Coordinated Assistance for Reproductive Health Supplies

(formerly Countries at Risk) A Workstream of the SSWG

Kaitlyn RocheUSAID/Commodities Security & LogisticsCARhs Co-coordinator

The CARhs Group

What is CARhs?

•CARhs is a forum ▫of key global-level partners who fund and

procure of contraceptives and condoms ▫who share information ▫to identify countries on the verge of or in

supply shortages, to better understand the causes of these shortages, to identify solutions, and to coordinate their implementation.

•Founded in 2004; first meeting in 2005

Who is involved?

•Core members include UNFPA, USAID, DELIVER, RHSC, RHI.

•The World Bank and UNF / PGH participate regularly.

•Marie Stopes and KfW provide additional information on shipments as requested / when available.

What do we do?•Primary data source: Procurement

Planning and Monitoring Report

•Areas of focus: stockouts, impending stockouts, overstocks

•Services provided: Primarily provide product and product shipment information, occasionally technical assistance or policy advice

•Primary means of work: electronic data sharing; monthly conference calls

The Procurement Planning & Monitoring Report (PPMR)

• Currently 23 countries• Data submission from

JSI, MSH, and Abt• Report either monthly or

quarterly• Report on different levels

of the supply chain (central, zones, districts, all)

• Varying number of programs reporting (public sector, social marketing, NGOs)

Actual months of stock and stock status

Date of next shipment, and supplier, indicates what shipments may create/resolve problems.

“Action Recommended” tells stakeholders how they can

help.

“Comments” describe the situation.

PPMR Database Upgrades

•USAID has allocated funding for the upgrade of the database in 2011/2012

•Move to a web-based platform▫Increase capacity for additional countries

while decreasing manual LOE for PPMR management

•Online reporting, ability to pull reports from web, quicker data availability

•Document requirements & specifications to ensure transferability

•Other features under discussion.

What does it take?•Over 200 days of effort per year, for

CARhs plus PPMR•Monthly CARhs process requires about 10

days of effort across all partners including:▫2 days for Secretariat coordination of

meeting, PPMR analysis, and agenda generation

▫1.5 days for USAID to respond to requests; 2 days for UNFPA to respond to requests

▫1 day for DELIVER to log information updates and disseminate information

•Financial resources are also required - mostly from UNFPA/CSB and USAID Mission funds

CARhs Indicators - Process

•Met monthly without fail•An average of 4-8 participating

organizations per call•194 distinct commodity issues

▫86 information issues▫108 action issues

FY 2010

CARhs Indicators - Countries at Risk

FY 2010

Country# of stockout events (duration of crises in

months)Products

Ghana 7 stockouts (2-6 months)Injectables (4 cases), IUDs,

Implants, POPs

Kenya 6 stockouts (3-8 months)Implants, Injectables, IUDs,

Female Condoms, Male Condoms, POPs

Tanzania 5 stockouts (2-3 months)Injectables, Implants (1

mainland, 1 Zanz), POPs (1 mainland, 1 Zanz)

Mali 4 stockouts (2-3 months)Implants, IUDs, Make

Condoms, Neo-SampoonBangladesh 2stockouts (3 months) IUDs, Implants

Liberia 2 stockouts (2-4 months) Injectables, Male CondomsMozambique 2 stockouts (2-6 months) COCs, POPs

Countries & products with 1< instances of stocks at or below 2 MOS, and CARhs action/ information requested.

CARhs Indicators - Products at Risk

FY 2010

CARhs Indicators - Effectiveness

Jan 2010 - Oct 2010

• Success rate on information items is 97.5%

CARhs Indicators - Effectiveness

Jan 2010 - Oct 2010

• Success rate on action items is 63.5%

Action outcomesExisting

StockoutsAvert Future

StockoutsExisting

Overstocks

Other (stocks btw

max/min)

Action Outcome Totals

CARhs took action that added value

6 26 11 4 47

CARhs took action that did not add value

0 2 0 0 2

CARhs only able to provide info

6 3 0 0 9

CARhs action not needed

4 15 8 1 28

CARhs unable to act 2 9 5 0 16Issue Type Totals 18 55 24 5 102

Action

How CARhs Actions Added Value

Possible actions that added value Total % of TotalNew Shipment 15 32%Expedited Shipment 17 36%Postponed Shipment 8 17%Canceled Shipment 4 9%Technical Assistance 0 0%Provided Policy Advice 3 6%Total 47 100%

Jan 2010 - Oct 2010

• Average duration until resolution was 2 months, with a range from 1 - 7 months

A CARhs Success Story

March - May 2011

• Nov 2010: Rwanda reported a massive overstock (67 MOS or 5.5 years) of Jadelle to the PPMR.

• Feb 2011: Stock at 79 MOS & GoR agreed to a transfer.

• CARhs identified countries in need & UNFPA confirmed Burkina Faso could absorb a shipment of 100,000 on March 3rd.

• UNFPA facilitated transfer product, including covering freight costs.

• May 22nd: Product arrived in Ouagadougou

• Total commodity cost saved: $2.1m

Looking Forward: Opportunities

•Transition of Secretariat from USAID to UNFPA

•Executive Committee for high-level policy issues Increased coordination on annual orders

•Additional countries to the PPMR•Recruiting participation from other

donors who now support RH commodity procurements outside of basket funding▫DfID, AusAID, Netherlands, France

•Support the creation of regional CARhs groups

Looking Forward: Challenges

•Decreased shipment visibility from UNFPA

•Funding constraints•Building in-country coordination among

donors, governments, World Bank, etc.•Encouraging country-led responses•LOE to manage additional countries•Addressing chronic RHCS policy

challenges

More questions? Contact us!

USAID CARhs Coordinators• Kevin Pilz – kpilz@usaid.gov• Kaitlyn Roche – kroche@usaid.gov

UNFPA/CSB CARhs Coordinator• Joe Abraham – jabraham@unfpa.org

USAID | DELIVER PPMR Coordinator• Trisha Long – trisha_long@jsi.com