Commodity Security

Initiative and Country Support

Anabella Sánchez, Nora QuesadaPanama, February 2010

What Is the Goal of the USAID LAC Commodity Security Initiative?

Identifies common and priority CS-related issues in the region, and designs and

implements regional- and country-level interventions to help achieve CS in an

efficient, sustainable and equitable manner.

The impetus…Strategic Pathway to Reproductive Health Commodity Security Framework

What approach have we used to move forward in Commodity

Security ?

5

1. Regional Meetings (2003-2009)

Managua, Nicaragua 2003 Launched Commodity Security (CS) initiativeAssessments (Bolivia, Nicaragua, Honduras, Paraguay, Perú, Ecuador, Dominican Republic, and Guatemala)

Lima, Perú 2004 -Dissemination of assessments-Commitment to form Commodity Security committees- Stakeholders of multiple organizations were exposed to the importance of CS to achieve health goals

Antigua, Guatemala 2006: Advocacy for CS

Sub-grants with civil society organizations and other CS committee members

Santo Domingo, Dominican Republic 2007 : Logistics in Times of Health Reform

-Lessons learned shared to protect the supply chain in decentralized and integrated settings, with a health systems strenghtening focus.

Antigua, Guatemala 2008: Equity in CS

- Prioritized interventions to reach vulnerable populations (Youth, women with no education, rural)

Cartagena, Colombia 2009 : Developing Options for Contraceptive Procurement

-Best practices and lessons learned for efficient procurement.-Information shared about global and national procurement options

• Contraceptive Procurement options (Regional and Country specific)

• Logistics in times of health reform: decentralization and integration studies

• State of the Practice briefs in LAC countries (2006)• Bolivia and Guatemala - Integrated Logistics Information

System

• Case studies of Social Security Institutes in LAC

• Ministry of Health Nicaragua: Integration of logistics system, with lessons learned for LAC and other regions

2. Special Studies and Best Practices

• Contraceptive Security monitoring and evaluation guide and indicators

• For CS Committees

• LAC Procurement Options Paper 2009

• Assessment of Honduras Social Security Institute

• Application of Geographic Information System (GIS) tool to:– Analyze unmet need using supply chain simulation tools in

Guatemala– Analyze logistics indicators in Paraguay– Analyze DHS data in Nicaragua

3. Special Studies and Best Practices

8

What Has this Regional- Country Support Approach Accomplished so Far?

• COMMITMENT:– Active and vibrant CS committees– CS champions (ministers, congresswomen, civil society)– Raised awareness on CS funding– Country CS plans include commitments from regional

workshops

• CAPITAL:– Incremental government funds allocated for contraceptive

procurement– Laws and budget line items (Paraguay, Nicaragua, El Salvador,

Guatemala)

Porcentaje de Fondos Asignados para Compra de Anticonceptivos - Ministerios de Salud

1% 0%

45%

53%

66%

10%

44%

50%

62%

23%

100%

53%

37%

68%

0%

75%

64%

80%85%

100% 100%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Nicaragua Paraguay Guatemala El Salvador RepúblicaDominicana

Perú Honduras

2006

2007

2008

Fuente: Estudio de Compras 2009 estudio de Opciones de Compra2009, USAID PROYECTO DELIVER

10

• CAPACITY:– Improved use of UNFPA procurement mechanisms– Countries empowered to:

• overcome legal barriers during the procurement process• Identify the best mechanism available through UNFPA• Make informed buying decisions• Explore other options (Reverse auction, AccessRH)

– CS indicators used for monitoring and evaluation of Strategic Plans

• LOGISTICS:– Best practices shared among countries to resolve common challenges

• Impact of integration on the supply chain

What Has this Regional-Country Support Approach Accomplished so Far?

What have countries gainedwith this approach?

Commonalities among countries

• Active CS Committees

• Government commitment to FP and CS

• Strong logistics systems

• Reduced contraceptive stock outs

• Improved contraceptive availability

• Market segmentation analysis

• Contraceptives included in Essential Drug lists

Overview of Country Achievements

• El Salvador– Integrated logistics system for essential drugs and contraceptives– Web Based logistics information system– Alliance between MOH and Social Security to procure contraceptives

• Nicaragua– CS Committee beyond contraceptives– Successful Integrated Logistics System, where contraceptives are

prioritized– Support to Public-Public partnership to secure FP services and supplies

• Dominican Republic– Manual logistics information system used nationwide– Funding for contraceptives– Efforts to integrate FP and HIV/AIDS

• Paraguay– Law earmarks budget line item for contraceptives– Successful Integrated Logistics System, where contraceptives are

prioritized

Key for Success...

• Cross fertilization between regional and country level activities

• Regional ------------ country --------------regional

• Collaboration with other partners at the national and regional levels has leveraged funding and impacted on meaningful results

• CS (DAIA) is a symbol, a brand name

Everybody talks about DAIA

• Getting full government funding for budget line items

• Contraceptive Market strategies: concrete and feasible strategies to diminish gaps in unmet need, access and equity– Social security institutes, NGOs, commercial sector, others

• Ensuring continuation of successful approaches to meet countries´ expectations and needs

• Expanding commitment to CS beyond government and USAID-UNFPA supported organizations (commercial sector)

• Consolidating integrated systems: automation, forecasting, with a health systems strengthening approach

• Protecting contraceptives in an integrated, decentralized environment

• Sustainability beyond donor support for – allocation of budget for logistics management key activities– Continuation of CS committees

• Identifying procurement options other than UNFPA

Challenges

Considerations to protect FP and CS

• Keep FP, CS, and funding on the political agenda

• Support the continuation of successful approaches to meet countries´ expectations and needs

• Support:– Public-private alliances – Public-public alliances

• Use a Total Market Approach and Strategies

• Expand membership and scope of CS committees

NO PRODUCT? NO PROGRAM!

!SIN INSUMOS, NO HAY PROGRAMA!

¿PREGUNTAS? QUESTIONS?