INFO Project Contraceptive Security: Ready Lessons

Publication date: 2004

Acknowledgements The Ready Lessons Overview and Lessons 1-5 were prepared by Tanvi Pandit and Alan Bornbusch. Carolyn Hart, David Sarley, Raja Rao, Daniel Thompson, Gregory Roche, Susan Scribner, Francoise Armand, Jeffrey Sine, Carol Shepherd, Babes Perez, Juan Negrette, Karen Angelici, Caroline Quijada, Tania Dmytraczenko, Joan Robertson, and Shannon Rogers provided valuable material. Thanks are due to Susan Wright, Nancy McCharen, Charles Llewelyn, Molly Gingerich, Steve Hawkins, Mark Rilling, Sandra Jordan, Bryant Robey, Nora Quesada, Gregorio Pérez-Palacios, Lori Ashford, Charlotte Feldman-Jacobs, and the Contraceptive Security Working Group, who reviewed drafts and offered useful comments. Francine Mueller and Linda Sadler provided assistance with layout and design. The preparation and publication of Ready Lessons has been funded by USAID under the following projects: Deliver Project (HRN-C-00-00-00010-00), Health Communication Partnership (GPH-A-00-02-00008-00), Information and Knowledge for Optimal Health (GPH-A-00-02-00003), Measure Communication Project (HRN-A-00-98-00001-00), Policy II Project (HRN-C-00-00-00006-00), Commercial Market Strategies Project (HRN-C-00-98-00039-00), and Partners for Health Reformplus (HRN-C-00-00019-00). Contraceptive Security Ready Lessons Overview Many countries face the challenge of meeting people’s needs for contraceptives and condoms on a sustainable basis. Demand is rising, strategies that will establish and maintain secure supplies of contraceptives and condoms. Contraceptive Security: Ready Lessons but financing is not keeping pace. Local and national capacities key to ensuring availability of supplies are also often inadequate to the task. Countries need to develop and implement suggests some practical steps USAID Missions and their partners can take to promote and sup­ port country-led programs for contraceptive security. Contraceptive Security Defined Contraceptive security exists when people are able to choose, obtain and use high quality contraceptives and condoms whenever they want them for family planning and HIV/AIDS/STI prevention. This definition emphasizes three concerns: • First and foremost, clients. Unless people can choose, obtain, and use the contraceptive methods and condoms they want, there can be no contraceptive security. Access to free or subsidized products is a special concern to meet the needs of the poor and vulnerable. Participation by the commercial sector is also key. Programs that are effective in increasing contraceptive security will attend to the entire market of current and potential users – from those who require free contraceptives and condoms to those who can and will pay for commercial products. • Second, commodities. Contraceptive security means that users are able to make informed choices from a full range of methods and services, of high quality and affordable price. Although short-term 1 resupply methods – because they require frequent and reliable financing, procurement, and distribution – are of particular concern, ensuring access to other methods – such as natural family planning and long-term and permanent methods – is part of contraceptive security. • And, third, long-term assurance. Contraceptive security means that the methods and services people want are reliably available. This requires long-term commitments from governments, the private sector, households, and donors. Contraceptive security does not necessarily mean self-reliance. Donor support – whether for contraceptive and condom donations, technical assistance, or capacity building – has been and will remain for the foreseeable future a vital part of securing contraceptive and condom supplies in many countries. Many elements are involved in securing supplies of contraceptives and condoms so people are able to reliably choose, obtain, and use them (see figure below). Within the context of the broader environment – determined by socioeconomic conditions, political and religious concerns, competing health priorities, health sector reforms, etc. – commitment and coordination by government, donors and other stakeholders at all levels help ensure supportive policies, resource mobilization, and effective allocation of resources. Human and systems capacity affects the entire system and must exist for a range of functions, including forecasting and procurement, logistics, service delivery, advocacy, and data-driven decision making. 2 Governments, the private sector (employers, insurers, and other third parties), households, and donors are all key participants in contraceptive financing (capital), which along with forecasting and procurement ensures programs have the necessary supplies. Client utilization – the bottom line for contraceptive security – can then result from client demand and successful efforts in fulfilling that demand with distribution and service provision through a range of public and private sector channels to respond to the needs of different clients. Ready Lessons Country partners, technical agencies, and donors are working to increase contraceptive security. USAID’s cooperating agencies are providing technical assistance in key areas. Advocacy, contraceptive logistics, policy development, market segmentation, and health sector reform are some. Ready Lessons draws from their experiences to provide USAID Missions and their partners with a better understanding of the challenges faced in trying to achieve contraceptive security and some suggested approaches on how to overcome them. Each brief describes a “ready lesson” for use by Missions, with practical “how to” information, country examples, and annotated lists of further reading. Ready Lessons is a continuing series. As USAID and partners develop new tools and approaches, apply them in the field, and advance country programs, the USAID Contraceptive Security Team will identify and disseminate new lessons. We invite Missions and partners to participate in this learning process by sharing your experiences with us. 3 Further Reading Ashford, L. 2002. Securing Future Supplies for Family Planning and HIV/AIDS Prevention. Washington, D.C.: MEASURE Communication/ Population Reference Bureau. (http://www.prb.org/pdf/SecFutureSupplies_ Eng.pdf ). [A short policy brief that describes the growing gap in contracep­ tive supplies and actions needed to bridge the gap.] Finkle, C. 2003. Ensuring Contraceptive Supply Security. Outlook Vol 2, No 3. Seattle, Wa.: PATH. (http://www.path.org/files/eol20_3.pdf ). [Discusses the global status of contraceptive funding, causes of shortages, challenges to contraceptive security, and steps being taken to improve coordination at country and global levels.] Ross, J. and Bulatao, R. 2001. Contraceptive Projections and the Donor Gap. Washington, D.C.: Population Action International. (http://www.popula- tionaction.org/resources/publications/commodities/PDFs/PAI_03_Eng.pdf ) [One of the first and most widely cited analyses to draw attention to the financing gap for contraceptives and condoms.] Sine, J. and Sharma, S. 2002. Policy Aspects of Achieving Contraceptive Security. Policy Issues in Planning and Finance No 1. Washington, D.C.: Policy Project/Futures Group International. (http://www.policyproject.com/ pubs/policyissues/PI_Eng.pdf ). [An overview of contraceptive security needs in awareness raising, advocacy, policy dialogue, planning, building an information base, and capacity building.] 4 The USAID Contraceptive Security Team works to advance and support planning and implementation for contraceptive security in countries by: • developing and supporting the use of appropriate strategies and tools for contraceptive security. • improving decision making for contraceptive security through increased availability and analysis of data, and • providing leadership at the global level The team provides technical assistance to Missions and partners in research and analysis, strategic planning and programming, monitoring and evaluation, and design and implementation of field activities. For further information, please contact: Contraceptive Security Team c/o Mark Rilling or Alan Bornbusch Commodities Security and Logistics Division Office of Population and Reproductive Health Bureau for Global Health USAID Washington, D.C. mrilling@usaid.gov or abornbusch@usaid.gov pdfOverview_2_recreated.pdf by Tanvi Pandit and Alan Bornbusch. Carolyn Hart, David

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