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Building a South-to-South
Exchange Network in the Latin
America and Caribbean Region
Nora Quesada
Nadia Olson
Anabella Sanchez
Wendy Abramson
June 24, 2011
Addis Ababa,
Ethiopia
In the summer of 2003,
the USAID LAC BUREAU
launched a Regional Initiative…
In Eight Countries:
Guatemala, El Salvador
Dominican Republic,
Bolivia…
…Honduras, Nicaragua,
Paraguay, and Peru
The inaugural event,
Contraceptive Security
Advocacy Conference,
Managua, Nicaragua, July
2003
 Completed country/
regional assessments
 Formed most of LAC
CS committees
The Road Has Been Long
and Winding…
We Learned Four Essential Principles
Along the Way…
Ensure Harmonization
Leverage Resources
Use Data for Decisions
Focus on Sustainability
We Have Come a Long Way…
2003
2006
2011
 Phase-out
process begins
 Country
assessments
show CS
challenges remain
 Six countries
financing 100% of
contraceptives
 Countries
depend on
contraceptive
donations
 Family
planning
mainly
supported by
donors
 CS committees
active in eight
countries
 Various countries
financing &
procuring
contraceptives
 Six countries
procuring quality
contraceptives at
internationally
competitive prices
 Five countries
managing
integrated supply
systems
We Built Roads Between Countries…
 3 countries passed laws to protect financing and
access to family planning
 3 countries are better coordinating service provision
 6 countries finance their contraceptives 100 percent
 6 countries realize significant cost savings by
procuring through UNFPA and other innovative options
 5 countries are building integrated supply chains,
based on the contraceptive model
 2 countries manage their supply chains on their own,
and one with minimal external assistance.
Contributed to Great Achievements…
Contraceptive Financing from Country Governments
2006–2010
100%
100%
90%
85%
100% 100%
100%
100% 100% 100% 100% 100%
84%
81%
80%
80%
75%
75%
2006
70%
70%
64%
60%
54%
62%
53%
50%
2008
2009
50%
45%
53%
2010
44%
37%
40%
30%
2007
68%
66%
23%
20%
10%
10%
0%
0%
1%
0%
0%
Dominican
Republic
El Salvador
Guatemala
Honduras
Nicaragua
Paraguay
Peru
Source: Olson, Nadia, Anabella Sánchez, Ángel Reynoso, y Nora Quesada. 2010. La Adquisición de Anticonceptivos en América Latina y el
Caribe: Un Análisis de Opciones Actuales y Futuras en Ocho Países. Arlington, Va.: USAID | PROYECTO DELIVER, Orden de Trabajo 1.
Notes: Donors provide the remaining funds to cover total public sector need in each country.
That Were Led by Local Leaders…
“The initiative helped me
to develop a vision for
closer collaboration
between Ministries of
Health and Social
Security Institutions. We
are working towards
achieving the same
objective but through
different channels.”
“The regional initiative
provided crucial assistance.
We had the opportunity to
share experiences with other
countries and this helped us
to broaden our approach to
the topic and allowed us to
move forward. Having this
support strengthens us..”
- Dra. Yesenia Díaz, Deputy Director
- Dr. Esmeralda Ramirez,
Director RH Department, MOH, El Salvador
of Health Services for the Insurance
Department, SSI, Dominican Republic
Who Helped Fuel Improved Outcomes…
Modern Contraceptive Use in LAC Countries
(Women in Union)
80
70
70
60
66
66
64 66
62
56
53
30
50
44
35 35
61
57
51
50
40
71
70
31
35
47
50
41
38
25
20
10
0
'98 '03 '08
Bolivia
'99 '02 '07
Dominican
Republic
'98 '02 '08
'99 '02 '09
El Salvador Guatemala"
'96 '01 '06
Honduras
'98 '01 '07
Nicaragua
'96 '04 '08
Paraguay
'00 '04 '09
Peru
But We Still Have a Long Way to Go…
• Health sector reform is still a major challenge
• Developing lasting procurement options will be difficult
• The fight for financing to distribute contraceptives and
other essential medicines never ends
• Huge disparities in access still exist in every country,
especially among our adolescents, our indigenous, and
our rural populations
• These supply systems still need to be fully embedded in
the health system and used as a strategic pillar for
delivering health services
Thank
[email protected]
You!
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