Introduction

Contraceptive Requirements and Logistics Management Needs

Training

Coordination and Collaboration

Monitoring and Evaluation

JOICFP-Executed Projects

Centres of Excellence for South to South Cooperation

Safe Motherhood Projects

HIV/AIDS Prevention Interventions

Implementing the Reproductive Health Approach

UNDAF Assessment

In Indonesia, home of this nursing mother, UNFPA is helping the Government forge partnerships with the private sector to improve access to affordable contraceprtives.

The Global Initiative on Contraceptive Requirements and Logistics Management Needs was established in 1992 with support from donors and international agencies.

Since then, the initiative has addressed a wide range of global as well as country-specific needs. During 1998, it focused on the following priority areas: national capacity-building in the areas of logistics management and distribution of reproductive health commodities; donor coordination and advocacy to improve the supply of reproductive health commodities; and sustainability of contraceptive and reproductive health commodities, to be achieved in part through collaboration with the for-profit sectors in developing countries.  

The Global Initiative, together with UNFPA country offices and Country Support Teams, contributes to national capacity-building in a variety of ways. For example, it provides technical support for logistics management, strategy development workshops and in-depth studies on contraceptive requirements and logistics management needs.

In 1998, such studies were conducted in Turkey, Viet Nam and Zimbabwe. The studies' reports helped identify contraceptive needs and determine national capacity to meet those needs. In Viet Nam, the report was used to generate donor resources to meet urgent contraceptive requirements, while Turkey's report made recommendations for cost-recovery mechanisms. In Zimbabwe, the report drew attention to long-term contraceptive needs.

The logistics management training and strategy development workshops held in Santiago, Chile, and Kampala, Uganda, each included participants from five to six countries. At the workshops, which offered participants a forum for developing logistics management strategies, particular attention was paid to the effects of health-sector reform upon the distribution and sustainability of reproductive health commodities. The "recommendations matrix" developed in 1998 is being used to monitor follow-up regarding the implementation of workshop strategies and the carrying out of study recommendations.

Coordinating donor support is a crucial part of strengthening national logistics systems and improving the flow of reproductive health commodities to developing countries. The major donors of contraceptive commodities are represented in the Working Group that supervises the Global Initiative. The Working Group's periodic meetings during 1998 provided opportunities to discuss current and future commodity provision; they also contributed to better planning and coordination among donors. An annual report, Donor Support for Contraceptive Commodities, which is compiled by UNFPA from data supplied by donors, provides details on the quantities, types and costs of contraceptives provided to developing countries and countries with economies in transition. The report, available on the UNFPA Web site, also analyses donor activities aimed at strengthening in-country logistics systems.

Programme sustainability is a major goal of the UNFPA private-sector initiative. The initiative, which was launched in 1997, works with the for-profit private sector and non-governmental organizations in developing countries to increase access to affordably priced commercial reproductive health products and services. In so doing, the initiative frees up public-sector resources, which can then be used to serve the needs of population groups unable to pay full price for such products and services.

A meeting held during 1998 reviewed progress on the private-sector initiative. Gathering at the Rockefeller Study and Conference Center, in Bellagio, Italy, from 16 to 20 November, the participants agreed that the initiative needed to be strengthened in a number of areas, including demand creation, public policy and donor coordination. They recommended that UNFPA continue to support further exploration of the initiative in selected countries. Six missions were fielded in 1998, to Egypt, Ghana, India, Indonesia, South Africa and Thailand. Egypt, Ghana and India in particular have shown considerable interest in the initiative. It is expected that affordable, commercial contraceptive products will become more widely accessible in these and other countries, as governments forge new partnerships with the private sector.

The Status of girls and women has a direct effect upon
the success of reproductive health programmes and
UNFPA-supported projects

In 1998, the Global Initiative produced a draft report on global requirements for reproductive health commodities. The draft expanded on a previous report entitled Contraceptive Use and Commodity Costs in Developing Countries, 1994-2005. The new report analyses the financial implications of meeting projected reproductive health commodity needs through the year 2015. It estimates an annual financial requirement of $8.4 billion for reproductive health commodities in the year 2000, with the requirement rising to $9.6 billion by 2015. Contraceptive costs make up about 10 per cent of the estimated total; commodities for antenatal and normal-delivery care constitute about 40 per cent; commodities for treatment of pregnancy-related complications about 25 per cent; and commodities for the treatment of reproductive tract infections the remaining 25 per cent.  

Aiming to strengthen the logistics management capacity of countries with UNFPA-supported programmes, the Global Initiative has prepared revised guidelines for logistics managers. The document, which provides checklists for the procurement and resupply of commodities, will help supply managers for UNFPA country programmes select the right products, at the right time, and at the right price. In addition, the UNFPA Procurement Unit has prepared guidelines to facilitate procurement by the World Bank and other agencies using UNFPA procurement services. When country programmes are being prepared, the Global Initiative staff collaborate with staff from the relevant UNFPA Geographical Division to estimate resource allocations for reproductive health commodities. Working closely with the Fund's Global Contraceptive Commodity Programme (GCCP), the Global Initiative is strengthening its mechanisms to provide follow-up technical support to countries experiencing shortages due to logistics problems.

The Global Initiative has helped build national capacities and strengthen national logistics systems in a variety of ways. For example, participants at the logistics management training and strategy development workshop in Santiago developed a plan to establish an interactive computer network to share their best, most successful practices, as well as the most valuable lessons learned, with logistics experts in the region. The network is expected to strengthen national capacities by developing regional expertise in managing reproductive health commodities. In India, the Global Initiative recently helped bring together the Government, donors and contraceptive manufacturers. The participants discussed ways to strengthen cooperative efforts between the public and private sectors, with a view towards expanding the availability of oral contraceptives. Based on the Global Initiative missions' predictions of imminent contraceptive shortages in Kazakhstan, Uzbekistan and Viet Nam, the respective Governments decided to establish and/or strengthen national logistics systems to reduce the likelihood of future shortages.

In 1998, countries with UNFPA-assisted programmes continued to utilize services provided through the GCCP. The GCCP was established in 1997, in response to decision 96/3 of the Executive Board. During 1998, the GCCP expanded stock holdings to include not only condoms, but also oral contraceptives and intra-uterine devices (IUDs). Oral contraceptives were added due to the lengthy lead times being experienced in obtaining some of those products, and IUDs were added to secure the remaining production of a manufacturer that was ceasing operations. During the year, UNFPA supplied over 2 million gross of condoms under the GCCP, to a total of 13 countries.

During 1998, UNFPA worked with the Inter-Agency Working Group on Reproductive Health in Refugee Situations to develop a set of kits containing essential drugs, basic equipment and contraceptives. Such cooperation is in keeping with the recommendations of ICPD, which stressed the importance of reproductive health programmes in emergency as well as non-emergency situations. The kits were incorporated into the GCCP at the beginning of 1998, with UNFPA initially setting up a stockpile valued at $500,000. However, a succession of crises around the world during the year resulted in UNFPA’s providing a total of nearly 2,000 kits (totalling $1.7 million) to 15 countries: Afghanistan, Bangladesh, Comoros, Republic of the Congo, Eritrea, Guinea, Guinea-Bissau, Honduras, Lesotho, Madagascar, Nicaragua, Papua New Guinea, Rwanda, Senegal and Uganda. Anticipating continued high demand, UNFPA is increasing the stockpile of kits currently maintained at a central location in Europe, in the Netherlands, with a total value of $1.5 million.