Progress to date on
Contraceptive
Security in
Latin America
Anabella Sánchez, Manager for LAC CS Regional Initiative
Nora Quesada, Manager for LAC country programs
Arlington May 20, 2009
What does the LAC CS Initiative do?
Designs and implements regional- and
country-level interventions to help
achieve CS in an efficient and equitable
manner, by identifying common and
priority CS-related issues in the region
CS Elements supported through the regional initiative
Status of Contraceptive Security
• Free contraceptive provision by governments
• High contraceptive prevalence rates (above 70%)
• Still high unmet need in some populations (17%+ in adolescents, rural
areas)
• Government funds allocated for contraceptive procurement and using
UNFPA as procurement agent
• Most CS Committees supported by (at least) a Ministerial Decree
• Stock-out rates reduced to minimum
• Most systems are integrated/working toward integration
Where are we now…
FIELD SUPPORT
• Five countries: Paraguay,
Nicaragua, Honduras, El
Salvador and Dominican
Republic
• Near graduation from USAID
assistance (2010-2011)
• Strong CS initiatives
• Integrated systems/moving
toward integration with large
number of drugs to manage
• Highly urbanized cities
• Fairly good infrastructure
(roads, communication)
LAC CS INITIATIVE
• Cross-fertilization with input
from on-going country work
• Document and disseminate
lessons learned
• Opportunity to apply new
technologies
• (GIS) for regional impact
• Supply Chain Guru
Major Accomplishments in CS
• El Salvador
– Maternity law includes contraceptives, elevating their status
– Government resources and leadership to develop and launch a
national web based LMIS
• Nicaragua
– Highly active CS Committee, with government procuring contraceptive
supplies
– Case Study on Integration of the Logistics System (2008)
– Use of GIS to analyze DHS results and further market segmentation
analysis
• Dominican Republic
– Central level using PipeLine (01/09)
• Training and empowerment
– Agreement between Profamilia and SESPAS to secure availability of
products
Major Accomplishments in CS
• Paraguay
– Budget line item for contraceptives
– GIS used in last LIAT (09/08): geo-coding of representative sample
of MOH health facilities for future use
• Honduras
– CS Committee has a work plan, an implementation plan, indicators,
and meetings are very structured and focused
• M&E guide shared with CS Committee
– Government procures all contraceptive supplies
– Procurement agreement with UNFPA saves GOH $1M per year
– TA to revitalize FP services in Social Security applying lessons
learned from other countries (Regional SS case studies)
Contraceptive Security:
Strenghts and Opportunities
•Budget for procurement is now part of the budgeting cycle
•Strong support for CS
•Use of PipeLine for contraceptive projections, even at regional
levels (El Salvador): great tool to negotiate budget allocations
•Integrated systems enables sustainability of the logistics system in
the future: more resources and commitment involved.
•Common themes allow collaboration between UNFPA and USAID at the
regional level (Regional Procurement options paper and workshop)
Contraceptive Security:
Challenges
•
Getting a budget line item
– Paraguay has it, but still advocates for more funding
•
Coordinating with other partners
– ensuring the same focus and approach toward a common goal, and meeting clients’
expectations and needs
•
Identifying procurement options, other than UNFPA
•
Expanding commitment to CS beyond government and USAID-UNFPA
supported organizations
•
Consolidating integrated systems: automation, forecasting, etc.
•
Protect contraceptives in an integrated, decentralized environment
•
Sustainability beyond donor support
– How to ensure CS committees are empowered to continue advocating for CS
•
Market segmentation: how to convert findings into actions that improve equity
and more effective use of resources in FP.
How to address these challenges?

Regional Study: Update of contraceptive procurement options in LAC


Regional procurement workshop in Colombia in September/09


Audience: MOH and Social Security Institutes
Technical assistance to selected CS committees to address challenges
facing Social Security Institutes to provide FP services and commodities


Procurement Capacity, UNFPA agreements, New suppliers, generics, Quality, Access RH
Regional Policy Brief for social security institutes
Policy briefs of GLP studies on contraceptive procurement practices and
lessons learned from Mexico, Colombia, and Chile
 Application of GIS tools to analyze health and logistics indicators

Disseminate monitoring and evaluation guide to institutionalize M&E within CS
committees and its stakeholders
Best practices - LAC CS Regional Initiative
•
Evolution of regional meetings
–
–
–
–
•
Share best practices, common challenges and lessons learned
From technical to policy and advocacy topics
Engaged other actors outside the health sector to commit to CS
CS champions within and beyond the health sector
Key for success: cross fertilization
– Regional ------------ country --------------regional
•
Document best practices, share with country counterparts and incorporate
into CS plans and graduation plans
•
Country CS plans include strategies developed during workshops:
– protect contraceptive procurement in decentralized settings
– Awareness raising to secure funding
•
Five years later…… CS (DAIA) is a symbol, a brand name
– Everybody talks about DAIA
THANK YOU!!!
Questions?