e x p a n d i n g f a m i l y p l a n n i n g o p t i o n s achieving security for sdm/cyclebeads in...
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E X P A N D I N G F A M I L Y P L A N N I N G O P T I O N S
Achieving Security for SDM/CycleBeads in Rwanda and Mali: Untangling Procurement, Distribution & Policy Issues
Marie Mukabatsinda, Country Representative, Rwanda
Georgetown University’s Institute for Reproductive Health
Caucus for New and Underused Method PanelRHSC Annual Membership MeetingAddis Ababa, Ethiopia | June 2011
Standard Days Method® & CycleBeads® Appropriate for women
with menstrual cycles between 26 and 32 days long
Identifies days 8-19 of the menstrual cycle as fertile
Helps a couple avoid or plan pregnancy
Is used with CycleBeads® to : identify fertile days communicate with
partner 95% effective with correct
use Reaches non-users,
traditional method users & reduces unmet need
Accounts for 2 CYPs
Introduced into programs in more than 30 countries USAID-funded programs can order CycleBeads through
USAID | DELIVER, just as they order other contraceptives Other programs can order directly from manufacturer, Cycle
Technologies at www.cyclebeads.com Sales data available on RHInterchange (as shown below)
SDM/CycleBeads: Available Worldwide
Source: RHInterchange
Method Concept & Efficacy Trial
1999-2002
Pilot Studies2000-2004
Operations Research
2003- 2005
Integration Studies
2005 - 2007
Scale-Up Case Studies 2007-2012
SDM: From Research to Scale
One factor IRH had to consider during scale-up was how CycleBeads would be integrated into—and sustained by—the health system. This presentation shares four lessons learned from this process.
Contraceptive Security for New and Underused Methods (NUMs): 4 Lessons Learned
#1: Creative forecasting tools are needed for new methods.
#2: Advocacy is needed to ensure that new methods are included in procurement tables and systems.
#3: Existing push-pull systems of commodity distribution are not well-suited to ensure new products reach existing health centers.
#4: Monitor effects of existing and new finance mechanisms on procurement decisions.
LESSON #1: Creative forecasting tools are needed for new methods.ISSUE: SOLUTION:
Forecasting for procuring new and underused methods (NUMs) should be based on factors including pilot results, expected increases in awareness, demand and program capacity, and timing issues to avoid stockouts.
“Guess work” estimating for initial
procurement of CycleBeads in Rwanda
& MaliInitial large supply
(note: CycleBeads don’t expire)
Donors delayed re-ordering CycleBeads even though demand and program capacity increased over time
(became a timing issue)
• IRH developed a CycleBeads forecasting guide with PATH/JSI to include these factors.
• IRH, with partners JSI and PSI, were awarded an Innovation Fund grant to develop a guide for forecasting NUMs. The guide will be available in early 2012.
LESSON #2: Advocacy is needed to ensure that new methods are included in procurement tables & systems.ISSUE:
SOLUTION:
Currently working with WHO to issue a statement recommending CycleBeads for public sector procurement.
LESSON #3: Existing push-pull systems of commodity distribution are not well-suited to ensure that new products reach health centers.
ISSUE: In many countries, CycleBeads are not included on reporting or requisition forms. CycleBeads are included on
reporting & requisition forms in Rwanda, but this is not enough.
GLOBAL SOLUTION: Continue advocacy & TA to ensure proper distribution & reporting mechanisms for new methods. RWANDA SOLUTION: DELIVER Project provided technical assistance to directly address the issue as part of their training & monitoring visits for procurement and supply chain management.
LESSON #4: Monitor effects of existing and new finance mechanisms on procurement decisions.
ISSUE 1: Performance
Based Financing in Rwanda
ISSUE 2: Bamako
Initiative in Mali
Does it include CycleBeads?
Sometimes Yes
Sometimes No
Solution: Advocate to include it in 2012 PBF & monitor reforms going forward
Community committees with decision-making authority over FP
commodity purchases resist purchasing
CycleBeads.Solution: Advocacy & training in community social responsibility & RH rights
The Questions to Ask: Is the method included in
national/local reporting mechanisms? Can donors order it as they order
other RH commodities? How will the commodity be
distributed in country? Who will be involved?
What policies and/or finance mechanisms are in place that will facilitate/inhibit uptake?
Are there gaps in the linkages between sub-systems that can inhibit commodity security?
What advocacy and/or technical assistance efforts are needed to overcome challenges?
For more information about SDM & CycleBeads, visit us at www.irh.org
Thank you for your attention.