Reproductive health problems can be significantly reduced if essential reproductive health supplies are available, affordable, of good quality, and properly used. However, ensuring access to supplies is a complex process. Sustainable access to contraceptives and condoms requires overcoming constraints at the local, national and global levels.
Reaching the hard to reach
Half of the world’s people live in rural areas, many of them hours away from the nearest health centre – which can be an eternity for a woman in labour. Conflicts and natural disasters have disrupted health services -- or created barriers to reaching them -- in many countries. In others, economic transition has eroded health infrastructures.
At the national level, commodity security is fundamentally dependent on a number of essential elements, including forecasting, financing, procurement and distribution
Performing each of these functions successfully requires good data about how much of each commodity has been used (consumption) and how much is left at each level of the supply chain (stock status). This data must be collected by an effective logistics management system and used to forecast future needs, determine financing requirements, procure supplies in a timely manner, and manage their distribution in order to avoid shortages.
These are key elements in the supply chain:
- Product Selection: This may be the responsibility of a national formulary and therapeutics committee, pharmaceutical board, board of physicians, or other government-appointed group. Many countries have developed a national essential drugs list (products deemed most cost-effective in treating priority health issues), which guides both procurement decisions and prescribing practices by health care workers. UNFPA partners with WHO to provide recommendations.
- Forecasting: After product selection, managers of the logistics cycle must determine the quantity of each product to procure, and over what time period. These figures are based on data showing past use as well as demographic and programming information that adjusts for likely increases in demand or expansion of services. Learn more about forecasting tools.
- Procurement: This can be a very complex task, and procurement decisions will affect the cost and quality of the products as well as the timing of their delivery. In general, there are significant cost-saving benefits to procuring large quantities of a product that meet a programme’s needs over a period of years rather than months. Learn more about UNFPA Procurement.
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Distribution: After items are procured and received at the national level, they are sent to regional warehouses, stored, and then transported health facilities as needed. Determining how much stock should be ordered is an important decision, and is determined by factors such as demand, shelf-life and finances.
- Transporting products: In resource-poor countries, which tend to have poor transportation infrastructures, transport can be the weakest link in the chain. Achieving universal access to reproductive health care (MDG5) requires that goods are moved across deserts, over mountain passes, and to remote islands.
- Information Systems: Information drives the logistics cycle. Without reliable information, the logistics system will not run smoothly. Ideally, managers are able to gather and analyze data in order plan and coordinate activities. An effective Logistics Management Information System (LMIS) can also provide data on wastage and stockouts, revealing problems in the logistics system that need to be addressed. Learn more about Information Systems .
- Monitoring quality: The quality (or efficacy) of the products selected should be checked at the time of procurement, as well as during storage and distribution. UNFPA checks and approves manufacturers so that countries can be sure they are spending their budgets on reputable products. It is also critical to monitor expiration dates and temperature of storage facilities, especially when refrigeration is necessary.
An efficient supply chain requires well-trained staff members to place orders, move boxes, and provide clients with goods. Health programmes must be organized to provide the appropriate resources (for example, knowledge, technology, managerial skills) to ensure that all logistics activities are carried out properly and thereby contribute to achieving commodity security.
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