Take Stock Advocacy Guide
Publication date: 2016
ADVOCACY GUIDE They often walk miles from home for contraception. Yet, when they arrive at the healthcarefacility or pharmacy they find their contraceptive of choice out of stock. And usually there’s no information about when the product will again be available. So these women, full of hope, repeat the trip the next week and the week after that. The shelf remains empty and the woman has no answers and no options. Several key factors can lead to stockouts of contraceptives, including long-lead times for procurement or delivery of products due to bureaucratic and manufacturing processes; insufficient funding for commodities and distribution, lack of supply chain training for health providers and the need to improve information systems and forecasting of stock needs. Women and families in low- and middle-income countries are most likely to experience stockouts in their local clinics and pharmacies. We can train all the service providers in a health system; we can raise awareness of family planning in communities; we can and do successfully create demand. But, if a woman cannot get the contraceptive method she needs, then all those efforts are wasted. Are you outraged yet? We certainly are. And that’s why we are taking stock of the issue and taking action to change it. We’re dreaming big. We want to put an end to stockouts of reproductive health supplies. That’s why Take Stock mobilizes stakeholders, facilitates the development of a common language we can all use to talk about stockouts and gathers the commitments needed to spur real action. Stockouts of reproductive health supplies are unacceptable in any clinic, in any community, in any country. We know how to fix the problems. The solutions are within reach. And that’s why we must take action now. Will you help us by advocating for action and commitment in your country? This advocacy toolkit will help get you informed on the issue, supply you with the tools you need to communicate to decision-makers about stockouts and why they matter, and press them to make a commitment to end reproductive health stockouts once and for all. Every day thousands of women in developing countries embark on a futile journey. JOIN US! NoEmptyShelves.org @TakeStockRHtakestock@rhsupplies.org @TakeStockRH WHAT YOU NEED TO KNOW Talking points for advocacy Access to family planning and contraception is essential to improving the health of women, children and economies and allows women and girls to exercise their sexual and reproductive rights time and space their pregnancies. Yet, in many of the world’s poorest countries women travel an entire day seeking access to contraceptives only to find an empty shelf. Contraceptive stockouts lead to high rates of unintended pregnancies and unmet need, and increased maternal and infant mortality. Take Stock aims to resolve the contraceptive stockouts and ensure every shelf is stocked with a wide range of high-quality contraceptives that women and families want and need. THE CORE NARRATIVE Around the world too many women do not have access to contraceptives simply because of product stockouts in local healthcare facilities. Their reproductive health needs are unmet and the implications are real. ǂ Currently, more than 220 million women have an unmet need for family planning—many as a result of stockouts. If these 220 million women used a method of modern contraception, this would result in: ǂ Women and girls have a right to contraceptive security and to a wide range of high-quality contraceptive methods since 198 countries adopted the Beijing Platform for Action in 1995. That platform recognized reproductive rights as fundamental human rights and reaffirmed that one of the aim of family-planning programs must be to ensure informed choices and make available a full range of safe and effective methods. ǂ Resolving stockouts means healthier women, healthier families and healthier communities. When women have consistent access to contraceptives, there are fewer maternal deaths, fewer infant deaths, fewer abortions, and fewer unintended pregnancies. *Guttmacher Institute and UNFPA. Adding It Up: The Costs and Benefits of Investing in Sexual and Reproductive Health. 2014. http://www.guttmacher.org/pubs/AddingItUp2014.pdf 52 M fewer unintended pregnancies 21 M fewer unplanned births 70,000 estimated number of lives saved* Women and girls have a right to contraceptive security and to a wide range of high-quality contraceptive. When women and girls have access to the reproductive health information and supplies they need to plan their families and space births, they, their families, and their communities thrive. ǂ Access to contraceptives empowers more young women to advance their education and build a better future for themselves and their children. • When adolescents delay their first pregnancy, they are more likely to stay in school and gain the skills and knowledge needed to help lift them and their families out of poverty. • When mothers are more educated, their children benefit. Across Africa and Southeast Asia, mothers who have a basic education are 50 percent more likely than uneducated mothers to immunize their children, and they are more likely to send them to school.* ǂ It is not enough to simply survive and be healthy. Women and children must have the chance to thrive and be active members of their family, community and nation, and enjoy full sexual and reproductive wellbeing. • Women and girls have the right to decide whether, when and how many children to have. • It is estimated that over 50 percent of the decline in child mortality over the past 40 years is associated with increased educational attainment of women of reproductive age. • To initiate this virtuous cycle, women and girls must be empowered to lead the lives they want and deserve. This includes the ability to decide whether, when and how many children to have, so they can make informed decisions that affect their health and future. *Anastasia Gage, Elisabeth Sommerfelt, and Andrea Piani, “Household Structure and Childhood Immunization in Niger and Nigeria,” Demography, vol. 34, 1997, pp. 295-309. Family planning is one of the smartest, most cost-effective ways that a country can invest in its future. ǂ Family planning is a best buy for development, and helps to build resilient societies. ǂ Access to contraceptives advances young girls’ education and for every 10 percent more girls who go to school, a country’s GDP increases by an average of 3 percent. ǂ Over time, countries that empower, educate and employ women and girls, and improve their health, set themselves up for rapid economic growth. ǂ Reducing the contraceptive stockout rate can improve a country’s access to a broad range of reproductive health supplies and strengthen maternal and child health. Access to contraceptives empowers more young women to advance their education. For every 10% more girls who go to school, a country’s GDP increases by an average of 3%. Central to solving the critical issue of stockouts is generating the political will needed to take action. ǂ Resolving stockouts of reproductive health supplies requires action from public health and political leaders. Take Stock is an initiative to help ignite and cultivate that response. ǂ Clear and comparable stockout data is needed to allow more people at all levels of health systems—from ministers of health to frontline healthcare providers to donors to NGO project managers—to understand the magnitude of the unmet need of family planning. Take Stock is asking partners to commit to measuring and reporting stockout data using the FP2020 indicators in order to work on solutions. Commitments to resolving contraceptive stockouts will contribute significantly to achieving the Sustainable Development Goals and Family Planning 2020 commitments. ǂ Reducing stockouts is key to making Sustainable Development Goal 3 (to ensure universal access to sexual and reproductive health-care services, including for family planning, information and education) a reality. ǂ Take Stock shares the same goal of increasing access to contraceptives for more women and families with the UN Global Strategy for Women’s, Children’s and Adolescents’ Health, the Sustainable Development Goals, Every Woman Every Child, and Family Planning 2020. Take Stock partners with them to make sure products are stocked on the shelves for women to receive them. Where can I find more information? There is a good deal of information available online if you want to learn more. And you can always contact Take Stock with any questions or for assistance while planning your advocacy activities: TakeStock@rhsupplies.org. KEY RESOURCES Take Stock www.NoEmptyShelves.org RHSC www.rhsupplies.org FP2020 www.familyplanning2020.org Every Woman Every Child www.everywomaneverychild.org PMA2020 www.pma2020.org Track20 www.track20.org Resolving stockouts requires action from public health and political leaders Reducing stockouts is key to making Sustainable Development Goal 3 ADOPT COMMON INDICATORS AND MAKE THE DATA PUBLICLY AVAILABLE Resolving contraceptive stockouts requires a standard way of measuring and reporting stockouts. A standard measurement allows for the comparison of stockout rates in different countries and regions and subsequently provides a clear framework to resolve stockouts. Take Stock has developed a Universal Indicator to align measuring and reporting on stockouts, as well as a Range of Methods indicator to take countries further towards meeting full, free and informed choice among methods. Making the data publicly available within countries and through FP2020 will allow for more focused attention on the issue and create opportunities to address it. A summary of the contraceptive stockout indicators and what they measure can be found on page 6 of this toolkit. Visit www.NoEmptyShelves.org for additional information about the suite of indicators. Required actions: ǂ Adopt the Universal Stockout Indicator and Range of Methods Indicator in order to measure stockouts and availability in a single, standard, and comparable way. ǂ Adopt the Range of Methods Indicator to measures the range of contraceptive methods available in a service delivery point on the day of the assessment. ǂ Report reproductive health commodities stockout data to Family Planning 2020 (FP2020) to be included in the 2016 FP2020 progress report, so that the community truly understands the magnitude of the stockout problem and is able to aggregate and compare stockouts globally. TAKE STOCK Taking action to resolve stockouts Below are essential actions required to make a real difference to ensure shelves are stocked with the contraceptives women want and need. Take Stock is asking country leaders to commit to one or more of these actions in order to help resolve stockouts. ADOPT COMMON INDICATORS AND MAKE THE DATA PUBLICLY AVAILABLE COMMIT RESOURCES AND POLICIES TO RESOLVE STOCKOUTS ASSURE QUALITY AND CHOICE COMMIT RESOURCES AND POLICIES TO RESOLVE STOCKOUTS Resolving stockouts in a country requires ministries of health and finance to prioritize financial support and clear policies for measurement and evaluation of reproductive health stockouts. Required actions: ǂ Develop clear policies and protocols that improve the supply chain and resolve stockouts. Examples of such policies are: the National Logistics Management Information Systems (LMIS), secured financing for commodities and training protocols for health staff to better manage the supply chain. ǂ Create and protect budget lines to improve supply chain functioning in a transparent, efficient and sustainable way. ASSURE QUALITY AND CHOICE Resolving stockouts requires that shelves are stocked with options for high-quality contraceptives that meet women’s diverse needs. Streamlined registration of quality-assured contraceptives will improve the choice of methods available, and will contribute to cost-effective procurement by allowing the purchase of lower-cost alternatives. Required actions: ǂ Lead facilitation and streamlining of registration for quality-assured contraceptives in order to improve the quality and quantity of contraception methods available. ǂ Develop service delivery points with at least five modern family planning methods available by November 2016 to increase women’s options. Advocacy tools and letter templates Various resources and advocacy tools are available online: www.noemptyshelves.org/resources Commitment letter templates can be downloaded from the following page: www.noemptyshelves.org/take-action/commit- to-take-stock/ TOOLS TEMPLATES ABOUT THE REPRODUCTIVE HEALTH SUPPLIES COALITION Launched in 2004, the Reproductive Health Supplies Coalition (RHSC) is a global partnership of public, private, and non-governmental organizations dedicated to ensuring that all people in low-and middle income countries can access and use affordable, high-quality supplies to ensure their better reproductive health. RHSC brings together diverse agencies and groups with critical roles in providing contraceptives and other reproductive health supplies. These include multilateral and bilateral organizations, private foundations, governments, civil society, and private- sector representatives. As of March 2016, the coalition is comprised of 362 members. Among its many initiatives, RHSC serves as the secretariat of the Take Stock campaign, which promotes women’s and girls’ rights to contraceptive security. Take Stock aims to resolve contraceptive stockouts through improved measurement and reporting of products across the supply chain. For more information on RHSC, please visit: www.rhsupplies.org.