/estimates made by the Ministry of Health Government Ministry of Health at central level in Kiyv and Oblast Health Administrations Yes N/A Since its start, the USAID funded project “Together for Health” (TfH, 2005-2010), implemented by JSI, worked closely with MOH and other governmental and non-governmental counterparts to develop the State Program "Reproductive Health of the Nation until 2015” (SPRHN) approved by the Cabinet of Ministers in December 2006. The SPRHN includes line items for procurement of contraceptives from National and Local government budgets. Since 2008 National and Local Governments have been partially mobilizing the budgeted resources to procure contraceptives. The bulk of financial resources for procurement of contraceptives has been coming from local government budgets. Regardless the start was an optimistic one, currently it looks like due to the budget cuts in government health expenditures the SPRHN will have its funding dramatically reduced for 2009 and 2010. Therefore, even though the line item in the state budget for contraceptive procurement will remain, future funding is very uncertain. Yes No Yes No Yes Yes No No Yes No No No No No No No No No Vaginal ring, patch, hormonal IUD, and spermicides. No N/A N/A N/A N/A Yes All contraceptives in Ukraine, excluding condoms, should be prescribed by doctors, and can be distributed through health facilities. Only ObGyn's are allowed to insert IUDs. Contraceptives are taxed in the same way as all other drugs. Advertising for contraceptives as well as for other prescribed drugs is neither permitted in mass-media nor through direct marketing. While all of these policies might be considered significant barriers, they are seen as normal commercial practices often in line with WHO and European regulations. The contraceptive manufacturers operating in Ukraine indicate that the incapacity to conduct direct advertising for contraceptives to doctors and clients is a significantr barrier for contraceptive provision in the country. Yes Hormonal contraceptives (orals, injectables, ring, patch, etc.) Only governmental clinics can dispense free products or prescribe them for purchase in governmental pharmacies, based on prescription. Private sector physicians can prescribe contraceptives. Licensed private pharmacies can sell them based on prescription. N/A N/A N/A N/A N/A N/A No No No No N/A N/A Yes All methods FP commodities sold in the commercial sector are taxed the same way as other drugs (custom taxation, VAT, etc…). The donated FP commodities are free from any duties and fees, if they are brought as humanitarian assistance to Ukraine and provided they are registered in the country. No No N/A Although there are no official charges to the client for FP services and/or contraceptives in public sector, there is a "culture" of under the table payment for any health services in Ukraine including FP services. Payments vary depending on the place of client's residency (urban/rural), the facility accessed (rayon/small city/oblast capital), client's income and the official rank of a health provider (FD, FP doctor, Ob-Gyn, professor). IUD insertion is considered to be a higher level service, and additional payment is expected. 2001-2009 No No No No Seems to only be in Ukrainian, not in English too. In Ukrainian at http://zakon.nau.ua/doc/?code=637/2001. Not available on IMF's website. 2009 Yes Yes Yes No (not registered) No No No Yes No N/A No Yes No Yes Yes Yes Yes No No No Yes N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A The overall Contraceptive Security in Ukraine is improving as can be seen through this survey or by looking at the latest 2007 Demographic Health Survey data that shows increase in the use of modern methods over the last eight years. However, there are still many issues that need to be addressed in the future, i.e., improvement of the government procurement process that secures public funding for FP programs and commodities; expansion of method mix; and better integration of FP with STI and HIV/AIDS services. Currently the US government is the only supporter of the Government of Ukraine's efforts to improve availability of affordable contraceptives. With USAID's assistance, the MOH have made important steps forward in the procurement process. However, due to a limited number of international partners and because of the current financial crisis future improvements in this area are questionable. The government funding for FP/RH in Ukraine as well as other health programs has been drastically reduced in 2009. In addition, inflation of the past years is pushing up the private sector contraceptive prices to levels which are not affordable by many people in Ukraine. USAID-supported TfH project played an active role in moving forward the CS agenda at the political and operational levels. Through an innovative public-private partnership that involved, in addition to MOH, a number of contraceptive manufacturers, TfH is working closely with the government of Ukraine to implement a range of activities aimed at expanding the contraceptive market. Europe and Asia Yemen Yes Reproductive Health Technical Group with sub committee for CS Yes Marie Stopes Yes Marie Stopes, German Development Bank No N/A Yes RNE, World Bank, USAID Yes UNFPA, WHO Yes RH and FP directories Yes at the MOPHP Yes 3-5 times Yes Yes Yes Yes 2008 No 0.0 Yes $2,500,000 Yes $723,613 No N/A 0.0 $3,223,613 Not available Not available Deputy Minister and RHInterchange Other N/A N/A UNFPA Yes Yes Yes Yes Yes Yes Yes Yes Not available Yes Yes Yes Yes Yes Yes Yes Yes Not available Not available Yes Reproductive Health Commodity Security framework Not available Yes No No N/A No N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No Not available Not available Not available No N/A N/A No No N/A N/A 2002 Yes No No No 2001 Yes Yes No No Yes Yes No No Yes spermicide No Yes No Yes Yes Yes Yes No Yes No No N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Europe and Asia Zambia Yes Reproductive Health Commodity Security Committee Yes Society for Family Health Yes Planned Parenthood Association (PPAZ), Marie Stopes International, USAID | DELIVER PROJECT No N/A Yes USAID, DFID, HSSP Yes WHO, UNFPA Yes Reproductive Health Unit, MoH Yes Medical Stores Limited No 1-3 times No No Yes Yes 2008 Yes $275,000 No 0.0 No 0.0 Yes DFID $275,000 $550,000 $3,131,530 15% CPT, Pipeline Database, MOH Government MoH Procurement Unit No N/A While the budget line for the procurement of Reproductive Health (RH) commodities exists, the funds are usually not adequate. Procurement of contraceptives competes with procurement of other non-contraceptive RH commodities. The procurement experience in 2008 was characterised by delays of up to 2 months and 6 months. Yes Yes Yes Yes Yes Yes Yes Yes Not available Yes No No No No Yes Yes No Not available Not available No N/A N/A N/A N/A Yes 1. Advertising ban 2. Distribution restricted through pharmacies and private clinics except for condoms which can also be sold in grocery and drug stores stores. Yes Hormonal contraceptives Restricted to trained health care providers to dispense following counseling Restricted to Chemists, pharmacies and private clinics to sell and dispense. IUDs Restricted to trained health care providers to insert following counseling Restricted to private clinics Implants Restricted to trained health care providers to provide following counseling Restricted to private clinics No No No Not available Not available Not available No N/A N/A No No N/A N/A 2007 No No No No 2004 Yes Yes Yes Yes Yes Yes Yes Yes Not available Not available Yes Yes Yes Yes Yes Yes Yes No Yes No Yes Yes No No No No No No Yes Central 2008-2009 Africa Zimbabwe Yes Reproductive Health Commodity Security Committee Yes PSI Yes Population Services Zimbabwe (Marie Stopes affiliate) No N/A Yes USAID, DFID, UNFPA Yes UNFPA Yes RH unit of the Ministrry of Health & Child Welfare (MOHCW, the Zimbabwe National Family Planning Council (ZNFPC), Medicines Control Authority of Zimbabwe (MCAZ) Yes NatPharm No 1-3 times Yes Yes No No 2008 No 0.0 No 0.0 No 0.0 No N/A 0.0 0.0 $8,808,638 0% PipeLine Shipment Summary (for non-govt spending) N/A N/A N/A N/A Yes Yes Yes Yes No Yes Yes No Not available No No Yes Yes Yes Yes Yes Yes Not available Not available Yes Not available Not available Yes Yes No N/A Yes Injectables CBDs cannot dispense long term methods Only registered nurses and doctors can dispense. Implants Only clinical offices and doctors can dispense Only doctors can dispense. IUDs Non-doctors cannot Only doctors can dispense. No No No No N/A N/A No N/A N/A No No N/A In theory all MOHCW institutions offer these commodities and services for free, although that may have changed in the course of the recent financial crisis. Local authority health facilities,i.e. municipal & city, charge for the services. (the local authority clinics, e.g., those owned by the city of Harare and Bulaway and other smaller minicipalities are under ddifferent management and rules than the central government MOHCW owned and operated clinics.) N/A N/A N/A N/A N/A Document not available on IMF's website. 2006 Yes Yes Yes Yes Yes Yes Yes Yes Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available Not available N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Africa Notes: N/A = not applicable, Not available = data not available To jump to the Introduction sheet, click here. Afghanistan Note: Click on "1" in the top lefthand corner to see just the main questions and "2" to see all of the questions. To jump to the Introduction sheet, click here. Contraceptive Security Indicator Questions 2009 Afghanistan Comments Leadership and Coordination L1. Is there a national committee that works on contraceptive security? No L1. Is there a national committee that works on contraceptive security? L1a. What is the name of the committee? N/A L1a. What is the name of the committee? L2. Are the following organizations represented on the committee? L2. Are the following organizations represented on the committee? L2a.Are social marketing organizations on the committee? N/A L2a.Are social marketing organizations on the committee? L2ai. Names of social marketing organizations on the committee N/A L2ai. Names of social marketing organizations on the committee L2b. Are NGOs on the committee? (e.g. service delivery, advocacy, Planned Parenthood afiliate, Marie Stopes afiliate) N/A L2b. Are NGOs on the committee? (e.g. service delivery, advocacy, Planned Parenthood afiliate, Marie Stopes afiliate) L2bi. Names of NGOs on the committee N/A L2bi. Names of NGOs on the committee L2c. Are commercial sector organizations on the committee? (e.g. pharmacy associations, manufacturers) N/A L2c. Are commercial sector organizations on the committee? (e.g. pharmacy associations, manufacturers) L2ci. Names of commercial sector organizations on the committee N/A L2ci. Names of commercial sector organizations on the committee L2d. Are donors on the committee? N/A L2d. Are donors on the committee? L2di. Names of donors on the committee N/A L2di. Names of donors on the committee L2e. Are UN agencies on the committee? N/A L2e. Are UN agencies on the committee? L2ei. Names of UN agencies on the committee N/A L2ei. Names of UN agencies on the committee L2f. Are Ministry of Health units on the committee? (e.g. logistics, RH, FP, MCH units) N/A L2f. Are Ministry of Health units on the committee? (e.g. logistics, RH, FP, MCH units) L2fi. Names of Ministry of Health units on the committee N/A L2fi. Names of Ministry of Health units on the committee L2g. Is the Central Medical Store or Central Warehouse on the committee? N/A L2g. Is the Central Medical Store or Central Warehouse on the committee? L2gi. Names of Central Medical Store or Central Warehouse on the committee N/A L2gi. Names of Central Medical Store or Central Warehouse on the committee L2h. Is the Ministry of Finance on the committee? N/A L2h. Is the Ministry of Finance on the committee? L3. How many times did the committee meet during the last year? (0, 1-3, 3-5, or 6+) N/A L3. How many times did the committee meet during the last year? (0, 1-3, 3-5, or 6+) L4. Does committee have legal status? N/A L4. Does committee have legal status? L5. Is there a Contraceptive Security "champion"? No L5. Is there a Contraceptive Security "champion"? Finance and Procurement (Capital) Finance and Procurement (Capital) F1. Is there a government budget line item for the procurement of contraceptives? No F1. Is there a government budget line item for the procurement of contraceptives? F2. Were government funds spent on contraceptives in the most recent complete fiscal year? (including internally generated funds, World Bank credits or loans, basket funds, or other government funds) No F2. Were government funds spent on contraceptives in the most recent complete fiscal year? (including internally generated funds, World Bank credits or loans, basket funds, or other government funds) F2a. Time period of funding (should be the same for all sources of funds) N/A F2a. Time period of funding (should be the same for all sources of funds) F2b. Did the government spend internally generated funds (for example, from public sector sources or taxes) for contraceptive procurement? No F2b. Did the government spend internally generated funds (for example, from public sector sources or taxes) for contraceptive procurement? F2bi. What was the amount of internally generated funds spent on contraceptive procurement? (in US$) $0 F2bi. What was the amount of internally generated funds spent on contraceptive procurement? (in US$) F2c. Did the government spend World Bank credits or loans for contraceptive procurement? No F2c. Did the government spend World Bank credits or loans for contraceptive procurement? F2ci. What was the amount of World Bank credits or loans spent on contraceptive procurement? (in US$) $0 F2ci. What was the amount of World Bank credits or loans spent on contraceptive procurement? (in US$) F2d. Did the government spend basket funds for contraceptive procurement? No F2d. Did the government spend basket funds for contraceptive procurement? F2di. What was the amount of basket funds spent on contraceptive procurement? (in US$) $0 F2di. What was the amount of basket funds spent on contraceptive procurement? (in US$) F2e. Did the government spend other funding sources for contraceptive procurement? (Including only funds given to the government used for contraceptive procurement. This does NOT include contraceptive supplies donated to the government (so for example, NOT from USAID)) No F2e. Did the government spend other funding sources for contraceptive procurement? (Including only funds given to the government used for contraceptive procurement. This does NOT include contraceptive supplies donated to the government (so for example, NOT from USAID)) F2ei. Specify source of other government funding N/A F2ei. Specify source of other government funding F2eii. What was the amount of other government funds spent on contraceptive procurement? (in US$) $0 F2eii. What was the amount of other government funds spent on contraceptive procurement? (in US$) F2f. In total, how much funding did the government spend on contraceptive procurement (including internally generated funds, World Bank credits or loans, basket funds, and other government funds)? (in US$) $0 F2f. In total, how much funding did the government spend on contraceptive procurement (including internally generated funds, World Bank credits or loans, basket funds, and other government funds)? (in US$) F3. What was the total amount of non-government funds spent on contraceptive procurement? (in US$) (This includes contraceptive supplies donated directly to the government, procured by donors (e.g. USAID). This is actual supplies donated, not funds. How much were these supplies worth?) Not Available F3. What was the total amount of non-government funds spent on contraceptive procurement? (in US$) (This includes contraceptive supplies donated directly to the government, procured by donors (e.g. USAID). This is actual supplies donated, not funds. How much were these supplies worth?) F4. Of the total amount of financing spent on public sector contraceptives for the most recent complete fiscal year, what percent was covered by government funding (including internally generated funds, World Bank credits or loans, basket funds, and other government funds)? (F2f./(F2f.+F3.) (in US$) Not Available F4. Of the total amount of financing spent on public sector contraceptives for the most recent complete fiscal year, what percent was covered by government funding (including internally generated funds, World Bank credits or loans, basket funds, and other government funds)? (F2f./(F2f.+F3.) (in US$) F4a. Specify data source (e.g. Contraceptive Procurement Table (CPT), National Health Account (NHA), Reproductive Health Account (RHA), etc.) N/A F4a. Specify data source (e.g. Contraceptive Procurement Table (CPT), National Health Account (NHA), Reproductive Health Account (RHA), etc.) F5. Which entity does procurement: government or other? N/A F5. Which entity does procurement: government or other? F5a. Specify government entity that does procurement (e.g. Central Medical Store, MOH logistics unit, MOH procurement unit, etc.) N/A F5a. Specify government entity that does procurement (e.g. Central Medical Store, MOH logistics unit, MOH procurement unit, etc.) F5ai. Is this procurement entity a parastatal? N/A F5ai. Is this procurement entity a parastatal? F5b. Specify non-government entity that does procurement (e.g. third-party agent such as UNFPA or Crown Agents, or private entity) N/A F5b. Specify non-government entity that does procurement (e.g. third-party agent such as UNFPA or Crown Agents, or private entity) F6. Comments about government procurement and financing Not Available F6. Comments about government procurement and financing Commodities Commodities C1. Are the following contraceptive methods dispensed in public sector facilities? C1. Are the following contraceptive methods dispensed in public sector facilities? C1a. Combined oral hormonal pills dispensed in public sector facilities? Yes C1a. Combined oral hormonal pills dispensed in public sector facilities? C1b. Progestin-only oral hormonal pills dispensed in public sector facilities? Yes C1b. Progestin-only oral hormonal pills dispensed in public sector facilities? C1c. Hormonal injections dispensed in public sector facilities? Yes C1c. Hormonal injections dispensed in public sector facilities? C1d. Hormonal implants dispensed in public sector facilities? No C1d. Hormonal implants dispensed in public sector facilities? C1e. Intrauterine devices (IUDs) dispensed in public sector facilities? Yes C1e. Intrauterine devices (IUDs) dispensed in public sector facilities? C1f. Male condoms dispensed in public sector facilities? Yes C1f. Male condoms dispensed in public sector facilities? C1g. Female condoms dispensed in public sector facilities? No C1g. Female condoms dispensed in public sector facilities? C1h. Emergency contraceptive oral hormonal pills dispensed in public sector facilities? No C1h. Emergency contraceptive oral hormonal pills dispensed in public sector facilities? C1i. Other contraceptives dispensed in public sector facilities? (See question C3 for name) Not available C1i. Other contraceptives dispensed in public sector facilities? (See question C3 for name) C2. Are the following contraceptive methods dispensed in social marketing or NGO facilities? C2. Are the following contraceptive methods dispensed in social marketing or NGO facilities? C2a. Combined oral hormonal pills dispensed in social marketing or NGO facilities? Yes C2a. Combined oral hormonal pills dispensed in social marketing or NGO facilities? C2b. Progestin-only oral hormonal pills dispensed in social marketing or NGO facilities? Yes C2b. Progestin-only oral hormonal pills dispensed in social marketing or NGO facilities? C2c. Hormonal injections dispensed in social marketing or NGO facilities? Yes C2c. Hormonal injections dispensed in social marketing or NGO facilities? C2d. Hormonal implants dispensed in social marketing or NGO facilities? No C2d. Hormonal implants dispensed in social marketing or NGO facilities? C2e. Intrauterine devices (IUDs) dispensed in social marketing or NGO facilities? Yes C2e. Intrauterine devices (IUDs) dispensed in social marketing or NGO facilities? C2f. Male condoms dispensed in social marketing or NGO facilities? Yes C2f. Male condoms dispensed in social marketing or NGO facilities? C2g. Female condoms dispensed in social marketing or NGO facilities? No C2g. Female condoms dispensed in social marketing or NGO facilities? C2h. Emergency contraceptive oral hormonal pills dispensed in social marketing or NGO facilities? No C2h. Emergency contraceptive oral hormonal pills dispensed in social marketing or NGO facilities? C2i. Other contraceptives dispensed in social marketing or NGO facilities? (See question C3 for name) Not available C2i. Other contraceptives dispensed in social marketing or NGO facilities? (See question C3 for name) C3. What is the name of the "other" contraceptive(s) dispensed in public sector, social marketing, or NGO facilities (referred to in question C1i and/or C2i)? N/A C3. What is the name of the "other" contraceptive(s) dispensed in public sector, social marketing, or NGO facilities (referred to in question C1i and/or C2i)? Policy (Commitment) Policy (Commitment) P1. Is there a contraceptive security or reproductive health commodity security strategy or is contraceptive security explicitly included in a country strategy? No P1. Is there a contraceptive security or reproductive health commodity security strategy or is contraceptive security explicitly included in a country strategy? P1a. Strategy name N/A P1a. Strategy name P1b. Years strategy covers N/A P1b. Years strategy covers P1c. Is the strategy formally approved by the Ministry? N/A P1c. Is the strategy formally approved by the Ministry? P1d. Is the contraceptive security strategy being implemented? N/A P1d. Is the contraceptive security strategy being implemented? P2. Are there policies that affect the ability of the private sector (commercial sector or NGOs) to provide contraceptives? (e.g. price controls, distribution limitiations, taxes/duties, advertising bans) No P2. Are there policies that affect the ability of the private sector (commercial sector or NGOs) to provide contraceptives? (e.g. price controls, distribution limitiations, taxes/duties, advertising bans) P2a. Policy description N/A P2a. Policy description P3. Do policies or regulations exist that restrict who can dispense or sell particular contraceptive methods? Yes P3. Do policies or regulations exist that restrict who can dispense or sell particular contraceptive

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