Technical Reference Team; Commodity: Contraceptive Implants

Publication date: 2013

S A F E G U A R D I N G W O M E N A N D C H I L D R E N W I T H E S S E N T I A L C O M M O D I T I E S Technical Reference Team Commodity: Contraceptive Implants © B il l & M e li n d a G a te s F o u n d a ti o n /F re d e ri c C o u rb e t Background The UN Commission on Life-Saving Commodities for Women and Children (the Commission) was formed in 2012 by the UN Secretary-General as part of the global Every Woman Every Child (EWEC) movement. EWEC challenges the global community to increase access to and appropriate use of essential medicines, medical devices, and health supplies that effectively address the leading preventable causes of death during pregnancy, childbirth, and childhood. Led by a wide range of high-level leaders from around the world, the Commission developed a framework for action on Reproductive, Maternal, Newborn, and Child Health (RMNCH) products that can be applied nationally and utilized in global RMNCH initiatives. The framework outlines a priority list of 13 commodities, key barriers to access and use, and 10 cross-cutting recommendations to rapidly increase both access and use. By increasing access to and use of these 13 commodities, it is estimated that 6 million women and children can be saved by 2017. Moving forward To help carry forward the Commission’s recommendations at the global and national levels, Global Technical Reference Teams (TRT) were established. One group was formed for each of the 13 commodities and 10 recommendations, and an advocacy working group is dedicated to advancing cross-cutting goals. The groups carry out their work through a variety of mechanisms, including guidance documents and tools to support countries in their efforts to implement recommendations and address global and regional bottlenecks. These reference teams are coordinated by a Strategy and Coordination Team hosted by the United Nations Children’s Fund (UNICEF). Spotlight on Contraceptive Implants Contraceptives are an important and cost-effective component of good maternal health care, supporting safe pregnancy, labor, and childbirth. Yet, an estimated 222 million women in developing countries want to use modern contraceptives but do not have access. The Contraceptive Implants TRT is working to provide women and couples with a wider range of contraceptive choices. The specific goals and objectives of the Contraceptive Implants TRT are: • Secure supply of affordable contraceptive implants available to women in low- and middle-income countries. • Increase demand for and adoption of implants by women for whom they are the method of choice. • Ensure a dynamic and sustainable market for affordable, high-quality implants as part of a broad range of contraceptive choices. • Strengthen systems and capacity for delivering quality services through appropriate human resources and effective supply chains. • Ensure providers are trained in the safe insertion and removal of contraceptive implants. • Foster technical improvements to implants and related products and services. A contraceptive implant is inserted into the upper arm of a woman. S A F E G U A R D I N G W O M E N A N D C H I L D R E N W I T H E S S E N T I A L C O M M O D I T I E S Enhanced access to implants Studies have shown that of the 600 million women in developing countries who are using modern methods of family planning, only 1 to 2 percent use implants; however, a significantly greater proportion would choose implants if they were consistently available and supported by counseling and clinical services. Group membership There are currently 66 registered members of the Contraceptive Implants TRT. The primary conveners are the UK Department for International Development (DFID), the Bill & Melinda Gates Foundation, and the Reproductive Health Supplies Coalition (RHSC). Progress to Date Since its inception, the Contraceptive Implants TRT has accomplished numerous goals with a variety of partners, including: • In January 2013, Bayer HealthCare finalized an agreement with public and private sector partners to make the Jadelle® contraceptive implant available to more than 27 million women in the world’s poorest countries at a more than 50 percent price reduction over the next six years. The price reduction is available worldwide. • In May 2013, Merck MSD signed an agreement to reduce the cost of IMPLANON® and its next- generation implant, IMPLANON NXT®, by approximately 50 percent over the next six years. • Currently underway is the development of a global forecast for implants, supported by country level forecasts and procurement data. • Stakeholders are jointly engaged in monitoring procurement, supply planning, forecasting, training, and service delivery progress. • Financial support has been provided to key social marketing organizations (SMOs), enabling them to expand procurement and the distribution of implants. Available Resources The following tools have been developed to support country-based plans and activities: • Jhpiego is leading an assessment of human resource training and delivery needs within the public sector and among SMOs. • The first evidence review on demand creation for implants was developed jointly with the Recommendation 7 TRT. • Currently under review is a proposal by the World Health Organization to develop standardized programmatic guidance on quality service delivery of implants and system expansion within countries. There are many existing programs through the US Agency for International Development, DFID, United Nations Population Fund, and other donors that support the delivery of contraceptive implants and other long acting and reversible contraception. The following examples illustrate the types of technical assistance available through the TRT to support national plans and activities: • Technical assistance is being provided by John Snow, Inc. to countries that wish to forecast needs for contraceptive implants. • Technical assistance in provider training is currently being made available in Nigeria, Zambia, and Kenya by Jhpiego. • The Clinton Health Access Initiative is providing technical assistance for the development of service delivery expansion plans and human resource plans in countries with high need. Contact us For more information or to request tools and technical assistance, please contact: Nel Druce, DFID (n- druce@dfid.gov.uk), Monica Kerrigan, Bill & Melinda Gates Foundation (monica.kerrigan@gatesfoundation.org), and John Skibiak, RHSC (jskibiak@rshupplies.org).

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