Strategic Approaches

Of the 46 GPRHCS-supported countries:
39 countries have put in place national guidelines and protocols that include a rights-based approach to reproductive health commodity security and family planning.
33 countries have developed policies that take into consideration young people’s access to contraceptive services.
32 countries have functional coordinating mechanisms for reproductive health commodity security, led by the government, with membership drawn from donor agencies, UN agencies, civil society, the private sector and other stakeholders.
In 2013, 25 countries had budget line allocations for either contraceptives, maternal health medicines or both.
In 2013, 23 national institutions received GPRHCS support to integrate reproductive health commodity security and family planning into training curricula for service providers.

How we work

The Global Programme to Enhance Reproductive Health Commodity Security (GPRHCS) is a unique and effective mechanism for delivering life-saving and live-improving reproductive health supplies in developing countries.
GPRHCS’s goal is universal access to reproductive health commodities and family planning services and information. To this end, our work aims to achieve five strategic results: improved enabling environments; increased demand for reproductive health commodities; improved efficiency for procurement; improved access to reproductive health and family planning; and strengthened national capacity and systems.

Improved enabling environments

Creating an environment where positive change can occur – an ‘enabling environment’ – is an ongoing process. It requires mobilizing political will and financial resources and fostering national ownership over the programme. GPRHCS advocates for the development of policies and strategies, promotes coordination and partnerships, and helps build political commitment.

Increased demand for reproductive health commodities

When people become aware of their needs and rights to access family planning services, demand for these services grows. When demand grows, services should be expanded. Awareness raising, education, advocacy, community mobilization, and a ‘total market approach’ all help drive the expansion of reproductive health services.

All 46 GPRHCS-supported countries conduct demand-generation activities. In 2013, 22 countries conducted at least five of effective interventions to create demand for contraceptives.

GPRHCS-support initiatives are also providing adolescents with age-appropriate reproductive health information and youth-friendly services. Specific methodologies and appealing tools are used to reach youth, including peer-to-peer discussion groups, audio-visual materials, media and mobile technologies, as well as music and drama.

UNFPA also promotes the ‘total market approach.’ This means working with all the sectors in the market – including the public sector, commercial suppliers and nongovernmental organizations – to ensure that all people can choose, obtain and use quality contraceptives whenever they need them. GPRHCS helps promote and facilitate partnerships and collaborations that increase access to male condoms as well as other contraceptives and reproductive health products.

A key issue is equity of access at an appropriate price, starting from free with rising cost contributions for those able to pay. Responsibility for coordination and leadership of the total market approach lies with government.

Improved efficiency for procurement and supply of reproductive health commodities

At the core of UNFPA’s mandate is making procurement processes efficient and environmentally friendly, and delivering an appropriate mix of quality commodities to countries based on their needs.

Within the UN system, UNFPA is the lead agency for the procurement of reproductive health commodities. Among development agencies, GPRHCS is the leading supplier of contraceptives. $108 million of GPRHCS funds accounted for 41 per cent of all aid shipments of reproductive health commodities in 2013. GPRHCS supported the procurement of about 33 per cent of all donated reproductive commodities.

In 2013, a consortium of partners signed minimum volume guarantee agreements with two global manufacturers of contraceptive implants. Under the agreements, if certain procurement volume thresholds are reached, the unit price per implant is reduced significantly. With the targets set currently being met, partner countries are currently able to benefit from unit price reductions per implant of more than 50 per cent – from as much as $18.50 to $8.50 per implant.

GPRHCS is ensuring that the terms of the minimum volume guarantee agreement for implants are met. Indeed, in 2013, GPRHCS accounted for 59 per cent of the total procurement of implants, which corresponds to 81 per cent of the minimum volume guarantee.

In addition, AccessRH, the UNFPA-managed reproductive health procurement platform and information service, has contributed to a significant reduction in delivery times compared to non-AccessRH sources. In 2013, with AccessRH, lead times were reduced by 87 per cent for fistula kits, 80 per cent for female condoms and 75 per cent for male condoms. Specifically, lead times dropped from 12 weeks to three weeks for male condoms, 10 weeks to two weeks for female condoms, and 16 weeks to two weeks for fistula kits.

As a leading international agency working on reproductive health, UNFPA considers the management of reproductive health products throughout their life cycles very important. In 2013, UNFPA issued guidelines for the management of waste from contraceptives. Since its publication, steps have been taken to inform countries about its content, purpose and relevance for the implementation of GPRHCS.

In 2013, country-level action was initiated in 11 countries, with steps taken to disseminate the document. In addition, UNFPA worked with 11 manufacturers that agreed to implement ISO14001, the internationally recognized standard for the environmental management of businesses. The manufacturers have active and documented waste water programmes and have agreed to reduce raw material usage.

Improved access to quality reproductive health and family planning services

Poor and marginalized women and girls face many barriers to accessing quality reproductive health services. UNFPA supports the efforts of government and other partners – including nongovernmental organizations, community-service organizations, faith-based organizations, youth groups and the private sector – to strengthen youth-friendly services, community-based services and services in humanitarian settings.

In 2013, 26 of the 46 GPRHCS-supported countries integrated sexual and reproductive health and family planning services into HIV and maternal health services, and also ensured a gender-responsive and human-rights-based approach in service delivery. GPRHCS also collaborated with 52 non-state actors (including nongovernmental organizations, social marketing organizations, faith-based organizations, civil society organizations, members of the private sector, and UN partners) to provide services to marginalized populations.

To ensure and improve the capacity of health workers, UNFPA has supported training on reproductive health commodity security and family planning across all 46 countries.

Strengthened national capacity and systems

Access is about going the last mile to reach individuals who are hard to reach due to poverty, geography, ethnicity, disability, displacement or age. This requires proper policies and functional logistics management systems that support a whole supply chain.

Through GPRHCS, UNFPA supports governments in strengthening supply chain management. This includes training in key areas such as demand forecasting, procurement, warehouse improvement, as well as inventory management and reporting.

UNFPA also supports the adoption and use of tools to monitor inventory of reproductive health commodities, such as the computer software programme CHANNEL. In 2013, 70 per cent of the GPRHCS-supported countries had a logistics management information system in place. Among the 46 countries, 70 per cent made no ad hoc request for contraceptives, meaning essential items were on hand when needed, in contrast to years prior to GPRHCS support, when sudden shortages endangered health and drove urgent procurement efforts to fill gaps.

Eighty per cent of all GPRHCS countries use CHANNEL or another health supply chain management information tool for monitoring reproductive health commodities.

In 36 of the GPRHCS countries, governments are leading demand forecasting processes. In 2013, 91 per cent of the countries used government institutions to coordinate demand forecasting, and 78 per cent used government institutions to coordinate procurement processes.

Keys to the success of GPRHCS
GPRHCS is the only UN programme that specifically addresses reproductive health commodity security. It is the key UNFPA programme to ensure access to a reliable supply of contraceptives, condoms, medicine and equipment for family planning, HIV and sexually transmitted infection prevention, and maternal health services. It leverages UNFPA’s comparative advantage in procurement as high-volume buyer and pooler of significant donor resources, maximizing buying power and ensuring value for money.

The programme has a proven track record in capacity building for procurement and supply chain management, in conducting policy dialogue with governments, and in executing strategies to increase access to commodities and services among poor and vulnerable populations.

Thanks to UNFPA’s intergovernmental mandate to work on family planning and reproductive health, and its credibility among donors and beneficiaries, GPRHCS has unique relationships with government partners as well as with regional, political and economic institutions.

Much of the programme’s success can be attributed to strategic partnerships with UN agencies, donor and partner governments, non-governmental organizations, community-based organizations, civil society groups, faith-based organizations and the private sector. Key partners include: Reproductive Health Supplies Coalition, FP2020, the United States Agency for International Development, the Bill & Melinda Gates Foundation, the World Bank, John Snow Inc., Population Services International, the International Planned Parenthood Federation, the Planned Parenthood Federation of America and other valued partners.

GRHCS is structured as a thematic trust fund – a performance-based and flexible mechanism that provides donors with the opportunity to target their commitment to a particular thematic priority, allows for pooled multi-year funding, and ensures more timely and flexible use of resources to address specific country needs. A dedicated Steering Committee gives donors full oversight of the programme. Transparency and accountability are ensured through a rigorous performance monitoring framework that allows stakeholders to clearly track progress and monitor results achieved.

GPRHCS is anchored in the principles of the International Conference on Population and Development’s Programme of Action, the Millennium Development Goals, the Paris Declaration on Aid Effectiveness and the Accra Agenda for Action. It contributes to the UN Secretary General’s Global Strategy on Women’s and Children’s Health and the Campaign for Accelerated Reduction of Maternal Mortality in Africa, and it aligns with the efforts of the UN Commission on Life-Saving Commodities for Women and Children.