Paraguay: Final Country Report Executive Summary

Publication date: 2007

PARAGUAY: 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. PARAGUAY: FINAL COUNTRY REPORT EXECUTIVE SUMMARY The authors’ opinions expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or of 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. Paraguay: Final Country Report Executive Summary. Arlington, Va.: DELIVER, for the United States Agency for International Development (USAID). Abstract The Ministry of Health (MOH), with continuous technical assistance, improved its logistics system; they are giving priority to the beginning of an improvement plan for the contraceptive logistics system. Although the logistic indicators quantitative assessment showed a high incidence of shortages six months prior to the assessment (December 2005), corrective actions are already being developed; good results are expected in the next assessment. The Contraceptive Security Committee, a multisectorial group was formally established in October 2004. It has achieved much progress in sustaining the present and future supply of contraceptives. A Contraceptive Security Strategic Plan and its respective implementation schedule have been developed, and a Funds Protection Act has been signed for the procurement of contraceptives and delivery kits. The MOH and UNFPA have signed a Memorandum of Understanding (MOU) to carry out procurements; the MOU will optimize the financial resources. For 2006, the MOH assigned sufficient funds to cover 65 percent of its needs. Changes have been implemented in the information system. Trainers attended training workshops; the MOH regional trainers’ team is implementing the training at the PES level to ensure that the documents are filled out correctly for the LMIS. DELIVER and the central level of the MOH are providing support and monitoring. DELIVER John Snow, Inc. 1616 North Fort Myer Drive, 11th Floor Arlington, VA 22209 USA Tel: 703-528-7474 Fax: 703-528-7480 Electronic mail: deliver_project@jsi.com Internet: www.deliver.jsi.com EXECUTIVE SUMMARY If the USAID/Paraguay Mission is to continue with financial aid only for the medium term, the logistics system for contraceptives at the Ministry of Health (MOH) urgently needs strengthening; this process will also make the MOH more efficient in using its own resources. Of equal importance is the MOH’s ability to achieve self-sustainability for contraceptives and, within the necessary legal framework, to empower the MOH to procure contraceptives. To strengthen the ability of the MOH, the USAID/Paraguay office contracted with the DELIVER project to establish an office in-country. Objectives included strengthening the supply chain and, with the Committee on Contraceptive Security and decision makers at the central level, improving the MOH’s ability to ensure contraceptive security. To accomplish these objectives, DELIVER posted a resident advisor in Paraguay in October 2005. The first step for DELIVER was to complete a qualitative and quantitative assessment that would establish impact indicators. The assessments helped identify the areas to improve: the information system, storage conditions, distribution system, and procurement and estimated needs. After these areas were identified, DELIVER developed activities to improve the logistics system in the 10 months remaining in the project. The Logistics Indicator Assessment, completed in December 2005, showed a shortage of 85 percent of one or more basic contraceptives (oral pills, injectables, condoms, and IUDs) six months before the study started. From February through July 2006, DELIVER, to improve the information system, developed manuals, modified the logistics management information system forms, and formed a trainers’ team at the central and regional levels. DELIVER also initiated a series of trainings in logistics with the goal of improving the distribution system. Meetings were held to activate the MOH’s commitment to procure contraceptives. A Memorandum of Understanding (MOU) was signed between the MOH and UNFPA to optimize the MOH’s financial resources. This represented a landmark for the sustainability process in the procurement of contraceptives for national needs. The MOH assigned sufficient funds to cover 65 percent of the contraceptive procurement. Another important sign of progress was the signing of the Funds Assurance Act for the Procurement of Contraceptives for the Family Planning Program and for Delivery Kits. Computers were provided to 19 regions as a first step toward automating the information system and inventory control. At the regional warehouses, partitions were built to create a safe and improved space for contraceptives commodities. To maintain the quality of contraceptive products, especially Depo- Provera, air conditioners were installed in the 16 regions with the greatest need. The challenges for the future are to— • Achieve the first procurement of contraceptives with UNFPA as a procurement agent and to keep the terms and conditions of the MOU in the future. • To benefit from low prices and to be able to implement family planning services in all its establishments, ensure that the Social Security Institute performs its first procurement of contraceptives using the same mechanism as the MOH. • Train 100 percent of the staff at all levels in the distribution system to prepare their reports with accurate data and to accurately estimate the quantity of contraceptives to be requested. Paraguay: Final Country Report Executive Summary i • Expand family planning services to all the establishments that are not currently providing these services. DELIVER continues to empower MOH officials to commit to the improvement of the logistics system. In 2006, a logistics director was appointed who is in charge of monitoring the logistics system. It will be necessary in the future to continue seeking funding to reinforce the logistics system. Paraguay: Final Country Report Executive Summary ii For more information, please visit www.deliver.jsi.com. 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