UNFPA Supplies Annual Report 2022: Strengthening Services and Supplies for Reproductive Health

Publication date: 2024

Strengthening services and supplies for reproductive health UNFPA SUPPLIES PARTNERSHIP ANNUAL REPORT 2022 48 programme countries The Partnership also provides support to the Pacific Island Countries and Territories. The designations employed and the presentation of the material on the map do not imply the expression of any opinion whatsoever on the part of UNFPA concerning the legal status of any country, territory, city or area or its authorities, or concerning the delimitation of its frontiers or boundaries. © UNFPA Cover: Adobe Stock photo used under licence. Afghanistan Benin Bolivia Burkina Faso Burundi Cameroon Central African Republic Chad Congo Côte d’Ivoire Democratic Republic of the Congo Djibouti Eritrea Ethiopia Gambia Ghana Guinea Guinea-Bissau Haiti Honduras Kenya Lao People’s Democratic Republic Lesotho Liberia Madagascar Malawi Mali Mauritania Mozambique Myanmar Nepal Niger Nigeria Papua New Guinea Rwanda Sao Tome and Principe Senegal Sierra Leone Somalia South Sudan Sudan Tanzania Timor-Leste Togo Uganda Yemen Zambia Zimbabwe Joining in 2023 Angola Cambodia Comoros Kyrgyz Republic Pakistan Tajikistan supplies partnership CONTENTS INTRODUCTION: IMPACT .3 2022 programme impact .3 Financial snapshot .6 OUTCOME 1: AVAILABILITY and CHOICE .8 Key results: Increasing availability and choice .9 Highlight: New methods in Rwanda .12 OUTCOME 2: SUPPLY CHAIN STRENGTHENING .13 Key results: Strengthening supply chains .14 Highlight: Availability in Cameroon .16 OUTCOME 3: GOVERNMENT COMMITMENT .17 Key results: Increasing government commitment . 18 Highlight: Ministerial Roundtable .20 OUTCOME 4: PROGRAMME MANAGEMENT .21 Key results: Operational effectiveness and efficiency . 22 Highlight: Partners Assembly .24 Lessons learned .25 Looking ahead .28 Steering Committee .29 Availability and choice Increase availability and choice of quality-assured reproductive health commodities, including for family planning. Strengthened supply chains Ensure contraceptives and other reproductive health commodities reach the last mile and promote harmonization and integration of supply chains. Increased government commitment Country financial contributions to quality reproductive health supplies and services are increased. Family planning is prioritized as a core element of sustainable development. Operational effectiveness and efficiency Improved programme management with shared accountability for results. Strategic objectives 2021–2030 Goal: All women and girls are able to access and use a choice of quality reproductive health commodities whenever they want or need them. UNFPA SUPPLIES PARTNERSHIP 2 INTRODUCTION Impact The UNFPA Supplies Partnership is the… • world’s largest provider of donated contraceptives and maternal health medicines • main driver in UNFPA towards the transformative result of ending the unmet need for family planning • main mechanism for implementing the UNFPA Strategy for Family Planning, 2022–2030 The programme is a partnership for impact. We work alongside countries in a system of shared accountability and prioritize the most strategic and effective use of technical and financial resources to reach the last mile. This partnership leverages the commitments of national governments, donors, non-governmental organizations, implementing partners, civil society organizations and other United Nations agencies – working together to ensure countries are equipped to overcome barriers to family planning and strengthen their health systems. Our sharpened focus on sustainable financing aims to ensure that governments are supported to gradually increase domestic financing for reproductive health commodities – building their capacity for long-term sustainability. In 2022, the programme provided financial and technical support to 48 countries, including 34 facing humanitarian and fragile contexts. UNFPA SUPPLIES PARTNERSHIP 3 8 million unintended pregnancies 2.2 million unsafe abortions 170,000 maternal and child deaths And the potential to reach 21 million women and girls in the lowest-income countries (users of quality modern methods) Contraceptives supplied through the programme have far-reaching impact, including US$ 508 million in estimated savings to countries and families from reduced health care costs for pregnancy, delivery and post-abortion care They also provided a total 39.6 million couple-years of contraceptive protection (CYP). Contraceptives provided through the UNFPA Supplies Partnership in 2022 had the potential to AVERT: UNFPA SUPPLIES PARTNERSHIP 4 UNFPA Strategy for Family Planning, 2022-2030 The family planning strategy launched in November 2022 confers a major role noting that: “Within the organization, UNFPA has leveraged the UNFPA Supplies Partnership to foster positive environments conducive to normalizing family planning and supporting its integration into primary health services. In addition, this global programme has the capability to use its purchasing power and influence to affect global markets for contraceptives.” The strategy has eight priority actions: 1. Expand availability and access 2. Improve quality 3. Strengthen data 4. Deepen integration 5. Increase sustainability 6. Build resilience and improve adaptation 7. Engage adolescents and youth 8. Enhance agency and address discrimination. Over the years ahead, the UNFPA Supplies Partnership will play a key role in implementing the strategy. The title of the Strategy captures the ultimate impact of this programme: Expanding choices, ensuring rights in a diverse and changing world. Humanitarian and fragile contexts In humanitarian crises and other emergencies, women’s loss of access to contraceptives increases the risk of unintended pregnancy when they are at their most vulnerable. 34 of 48 countries in the programme were in humanitarian and fragile contexts. 54% implemented strategies to strengthen humanitarian preparedness and resilience including sexual and reproductive health services (14 out of 26 countries). This is up from 21% in 2021. US$ 1.3 million spent to procure emergency reproductive health kits through the programme for 17 countries facing humanitarian situations. UNFPA supports efforts to build resilience and improve adaptation, in settings of humanitarian crisis and environmental change, starting with the Minimum Initial Service Package and including family planning in national policies, plans and strategies. UNFPA SUPPLIES PARTNERSHIP 5 Financial snapshot US$ 185 million Approved spending plan 2022 utilization by outcome US$ 163 million Total utilization 88% Utilization rate 2022 UTILIZATION BY OUTCOME OUTCOME 1 Availability and choice 86% (US$ 142,438,477) US$ 120,337,915 is for commodities OUTCOME 2 Strengthened supply chains 7% (US$ 10,390,963) OUTCOME 3 Increased government commitment 1% (US$ 1,075,453) OUTCOME 4 Operational effectiveness and efficiency 6% (US$ 9,037,911) The programme spending plan totalled US$ 185 million in 2022 with a utilization rate of 88 per cent (utilization = expenses adjusted for purchase order commitments). An increase in donor contributions enabled a gradual increase from the original approved plan of US$ 127 million for 2022. In addition, contributions received in the fourth quarter were carried forward for programming in 2023. Funds used for commodity provision totalled US$ 120 million. The programme received US$ 232 million in donor contributions, up from US$ 221 million in 2021. The programme welcomed strong support: 20 donors contributed to the Partnership in 2022, matching the record- high of 20 in 2021. Three new donors made commitments including Cartier Foundation, the European Commission and Spain (Justice and Social Affairs of the Basque government). Five partners increased commitments: Germany, Luxembourg, the Netherlands, Portugal and Spain (Spanish Agency for International Development Cooperation (AECID)). Two donors provided in-kind support: HELP Logistics and the United Kingdom. And 14 partners made multi- year commitments that facilitate longer-term planning. UNFPA SUPPLIES PARTNERSHIP 6 How we work The UNFPA Supplies Partnership is a thematic fund guided by a programmatic framework. Launched by UNFPA in 2007, we catalyse health system development through implementing partners – backed by technical assistance from UNFPA. Countries are invited to apply for support through three funding streams that work together to drive sustainable change and achieve programme results set out in the performance measurement framework. PERFORMANCE: This funding stream covers the costs of programme delivery, coordination and managing accountability and visibility, including the costs of personnel, supplies management and the last mile assurance (LMA) process. SUPPLIES: This funding stream supports the procurement of reproductive health commodities and related costs (freight, packaging and labelling, sampling and testing), with a substream for new and lesser-used products and for humanitarian needs and priorities. TRANSFORMATIVE ACTION (TA): This funding stream supports assistance to strengthen supply chains and the enabling environment for reproductive health/family planning policy, with an additional short-term seed fund to help bridge availability and access. OUTCOME 1 Availability and choice Quality family planning services depend on contraceptive methods that are accessible, affordable and used when needed – including by adolescents and youth, persons with disabilities and those caught in humanitarian crises. UNFPA supports countries to expand contraceptive options and choices and improve the delivery of good quality counselling. Information on each option, free from discrimination and with the benefits and risks of each method empowers the user to freely choose according to their preference and lifestyle. To ensure services can be used by those who need them, the programme is guided by the principles of equity and leaving no one behind and a commitment to reaching the last mile. In 2022, UNFPA began to roll out the Support Tool for the Human Rights-Based Approach to Family Planning Programming with a successful workshop in Uganda. UNFPA Country Offices and national partners assessed the alignment of family planning programmes and policies with international human rights standards. New and lesser-used commodities gained ground in 2022. Access to commodities that are new to public health procurement expands the choice and range of supplies available. Introduction and scale- up of self-care interventions continued to expand access and choice. UNFPA SUPPLIES PARTNERSHIP 8 KEY RESULTS Percentage increase in use of long-acting reversible methods Use of IUDs is relatively limited yet increased by almost 1% from 4.7% of users in 2021 to 5.6% in 2022. This method is more widely used in Benin, Bolivia, Guinea- Bissau, Nepal, Yemen and Zimbabwe, with more than 10% of contraceptive users choosing IUDs. Use of contraceptive implants increased by 1.5%, up from 17.2% in 2021 to 18.7% in 2022. Action to improve humanitarian preparedness doubled 52% of countries (14 out of 27) reported the implementation of strategies to strengthen humanitarian preparedness and resilience. This is up from 21% in 2021, inspired in part by a round of Sustainability Readiness Assessments. Countries focused on providing the Minimum Initial Services Package (MISP), building community capacity for preparedness and response, and strengthening reporting and surveillance. 23 countries integrated the MISP The number of countries that have integrated all six objectives of the Minimum Initial Services Package (MISP) for Sexual and Reproductive Health in Crisis Situations into existing national health and emergency frameworks increased from 21 in 2021 to 23 in 2022. Increasing availability and choice UNFPA SUPPLIES PARTNERSHIP 9 Essential supplies Slow but steady progress in increasing availability of a choice of contraceptives through supply chain strengthening efforts to overcome in- country challenges especially at the “last mile”. 80% of countries have 3 modern contraceptive methods available at 85% or more at primary-level points of care – an increase of 1.2 percentage points from 2021. 60% have 5 modern contraceptive methods available at 85% or more secondary- and tertiary-level points of care – an increase of 8 percentage points compared with 52% in 2021 (18 of 30 countries). 45% have life-saving maternal health medicines (magnesium sulfate, misoprostol and oxytocin) available at 85% or more points of care – up from 35% in 2021 (13 of 29 countries). Supplies for voluntary family planning include: male condoms, female condoms, oral contraceptive pills, injectables, emergency contraceptive pills, IUDs, implants, sterilization for females, sterilization for males Increasing availability and choice New and lesser-used methods 29 countries procured DMPA-SC through UNFPA. Self-administration of this subcutaneous injectable is being rolled out in 30 countries and 43 countries have placed orders since the method’s introduction to the programme. 16 countries procured new and lesser-used reproductive health commodities through UNFPA: • 8 countries introduced a hormonal IUD, up from four in 2021 • 7 countries procured the combipack of misoprostol plus mifepristone • 5 countries trialled tranexamic acid and 4 countries trialled heat stable carbetocin to prevent and treat post-partum haemorrhage • 5 countries procured MVA kits • 3 countries procured non-scalpel vasectomy kits. Vasectomy in 3 countries Three countries implemented monitored male vasectomy programmes: Burundi, Papua New Guinea and Rwanda. UNFPA SUPPLIES PARTNERSHIP 10 Inter-agency RH kits: Kits range from simple supplies for clean delivery to a 34-box kit that can equip an entire surgical maternity ward. Family planning kits contain male and female condoms, oral contraceptives, subcutaneous and intramuscular injectable contraceptives, and intrauterine devices. Reproductive health supplies provided by the UNFPA Supplies Partnership L = lesser-used commodities * = commodities newer to public health procurement Short-acting contraceptives • Combined oral contraceptive pills • Progestin-only pills • Emergency contraceptive pills L • Injectable contraceptives: DMPA-SC (N); DMPA-IM; NET-EN • Male and female condoms • Hormonal vaginal rings * Long-acting and reversible and permanent contraceptives • Contraceptive implants * • Copper intrauterine devices L • Hormonal intrauterine devices • Non-scalpel vasectomy (NSV) kits L • Supplies for tubal ligation L • Supplies for insertion or removal of implants and IUDs Reproductive health medicines and supplies • Oxytocin • Heat-stable carbetocin * • Tranexamic acid * • Misoprostol L • Mifepristone L • Combipack (misoprostol and mifepristone) L • Manual vacuum aspirator (MVA) L • Magnesium sulfate • Calcium gluconate HIV supplies • Male and female condoms • Lubricants • HIV test kits UNFPA SUPPLIES PARTNERSHIP 11 HIGHLIGHT New methods support post-partum family planning in Rwanda Post-partum family planning (PPFP) helps prevent unintended and closely spaced pregnancies after childbirth. At 17, Nyiraneza Chanceline learned about long-acting implants and injectables after giving birth and dropping out of school: “Before I got pregnant, I did not know anything about family planning. I came to know family planning methods and their benefits, through the antenatal care programme at Karengera Health Centre where I gave birth.” New and lesser-used methods are an important part of PPFP in Rwanda, which has introduced injectables and the hormonal IUD in all 30 districts, with support from the UNFPA Supplies Partnership and other partners. Introducing a modern contraceptive method can increase use of modern contraception (mCPR) by as much as 8 per cent. Rwanda is one of the countries that has successfully included PPFP indicators to capture data in their health management information system. In 2022, the ongoing introduction of new methods accompanied by provider training at health facilities and at the community level contributed to an increase of 5 per cent of family planning users, 60 per cent increase for DMPA-SC and over 40 per cent increase for hormonal IUD compared with 2021 according to health management (HMIS) data. The Government of Rwanda has worked with UNFPA to introduce a new method nearly every year since 2014. Nyiraneza and her nurse discuss different family planning methods before she made her choice of self-administered injectable, following three years with an implant. © UNFPA Rwanda 2014/15 • • 1-rod implant 2016/17 • • Female condom 2017 • • Emergency contraceptive pill 2018 • • Permanent methods (non-scalpel vasectomy + tubal ligation) 2020 • • Self-administered injectable (DMPA-SC) 2020/21 • • Hormonal IUD UNFPA SUPPLIES PARTNERSHIP 12 OUTCOME 2 Supply chain strengthening Countries in the UNFPA Supplies Partnership are investing in supply systems that are stronger, more functional and more resilient, especially in humanitarian contexts. This work complements national efforts to build stronger, integrated health systems that will secure availability of family planning services, contraceptives and maternal health medicines far into the future. Key strategies to reach the last mile and harmonize supply systems include building capacity to forecast and quantify needs; implementing logistics management information systems (LMIS); and procuring quality-assured contraceptives and life- saving maternal health medicines. Efforts to strengthen the overall health system need effective supply chain management, which means addressing specific reasons for stock-out at points of care and bottlenecks and gaps in capacities as well as commodities. UNFPA boosted its role in strengthening end- to-end supply chain functionality with the establishment of the Supply Chain Management Unit in Copenhagen, effective January 2022. The Global Family Planning Visibility and Analytics Network, or Global FP VAN – a family planning data platform designed to improve how supply chain decisions are made – continued to improve the collection, aggregation and validation of data. UNFPA is a founding member of the VAN, which can track in real time over 7,500 shipments of 71 products across 145 countries. In 2022, despite the continued impact of COVID-19 and funding shortfalls, the VAN has supported informed, evidence-based decision-making on product allocation or intercountry transfers, and order prioritization to avert pending shortages and stock-outs. UNFPA SUPPLIES PARTNERSHIP 13 KEY RESULTS 67% had no stock-out of contraceptives 67% of countries reported they had “no contraceptive stock- out” in 60% or more points of care on the day of the survey or data collection in 18 of 27 countries surveyed. This is up from 44% in 15 of 34 countries surveyed in 2021. Data are collected for a two-year period. Over time this measurement helps to understand the maturity of the national supply chain. 41 countries had orders on time and in agreed quantities 75% or more of UNFPA Supplies Partnership commodity orders were delivered on time and in agreed quantities – up from 39 countries in 2021. 20 countries have a costed supply chain strategy The countries had in place a supply chain management strategy with a costed implementation plan that addresses all elements of contraceptive commodities availability and accessibility in line with the UNFPA/WHO implementation guide, up from 19 in 2021 with the addition of Chad. Strengthening supply chains UNFPA SUPPLIES PARTNERSHIP 14 Strengthening supply chains Electronic LMIS continue to expand More countries are using real time logistics data management with linkages between warehouses at different levels: 2 more countries extended their computerized logistics management system including contraceptives and maternal health medicines all the way from central warehouses to community-level points of care – Mali and Mozambique. An additional 2 countries extended their eLMIS to district level. 16 countries provided eLMIS training to nearly 3,000 health workers supporting increased product availability, efficiencies and effective decision-making. 2 countries integrated their national eLMIS with the Global Family Planning Visibility & Analytics Network (GFPVAN) in 2022 to assess supply needs and prevent stock-outs: Ghana and Malawi. Last mile assurance process Following a redesign, the LMA process now serves to identify priority supply chain interventions to be considered for the programme’s Transformative Action (TA) applications to facilitate national public health supply chain system strengthening. All 48 countries conducted last mile assurance activities to obtain visibility on how UNFPA programme supplies are managed at different levels of the supply chain and strengthen accountability, up from 46 in 2021. LMA spot-checks in 28 countries provided recommendations and actions to strengthen supply chains. Countries can use this information when preparing Transformative Action (TA) plans, one of the programme’s funding streams that taps catalytic resources for strengthening supply chain management. 81% acted on LMA recommendations. At least 39 out of 48 countries have now implemented recommendations from the LMA process to improve commodity and data visibility. UNFPA SUPPLIES PARTNERSHIP 15 HIGHLIGHT One out of six people living in Cameroon is suffering from the effects of violence, climate shocks and disease outbreaks. Efforts taken through support from UNFPA are helping ensure that contraceptives and maternal health medicines reach all communities, including those in areas affected by humanitarian crises. UNFPA worked with implementing and government partners to improve storage and reduce wastage of reproductive health supplies, and find solutions for more efficiently moving products to the last mile or redistribution across the health system. Several interventions are providing a base for the successful response: • Raise awareness and commitment to global standards: Cameroon is strengthening the supply chain as part of its Compact with the UNFPA Supplies Partnership. • Develop a capacity building plan: The focus is on planning, procurement, storage (including cold chain), pre-positioning, distribution and monitoring. • Update the national supply plan: This will rationalize quantities and shipments to prevent overstock and stock-out. • Organize training: Supply chain staff of UNFPA and implementing partners are gaining knowledge and skills. • Develop a road map for WHO certification: Central and regional warehouses will adopt global standards for good storage and good distribution practices. © UNFPA Cameroon, June 2022 A strategic focus aims to strengthen availability of supplies in Cameroon including for humanitarian crises-affected regions UNFPA SUPPLIES PARTNERSHIP 16 OUTCOME 3 Government commitment The UNFPA Supplies Partnership supports governments in achieving global commitments including the Sustainable Development Goals, those made at the Nairobi Summit on ICPD25 and through the Family Planning 2030 initiative. Good progress has been made in supporting the shift from development funding to development financing. UNFPA works to increase sustainability of national family planning programmes with strengthened health systems, more domestic commitment to financing and more efficient use of resources. This work follows the principle that national capacity development is the overarching strategy. In November 2022, the Ministerial Roundtable on Sustainable Financing for Family Planning was organized on the margins of the International Conference on Family Planning in Pattaya, Thailand. Eight ministers announced commitments to increasing their countries’ domestic budget expenditures for contraceptives during the event. The event also celebrated the signing of Compacts – an innovative agreement to share costs that gradually increases domestic financing for contraceptives. Ministries of health and ministries of finance from 24 countries signed Compacts with the programme by the end of 2022. The Compacts define responsibilities and commitments and affirm that partners recognize the value of family planning for the development of communities and countries. UNFPA SUPPLIES PARTNERSHIP 17 Increasing government commitment KEY RESULTS Governments of 11 countries sustained or increased the amount for the procurement of contraceptives The same countries also spent more than 80% of the allocated amount for the year. This is an increase from four countries in 2021. The countries are Benin, Bolivia, Burkina Faso, Burundi, Chad, Côte d’Ivoire, Ethiopia, Malawi, Rwanda, Timor-Leste and Zimbabwe. 33 countries have family planning in their essential health package Four additional countries (Afghanistan, Eritrea, Gambia and Timor-Leste) have family planning explicitly included in the Essential Package of Health Services (EPHS) in 2022 compared with 2021. This brings the total to 33 UNFPA Supplies Partnership countries where the EPHS explicitly included family planning. National budget expenditures have increased Spending by countries for the procurement of contraceptives was more at US$ 30.7 million in 2022 compared with US$ 21.2 million in 2021. The programme’s focus on sustainable financing aims to ensure that governments are supported to gradually increase domestic financing for reproductive health commodities — building their capacity for long-term sustainability. UNFPA SUPPLIES PARTNERSHIP 18 Increasing government commitment UNFPA Supplies Match Fund Launched in 2022, the UNFPA Supplies Match Fund is a financing mechanism to match additional government contributions for contraceptive procurement. It builds on lessons learned from the Ouagadougou Partnership Matching Fund. The Match Fund awarded US$ 3.5 million and leveraged more domestic financing for supplies. In 2022, UNFPA awarded US$ 3,446,852 to five countries (Chad, Democratic Republic of the Congo, Madagascar, Papua New Guinea and Zimbabwe), to match additional government contributions. This leveraged an additional US$ 2,605,250 in domestic financing for quality-assured reproductive health commodities for use in 2023. Progress continued in National Supply Plans All 48 countries developed National Supply Plans and procured contraceptives and life-saving maternal health medicines. And in 39% of UNFPA Supplies Partnership countries the government contributed towards the funding of the National Supply Plan at the same or increased level compared to the previous year. This is an increase from 22% in 2021. Governments of 28 countries used different financing approaches including the Third Party Procurement (TPP) for the procurement of commodities, up from 24 in 2021. UNFPA SUPPLIES PARTNERSHIP 19 HIGHLIGHT Ministerial Roundtable on Sustainable Financing for Family Planning Eight ministers announced commitments to increasing their countries’ domestic budget expenditures for contraceptives during an event on the margins of the 2022 International Conference on Family Planning in Pattaya, Thailand – the Ministerial Roundtable on Sustainable Financing for Family Planning. Four of these countries took the historic step of signing country Compacts with UNFPA during the event. The UNFPA Supplies Partnership Compact is an accountability mechanism that gradually increases domestic financing for contraceptives. As of June 2023, 45 of 48 countries have signed these agreements with the programme. The Compacts are part of a significant shift towards sustainable financing for family planning, as countries are increasingly moving towards financing their own family planning budget needs, rather than relying on donor contributions. © UNFPA, November 2022 “When women and girls have access to family planning, the ripple effects can transform, not only a single woman’s life, but an entire society. Sustainable financing for family planning can advance progress towards universal health coverage and uplift the rights and well-being of women, girls and communities.” – DIENE KEITA, UNFPA DEPUTY EXECUTIVE DIRECTOR OF PROGRAMMES AND UN ASSISTANT SECRETARY-GENERAL UNFPA SUPPLIES PARTNERSHIP 20 © UNFPA Yemen OUTCOME 4 Programme management The transition to Phase III of the UNFPA Supplies Partnership, 2021–2030 started in 2021 and continued for an additional year in 2022, providing time to adjust to COVID-19 impacts around the world. The programme achieved high levels of operational effectiveness and efficiency. The 2022 human resources skills and competencies assessment recommended skills and competencies strengthening around: family planning policy dialogue and advocacy; health financing; and contraceptive method mix and choice. Development and roll out of a comprehensive capacity building action plan with formal training modules is in progress to ensure UNFPA staff are enabled to deliver fully on the programme. A partner’s independent review awarded top scores to the programme. Released in December 2022, it concluded that the Phase III governance model is providing donors with stronger oversight and assurance; that last mile assurance mechanisms have played a key role in reducing waste and stock-outs; and that new financing initiatives such as the Compacts and Match Fund are progressing better than expected. UNFPA SUPPLIES PARTNERSHIP 21 Operational effectiveness and efficiency KEY RESULTS First annual UNFPA Supplies Partners Assembly The first UNFPA Supplies Partners Assembly took place 14 November 2022 at the International Conference on Family Planning in Pattaya, Thailand, operationalizing an important programmatic mechanism for governance accountability. 50% of countries had an increase in their SRAT score The Sustainability Readiness Assessment Tool (SRAT) was designed by the UNFPA Supplies Partnership to help countries identify critical gaps in their national family planning programmes, inform programme design and introduce accountability mechanisms. It is an Excel-based questionnaire completed with stakeholders. In 2022, its second year, 24 out of 48 countries had an increase in the sustainability readiness assessment score when compared with the score in 2021. Six countries will join the Programme for 2023 Angola, Cambodia, Comoros, Kyrgyz Republic, Pakistan and Tajikistan In 2022, they successfully completed onboarding and orientation. The countries created road maps to engage government in Phase III of the programme. UNFPA SUPPLIES PARTNERSHIP 22 Operational effectiveness and efficiency 100% of the decisions taken by the Steering Committee were implemented, including those based on the findings of the completed Human Resources Skills and Competency Review. 100% of audit and evaluation recommendations for which actions were due were completed. All 48 countries conducted a funding gap analysis in collaboration with stakeholders that informed advocacy and resource mobilization on reproductive health, including domestic resource mobilization. All 48 countries provided information to update the global risk matrix in 2022. In 44 of 48 countries, stakeholders are engaged in programme planning, decision-making and monitoring processes, up from 36 in 2021. 35 technical abstracts presented at the ICFP, the International Conference on Family Planning, showcased successes and lessons learned through UNFPA Supplies-supported programmes in countries. 94% of countries were rated as “within appetite” for risk in the UNFPA Supplies Partnership risk assessment, up from 85% in 2021. UNFPA SUPPLIES PARTNERSHIP 23 HIGHLIGHT UNFPA Supplies Partners Assembly: shared accountability and stakeholder engagement More than 100 programme partners gathered for the inaugural Partners Assembly, an event to engage in creative problem-solving and to chart the course for the programme. UNFPA Technical Director Dr. Julitta Onabanjo described the event’s purpose: “We envision that the Partners Assembly will enable us to be more accountable to our stakeholders, more transparent about our efforts, and more representative of the people whom we serve.” Roundtable discussions provided input on three themes: • moving from funding to sustainable financing • strengthening broad-based multi-stakeholder partnerships • leaving no one behind. Government representatives from Ethiopia, Norway and the United Kingdom described the transformational impact of quality contraceptives and family planning services on the lives of women and girls. Presentations from the Reproductive Health Supplies Coalition and a youth advocate from Sierra Leone personalized the commitment of programme partners to family planning. © UNFPA, November 2022 UNFPA SUPPLIES PARTNERSHIP 24 CONCLUSION Lessons learned in 2022 The approach is comprehensive. The approach in Phase III is to leverage the Partnership’s role as the main provider of donated commodities to strengthen health systems and achieve sustainable results in family planning policy, especially with regard to sustainable financing, domestic resource allocation and improved supply chain management to achieve equitable access to modern contraceptives. The programme extended the transition to Phase III (2021–2030) for a second year, from 2021 to 2022. This time allowed countries to make adjustments around COVID-19 and unforeseen fluctuations in donor funding from the previous year. The need-based model is working. Many measurements show progress compared with the 2021 results as well as the milestones planned for 2022. Plans and targets for the year were not only achieved, but in the promotion of sustainable financing, exceeded. This affirms the importance of taking a tailored approach to supporting our partner countries, with data to inform decision-making and prioritization of efforts. In other words, it affirms the programme’s need-based model and the flexibility it affords to countries in reducing unmet need for family planning. UNFPA SUPPLIES PARTNERSHIP 25 Sustainable financing The tools we have developed in recent years demonstrated their value, with the newest already starting to fulfil its promise. In its first year, 24 countries signed the Compact, an agreement between UNFPA and ministries of health and finance that defines roles and responsibilities and gradually increases the level of domestic resources governments use for contraceptive procurement. Testimonials attest to the impact of the signature process on raising awareness. With nearly all signatures in place as of June 2023, the introduction of the Compact has taken the UNFPA Supplies Partnership from a donation model to an incentivization model supporting countries towards sustainable financing. A complementary new tool in these efforts is the Match Fund, a two-year pilot to match additional national resources for contraceptive procurement that has leveraged millions in its first year. Sustainable programming The implementation of the SRAT – short for Sustainability Readiness Assessment Tool – among the Partnership countries has contributed in a significant way to improving the quality and comprehensiveness of the programmatic interventions included in the Transformative Action (TA) plans by each country. The tool entails a collaborative process engaging key stakeholders. The process as well as the data gained through the questionnaire is diagnosing critical needs and, thereby, improving the way TA funds are allocated to address identified gaps. Data for decision-making Informed, evidence-based decision-making on product allocation or intercountry transfers, and order prioritization for supply-constrained products is an ongoing need. In 2022, especially since the launch of the UNFPA Supply Chain Management Unit, with its new mandate, the programme continued its productive interaction with the Global FP VAN and the Consensus Planning Group to review and validate commodity requests submitted by the UNFPA Country Offices. The programme has also benefited from the capabilities of the Global FP VAN “control tower”, which aggregates contraceptive procurement and shipment data from different procurers and suppliers. Going the last mile The last mile assurance process continued to prove crucial in identifying end-to-end and supply chain-related constraints, with in-country assessments yielding recommendations that countries are acting on. LMA keeps alive lessons learned. For example, effective commodity quantification and the timely delivery of needed commodities does not necessarily mean that Tools are in place and helping countries maximize the programme's impact. UNFPA SUPPLIES PARTNERSHIP 26 countries have the distribution and warehousing/ storage capacity that meets their needs, and that donated commodities do not always make it to the poor and underserved – those at the end of the last mile. Leave no one behind With these tools in place, the programme is poised to address persistent challenges to the provision of family planning and maternal health care in our partner countries. The tailored approach of a funding model responsive to country-specific needs is on the right track. However, we urgently need to step up efforts to address continuing disparities between rural and urban populations, among underserved young people and persons with disability, women and adolescent girls in settings of high maternal mortality and low use of modern contraceptives, and others for whom “leave no one behind” is a transformational principle.  Partnership and collaboration We enter the next decade of the UNFPA Supplies Partnership together with valued partners, recognizing that progress is a collaborative effort of many – national governments, donors, non-governmental organizations, civil society organizations, academia, the private sector and the United Nations system. With your continued support and engagement, we can build on lessons learned in a collective effort to make sexual and reproductive health and rights a reality for everyone, everywhere. “We can build on lessons learned in a collective effort to make sexual and reproductive health and rights a reality for everyone, everywhere.” UNFPA SUPPLIES PARTNERSHIP 27 Looking ahead As we enter 2023, the transition to the third phase of the UNFPA Supplies Partnership is complete. The programme is fully operational with a total of 54 countries. With the support of donors, we will strengthen health systems and supply chains for increased contraceptive choices for all populations of reproductive age, ensuring that no one is left behind and supplies reach the last mile. With the commitment of partner countries, we will continuing investing in our provision of reproductive health supplies to strengthen health systems through evidence-based approaches, supporting the journey towards long-term sustainability in family planning. We will work together to expand rights and choices through approaches that advance gender equality and human rights – especially in the many countries challenged by humanitarian situations and fragile contexts.  An emphasis on new and lesser-used methods and provision of technical assistance that is closely tailored to country context will continue to form important aspects of our strategic contribution. Phase III begins with a strong set of tools to support the programme countries – the Compact and Match Fund, Transformative Action (TA) applications, the Emergency Fund for humanitarian crises and the Global FP VAN. We have quarterly reporting systems, close communication with partner countries and UNFPA Country Offices, and essential collaboration with the Supply Chain Management Unit. All of this and more are measures contributing to improvement and success. Yet a closer look is required at the challenges faced by our partner countries. The UNFPA Supplies Partnership will be addressing the use of modern contraceptives in rural versus urban areas and among adolescent girls, and exploring with countries how to programme at subnational levels. We will be focusing on settings with high unmet need and low mCPR, for example, applying the principles of leave no one behind. Spanning policy, programming and procurement, the programme will be at the forefront of operationalizing the UNFPA Strategy for Family Planning and galvanizing UNFPA leadership towards achieving universal access to sexual and reproductive health. UNFPA SUPPLIES PARTNERSHIP 28 Steering Committee members Phase III of the UNFPA Supplies Partnership is governed through a Steering Committee comprising key stakeholders from donors, programme governments, civil society and strategic partner organizations. Three subcommittees focus on issues of Strategy and Planning, Finance and Risk, and Leadership. Members of the Steering Committee are grouped into constituencies and represented by focal points that rotate every three years. A participatory governance structure enables the Partnership to be accountable and transparent to those it serves. It strengthens efforts to monitor performance, share knowledge and communicate results. Independent Chair: • Mr. Pape Gaye Donor seats: • The Bill & Melinda Gates Foundation representing an anonymous donor, Cartier Foundation, CIFF, HELP Logistics and the Winslow Foundation • Denmark representing Canada and Luxembourg • European Commission representing Belgium, Portugal and Spain (AECID) and Spain (Justice and Social Affairs of the Basque government) • Netherlands representing France, Germany and Norway • United Kingdom representing Australia Strategic partner seats (non-voting): • United States • FP coordinating body seat: Reproductive Health Supplies Coalition (representing FP2030) Non-governmental organization seats: • Commodity seat: IPPF (representing DKT, MSI Reproductive Choices and PSI) • Advocacy seat: MSI Reproductive Choices (representing 100+ NGOs) • Community-based organization seat: International Centre for Reproductive Health– Kenya Programme country seats: • Sierra Leone • Lao People’s Democratic Republic UNFPA seats (non-voting): • UNFPA senior management representative • UNFPA Supplies Programme Leader as Secretary to the Steering Committee UNFPA SUPPLIES PARTNERSHIP 29 We are grateful to the support of all our donors since the launch of the programme in 2007: • Anonymous donor • Australia • Bayer • Belgium • The Bill & Melinda Gates Foundation • Canada • Cartier Foundation • Children’s Investment Fund Foundation • Denmark • European Commission • France • Finland • Germany • HELP Logistics • Ireland • Liechtenstein • Luxembourg • The Netherlands • Norway • Portugal • Private individuals • Regione Lombardia (Italy) • The RMNCH Trust Fund • Slovenia • Sweden • Spain (Spanish Agency for International Development Cooperation [AECID]) • Spain (Catalan agency of Cooperation to the Development [ACCD]) • Spain (Justice and Social Affairs of the Basque government) • Treehouse Investments • United Kingdom • United States • Winslow Foundation Donors Thank you for your continued support and engagement. UNFPA SUPPLIES PARTNERSHIP 30 United Nations Population Fund 605 Third Avenue New York, NY 10158 Tel. +1 212 297 5000 www.unfpa.org @UNFPA © UNFPA, June 2023 UNFPA SUPPLIES PARTNERSHIP VISION: A world where everyone can access quality reproductive health supplies whenever they want or need them For more information, please see the accompanying Performance Measurement Framework Report with a scorecard by indicator. Available at www.unfpa.org.

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