Shafia Rashid is senior program officer for global advocacy at Family Care International.
In late October, the Reproductive Health Supplies Coalition (RHSC) held its annual membership meeting in Mexico City. Representatives from governments, international organizations, pharmaceutical companies, and civil society came together to press for greater and more equitable access to reproductive health supplies. The RHSC’s focus includes family planning commodities, such as condoms, oral contraceptives, and other methods that allow men and women to safely and effectively prevent or space pregnancies.
This was my first time attending the annual RHSC meeting. I was there because the Coalition has expanded its mandate to explicitly address maternal health supplies. Earlier this year, it commissioned FCI to develop a series of seven policy briefs, Essential Medicines for Maternal Health: Ensuring Equitable Access for All, which were launched at the Mexico City meeting. These briefs highlight challenges and strategies for increasing the availability of three maternal health medicines – oxytocin, misoprostol, and magnesium sulfate – and:
- Make the case for increasing priority and investment in these medicines
- Provide examples of successful strategies from around the world
- Highlight linkages with reproductive health supplies
A special plenary session addressed this crucial question: How are maternal health supplies reproductive health supplies? This sparked a wide-ranging, engaging, and very interesting discussion. Here are some of the key points that emerged:
- Many countries can already see clear value in linking reproductive and maternal health supplies, and are moving toward integrating their supply chains to include family planning commodities and essential medicines, including medicines for maternal health. In Ethiopia, for instance, the government (with the support of in-country partners) integrated their supply chain to include all health commodities and to connect all levels of the supply chain with accurate and timely data for decision-making. In Nicaragua, where the supply chain was vertical until 2005, the health ministry has integrated the essential medicines system with the contraceptives’ supply chain, which has now been automated and expanded to include all essential medicines.
- The RHSC and other partners have developed a wide range of tools and resources to support countries in strengthening their forecasting, procurement, and other supply chain functions. Tools originally developed with a sole focus on reproductive health supplies now include or can be adapted to apply to maternal health supplies as well, so they can now be used by country managers working to improve the supply of maternal health medicines.
- Lessons learned from successes in improving access to family planning commodities can help us to effectively address the challenges related to maternal health medicines. Family planning advocates have, for example, tracked government expenditures on reproductive health supplies: in Indonesia, budget analysis and concerted advocacy led the mayors of five districts to increase their family planning budgets by as much as 80%. Similarly, many countries — including Bolivia, the Dominican Republic, El Salvador, Honduras, Nicaragua, and Paraguay – have established contraceptive security committees that bring together multiple supply chain stakeholders to support coordination, address long-term product availability issues, and reduce duplication and inefficiencies. These committees have advocated for increased financial support for contraceptives, improved inventory management, developed standard operating procedures, published reports, and provided technical assistance. These efforts to increase budgets and ensure commodity security for contraceptives can effectively adapted and expanded to improve financing and security for maternal health supplies as well.
Many parallels and potential synergies exist between maternal and reproductive health supplies, and the reproductive and maternal health communities must take action to address the interrelated barriers that prevent access to and use of life-saving commodities. These actions include:
- Advocating for development and implementation of supportive policies at the national and sub-national levels, and for dedicated budget lines to enable monitoring and evaluation of policy implementation
- Improving government systems and procedures for procuring high-quality medicines and maintaining their quality throughout the supply chain
- Investing in a streamlined, coordinated supply chain across sectors and levels, reducing inefficiency and duplicative efforts
- Strengthening the knowledge and skills of health providers so that they are aware of evidence-based policies and guidelines and can effectively administer these essential medicines
→ For more information, you can download the Essential Medicines for Maternal Health policy briefs here.