Reproductive Health Supplies in Six Countries

By Elizabeth Leahy with Esther Akitobi, Nel Druce, Karen Hardee, Carlos Manuel Indacochea, Joana Nerquaye-Tetteh, Leslie Patykewich and Carolyn Gibb Vogel

Reproductive Health Supplies in Six Countries: Themes and Entry Points in Policies, Systems and Funding, identifies the challenges faced by reproductive health programs in Bangladesh, Ghana, Mexico, Nicaragua, Tanzania, and Uganda. Funding constraints, combined with a weak commitment to prioritize the purchase of reproductive health supplies on the side of the recipient countries and a limited capacity for distribution, have created an unstable environment for supplies worldwide. The report, and its six associated case studies, calls for renewed attention to reproductive health supplies to avoid putting the health of millions of women at risk.

Key Findings

  • Policies on family planning and reproductive health supplies exist but are poorly implemented due to weak government commitment.
  • Funding for reproductive health supplies from country governments is increasingly fragile in both the short- and long-term as donors withdraw support.
  • Budget line items for reproductive health supplies are often drawn from pooled health sector or general budget funds, or remain largely underspent, and do not necessarily indicate a dedication on the part of the government to use its own resources for reproductive health supplies.
  • Countries have made major improvements in their reproductive health supplies logistics systems in recent years, thanks in part to external technical assistance, and have taken on a greater share of the management of regular forecasting and smooth procurement.
  • The security of reproductive health supplies is most precarious at the district and facility level, in some cases compounded by decentralization.
  • Advocacy on reproductive health supplies is a new issue for many civil society organizations, who are often viewed by governments as service providers, despite their advocacy capacity.
  • Support of civil society advocacy is key to promote and monitor the necessary increases in commitments from national governments.

Advocacy Entry Points

  • Motivate government officials and public opinion through communication campaigns.
  • Provide quantified projections of need for reproductive health supplies, working with contraceptive coordination committees, to justify the commitment of sufficient financial resources.
  • Link into government through targeted supporters, such as parliamentarians and former government officials.
  • Add relevant indicators to policies and planning documents, monitor budgets and promote transparency.
  • Promote integration of reproductive health supplies and related issues, such as HIV/AIDS and maternal mortality.
  • Ensure that health systems strengthening efforts emphasize sustainability of the supply chain for contraceptives and condoms, and promote mechanisms to improve coordination across levels.
  • Provide budget oversight, community sensitization and coordination at the regional and local levels.
  • Utilize global-level commitments such as the Millennium Development Goals and Paris Declaration on Aid Effectiveness to motivate country governments and donors.