Terms of Reference for Contraceptive Security
Committees
1. Background Overview
The success of family planning programs and the growing response to curb the HIV/AIDS
pandemic has led to an increased demand for contraceptives and condoms. Countries are faced
with the challenge of ensuring their contraceptive and condom requirements can be sustainably
met when donor contributions do not keep pace with the rising demand. It is essential, then, for
the Ministry of Health (MOH) and its partners to work together to develop strategies for
achieving contraceptive security and to develop the capacity to effectively forecast, finance,
procure, and distribute contraceptives, including condoms.
Contraceptive security exists when every person is able to choose, obtain, and use high-quality
contraceptives and condoms whenever she or he wants them for family planning and
HIV/AIDS/STI prevention. The emphasis is in three areas, as follows:
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First and foremost, contraceptive security interventions must ultimately ensure that clients
have an increased ability to choose, obtain, and use the contraceptives and condoms they
want. Contraceptive insecurity is greatest for clients who want to use contraceptive methods
and condoms, but cannot afford them or do not have access to them.
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Second, contraceptive security means that users are able to choose from a full range of
methods, of high quality, and at an affordable price. While resupply methods are particularly
vulnerable to contraceptive insecurity, access to other methods—such as natural family
planning and long-term, permanent methods—are just as important for contraceptive
security. Increasing access to these methods may not only meet client needs, but also reduce
pressure on scarce public resources.
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Third, long-term assurance. Contraceptive security means that the contraceptives, including
condoms people want, are always available when they need them and that they can obtain
them. This requires long-term commitments from governments, the private sector, and
donors.
2. Rationale
Country partners, technical agencies, and donors have been engaged in an effort to operationalize
contraceptive security at the country and global levels. Through a collaborative process,
stakeholders have agreed the focus of contraceptive security is at the client level, which will
ensure availability, access, and long-term assurance of high-quality supplies for family planning
and HIV/AIDS/STI programs and the clients they serve.
Within the context of the broader health environment, contraceptive security requires—
(1) commitment from governments, donors, and other stakeholders;
(2) coordination among stakeholders, at all levels;
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(3) capacity for high-quality service delivery, a strengthened logistics system, and a full range of
service provider channels (public, nongovernmental organizations [NGOs], social marketing,
commercial); and
(4) capital or finance from governments, the private sector, households, and donors.
To make progress toward contraceptive security, it is important to form/establish a multi-partner
Contraceptive Security Committee, which will, using a collaborative approach, review, discuss,
and suggest approaches on how to overcome contraceptive security challenges. The purpose of
the group will be primarily to address the issues in the following section.
3. Role

Quantify contraceptive needs, and coordinate the securing of the financial resources
necessary to cover them, through both donor contributions and Government of Tanzania
funding.
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Develop procurement plans to schedule shipments appropriately, and regularly monitor their
implementation, facilitating the resolution of any difficulties.
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Build and maintain multi-stakeholder, multisectoral commitment to contraceptive security by
raising awareness of and support for it.
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Assess challenges and opportunities for contraceptive security by providing the framework
and tools necessary to make a joint diagnosis of the problems and strengths in the system.
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Develop, implement, and monitor a multi-partner strategy by harnessing synergies across
sectors, through collaboration and cooperation, to achieve equitable access to contraception
(including permanent methods) and condoms.
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Maintain political commitment through strengthened advocacy for contraceptive security.
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Throughout, foster information-based decision making as a motivator for action at all levels
of the health care delivery system.
4. Organization and Composition
Contraceptive security will have 2 distinct “levels,” best defined by the time horizons relative to
the activities connected with each one.
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National contraceptive security working group: The activities connected with this level are
strictly operational; they focus on the short-term implementation of the program—a need to
regularly monitor donors’ and other funding mechanisms’ capacity to ensure that orders are
placed in accordance with suggestions made during the yearly Contraceptive Procurement
Table (CPT) exercises, and that they arrive and are made available for distribution in a timely
manner. Distribution data (and ideally consumption data) needs to be monitored and
analyzed regularly so that any problems or variations in the presumed delivery schedules and
distribution rates can be detected in time to allow for modifications or additions to the
scheduling of orders.
 Frequency: Monthly
 Duration: 2 hours
 Day: First Thursday of each month
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Location:
Attendees: (Illustrative)
 (Insert Chairperson and Organization)
 Medical Stores Department (MSD) representative
 USAID | DELIVER PROJECT representative
 USAID representative
 UNFPA representative
 Other collaborating partners, as appropriate (Marie Stopes International, Population
Services International [PSI], etc.)
Topics for discussion:

upcoming shipments

status of on-going procurement
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shipments in transit/in port/clearing
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stock levels at all MSD stores
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update of reporting levels from districts
For National Contraceptive Security Working Group meetings, the (insert designated chair), will
be responsible for ensuring that the minutes of each meeting are prepared, circulated among the
participants for comment, finalized, archived, and forwarded to the appropriate parties in the
MOH hierarchy. To this effect, the Reproductive and Child Health Section (RCHS) may enlist
the assistance of the meetings’ participants, on a voluntary or rotating basis, to take notes during
the meetings and to prepare draft minutes for circulation.
National Advisory Contraceptive Security Committee: Activities undertaken at this level are
more programmatic and strategic in nature, and focus on the mid- to long-term evolution of the
program. They will be linked with the yearly preparation of the CPTs and a review of supply
versus consumption; multiple year trends in the evolution of the method mix; and trends in
market share captured by public, social marketing, and private sectors, etc. This level will
involve higher-level strategic partners and will seek to determine what interventions should be
envisioned to influence observed trends in method mix and market share evolution; and the
percentages of total funding provided by donors, private sector, community-generated
supplemental funding; and the individual clients. This analysis will focus on policy issues,
service provision issues, capacity building, demand generation and satisfaction, and other
broader factors that impact the overall landscape of the evolution of the family planning
program.
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Frequency: Annually (with the possibility of additional ad hoc meetings, if warranted)
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Duration: 4 hours

Day: TBD: Immediately following annual CPT exercise (o/a March)
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Location: MOH
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Attendees:
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(Chairperson)
RCHS Head
MSD representative
USAID | DELIVER PROJECT representative
USAID representative
UNFPA representative
World Bank representative
Other donor representatives
Other collaborating partners, as appropriate (Marie Stopes International, PSI, etc.)
Topics for discussion:

results of forecasting/CPTs

comparison of forecast to performance

aggregation of consumption data/couple-years of protection [CYP] and method mix analysis

policies recommended to improve availability (especially service delivery)

desired changes in consumption and how to affect them (demand creation)
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programming of activities to be coordinated with logistics
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comparison of annual program activities to contraceptive issues
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comparison of public and social marketing sector performance

financial requirements for 2 to 5 years
For National Advisory Contraceptive Security Committee meetings, the Chief Medical Officer
(CMO), as chairperson, will appoint one of the meetings’ participants to take notes and draft the
minutes. The draft minutes will then be forwarded to the RCHS, who will, in turn, be responsible
for ensuring that the minutes are circulated among the participants for comment, finalized,
archived, and forwarded to the appropriate parties in the MOH hierarchy.
5. Meetings Schedule
The National Contraceptive Security working group coordination meetings should be held
monthly and attendees (primarily logistics-related MOH and donor staff) should be prepared to
present updated delivery schedules and distribution and stock level data.
National Advisory Contraceptive Security Committee coordination meetings should be held
annually when CPTs are prepared (o/a February of each year) to make use of data compiled for
the CPT exercise. Attendees should comprise both operational, logistics-related staff, and
program managers; MOH strategic planners; and donor program team leaders. Should the need
arise, and be identified during a Level 1 meeting, additional ad hoc Level 2 meetings may be
called during the year. Should this occur, it will be the responsibility of the RCHS Head to
initiate the process of making the necessary arrangements to organize the ad hoc meetings.
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6. Mechanism for Communication of Resolutions
(Insert designated chairperson) will be responsible for taking minutes at each meeting. (This
could also be done on a revolving basis among the regularly attending institutions.) All decisions
taken, actions recommended, and tasks assigned will be included in the minutes; and circulated
to all committee members as soon as possible after each meeting (within one week). At each
meeting, actions identified and tasks assigned at the previous meeting will be reviewed to
determine what progress has been made.
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