Nicaragua: Final Country Report Executive Summary

Publication date: 2007

NICARAGUA: FINAL COUNTRY REPORT EXECUTIVE SUMMARY MARCH 2007 This publication was produced for review by the United States Agency for International Development. It was prepared by the DELIVER project. NICARAGUA: FINAL COUNTRY REPORT EXECUTIVE SUMMARY The authors’ views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government. DELIVER DELIVER, a six-year worldwide technical assistance support contract, is funded by the U.S. Agency for International Development (USAID). Implemented by John Snow, Inc. (JSI) (contract no. HRN-C-00-00-00010-00) and subcontractors (Manoff Group, Program for Appropriate Technology in Health [PATH], and Crown Agents Consultancy, Inc.), DELIVER strengthens the supply chains of health and family planning programs in developing countries to ensure the availability of critical health products for customers. DELIVER also provides technical management of USAID’s central contraceptive management information system. Recommended Citation DELIVER. 2007. Nicaragua: Final Country Report Executive Summary. Arlington, Va.: DELIVER, for the U.S. Agency for International Development. Abstract DELIVER’s technical support has significantly improved the Ministry of Health’s (MOH) contraceptive availability in all the service delivery points. This successful experience in family planning logistics has also improved the process of integration for the other essential drugs. In June 2006, the Information System for the Integrated Logistics System for Essential Drugs and Contraceptives (SIGLIM) was implemented in five regions with the expectation of being extended to the rest of the country in 2007. DELIVER has also strengthened the postpartum family planning services in 22 Mother and Child Health Care (MCHC) hospitals. DELIVER provided support to Profamilia staff in the use of management tools to evaluate their logistics system and forecast their contraceptive needs. The staff have been trained on how to use the LSAT and how to use the software PipeLine, which is now being used with an established community-based distribution services in nine clinics. Since 2005, assistance to the Social Security Institute (INSS) started with an assessment of the family planning logistics system and services in the companies that provide private medical services (EMPs in Spanish). Based on the findings, a training program and supervision system have been developed to further develop the commodity logistics system. In July 2003, the National Contraceptive Security Committee was created and constituted by officials from the MOH, INSS, Profamilia, donor agencies, and cooperating agencies. During 2005, the contraceptive security committee held 14 meetings, designed a Contraceptive Security Strategic Plan 2005–2008 and a proposed implementation plan, developed a manual describing roles and responsibilities for the committee members, and proposed meetings with and presentations to policymakers. DELIVER John Snow, Inc. 1616 North Fort Myer Drive, 11th Floor Arlington, VA 22209 Phone: 703-528-7474 Fax: 703-528-7480 Electronic mail: deliver_project@jsi.com Internet: www.deliver.jsi.com EXECUTIVE SUMMARY The U.S. Agency for International Development/Nicaragua, through the DELIVER project, has provided technical and financial assistance to local counterparts since 1998, with the purpose of implementing a sound contraceptive logistics system in the Ministry of Health (MOH) and the nongovernmental organization Profamilia. With a local office, beginning in 2003, DELIVER has provided support and technical assistance to the 17 local integrated health service systems (SILAIS) in the country, particularly in the process of systems integration of contraceptives and essential drugs systems and in the strengthening of postpartum family planning (FP) services. The technical assistance to Profamilia to strengthen FP services supports the process of forecasting, procurement, storage, and inventory of contraceptives. Since 2005, to contribute to the improvement of FP services offered to the insured population, the project has provided technical assistance to the Nicaraguan Institute of Social Security (INSS) and private medical services companies (EMPs) through the National Chamber of Health (CANSALUD). DELIVER’s efforts in coordination with other partners and donors have led to the improvement of FP indicators and helped the MOH staff focus on developing the needed skills to guarantee an appropriate supply of contraceptives in 100 percent of the health units. DELIVER assisted the logistics system to evolve from a vertical logistics systems to an integrated information system for essential drugs and contraceptives in five SILAIS, using the contraceptive logistics system as a model because of its successful implementation throughout the years. The integrated system has contributed to the strengthening of postpartum FP services in 22 mother and child health care hospitals. The DELIVER project supported the MOH and Profamilia in estimating contraceptive needs based on consumption data and trends. In addition, PipeLine software has been implemented in 17 Profamilia clinics, which has contributed to having reliable data and supporting efforts toward financial sustainability. In the case of INSS and CANSALUD, an assessment of the contraceptive logistics system and the potential benefits of providing FP services through the EMPs have allowed the development of actions aimed at improving the commodity logistics management of the EMPs through training activities that focus on forecasting, storage, and inventory control management. DELIVER’s leadership in promoting coordination among different donors and local organizations within the Contraceptive Security Committee has allowed the committee to develop a contraceptive security strategic plan, which includes a phaseout of contraceptive donor support and a gradual procurement of these commodities with government funds. Both monitoring and supervisory training have been vital pillars for the development of the strategies implemented in recent years. Nicaragua: Final Country Report Executive Summary i Nicaragua: Final Country Report Executive Summary ii For more information, please visit www.deliver.jsi.com. 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