Contraceptive Security Indicators Data- 2010 Data Collection

Publication date: 2010

Introduction Contraceptive Security Indicators 2010 Data Collection Introduction and Purpose: This activity highlights a comprehensive set of indicators that can be used to monitor contraceptive security (CS) for programmatic and advocacy purposes. The CS Indicators were developed to reflect key aspects of contraceptive security to help in-country stakeholders monitor and evaluate their country’s CS status. This dataset presents CS indicators for 35 countries and builds upon the Strategic Pathway to Reproductive Health Commodity Security (SPARHCS) framework. This data was collected in 2010 through the second annual round of data collection. Worksheets: This dataset presents data by country and also provides two sheets of data showing all surveyed countries together. - The individual country worksheets may contain a small amount of additional information about the indicator responses in cells' inserted comments. - The first summary worksheet contains all countries' responses. - The second summary worksheet provides the option to filter the data by various categories. (It contains all countries' responses as well.) We encourage readers with questions, corrections or more information on the countries concerned, or information on additional countries, to contact the USAID | DELIVER PROJECT. We also invite suggestions for improving the indicators and methodology. Click below to jump to the following data sheets: Individual countries: Afghanistan Albania Armenia Azerbaijan Bangladesh Burkina Faso Dominican Republic El Salvador Ethiopia Georgia Ghana Guatemala Honduras India Kenya Liberia Madagascar Malawi Mali Mozambique Nepal Nicaragua Nigeria Pakistan Paraguay Philippines Russia Rwanda Senegal Tanzania Uganda Ukraine Yemen Zambia Zimbabwe Consolidated (summary) sheets: All countries All countries, filtered & grouped This worksheet contains grouping so that a summary of key indicators can be displayed by clicking "1" in the upper lefthand corner. All indicators can be displayed by clicking "2". Data Sources: The indicators were designed with the intention that they could be routinely captured with accessible and relatively objective information either through key informants or a literature review of existing local documents. Country respondents were mainly USAID mission and USAID | DELIVER PROJECT staff. Indicator questions were constructed so that a range of respondents could answer them easily with as little background research as possible. While efforts were made to verify the data provided, mainly through crosschecking with country informants, the data are contingent upon the knowledge of the respondents. Data was collected and crosschecked between February and July 2010. Topics: Indicator questions cover the following topics: -- Finance & Procurement (Capital)—extent of funding for public sector contraceptives; funding sources; existence of a government budget line-item for contraceptives, and information about the procurement mechanism. - Commodities—range of contraceptive methods offered in public, private, and NGO facilities, respectively. - Policies (Commitment)—existence of a national contraceptive security strategy; existence of policies limiting or expanding access to family planning; inclusion of contraceptives on the National Essential Medicine List (NEML), and inclusion of contraceptive security concepts in the Poverty Reduction Strategy Paper (PRSP). - Coordination and Leadership—existence of a national committee that works on contraceptive security and types of organizations represented therein; frequency of committee meetings; legal status of the committee, and existence of a contraceptive security “champion”. - Supply Chain (Capacity)—stockout information at the central level; and whether stockouts are a serious problem at the service delivery point and central levels, respectively. Additional Information: For information on last year's findings, please refer to Measuring Contraceptive Security Indicators in 36 Countries, on the USAID | DELIVER PROJECT website at http://deliver.jsi.com/dlvr_content/resources/allpubs/guidelines/CS_Indicators36.pdf. Stay tuned for a paper summarizing this year's findings. This spreadsheet can be cited as: USAID | DELIVER PROJECT, Task Order 1. Contraceptive Security Indicators Data 2010. Available at http://deliver.jsi.com/dlvr_content/resources/allpubs/factsheets/CS_Indicators_Data_2010.xls. Afghanistan Albania Armenia Azerbaijan Bangladesh Burkina Faso Dominican Republic El Salvador Ethiopia Georgia Ghana Guatemala Honduras India Kenya Liberia Madagascar Malawi Mali Mozambique Nepal Nicaragua Nigeria Pakistan Paraguay Philippines Russia Rwanda Senegal Tanzania Uganda Ukraine Yemen Zambia Zimbabwe All countries All countries, filtered & grouped All countries To jump to the Introduction sheet, click here. Contraceptive Security Indicator Questions 2010 - All Surveyed Countries Afghanistan Albania Armenia Azerbaijan Bangladesh Burkina Faso Dominican Republic El Salvador Ethiopia Georgia Ghana Guatemala Honduras India Kenya Liberia Madagascar Malawi Mali Mozambique Nepal Nicaragua Nigeria Pakistan Paraguay Philippines Russia Rwanda Senegal Tanzania Uganda Ukraine Yemen Zambia Zimbabwe A. Leadership and Coordination A1. Is there a national committee that works on contraceptive security? No Yes No No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes A1a. What is the name of the committee? N/A National Reproductive Health Committee N/A N/A Logistics Coordination Forum (LCF) Contraceptives Security Strategy Plan Implementation follow up Committee (Comité de suivi du Plan de Stratégique de Sécurisation des Produits Contracepifs) Comite para la Disponibilidad Asegurada de Insumos y Planificacion Familiar (Contraceptive Security Committee) Contraceptive Security Committee Family Planning and Logistics Technical Working Group Natonal Reproductive Health Committee Inter-Coordinating Committee for Contraceptive Security (ICC/CS) Comision Nacional para el Aseguramiento de Anticonceptivos (CNAA) (National Contraceptive Security Committee) Comite Interinstitucional para la Disponibilidad Asegurada de Insumos Anticonceptivos (CIDAIA) (Inter-institution Committee for Contraceptive Security) Supply and Social Marketing Division of Ministry of Health and Family Welfare Family Planning Logistics Working Group National Reproductive Health Commodity Security Committee "Reproductive Health/Family Planning Partners Committee" and sub-committee "RH/FP Logistics Committee" Reproductive Health Technical Working Group Commision de Suivi de la Mise en Oeuvre du Plan d'Action a long terme pour la Contraception Securisee au Mali (committee for follow-up to the implementation plan for long-term contraceptive security) Reproductive Health Commodity Security (CS) Committee Reproductive Health Commodities Security Working Group (also known as Contraceptive and Essential Commodities Security Working Group) Comité Nacional para la Disponibilidad Asegurada de Insumos y Anticonceptivos DAIA Nicaragua (National Contraceptive Security Committee) Reproductive Health Commodity Security Stakeholder's Committee Reproductive Health Commodity Security Committee (RHCS) - Currently the committee is inactive and the USAID | DELIVER PROJECT plans to revitalize it through CS inputs. Disponibilidad Asegurada de Insumos y Anticonceptivos (DAIA) Committee (Contraceptive Security Committee) Contraceptive Self-Reliance (CSR) Technical Working Group N/A Family Planning Logistics Committee Comité National de Sécurisation des Produits Contraceptifs (National Contraceptive Security Committee) National Contraceptive Security Committee Reproductive Health Commodity Security Committee National Committee for Implementation of the State Program "Reproductive Health of the Nation up to 2015" (SPRHN) Reproductive Health Commodity Security (RHCS) Reproductive Health Commodity Security Committtee Reproductive Health Commodity Security Committee A2. Are the following organizations represented on the committee? A2a. Are social marketing organizations on the committee? N/A Yes N/A N/A Yes Yes Yes Yes Yes No Yes Yes Yes No Yes No Yes Yes Yes No Yes Yes Yes Yes Yes Yes N/A Yes Yes Yes Yes No Yes Yes Yes A2ai. Names of social marketing organizations on the committee NESMARK Social Marketing Company (SMC) PROMACO PROFAMILIA, ADOPLAFAM, MUDE Asociación Demográfica Salvadoreña (ADS) DKT Ethiopia EXP Social Marketing (SM), Ghana Social Marketing Foundation (GSMF) International PASMO PASMO Population Services International (PSI) Population Services International PSI Centrale d'Achat des Generiques (C.A.G.) PSI Nepal Contraceptive Retail Sales (CRS) Company PASMO Society for Family Health Greenstar Social Marketing, Pakistan PSI Paraguay DKT Phlippines, Family Planning Organization of the Philippines, League of Municipalities PSI Agence pour le Développement du Marketing Social (ADEMAS). USAID Implementing Partner (IP) Tanzania Marketing and Communications for AIDS, Reproductive Health and Child Survival (T-MARC) project, Population Services International (PSI) AFFORD/Uganda Health Marketing Group, PSI, Marie Stopes Uganda Marie Stopes International Society for Family Health PSI A2b. Are NGOs on the committee? (e.g. service delivery, advocacy, Planned Parenthood afiliate, Marie Stopes afiliate, faith-based organizations) N/A Yes N/A N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes No Yes No Yes Yes Yes Yes Yes Yes N/A Yes Yes Yes Yes Yes Yes Yes Yes A2bi. Names of NGOs on the committee Albanian Association for Population Development Family Planning Association of Bangladesh ABBEF (IPPF Affiliate) PROFAMILIA, ADOPLAFAM, MUDE and 30 more institutions Asociación Demográfica Salvadoreña (ADS) CARE, EngenderHealth, Family Guidance Association of Ethiopia (FGAE), Family Health International (FHI), Integrated Family Health Program (IFHP), IPAS, Marie Stopes International JSI Planned Parenthood Association of Ghana (PPAG), MSIGh APROFAM ASHONPLAFA Management Sciences for Health (MSH), Marie Stopes, Family Health Options Kenya, John Snow Inc. (JSI) Family Planning Association of Liberia FISA (IPPF affiliate), Marie Stopes Madagascar, Religious platform represented by (1) SAF-FJKM - the Health Department of Protestant church and 2) SALFA -- health department of Lutheran Church), Voahary Salama (the NGO platform) Groupe Pivot Sante et Population (GPSP), AMPPF (IPPF affiliate), Marie Stopes Family Planning Association of Nepal (IPPF affiliate) PROFAMILIA. MOH wants to include other NGOs (for example IXCHEN). Planned Parenthood Federation of Nigeria (PPFN) and Association for Reproductive and Family Health USAID | DELIVER PROJECT, USAID | FALAH PROJECT and USAID | PAIMAN PROJECT CEPEP (Centro Paraguayo de Estudios de Poblacion) IPPF Philippine NGO Council, Family Planning Organization of the Philippines, Cooperative Movement for Encouraging NSV (non-scalpel vasectomy), League of Provinces, League of Cities, League of Municipalities, Union of Local Authorities of the Philippines Association Rwandaise pour le Bien-Etre Familial's (ARBEF) Association sénégalaise pour le Bien-etre Familial (ASBEF). IPPF affiliate - IntraHealth (USAID IP) - Child Fund & Consortium (USAID IP) John Snow Inc., Engender Health, Chama Cha Uzazi na Malezi Bora Tanzania (UMATI) - IPPFaffiliate, Marie Stopes, Pathfinder Reproductive Health Uganda (RHU), Marie Stopes Uganda (MSU) All-Ukrainian Federation of Young Doctors, All-Ukrainian Women's Society Yemen Family Care Association, Yamaan Foundation Planned Parenthood Association(PPAZ), Marie Stopes, USAID | DELIVER PROJECT, Zambia Prevention Care and Treatment II ( ZPCT II), Center for Infectous Diseases Research in Zambia ( CIDRZ) Churches Health Association of Zambia (CHAZ) Population Services Zimbabwe (Marie Stopes Affiliate) A2c. Are commercial sector organizations on the committee? (e.g. pharmacy associations, manufacturers) N/A Yes N/A N/A No Yes No No No No Yes No Yes No No No Yes No Yes No No No Yes No No Yes N/A Yes No Yes No No No No No A2ci. Names of commercial sector organizations on the committee Bayer-Schering Pharmacist Association Ghana Registered Midwives Association, Society of Private Medical and Dental Practitioners, Pharmaceutical Society of Ghana Pfizer, Vijosa, ARSAL ORGANON Centrale d'Achat des Generiques (C.A.G.) Pharmaceutical Society of Nigeria (PSN), Society of Gynecologists and Obstetricians of Nigeria (SOGON), and Nigeria Medical Association Philippine Chamber of Commerce and Industry, Drugstores Association of the Philippines Associations of Private Pharmacists and Physicians World Wide Movers (Aglity's local rep) A2d. Are donors on the committee? N/A Yes N/A N/A Yes Yes Yes Yes Yes Yes Yes No Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes N/A Yes Yes Yes Yes Yes Yes Yes Yes A2di. Names of donors on the committee USAID USAID, World Bank, CIDA, KfW, DFID, JICA, EU UNFPA USAID USAID UNFPA, USAID, Packard USAID USAID, UNFPA, Royal Netherlands Embassy (RNE), DANIDA, UNAIDS, WHO, JICA USAID USAID, KfW USAID USAID, UNFPA, JICA USAID, Clinton HIV/AIDS Initiative (CHAI) USAID, UNFPA, KFW USAID USAID, KfW, DFID, World Bank UNFPA, USAID USAID, DFID, CIDA USAID, DFID UNFPA, USAID USAID, UNFPA USAID , UNFPA,GFTAM,GTZ/KFW USAID - UNFPA - JICA - KFW USAID USAID USAID (represented by the staff of the Together for Health Project and Maternal & Infant Health Project) USAID,GTZ Global Fund, DFID, USAID USAID, DfID A2e. Are UN agencies on the committee? N/A Yes N/A N/A Yes Yes Yes Yes Yes Yes Yes No Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes N/A Yes Yes Yes Yes Yes Yes Yes Yes A2ei. Names of UN agencies on the committee UNFPA, UNICEF, WHO UNFPA UNFPA UNFPA, OPS/OMS UNFPA UNFPA UNFPA, UNICEF, WHO WHO, UNAIDS,UNFPA PAHO, UNFPA UNFPA UNFPA UNFPA, UNICEF, UNAIDS, World bank, WHO UNFPA UNFPA UNFPA UNFPA, UNICEF UNFPA UNFPA UNFPA OPS, UNFPA WHO UNFPA WHO - UNFPA UNFPA UNFPA UNFPA UNFPA, UNICEF UNFPA, WHO,UNICEF UNFPA A2f. Are Ministry of Health units on the committee? (e.g. logistics, RH, FP, MCH, HIV/AIDS, pharmacy units) N/A Yes N/A N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes N/A Yes Yes Yes Yes Yes Yes Yes Yes A2fi. Names of Ministry of Health units on the committee Directorates of Public health, Hospitals, Pharmacies, Health Statistics, Economy Directorate General Family Plannning (DGFP) Reproductive Health Directorate, Pharmacy and Lab. Directorate, General Directorate of Health, Study and Planning Directorate Reproductive health, logistics, HIV program, pharmacy units. Women's Health Unit, Planning Unit, Financial Unit Health Promotion & Disease Prevention directorate Policy Unit, Quality Control and Licensing, Advisor to the Minister in Reproductive Health Ghana Health Service (Stores, supplies and drug management, family health division, public health directorate, policy planning monitoring and evaluation, regional medical stores, finance), MOH (procurement and supplies, CMS, Food and drugs board, pharmacy National Reproductive Health Program, logistics management unit Vice-Minister of Health Services Network, Logistics Unit, Women's Health Unit, Essential Drugs Unit Supply and Social Marketing Division of Ministry of Health and Family Welfare Division of Reproductive Health, Family Planning Program Ministry of Health and Social Welfare Family Planning Directorate (FPD) Reproductive Health Unit, Health Technical Support Services - Pharmaceutical and HIV/AIDS Unit, National AIDS Commission Direction Nationale de la Sante (DNS), Direction de la Pharmacie et du Medicament (DPM), Pharmacie Populaire du Mali (PPM) MOH RH Unit Family Health Division, Logistics Management Division, Child Health Division, National Center for AIDS and STD Control, Ministry of Health and Population DAIS (Direction of logistics and supplies), DGSS (Direction of Health Services, FP), DGPD (Division of Planning and Development and External Cooperation) 1. FP Division 2. Dept of Planning, Research and Statistics 3. National Agency for Food and Drug Administration and Control (NAFDAC) 4. National Population Commission 5. Federal Ministry of Women Affairs 6. States Ministries of Health 7. Ministry of Defence 8. National Health Insurance Services Director General (M&S) MOPW, Lady Health Worker Program, MOH RH,PH, Logistic DOH: National Center for Disease Prevention and Control (includes FP and HIV/AIDS), Bureau of Local Health Development, Bureau of International Health Coordination, Health Policy Development and Planning Bureau, National Drug Program, Center of Health Development Region 4A and National Capital Region; DOH attached agencies: Bureau of Food and Drugs, Population Commission, Philippine Health Insurance Corp (PhilHealth).; Local Government Unit (LGU): Pangasinan Provincial Population Office Maternal Child Health and Pharmacy Task Force Division de la Santé de la Reproduction(FP/RH/MCH Division) - Direction de la Pharmacie et du Medicament, Laboratoire Nationale de contrôle des Médicaments. Reproductive and Child Health Service (RCHS), National AIDS Control Programme (NACP) RH Division MCH Department/RH Division, Finance and Economic Department, Academy of Science, National Academy of Post-Graduate Education Supply directorate, Family planning directorate, National drug supply programme Pharmacy, Procurement Unit, and Reproductive Health Unit Reproductive Health Unit of Ministry of Health and Child Welfare (MOHCW), Zimbabwe National Family Planning Council (ZNFPC), Medicines Control Authority of Zimbabwe (MCAZ) A2g. Is the Central Medical Store or Central Warehouse on the committee? N/A N/A N/A N/A Yes Yes Yes No No No Yes Yes Yes No Yes Yes Yes No Yes Yes Yes No Yes No Yes Yes N/A Yes Yes Yes Yes No Yes Yes Yes A2gi. Specify Central Medical Store or Central Warehouse on the committee There is no such organization in Albania Central warehouse of DGFP CAMEG Central Warehouse MOH (expecting Pharmaceutical Fund and Supply Agency [PFSA] in the future) Central Medical Store Logistics unit in charge of central warehouse is a key member Central warehouse manager Kenya Medical Supplies Agency (KEMSA) National Drug Service SALAMA, the national essential drug purchasing agency Pharmacie Populaire du Mali (PPM) CMAM Central Warehouse, Teku Central Contraceptive Warehouse Central warehouse DOH Materials Management Service Rwanda Drug, Consumables and Equipments Central Procurement Agency (CAMERWA) Pharmacie Nationale d'Approvisionnement (PNA) Medical Stores Department (MSD) National Medical Stores Central warehouses Medical Stores Limited (MSL) - Central Warehouse NatPharm A2h. Is the Ministry of Finance or Ministry of Planning on the committee? N/A No N/A N/A No No No No Yes No Yes Yes No No No No Yes No No No Yes No Yes No No No N/A No No No No No No Yes No A2hi. Specify Ministry of Finance or Planning on the committee Population Department of Ministry of Finance and Economic Development (MOFED) Ministry of Finance and Economic Planning - Health desk officer Ministry of Finance Ministry of Finance (sometimes) National Planning Commission Federal Ministry of Finance Ministry of Finance and National Planning - Planning unit A3. How many times did the committee meet during the last year? (Responses from dropdown list choices: 0, 1-2, 3-5, or 6+) N/A 3-5 times N/A N/A 3-5 times 1-2 times 6 or more times 6 or more times 6 or more times 6 or more times 1-2 times 3-5 times No Data 3-5 times 3-5 times 1-2 times 1-2 times 3-5 times 1-2 times 3-5 times 1-2 times 6 or more times 1-2 times 1-2 times 6 or more times 0 times N/A 3-5 times 1-2 times 3-5 times 3-5 times 1-2 times 3-5 times 3-5 times 3-5 times A4. Does committee have legal status? N/A No N/A N/A Yes Yes Yes Yes No Yes Yes Yes No Data Yes No No Data No No Yes No Yes Yes Yes Yes No Yes N/A Yes No No No Yes No Data No Yes A5. Is there a Contraceptive Security "champion"? No Yes No No Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes No No No Yes Yes Yes Yes Yes Yes No Yes Yes No No No No Yes Yes A5a. "Champion's" organization IPH USAID Family Heath Directorate (FHD) Reproductive Health department MOH FMOH Health Promotion and Disease Prevention (HPDP) Directorate, DELIVER, IFHP, EngenderHealth, FGAE USAID, UNFPA, Family Health Division, USAID | DELIVER PROJECT National Reproductive Health Program Ministry of Health Government of India, Secretary Health Public Health and Sanitation MOH The Directorate of Family Planning Logistics Management Division MOH, in the DGSS and DAIS Association for Reproductive and Family Health MOPW MOH NGOs & Philippine Legislative Committee on Population & Development (PLCPD - an NGO of legislators), Forum, & Reproductive Health Advocacy Network MOH USAID & Implementing Partners MoH ZNFPC A5b. "Champion's" job title LMIS Project coordinator FHD's Director Subdirector Family Planning Coordinator FP advisors, Director of the FHD and the COP Coordinator of the National Reproductive Health Program Advisor to the Vice-Minister Key person for planning health activities / procurements, programs Director of Public Health and Sanitation Head of Family Health Division Director Director General Directors CEO Director General M&S, MOPW Directors of logistics DGPS Whole organizations & Executive Directors. For Forum, the chairman. MCH task force coordinator USAID MD and Health Team Family Planning Officer Executive Director B. Finance and Procurement (Capital) B2. Is there a health basket funding mechanism? No Yes No No Data Yes Yes No No Yes No No No No No No No No Yes Yes No Yes Yes No No No Yes No Yes No Yes Yes No No Data Yes No B3. Is there a government budget line item for the procurement of contraceptives? No Yes No No Yes Yes No Yes Yes No Yes No No Yes Yes No Yes No Yes No Yes Yes Yes Yes Yes No No Yes Yes Yes Yes Yes No Yes No B4. Were government funds spent on contraceptive procurement for the public sector in the most recent complete fiscal year? (including internally generated funds, basket funds, World Bank credits or loans, and other donor funds given to the government) No Data Yes No No Yes Yes Yes Yes Yes No Yes Yes No Yes Yes No Yes Yes No No Yes Yes No Yes Yes Yes No Yes No Yes No Yes Yes Yes No B4a. Did the government spend internally generated funds for contraceptive procurement for the public sector (for example, from public sector sources, taxes, or user fees)? No Data Yes No No No Yes Yes Yes Yes No Yes Yes No Yes Yes No Yes No No No Yes Yes No Yes Yes Yes No Yes No Yes No Yes No No No B4ai. What was the amount of internally generated funds spent on contraceptive procurement? (in US$) No Data $21,931 0.0 0.0 $700,000 $138,579 $486,204 $784,000 $889,000 0.0 $800,000 $1,325,301 0.0 No Data $6,106,555 0.0 $125,127 0.0 0.0 0.0 $1,691,440 $227,120 0.0 $9,257,171 $566,000 No Data 0.0 0.0 $2,850,531 0.0 $235,000 0.0 0.0 0.0 B4aii. Time period for internally generated funds (mm/yy-mm/yy) No Data 1/09-12/09 1/09-12/09 1/09-12/09 2008-2009 1/09-12/09 1/09-12/09 1/09-12/09 7/08-6/09 1/09-12/09 1/09-12/09 1/09-12/09 8/09-7/10 4/09-3/10 7/08-6/09 1/09-12/09 1/09-12/09 10/08-9/09 7/09-6/10 10/08-9/09 7/08-6/09 1/09-12/09 1/09-12/09 7/08-6/09 1/09-12/09 1/09-12/09 1/09-12/09 1/09-12/09 1/09-12/09 7/08-6/09 1/09-12/09 1/09-12/09 FY 2008 1/09-12/09 10/08-9/09 B4aiii. Data source for information on internally generated funds Expenses for Purchase of Contraceptives, Public Sector year 2009 UNFPA and IPH finance DGFP CPTs, FHD, CAMEG Contraceptive procurement table Women's Health Unit, and Financial Unit Ministry financial transaction records ICC/CS minutes, Financial sustainability report and PPAG "time to take charge" fact sheet Report from the National Committee for Contraceptive Secuirity CPT, Ministry of Health's reports Government of India, Ministry of Health and Family Welfare KEMSA FPD National Pipeline report, LMD Contraceptive procurement table of MOH MOH and RHInterchange Database CPTs RCHS Ministry of Health of Ukraine, Report on SPRHN implementation in 2008 CPTs, PipeLine and MoH B4aiv. Comments regarding internally generated funds Cost recovery funds Includes regional funds (SNNP and Oromia) The government did not provide funds in 2009 due to the political situation. In the previous year they made 1.2 million USD available. GoK funded procurement Both the Ministry of Health and the Ministry of Population Welfare provided funding for contraceptives during their June 2008-July 2009 fiscal year. The MOH provided approximately 2.24 Million through the Lady Health Workers Program and the MOPW provided approximately 7.01 Million = 9.25 M Total. Internally generated funds came from the Maternal Neonatal Child Health and Nutrition grant from the National Department of Health. This fund was drawn down to or received by specific local government units not at the same time and not all of the amount is for contraceptives. As a result, specific data as to how much is not available. Rwanda does not track its internally generated revenue independently of basket. It has been reported that funding was allocated at central medical store but returned to treasury unspent. A commitment of $672,400 was made by the goverment in 2009, but was not fulfilled. B4b. Did the government spend other government funds for contraceptive procurement (for example, basket funds, World Bank credits or loans, or other donor funds given to the government, such as from UNFPA, CIDA, DANIDA, etc.)? (This does NOT include in-kind donations.) No Data No No No Yes Yes No No Yes No Yes No No No Yes No No Yes No No Yes Yes No No No No No Yes No Yes No No Data Yes Yes No B4bi. Specify source(s) of funding from donors No Data N/A N/A N/A World Bank credit Basket funds and World Bank poverty fund N/A N/A PBS II (Protecting Basic Services II) N/A DANIDA N/A N/A N/A KfW N/A N/A Swap funds N/A N/A Pooled funds - World Bank, DFID, AusAID UNFPA, public sector, and other donors N/A N/A N/A N/A basket and GFATM N/A basket N/A No Data World Bank & Netherlands embassy DFID N/A B4bii. What was the amount of these other government funds spent on contraceptive procurement for the public sector? (in US$) No Data 0.0 0.0 0.0 $20,342,200 $872,902 0.0 0.0 $20,000,000 0.0 $600,000 0.0 0.0 0.0 $2,519,694 0.0 0.0 $900,000 0.0 0.0 $422,860 $1,106,618 0.0 0.0 0.0 0.0 0.0 $2,347,048 0.0 $3,912,593 0.0 No Data $2,488,515 $1,629,104 0.0 B4biii. Time period for these other government funds (mm/yy-mm/yy) No Data 1/09-12/09 1/09-12/09 1/09-12/09 2008-2009 1/09-12/09 1/09-12/09 1/09-12/09 7/08-6/09 1/09-12/09 1/09-12/09 1/09-12/09 8/09-7/10 4/09-3/10 7/08-6/09 1/09-12/09 1/09-12/09 10/08-9/09 7/09-6/10 10/08-9/09 7/08-6/09 1/09-12/09 1/09-12/09 7/08-6/09 1/09-12/09 1/09-12/09 1/09-12/09 1/09-12/09 1/09-12/09 7/08-6/09 1/09-12/09 1/09-12/09 FY 2008 1/09-12/09 10/08-9/09 B4biv. Data source for information on these other government funds DGFP CAMEG Ministry financial transaction records Ministry of Health KEMSA CMS and PipeLine National Pipeline report, LMD Contraceptive procurement table of MOH Pipeline CPTs RCHS Supply directorate - Population sector (MoPHP) CPTs, PipeLine and MoH B4bv. Comments regarding these other government funds Ordered by CAMEG with Government Funds (Basket Fund) and World Bank poverty fund Government of India is self-sufficient in procuring contraceptives. Contraceptives are supplied for free in the government programs. KfW funded procurement for 1 million DMPA vials (received in the country in November 2009) UNFPA puts its funds into the basket and also donates some other RH supplies (not contraceptives) to the public sector through in-kind donations. USD1.512 from Basket funds (Rwanda does not track its internally generated revenue independently of basket). USD834k from GFATM funds All this comes from the Basket money. None of the products bought from this have arrived. This amount is for 2008 and covered the 2009 supply as well because the MOPHP had extra stock from previous years. The orders for contraceptive commodities to be procured using the DFID funds were made in November 2009 and will be received in-country in 2010. B4c. In total, how much funding did the government spend on contraceptive procurement for the public sector? (in US$) This will auto-calculate. (It will sum internally generated funds and all other government funds.) No Data $21,931 0.0 0.0 $21,042,200 $1,011,481 $486,204 $784,000 $20,889,000 0.0 $1,400,000 $1,325,301 0.0 No Data $8,626,249 0.0 $125,127 $900,000 0.0 0.0 $2,114,300 $1,333,738 0.0 $9,257,171 $566,000 No Data 0.0 $2,347,048 0.0 $6,763,124 0.0 No Data $2,488,515 $1,629,104 0.0 B4ci. Comments on total government funding The Government of Georgia has never spent funds on contraceptives. No data on complete total. B5. In-kind donations B5a. Were in-kind donations of contraceptives provided for the public sector (including emergency supplies)? No Data Yes Yes No Yes Yes Yes Yes Yes Yes Yes No Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes No Yes Yes Yes Yes Yes No Data Yes Yes B5ai. Source(s) of in-kind donations No Data UNFPA UNFPA N/A CIDA UNFPA, USAID USAID USAID USAID and UNFPA/Global Program. (DKT also donated in-kind to the public sector for Regional Health Bureaus (RHBs), but the exact amount is not known.) USAID & UNFPA USAID and UNFPA N/A UNFPA N/A Donations from UNFPA and USAID For 2009, UNFPA ($414k) and USAID ($516k) UNFPA USAID ($2,316,905.74) and UNFPA ($1,289,119.22) USAID, UNFPA UNFPA, USAID USAID, KfW USAID UNFPA (There's a CIDA grant managed by UNFPA), & USAID UNFPA N/A UNFPA N/A UNFPA and USAID USAID. UNFPA also provided (only for emergency contraceptives), but the amount is not included here. USAID USAID and UNFPA USAID/Washington No Data UNFPA and USAID Male and female condoms (USAID), contraceptives (DfID and a small amount from UNFPA) B5aii. What was the value of in-kind donations of contraceptives for the public sector? (in US$) No Data $17,206 $12,628 0.0 $800,000 $1,793,046 $418,510 $150,000 $9,500,000 $86,555 $1,952,272 0.0 $900,000 0.0 $3,028,363 $930,434 $2,927,412 $3,606,025 $2,348,095 $2,604,765 $309,100 $577,833 $1,775,578 $3,674,803 0.0 No Data 0.0 $3,479,377 $1,600,000 $2,034,090 $4,700,000 $200,000 No Data $5,368,104 $5,623,632 B5aiii. Time period for in-kind donations (mm/yy-mm/yy) No Data 1/09-12/09 1/09-12/09 1/09-12/09 2008-2009 1/09-12/09 1/09-12/09 1/09-12/09 7/08-6/09 1/09-12/09 1/09-12/09 1/09-12/09 8/09-7/10 4/09-3/10 7/08-6/09 1/09-12/09 1/09-12/09 10/08-9/09 7/09-6/10 10/08-9/09 7/08-6/09 1/09-12/09 1/09-12/09 7/08-6/09 1/09-12/09 1/09-12/09 1/09-12/09 1/09-12/09 1/09-12/09 7/08-6/09 1/09-12/09 1/09-12/09 FY 2008 1/09-12/09 10/08-9/09 B5aiv. Data source for information on in-kind donations UNFPA and IPH finance UNFPA UNFPA CPTs Contraceptive Procurement table USAID files Donor records Reproductive Health Supplies Coalition website at http://rhi.rhsupplies.org RHI and USAID "My Commodities" UNFPA RH Interchange RHI RHI USAID | DELIVER PROJECT My Commodities & PipeLine Records RHI CPTs National Pipeline report, LMD Contraceptive procurement table of MOH RHI RHInterchange Database Pipeline Deliver/JSI shipment report CPT memo CPT Records of HIV/AIDS Alliance and TfH projects supported by USAID CPTs, PipeLine and MoH PipeLine B5av. Comments regarding in-kind donations 30 FP units have been supplied with contraceptives worth $12,628 USD. CIDA-donated implant Quantity ordered and received in country in 2009 from UNFPA and USAID $6 million's worth from USAID and $3.5 million's worth from UNFPA/Global Program Donation Government of India is self-sufficient in procuring contraceptives. They are supplied for free in the government programs. The data were obtained from the RHInterchange for the same date range as the public sector fiscal year. A total 1,407,195.87$ from UNFPA and 2,072,181.68 from USAID donations USAID fiscal year 08 budget (spent in 2009) Amount is an estimate and could not be verified. $3,357,257 from UNFPA (which includes $238,419 for Noristerat and $358,737 for Microlut that were ordered in 2009 and to be received in 2010) and $2,010,847 from USAID (which includes 15,000 Jadelle [for $333,938] ordered in 2009 and received in 2010) This includes products distributed on DTTU for which data is available only (male & female condoms, oral and injectable contraceptives). Values include insurance and freight. B6. Government share of spending on contraceptive procurement for the public sector - Of the total amount of financing spent on public sector contraceptives in the most recent complete fiscal year, what percent was covered by government funding (including internally generated funds, basket funds, World Bank credits or loans, and other funds given to the government.)? This will autocalculate -Total government funding (Question B4c) / Grand total of all funding for public sector contraceptives (Questions B4c+B5) No Data 56% 0% N/A 96% 36% 54% 84% 69% 0% 42% 100% 0% 100% 74% 0% 4% 20% 0% 0% 87% 70% 0% 72% 100% No Data N/A 40% 0% 77% 0% No Data No Data 23% 0% B6a. Comments about government share of spending on contraceptive procurement for the public sector 0 During the most recent fiscal year, the GOHO did not allocate funds for contraceptive procurement As indicated earlier, a committment was made by GRZ/MoH (to use internally generated funds) but was not fullfilled. That what was committed was not spent and not going to be fulfilled was only communicated this year (early 2010). B7. If the government is financing contraceptive procurement, which entity does procurement? (responses from dropdown list choices) No Data Third-party agent (e.g., UNFPA, Crown Agents) N/A N/A The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) Third-party agent (e.g., UNFPA, Crown Agents) Third-party agent (e.g., UNFPA, Crown Agents) N/A The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) Third-party agent (e.g., UNFPA, Crown Agents) Third-party agent (e.g., UNFPA, Crown Agents) The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) N/A Other The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) N/A N/A The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) Third-party agent (e.g., UNFPA, Crown Agents) N/A Third-party agent (e.g., UNFPA, Crown Agents) Third-party agent (e.g., UNFPA, Crown Agents) The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) N/A The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) N/A The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) Third-party agent (e.g., UNFPA, Crown Agents) The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) N/A B7a. Specify entity that does procurement No Data UNFPA N/A N/A DGFP CAMEG Direccion Materno Infantil y Adolescentes/PF program UNFPA UNFPA (but PFSA - a parastatal - is likely to procure in the future) N/A MOH Procurement Unit, Stores Supplies and Drug Management Directorate of GHS. (GHS is under MOH.) (MOH contracts with Crown agents for support.) UNFPA UNFPA Supply and Social Marketing Division of Government of India Kenya Medical Supplies Agency (KEMSA) N/A SALAMA - Central Essential Drugs Purchasing Agency CMS N/A N/A Logistics Management Division/MoHP. (Crown Agents provides quality assurance.) UNFPA, through cost-sharing agreement N/A UNFPA UNFPA Local Government Unit’s General Property and Supplies Office N/A CAMERWA Pharmacie Nationale d'Apprivisionnement (PNA) MSD N/A Ministry of Health at central level in Kyiv (MCH Department in collaboration with Procurement Department) and Oblast Health Administrations (Oblast Health Departments in collaboration with Oblast FP/RH Centers) UNFPA MOH Procurement Unit N/A B7ai. Is this procurement entity a parastatal? No Data N/A N/A N/A No Yes No N/A N/A N/A No N/A N/A No Yes N/A Yes No N/A N/A Yes N/A N/A N/A N/A No N/A Yes Yes Yes N/A Yes N/A No N/A B9. Comments about finance and procurement DGFP, under MOHFW, procures all FP-RH commodities, using WB credit money, through open bidding following GOB and IDA procurement guidelines. In 2009, there was a shortage of Lo-femenal at the central level; then the Family Health Directorate (FHD) requested to CAMEG to use part of the funds generated by contraceptive distribution to procure 600,000 cycles of combined oral pills. The FHD also uses part of the contraceptive-generated funds to support the CPTs (contraceptive procurement tables) exercise workshops. UNFPA was delegated on the Ministry's behalf for the procurement of contraceptives funded by PBS I and PBS II. However, experience from PBS I procurement indicates that the procurement process is extremely lengthy. PFSA is a newly established government procurement entity and is expected to take on procurement responsibilities in the future. DELIVER continues to support the facilitation of contraceptive procurement by sharing information with the FMOH through the FPTWG. Regarding financing, even though the amounts are not significant, the central Government and some of the Regional Government’s continue to finance contraceptive procurement from internally generated (budget) funds. The existence of basket funds and the possibility of future funding as well as an overall increase in donor support for FP have put the country in a better position when compared to previous years. So far three condom tenders have been made - the 1st one has been completed, the 2nd one has seen the award done but supplies have not arrived, and the 3rd one has the tender results under evaluation. By law, 15% of all taxes on alcoholic beverages sold in the country should go to finance reproductive health interventions. It is not clear how much is contributing to financing contraceptives. During the most recent fiscal year, the government did not allocate any funds for contraceptive procurement, due to the economic crisis. This year, they have requested around $800,000, which won't cover total needs (estimated at $1.4 M for 2011). The family planning program of the Ministry of Health and Family Welfare is a priority program and the government of India is self-sufficient in procuring contraceptives. Contraceptives are supplied for free in the government programs. 90% of the total funds for contraceptive procurement used to come from donors including USAID who provided 60% of the contraceptives before the March 2009 coup declaration and suspension of the USG assistance to the Government. Donors have provided 100% of needs. There has not been a shortage of available funding for contraceptives and condoms. While CMAM has received significant TA to conduct procurement, and theoretically could procure contraceptives and condoms, funds the MOH manages have been used for other priority health commodities. The government is committed to financing the procurement of contraceptives; the increase in budget from 2008/09 to 2009/10 is by 87%. In the FY 2009/10, the government has committed 100% of the public sector procurement needs for contraceptives. Kfw has commited to provide condoms and injectables to the public and NGO sectors and oral pills to social marketing for the coming 3 years, till 2011. The government procures through international competitive bidding, and it is working well. LMD recently made a multi-year procurement contract for Condoms and Injectables. Finance has historically been unable to keep up with procurement requirements. Until now, all commodities in the public sector have been donor funded. The line item for procurement of contraceptives is at the LGU level. LGUs fund and procure their contraceptive requirements. Prices of contraceptives, even for the same contraceptive method and brand, are not uniform across LGUs. Currently, there is no systematic data that provides report on LGU procurements. PhilHealth enrollment is another mechanism for LGU financing of contraceptives. When an LGU enrolls its constituents (indigent constituents) with PhilHealth, it is indirectly financing its contraceptive requirements, through: a) the enrolled constituent can avail of the PhilHealth benefit packages that cover the costs of some contraceptive methods (as described previously in this survey); and/or (b) using part of the capitation fund received from PhilHealth (for enrollments made) to procure contraceptives. USAID/Philippines, through the Health Policy Development Project assisted the DOH to conduct a rapid assessment survey on 2007 LGU (local government unit) procurements covering all provinces and cities (N: 122). The result of the survey showed that 55% of the LGUs (N: 67) procured contraceptives at or above the level of donated contraceptives they used to receive before the phase out of USAID's donation. The remaining 45% (N: 55) did not procure. In 2004, the DOH issued the guidelines on the management of the donated commodities under the Contraceptive Self-Reliance Strategy which includes the guidelines and schedule for phasing out of contraceptive donations at the national and local level. The LGUs were divided into three batches, the first being the richest LGUs and the last being the poorest LGUs. While the last shipment of USAID donated contraceptives (excluding IUDs) was in September 2007, the last DOH shipment to the third batch of LGUs to be phased out was in the quarter October-December 2008. The Russian federal government stopped its federal family planning program back in 1998 including the procurement of contraceptives. However, some regions and municipalities provide limited contraceptives (both in range and number) to vulnerable groups of population mostly under mandatory health insurance programs and small donations from pharmaceutical firms. However, a range of modern contraceptive methods are widely avaiable through pharmacies, including in the public health care facilities for a fee/purchase. Even though FP is not included in the provision of health services, some USAID target regions cover/reimburse FP counseling under the regional mandatory health insurance plans. During the last 3 years, funding was allocated for contraceptives but wasn’t spent. Many reasons have been given; central store mismanagement, non-response to solicitation, funding taken back by treasury secondary to financial crisis. When funding is availlable, the PNA does the procurement In previous years, what was released was always much lower than what was allocated or promised and beyond that, what was allocated is historically less than what is requested or needed. Last year however, after much advocacy for increased allocation and release of funding, the amount released topped the amount of forecasted need. Each of the previous years however did not even come close to the forecasted need, so while there was technically 129% of forecasted need, the previous years had only seen a small percentage of the funding need met. GoU has ring-fenced budget line item for RH commodity procurement but is not successful in spending it, partly because of quarterly fund releases which do not allow for advance procurement arrangements. The "Together for Health" (TfH) project funded by USAID continues working with the national (MOH) and local governments in 13 regions of Ukraine on implementation of the SPRHN, including related to the procurement of contraceptives. The Government of Ukraine (GOU) continued to mobilize budgeted resources for the procurement of contraceptives in 2008-2009 with the bulk of these resources coming from the local level budgets. As an example, $226,400 was spent from local budgets in 13 TfH participating regions versus $94,600 from the national level budget. However, the GOU commitment to finance the SPRHN in FY10 is not clear with a reported planned 60% decrease in funds for contraceptive procurement. TfH project supported by USAID has limited ability to influence the GOU contraceptive procurement process. Regional councils that make decisions on funding of regional RH programs are reporting decreases in social and health budgets amidst other competing health priorities (like HIV/AIDS, TB, pandemic flu, etc.) The ongoing economic crisis that hit Ukraine severely resulted in significant increases in prices for contraceptives for the population. In addition, according to the WB "Human Development: Eastern Europe and Central Asia, December 2009", accumulated wage arrears doubled and tripled in Ukraine, the working hours for the population decreased, and unemployment increased; this all resulted in a significantly decreased purchasing power of the population. Government procurements take very long - procurements for 2009 have not yet been fulfilled. There is currently uncertainty about when the GFATM committed funds will be released for use and what channel of procurement will be used. USAID|DELIVER PROJECT implemented by JSI procures on behalf of USAID while Crown Agents procures on behalf of DfID C. Commodities C1. Are the following contraceptive methods offered in private sector facilities? (Please indicate which methods are intended to be offered. This question is not asking whether the method is in stock.) C1a. Combined oral hormonal pills offered in private sector facilities? Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Data Yes Yes Yes Yes C1b. Progestin-only oral hormonal pills offered in private sector facilities? Yes Yes Yes No Yes Yes Yes No Data Yes No Yes Yes No Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes No Data Yes Yes Yes Yes C1c. Hormonal injections offered in private sector facilities? Yes Yes Yes No Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes No Data Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Data Yes Yes Yes Yes C1d. Hormonal implants offered in private sector facilities? No No No No Yes No Yes No Data Yes No Yes Yes No No Yes No Yes Yes Yes No Data Yes Yes Yes No No No Yes Yes Yes Yes No Data No No Yes Yes C1e. Intrauterine devices (IUDs) offered in private sector facilities? Yes Yes Yes Yes Yes No Yes No Data Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes No Data Yes Yes Yes Yes C1f. Male condoms offered in private sector facilities? Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Data Yes Yes Yes Yes C1g. Female condoms offered in private sector facilities? No No No No No Data Yes No No Data No Data No Yes Yes No Yes Yes Yes Yes Yes No Yes Yes Yes Yes No No No No Yes Yes No Data No Data No No Yes Yes C1h. Emergency contraceptive oral hormonal pills offered in private sector facilities? No Yes Yes Yes No Data Yes Yes No Data Yes Yes Yes Yes No Yes Yes Yes No Yes Yes No Yes Yes Yes Yes Yes No Yes Yes Yes Yes No Data Yes No Data No Data Yes C1i. Long-acting permanent method for males (e.g., vasectomy) offered in private sector facilities? No No No Data No Data Yes No Yes No Data No Data No Yes Yes Yes Yes Yes No Yes Yes No Data No Data Yes Yes Yes Yes Yes Yes No No Data Yes Yes No Data Yes No Data No Data Yes C1j. Long-acting permanent method for females (e.g., tubal ligation) offered in private sector facilities? Yes Yes No Data No Data Yes No Yes Yes No Data Yes Yes Yes Yes Yes Yes No Yes Yes No Data No Data Yes Yes Yes Yes Yes Yes Yes No Data Yes Yes No Data Yes Yes No Data Yes C1k. CycleBeads offered in private sector facilities? No No No No No No Yes No Data No No No Yes No Yes No Data Yes Yes No Yes No No No Yes Yes No No No Yes Yes No No Data No No Data No Data Yes C1l. Specify other contraceptive(s) offered in private sector facilities N/A Spermicides Vaginal spermicides N/A Foam, Jelly, vaginal tablets Patch foaming vaginal tablets N/A N/A patch, spermicide contraceptive patch Evra and vaginal ring Novaring Vaginal ring, patch, spermicides N/A C2. Are the following contraceptive methods offered in public sector facilities? (Please indicate which methods are intended to be offered. This question is not asking whether the method is in stock.) C2a. Combined oral hormonal pills offered in public sector facilities? Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes C2b. Progestin-only oral hormonal pills offered in public sector facilities? Yes Yes Yes No No Yes Yes No Yes Yes Yes No No No Yes Yes Yes Yes Yes Yes No No Yes Yes No Yes Yes Yes Yes Yes Yes No Yes Yes Yes C2c. Hormonal injections offered in public sector facilities? Yes Yes No No Yes Yes Yes Yes Yes No Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes C2d. Hormonal implants offered in public sector facilities? No No No No Yes Yes Yes Yes Yes No Yes Yes No No Yes No Yes Yes Yes No Yes No Yes Yes No No Yes Yes Yes Yes Yes No Yes Yes Yes C2e. Intrauterine devices (IUDs) offered in public sector facilities? Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No C2f. Male condoms offered in public sector facilities? Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes C2g. Female condoms offered in public sector facilities? No No No No No Yes No No No No Yes No No No Yes Yes No Yes No No No No Yes No No No No Yes Yes Yes No No No Yes Yes C2h. Emergency contraceptive oral hormonal pills offered in public sector facilities? No No Yes No No Yes Yes No Yes Yes Yes No No Yes Yes No No No Yes No Yes No No Yes Yes No Yes No Yes No Yes No No Yes No C2i. Long-acting permanent method for males (e.g., vasectomy) offered in public sector facilities? No Yes No Data No Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes No No Data Yes No Data No Data Yes Yes No Data Yes Yes Yes No Yes Yes Yes Yes Yes No Data Yes No C2j. Long-acting permanent method for females (e.g., tubal ligation) offered in public sector facilities? Yes Yes No Data No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No Data Yes Yes No Data Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No C2k. CycleBeads offered in public sector facilities? No Yes No No No Yes No No No No No Yes No No Yes Yes Yes No Yes No No Yes No No No Yes No Yes Yes No No Data No No Data No No C2l. Specify other contraceptive(s) offered in public sector facilities N/A N/A foaming vaginal tablets N/A N/A N/A contraceptive patch Evra and vaginal ring Novaring Vaginal ring, patch, spermicides N/A C3. Are the following contraceptive methods offered in NGO facilities? (Please indicate which methods are intended to be offered. This question is not asking whether the method is in stock.) C3a. Combined oral hormonal pills offered in NGO facilities? Yes No Data No No Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes N/A Yes Yes Yes Yes No Yes Yes No Data C3b. Progestin-only oral hormonal pills offered in NGO facilities? No No Data No No Yes Yes Yes Yes Yes No Yes No No No Yes Yes No Yes Yes Yes No No Yes No Yes Yes N/A Yes Yes Yes Yes No Yes Yes No Data C3c. Hormonal injections offered in NGO facilities? Yes No Data No No Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes N/A Yes Yes Yes Yes No Yes Yes No Data C3d. Hormonal implants offered in NGO facilities? No No No No Yes Yes Yes Yes Yes No Yes Yes No No Yes No Yes Yes Yes No Yes No Yes No No No N/A Yes Yes Yes Yes No Yes Yes No Data C3e. Intrauterine devices (IUDs) offered in NGO facilities? Yes No Data No No Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes N/A Yes Yes Yes Yes No Yes Yes No Data C3f. Male condoms offered in NGO facilities? Yes Yes No No Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes N/A Yes Yes Yes Yes No Yes Yes No Data C3g. Female condoms offered in NGO facilities? No No No No No Yes Yes No No Data No Yes Yes No Yes Yes Yes Yes Yes Yes Yes No No Yes No No No N/A Yes Yes Yes Yes No No Yes No Data C3h. Emergency contraceptive oral hormonal pills offered in NGO facilities? Yes No No No No Yes Yes No Yes No Yes Yes No Yes Yes No No Yes Yes No No Yes Yes Yes No No N/A Yes Yes Yes Yes No No Data No Data No Data C3i. Long-acting permanent method for males (e.g., vasectomy) offered in NGO sector facilities? No No No No Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes No Data Yes No Data No Data Yes Yes Yes Yes Yes Yes N/A No No Yes Yes No No Data No Data No Data C3j. Long-acting permanent method for females (e.g., tubal ligation) offered in NGO sector facilities? Yes No No No Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes No No Data Yes Yes No Data Yes Yes Yes Yes Yes Yes N/A No Yes Yes Yes No Yes No Data No Data C3k. CycleBeads offered in NGO sector facilities? No No Data No No No Yes Yes No No No No Yes No Yes Yes Yes No Data Yes Yes No No No Yes Yes No Yes N/A Yes Yes No Yes No No Data No No Data C3l. Specify other contraceptive(s) offered in NGO sector facilities N/A N/A Vaginal spermicides N/A N/A Patch, Silastic Rings, Low-dose oral (Marvelon) foaming vaginal tablets N/A N/A N/A N/A N/A C4. Comments about methods offered C4a. Comments about combined oral hormonal pills offered Just a limited amount of COCs and IUDs are available due to the UNFPA donation. Otherwise providers write a prescription and clients go to pharmacies to buy the method. Only small amount of free UNFPA commodities are available just in a few clinics. Available in private sector including through social marketing provided by AMODEFA (IPPF affiliate) There are not many FP NGOs. C4b. Comments about progestin-only oral hormonal pills offered Very rarely is available in private pharmacies Not yet available in government program provided by AMODEFA (IPPF affiliate) C4c. Comments about hormonal injections offered Not yet available in government program PSI Exploring C4d. Comments about hormonal implants offered not available in Albania Available in private sector through USAID public/private partnerships (providing long-acting methods in 70 higher clinics in 5 major regions in private facilities) and DKT (who started distributing Sinoimplant). Available in NGO facilities through Marie Stopes and FGAE. Some studies are occurring but implants are not yet in the government program C4e. Comments about intrauterine devices (IUDs) offered Just a limited amount of COCs and IUDs are available due to the UNFPA donation. Otherwise providers write a prescription and clients go to pharmacies to buy the method. Only small amount of free UNFPA commodities are available just in a few clinics. C4f. Comments about male condoms offered C4g. Comments about female condoms offered not available in Albania UNFPA doing pilot to re-activate female condoms w/ NGOS C4h. Comments about emergency contraceptive oral hormonal pills offered Available in the pharmacies. Currently there is a stockout of Postinor - EC is not available in public sector Public sector - piloting in 4 (out of 75) districts The MOH prescribes but does not provide the packaged product itself. IPPF/ARBEF Public sector providers are trained on using combined orals as emergency contraception. C4i. Comments about long-acting permanent method for males (e.g., vasectomy) offered not well accepted in Albania, practically non-existent Available in most public central and regional referral hospitals in cities. Available in NGO facilities through Marie Stopes and FGAE. MSS/Pakistan C4j. Comments about long-acting permanent method for females (e.g., tubal ligation) offered Tubal ligation is sometimes performed during surgeries for other medical reasons. Available in public referral hospitals in cities. Available in NGO facilities through Marie Stopes and FGAE. C4k. Comments about CycleBeads offered only in one region (Diber), not common Not included in the government program in non-profit private sector facilities and at community level (health hut with CHW) supported by NGO C3l. Comments about other contraceptive(s) offered There are no NGOs or social marketing programs in Ukraine supporting provision of contraceptives. D. Policy (Commitment) D1. Is there a contraceptive security or reproductive health commodity security strategy or is contraceptive security explicitly included in a country strategy? No Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes No Yes No Yes Yes Yes D1a. Strategy name National Strategy of Contraceptive Security National Strategy, Program and Actions Timeframe on Reproductive Health Improvement Reproductive Health Strategy Health and Nutrition Sector Plan Plan Strategique de Securisation des Produits contraceptifs (PSSCS) Contraceptive Security Strategic Plan National Reproductive Health Strategy National Reproductive Health Strategy Ghana National Contraceptive Security Strategy 2004 - 2010 Law of Universal Access to Family Planning Estrategia CIDAIA National Population Policy National Contraceptive Commodity Security Strategy National Reproductive Health Commodity Security Strategy and Operational Plan Contraceptive Security Strategy Reproductive Health Commodities Security Strategy Plan pour la Contraception Securisee au Mali RH Commodity Security Strategy National Reproductive Health Commodity Security (RHCS) Strategy National strategy reproductive health National Strategic Plan for Reproductive Health Commodity Security Draft Pakistan Population Policy (USAID | DELIVER PROJECT has agreed input to development of a National CS Strategy in FY 2010) Plan estrategico DAIA Paraguay (contraceptives security strategic plan) National Family Planning Policy and others (National Family Planning Policy (DOH Administrative Order No. 50-A s. 2001, dated September 17, 2001) Guidelines on the Management of Donated Commodities under the Contraceptive Self-Reliance Strategy (DOH Administrative Order No. 158 s. 2004, dated July 9, 2004) Guidelines on Public-Private Collaboration in Delivery of Health Services Including Family Planning for Women of Reproductive Age (DOH Adminstrative Order No. 2006-0008, dated May 20, 2006) Implementing Health Reforms for Rapid Reduction of Maternal and Neonatal Mortality (Administrative Order No. 2008-0029, dated September 9, 2008)) RHCS Programme National de Developpement Sanitaire et Social. Strategie Nationale de Sécurisation des Produits Contraceptifs RH Commodity Security Strategic Plan Reproductive Health Commodity Security Framework a) National reproductive health policy b) National health strategic plan (Contraceptive security is explicitly included in various existing national policies and plans, including these. Zambia is also in the process of developing the reproductive health commodity security strategy.) ZNFPC Strategic Plan D1b. Years strategy covers 2003-2010 2007-2015 2008-2013 2006-2011 2006-2015 2008 2006-2015 2005-2015 2004-2010 Many 4 years 2000-2016 2007-2012 2008-2012 2007-2012 2006-2010 2002-2012 2009-2012 2007-2011 2007-2011 2002-2007 but still being followed 2010-2015 2006-2010 November 2008- December 2012 2009-2014, 2007-2011 2010-2015 2008-2012 a) 2008 b) undergoing review - likely to cover a 5-year period 2009-2013 D1c. Is the strategy formally approved by the Ministry? Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes No Yes Yes No Yes Yes Yes Yes Yes D1d. Is the contraceptive security strategy being implemented? Yes Yes No No Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes No Yes Yes Yes No Yes Yes Yes Yes Yes No No Data Yes D2. Are any family planning commodities subject to duties, import taxes, or other fees? No Yes Yes Yes Yes No Yes Yes No Yes No Yes No No Yes No Yes No Yes No Yes No No No Yes Yes Yes Yes Yes No Yes Yes No No No D2ai. If yes, for which method(s) are there duties, taxes, or fees? 1) For Public Sectors: VAT (20%) Condoms, syringes, IUD (Non Drugs) 2) From March 2010 the Albanian Government has decided that every medicine shipment must be accompanied by an export declaration from the country of origin. All methods All All commodities imported directly by private sector, including social marketing. All All methods Oral Pill, Injectables, IUD, Condom, Implant Condoms, IUDs, Orals, Injectables, Implants Progestin-only pills, combined oral pills, implants (Jadelle), IUCDs (Copper T), DMPA injectables, emergency contraceptive pills, male and female condoms All products brought into the country are taxed All FP methods All All methods All For all methods in the public sector, MOH pays storage for the central warehouse. All methods A 2% verification fee must be paid on all drug imports, including contraceptives All methods D2aii. For which sector(s) (public, NGO, commercial sector) are there duties, taxes, or fees? Public Sectors (VAT) Commercial Import taxes for commercial sector Private sector (including social marketing) Commercial methods, NGO Private and NGO sectors Commercial Sector All sectors Public Sector Private USAID-donated products are tax-exempt Commercial sector Both All sectors - however, if an NGO has obtained tax exemption, payment of taxes and duties may be waived. The Department of Health (DOH) pays for taxes & duties for donations and social marketing. All Public sector All sectors All Commercial sector D2b. How much are the duties, taxes, or fees? VAT: 20% 20% VAT 0.18 2.25% VAT, payable in advance 16% VAT Don't know In late 2008 the government announced that there would not be any taxes/duties for contraceptives in any sector. 1) If the commodity is humanitarian it is not subject to any taxation and documentation fee should not exceed 100GEL 2) If the commodity is commercial (intended to be sold) it is subject to taxation and the fees are: Registration in Drug Agency 500 GEL Custom Tax 18% from the total price (gross including transportation) Custom Fee 60 EU After sales revenue tax 10% 5% duty fees and 12% taxes. MOH commodities are exempt through their procurement agreement with UNFPA. UNFPA pays 5% of commodity cost to KEMSA for handling, warehousing, and distribution. The fee paid is intended to add onto KEMSA’s resource envelope for warehousing and distribution. UNFPA only pays for the products it donates. Tax: 20% VAT: 20% 2.5% tax A 1% tax is charged for the commercial sector. (There is no tax for contraceptives for the public sector or social marketing sector.) 0.1 Customs duties on condoms and hormonal contraceptives is 3% of total value. Customs duties on Copper T IUDs is 15% of total value. All contraceptives are subject to 12% Value Added Tax (VAT). However, if an NGO has obtained tax exemption, payment of taxes and duties may be waived. 10% custom/import duties, 10%VAT 9% value of the product For private sector - 20% duties 18% VAT for IUD only. 2.7% for all goods entering in UEMOA area (Taxe commun à l'importatation), but the government can do a tax exemption for the public sector. $0,30 to $3 fees in public sector. 2% FOB value Custom taxes, VAT (VAT is 20% of the total cost) D3. Are there policies that affect the ability of the private sector (commercial sector or NGOs) to provide contraceptives? (e.g. price controls, distribution limitations, taxes/duties, advertising bans) No Yes Yes No Yes No No No No Yes No No No No No No Yes Yes Yes Yes No Yes No No No Yes Yes No Yes Yes No Yes No Yes No D3a. Policy description IUDs are only provided by OB/GYN in the public sector. There are advertising ban policies. In particular, contraceptive pills and spermicides are not among the "over the counter" medicines and cannot be advertised. For the advertisement of other contraceptives, Ministry of Health permission is required. Private sector organizations currently not allowed to import IUDs. See previous information about taxes and fees Tax for contraceptives imported by private sector The largest NGO in Malawi is Banja La Mtsogolo (BLM), an affiliate of Marie Stopes International (MSI). Until now, they have not been able to access the USAID donated contraceptives through the government system (because of the Mexico City policy). Mechanisms are being worked out to change this. All products brought into the country are taxed. Reportedly lengthy process for registration and MOH approval to launch socially marketed FP products. The national procurement law creates preferences for local procurement. This limits the public sector from accessing a cost-effective supplier. An exception is made that allows the government to procure through UNFPA. Taxes/duties. Donated commodities, socially marketed commodities and commercially marketed contraceptives are subject to taxes and duties. Taxes/duties on donated contraceptives consigned to the Department of Health (such as those donated by USAID) are shouldered by the Government of the Philippines through automatic appropriations of the Department of Budget Management. Taxes/duties of socially marketed contraceptives consigned to the Department of Health are paid by the Department of Health. Taxes/duties on socially marketed contraceptives that are not consigned to the Department of Health are paid by the organizations (NGOs) marketing those contraceptives. Taxes/duties on commercially marketed contraceptives are paid by the manufacturer, importer or trader. Pharmacy Law. This law bans brand advertising of ethical/regulated drugs. Hormonal contraceptives (oral pills, injectables and hormonal IUDs) are classified as ethical/regulated drugs, therefore, brand advertising is banned. Copper T IUDs are classified as medical device and registered as unregulated product and not subject to the same restrictions. There is no prohibition on brand advertising of Copper T IUDs. The pharmacy law also prohibits dispensing of ethical/regulated drugs without prescription. It's illegal to advertise a specific contraceptive brand as well as any other prescription drug. However, they can be promoted and advertised in professional health care literature and facilities. Public campaigns on contraception in general are allowed. Advertising for specific brands of products is forbidden. Private doctors connot prescribe and distribute drugs in the same premises. Pharmacists cannot dispense most methods without doctors' prescription. (emergency contraception is available without a prescription in private pharmacies) Brand specific advertising for oral contraceptives is not allowed since they are considered a prescription-only product. The current law of Ukraine "On Advertising", article 21 prohibits advertising of prescription-based medicines. This prohibition affects contraceptives as they are prescription-based medicines. In addition, the former Government of Ukraine (GOU) led by Yuliya Timoshenko was trying to regulate the prices for medicines sold through private pharmacies and increase the number of state pharmacies in the country. However, this GOU "initiative" received strong resistance from the private sector employees and did not go very far. Policy on: 1. Sale/distribution of contraceptives restricted to retail pharmacies and private clinics, except for condoms which can also be sold in supermarkets and drugstores. 2. Advertising ban D4. Do policies or regulations exist that restrict who can dispense or sell particular contraceptive methods? Yes No Yes Yes Yes Yes No Yes Yes Yes Yes No Yes Yes Yes No No Yes Yes Yes No No Yes Yes No Yes Yes No Yes Yes Yes Yes No Yes Yes D4a. Name of contraceptive method 1 Injectables Pills, IUDs, spermicides IUD, pills Injectables Implants Injectables One-rod implants IUDs Injectables Emergency Contraception Injectable contraceptives and progesterone-only pills Progestin-only pills, combined oral pills, DMPA injections, emergency contraceptive pills IUCDs, implants and injectables IUDs and implants IUDs Injectables IUD, Surgical/Permanent contraception, Implanon, Injectables Oral contraceptive pills & injectables All except condoms Oral Contraceptives Oral contraceptives Injectables Hormonals (oral, injectable, patch, ring, etc.) All methods except male and female condoms Injectables D4ai. Description of public sector restriction regarding who is allowed to dispense or sell method 1 Community health workers are not authorized to administer injectable contraceptives. Only OB/GYNs can prescribe and dispense all methods, including IUD insertion. Family doctors (FDs) provide FP counseling and dispense all contraceptives, except for hormonal pills and IUD insertion. Nurses can only refer for FP counseling and dispense condoms. Since September 2009, health providers (including primary level providers*) who received training on FP standard protocols are also allowed to prescribe hormonal contraceptives. (*This mainly refers to non-gynecologist MDs. If there is no doctor at a primary level facility though, trained midwives can also prescribe.) Community workers can't give first dose Nurses, Midwives and Doctors Only trained staff, including promoters in rural and peri-urban areas Task-shifting policy positively affects the family planning program. Midwives, nurses, health officers, and doctors can provide any kind of implant (1 or 2 rods). Trained health extension workers (HEWs) can provide 1-rod implants (i.e., Implanon). (They can also provide injectables, pills, and condoms.) Only OB/GYN and Reproductologist can dispense Community-based distributors (CBDs) cannot provide. Nurses and community health officers can provide. In April 2009, the Parliament of Honduras approved a bill prohibiting the promotion, commercialization, free distribution and use of EC pills. The bill also prohibits the dissemination of information about the use of contraceptive pills like EC. N/A (Product not available through public sector) All facility levels are allowed to dispense these methods as long as there are skilled health workers. Only in facilities with trained personnel. Health Surveillance Assistants are allowed to administer injectable contraceptives. Non-qualified personnel (not trained) are not allowed to provide certain methods such the Long Acting Methods (IUDs, Implants) Only trained MCH Nurses can insert (basic nurses cannot) Only trained personnel are allowed to administer injections (nurses, midwives, and community health extension workers). Trained HCP Only trained health workers are allowed to dispense. Dispensing without prescription is not allowed. However, since public facilities are headed by doctors who supervise all health workers in the facilities, prescriptions are easy to obtain. However, in practice, OCPs can be obtained without prescription from pharmacies/drugstores. Only pharmacies are allowed to sell contraceptives and only OB/GYNs can prescribe them Only doctors, midwives and nurses are allowed. We are currently piloting community-based distribution (CBD) of pills with community health workers (CHWs). N/A N/A Only public clinics can either dispense them or prescribe them for purchase in state pharmacies. Both the public and private sectors limit contraceptive prescriptions to highly trained medical professionals - medical doctors. Nurses and midwives are not allowed to prescribe hormonals nor insert implants or IUDs, but they can provide the Depo injections, in a health facility, upon the recommendation from a doctor. Non-medical personnel cannot dispense the methods. (Pharmacist/ Pharmacy technologists, trained family planning nurses, clinical officers and doctors can.) CBDs cannot dispense/administer long term methods D4aii. Description of private sector restriction regarding who is allowed to dispense or sell method 1 N/A N/A Only pharmacies sell contraceptives. Data not available No data Only pharmacists N/A Only OB/GYN and Reproductologist can dispense Same as in the public sector. In April 2009, the Parliament of Honduras approved a bill prohibiting the promotion, commercialization, free distribution and use of EC pills. The bill also prohibits the dissemination of information about the use of contraceptive pills like EC. Only qualified, certified allopathic medical practitioners are allowed to provide and only qualified pharmacists (with pharmacology degree) are allowed to sell. Only registered pharmacies, clinics, and hospitals are allowed to sell or dispense these methods. Only in accredited premises and by registered personnel Only trained personnel are allowed to administer injections. Trained HCP Only trained health service providers are allowed to dispense. Service providers other than physicians, such as midwives, cannot dispense without a prescription. However, most midwives, and all PhilHealth (Phil. Health Insurance Corp) accredited midwives have back-up physicians who write the prescriptions. Only pharmacies are allowed to sell contraceptives and only OB/GYNs can prescribe them Pharmacists cannot dispense and cannot distribute without prescription Pharmacies and accredited drug dispensing outlets (Addos) Drug shops cannot dispense injectables Licensed private pharmacies can sell them based on physician prescription. Non-medical personnel cannot dispense the methods. (Registered pharmacies, chemists, and registered medical/clinics can.) long term methods can only be dispensed by qualified medical personnel. Registered nurses and doctors for injectables, doctors only for implants and IUCDs D4b. Name of contraceptive method 2 IUDs IUDS IUDs Implants and IUDs Implants and IUDs Oral contraceptives Injectables Implants IUDs Implants and IUDs Implants and IUDs IUDs Implants D4bi. Description of public sector restriction regarding who is allowed to dispense or sell method 2 Nurses, Midwives and Doctors Only trained staff, including nurses Trained midwives, nurses, health officers, and doctors can provide. Doctors and midwives can provide. DRH limits provision of these methods to higher level health facilities due to limited availability of skilled health workers at dispensary level. Only by trained personnel. Community Health Workers provide oral contraceptives (and condoms). Only MCH Nurses can provide injections Only trained nurses and doctors are allowed to administer implants. Only trained health workers are allowed to dispense. Dispensing of hormonal IUD without prescription is not allowed. However, since public facilities are headed by doctors who supervise all health workers in the facilities, prescriptions are easy to obtain. Barangay Health Station (the lowest level of public health facility) health service providers do not dispense IUDs. Doctors, midwives and nurses are allowed Restricted to Public Health Nurse of Higher Grade MOH staff Only specially trained Ob/Gyns can insert IUDs. The other medical specialties, like family doctors and pediatricians, cannot insert IUDs; they can only prescribe them to clients, who then have to go to an Ob/Gyn for IUD insertion. Only clinical officers and doctors can dispense D4bii. Description of private sector restriction regarding who is allowed to dispense or sell method 2 No data Only physicians and trained clinical staff N/A Chemical sellers are restricted; they can only provide condoms and oral contraceptives. Only registered pharmacies, clinics, and hospitals are allowed to sell or dispense these methods. Only by trained and registered personnel Only trained personnel are allowed to administer implants. Only trained health service providers are allowed to dispense. Service providers other than physicians, such as midwives, cannot dispense without a prescription. However, most midwives, and all PhilHealth (Phil. Health Insurance Corp) accredited midwives have back-up physicians who write the prescriptions. Private doctors can insert, but they cannot keep stock in their offices. Patients must procure from pharmacies. N/A Only specialy trained Ob/Gyns can insert IUDs. The other medical specialties, like family doctors and pediatricians, cannot insert IUDs; they can only prescribe them to clients, who then have to go to an Ob/Gyn for IUD insertion. D4c. Name of contraceptive method 3 Long-acting permanent methods Implants Permanent methods Orals IUDs IUDs D4ci. Description of public sector restriction regarding who is allowed to dispense or sell method 3 Only the Medical Doctors can provide this service Only trained staff Only doctors can provide surgical methods. MCH Activists after the first consultation with SMI nurse Only trained personnel are allowed to administer IUCDs (doctors and midwives). Only doctors can dispense D4cii. Description of private sector restriction regarding who is allowed to dispense or sell method 3 No data Only physicians and trained clinical staff N/A Only trained personnel are allowed to administer IUCDs. D5. Does the country have laws, regulations, or policies that make it difficult for the following sub-populations to access effective family planning services? D5a. Laws/regulations/policies limiting access to family planning services for unmarried women? No No No No Yes No No No No No No No No No No No No No No No No No No Yes No No No No No No No No No No No D5ai. Description of the rules or policies limiting access for unmarried women Unmarried women can't receive IUDs, injectables, implants, or tubal ligation. MOPW uses MWRA (Married Women of Reproductive Age) as the sub-population for contraceptive services among female population. D5aii. Are the rules/policies limiting access for unmarried women implemented? Yes No D5b. Laws/regulations/policies limiting access to family planning for young people? No No No No No No No No No No No No No No No No No No No No No No No No No No No No No No No No No No No D5bi. Description of the rules or policies limiting access for young people D5bii. Are the rules/policies limiting access for young people implemented? D5c. Other laws/regulations/policies limiting access to family planning services? No No Yes No No No No No No No No No No No No No No No No No No No No No No No No No No D5ci. Specification of other policies limiting access Low parity women and men can't receive IUDs, tubal ligation, or vasectomy. Non-parous women cant receive injectables or implants. D5cii. Are the other rules/policies limiting access implemented? Yes D6. Are there charges to the client in the public sector for family planning services or commodities? D6a. Charges to client in public sector for family planning services? No No No No No Yes No No No No Yes No No No No No No No Yes No No No No No No Depends No No Yes No No No No No Yes D6b. Charges to client in public sector for family planning commodities? No No No N/A No Yes No No No No Yes No No No No No No No Yes No No No Yes Yes No Depends Yes No Yes No No No No No Yes D6c. If there are charges, are there exemptions for those who cannot afford to pay? N/A N/A N/A N/A N/A Yes N/A N/A N/A N/A Yes N/A N/A N/A N/A N/A N/A N/A No N/A N/A N/A No Yes N/A Depends Yes N/A Yes N/A N/A N/A N/A N/A Yes D6ci. Description of exemptions The service provider appreciates the situation of unaffordability of the client. There is no official law for exemptions for clients who cannot afford to pay. There are no charges now, but in the future the health care financing (HCF) policy will be implemented for hospitals to charge (in order to promote clients to access contraceptives from health centers instead of from hospitals). There will be a fee waiver for those who cannot afford to pay. indigent populations (very poor as determined by the dept of social welfare) Ministry of Health provides contraceptives free of charge for both services and commodities, however a similar approach of free of charge is under review by the GOP for MOPW too. Exemption for poor people through structured "Baitul Maal"/Zakat system. Because of devolution, LGUs craft their own policies. Policies are not uniform across LGUs. In general, services in public sector facilities are provided for free but there are some LGUs that have fee for service policies in some of their facilities. In general, commodities in public sector facilities are provided for free but there are some who charge at full or subsidized prices. Only a few LGUs have policies on client segmentation. While this is the case, other funding mechanisms for paying of contraceptives are available to public sector clients. If the client is a PhilHealth member, the client can avail of three PhilHealth benefit packages: (1) Maternity Care Package for normal deliveries that includes the first cycle of oral contraceptives and the first dose of injectable postpartum; (2) IUD Package; and (3) Voluntary Surgical Sterilization Package for bilateral tubal ligation and vasectomy. A significant number of LGUs have enrolled their poor constituents with PhilHealth. Some regions provide free contraception for vulnerable groups. The local health committee determines who cannot pay. There are no specific group exemptions. Some clinics charge for commodities. Over 65 years old and under 5 years exempted for commodities in general. D7. Information in country's Poverty Reduction Strategy Paper (PRSP) D7a. Year of Poverty Reduction Strategy Paper (PRSP) (most recent actual PRSP on IMF's site (not progress or summary report) 2008 2008 2008 2003 2005 2005 N/A N/A 2007 2003 2005 N/A 2001 N/A 2005 2008 2007 2007 2008 2007 2003 2005 2004 2004 N/A N/A N/A 2008 2007 2006 2005 2005 2002 2007 N/A D7b. Is family planning or reproductive health a priority in the PRSP? Yes No Yes Yes Yes Yes N/A N/A Yes No Yes N/A Yes N/A No No Yes No No Yes Yes Yes No Yes N/A N/A N/A Yes Yes Yes Yes Yes Yes No N/A D7c. Is contraceptive security included in the PRSP? No No No Yes No No N/A N/A Yes No No N/A No N/A No No Yes No No No No No No Yes N/A N/A N/A Yes No No No No No No N/A D7d. Is contraceptive prevalence rate (CPR) included as an indicator in the PRSP? Yes No No No Yes No N/A N/A Yes No No N/A No N/A Yes Yes Yes Yes No No Yes No No Yes N/A N/A N/A Yes No No No No No No N/A D7e. Are contraceptive supply indicators included in the PRSP? No No No No No No N/A N/A No No No N/A No N/A No No No No No No No No No No N/A N/A N/A No No No No No No No N/A D7f. Notes about the PRSP D8. Inclusion of contraceptives in country's National Essential Medicine List (NEML) D8a. Is a combined oral hormonal pill included on the NEML? Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes D8b. Is a progestin-only oral hormonal pill included on the NEML? Yes Yes Yes No No Yes Yes No Yes No Yes N/A Yes No No Yes Yes Yes Yes Yes No No Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes D8c. Is a hormonal injection included on the NEML? Yes No Yes No No Yes Yes Yes Yes No Yes N/A Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes No Yes Yes D8d. Is a hormonal implant included on the NEML? No No No No No Yes No No Yes No Yes N/A No No No No Yes Yes Yes No Yes No Yes Yes No No No Yes Yes Yes Yes No No Yes Yes D8e. Is an IUD included on the NEML? Yes Yes No Yes No Yes Yes Yes Yes No Yes N/A Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No Yes Yes Yes Yes No Yes Yes Yes D8f. Is a male condom included on the NEML? Yes No No Yes Yes Yes Yes Yes Yes No Yes N/A Yes Yes No Yes Yes Yes Yes No Yes Yes Yes Yes Yes No No Yes Yes Yes Yes No Yes Yes Yes D8g. Is a female condom included on the NEML? No No No No No Yes No No Yes No Yes N/A No No No Yes Yes Yes Yes No No No Yes No No No No Yes Yes Yes Yes No No Yes Yes D8h. Is an emergency contraceptive oral hormonal pill included on the NEML? No Yes Yes No No Yes No Yes No No Yes N/A No Yes Yes No No No No Yes Yes No No Yes Yes No No Yes Yes No No Yes No Yes Yes D8i. Is any other contraceptive included on the NEML? No No Data No Data No No Data No Yes No Data Yes No No Data N/A No Data No No No Yes No Data Yes Yes No Data No Data No Data Yes No No No No Yes No Data No Data No Yes No Data No Data D8ii. Name of other contraceptive on NEML N/A No Data No Data N/A No Data N/A Cycle beads and vaginal spermicide No Data Diaphragms with spermicide N/A No Data N/A No Data N/A N/A N/A VFTs No Data Spermicide Spermicide No Data No Data No Data diaphragms N/A N/A N/A N/A Spermicide No Data No Data N/A Spermicide No Data No Data D9. Year of National Essential Medicine List (NEML) 2007 2009 No Data 2009 No Data 2008 2007 2006 2004 N/A 2009 N/A 2007 2003 2003 2007 2008 2009 2004 2007 2009 No Data 2003 2007 2010 2008 2009 2010 No data on exact year, but was updated after 2003. 2007 2010 2009 2001 2009 2006 D10. Notes about the NEML Reviewed registered drug list and was told contraceptives not on reimbursable drug list either. (Since the registered drug list is not separated into categories, it is possible that a contraceptive listed here was included on the list for a different purpose. In addition, there could be more contraceptives that were inadvertently overlooked.) IUDs, condoms, and spermicides are not on the list since they're not drugs. Implants are not registered or popular. The list is available online on the MOH website. Emergency contraceptives are not confirmed- the list is under revision since 2007 and comments have been made to incorporate emergency contraceptives. No legally approved essential drug list exists at the national level, however most insurance companies have their own lists. Neither the list of generics prepared as the national essential drug list (draft, which includes just 200 drugs), nor any of the essential drug lists elaborated by the insurance companies contain any kind of contraceptive. (Two years ago, under one of the Word Bank funded programs, the essential drug list was drafted but was never approved by the MoH or Parliament.) The list is derived from the Standard Treatment Guidelines. The list is reviewed every two years. No NEML at the national level. Revision of the essential drugs list is currently ongoing. It is expected that implants, IUDs, and barrier methods will be added to the list. Expecting new NEML in 2010. National Formulary of Medications was the list reviewed. IUD and male condom listed on Medical Supplies List instead of NEML. The printed version will be available shortly (in 2010). The tender for printing is over and printer identified. Emergency contraceptive oral hormonal pills listed as "pending". The list does not include condoms or IUDs because the Ukrainian legislation considers them medical devices, and there's no list of essential medical devices. They are though regulated for import, procurement and distribution. The NEML is combined with the Standard Treatment Guidelines and Essential Laboratory List. Male and female condoms are classified as medical devices on Zimbabwe National Family Planning Council (ZNFPC) List. IUD also on ZNFPC list. NEML List is called EDLIZ. E. Supply Chain (Capacity) E1. Have stockouts occurred for any contraceptive at the central level in the last 12 months? (The central level refers to the central level warehouse for the public sector.) No Yes No N/A Yes Yes Yes No Yes No Yes Yes Yes No Yes Yes Yes Yes Yes No No Yes Yes No No N/A N/A No No Yes Yes No Data Yes Yes No E2. In the last 12 months, has there ever been a stockout at the central level of any of the following contraceptives? E2a. Combined oral hormonal pills stocked out at central level in last 12 months? No No No N/A No Yes Yes No No No No Yes Yes No No Yes Yes No No No No Yes Yes No No N/A N/A No No No Yes No Data No No No E2b. Progestin-only oral hormonal pills stocked out at central level in last 12 months? No No No N/A N/A No No N/A Yes No Yes N/A N/A N/A Yes No Yes No No No N/A N/A Yes No N/A N/A N/A No No Yes No No Data Yes Yes No E2c. Hormonal injections stocked out at central level in last 12 months? No No N/A N/A Yes No Yes No No N/A Yes Yes Yes N/A Yes Yes Yes No No No No No Yes No No N/A N/A No No Yes No N/A No No No E2d. Hormonal implants stocked out at central level in last 12 months? N/A N/A N/A N/A Yes Yes No No No N/A Yes No N/A N/A Yes N/A Yes Yes Yes N/A No N/A Yes No N/A N/A N/A No No Yes Yes N/A No Yes No Data E2e. Intrauterine devices (IUDs) stocked out at central level in last 12 months? No Yes No N/A Yes Yes No No Yes No Yes No Yes No Yes Yes No No Yes No No No No No No N/A N/A No No No Yes No Data No Yes N/A E2f. Male condoms stocked out at central level in last 12 months? No No No N/A No No Yes No No No No No Yes No No No No Data No Yes No No No Yes No No N/A N/A No No No No No Data No No No E2g. Female condoms stocked out at central level in last 12 months? N/A N/A N/A N/A N/A No N/A No N/A N/A No N/A N/A N/A Yes No N/A Yes N/A N/A N/A N/A No N/A N/A N/A N/A No No N/A Yes N/A N/A No No E2h. Emergency contraceptive oral hormonal pills stocked out at central level in last 12 months? N/A N/A No N/A Yes No N/A N/A Yes N/A Yes N/A N/A No Yes N/A N/A N/A No N/A N/A N/A N/A No Yes N/A N/A No No N/A No Data N/A N/A Yes N/A E2i. CycleBeads stocked out at central level in last 12 months? N/A No N/A N/A N/A No N/A N/A N/A N/A N/A No N/A N/A Yes N/A Yes N/A No N/A N/A Yes N/A N/A N/A N/A N/A No No N/A No Data N/A N/A N/A N/A E2j. Time period of stockout information January - December 2009 January - December 2009 January - December 2009 January - December 2009 various times throughout the year December 2009 - January 2010 July 2009 - September 2009 No data January - December 2009 September 2008 - September 2009 January - December 2009 October 2009 - December 2009 May - September 2009, February - May 2010 April 2009 - March 2010 January - December 2009 January - December 2009 January - December 2009 likely October 2008 - September 2009 December 2009 and March 2010 January - December 2009 January - December 2009 January - December 2009 October 2008 - September 2009 No Data January - December 2009 N/A January - December 2009 March 2009 - February 2010 January - December 2009 N/A 12 months January - December 2009 No Data E2k. Data source for stockout information Warehouse reports from partners Logistics Management Information System, periodic physical inventory, warehouse reports UNFPA and Institute of Perinatology, Obstetrics, and Gynecology Personal communication with the MOH/warehouse staff. There were no contraceptives in the public sector warehouse in 2009. Logistics Management Information System (LMIS) Central Warehouse report, Procurement Planning and Monitoring Report Logistics Management Information System, Monitoring Report LMIS Procurement Planning and Monitoring Report (PPMR), which for Ethiopia includes central, regional, and IFHP data. Healthy Women in Georgia Program Logistics Management Information System (LMIS) PPMR, CMS stock reports (micronor, norigynon and postinor were out of stock at various times) Logistics Management Information System Central warehouse data Government of India KEMSA Monthly Stock report stock management report (central level) Logistics Management Information System, SALAMA report LMIS PPMR based on reports for Dec 31, 2009 and Mar. 31, 2010 CPTs, Physical Inventory LMIS Warehouse reports Central Contraceptive Warehouse Stock Status Reports Contraceptive Performance Report Dec 2009, MOPW, GOP PPMR N/A Procurement planning and monitoring report, LMIS, annual national physical inventory, warehouse reports CPTs, logistics management information system and reports MSD, quarterly reports Periodic stock status reports from National Medical Stores and Procurement Planning and Monitoring Report (PPMR) N/A. There is no concrete data on how the MOH and central warehouse handles the procured contraceptives. Some methods are N/A because they aren't registered in Ukraine or they weren't procured by the government. Monitoring report & warehouse reports Central Warehouse Reports (Medical Stores Limited), PipeLine Periodic physical inventory and warehouse reports E3. Do you think stockouts are a serious problem at the following levels? E3a. Do you think stockouts are a serious problem at the service delivery point level? No Yes Yes Yes Yes No Yes No No Yes Yes No No No Yes No Data No Yes Yes Yes No No Yes No Data No No N/A No Yes Yes Yes Yes Yes Yes No E3b. Do you think stockouts are a serious problem at the central level? No Yes No Yes Yes Yes Yes No No Yes Yes No Yes No Yes No No No Yes No No No Yes No No N/A N/A No No Yes Yes No Data Yes No No F. Overall comments about issues with contraceptive security The government will start working on the extension of the contraceptive security strategy beyond the year 2010. CS is a serious issue in Azerbaijan. Available only in private pharmacies, contraceptives are quite expensive. Some contraceptives are not available even in private setings (e.g., progestin-only pills, injectables). Inclusion of contraceptives into the Essential Drug List does not mean they are going to be subsidized by the government and provided free of charge. In other words they will not necessarily be offered in public health facilities. There is still a significant bottleneck in the procurement end of the supply chain. With the Marie Stopes strategy focusing on long-lasting methods (IUD, implants), the consumption of these two methods is really increasing and the level of stock at the central level is not sufficient to support this strategy. The contraceptives ordered by the Government through CAMEG for 2009 (implant, pills) were delayed due to the procurement procedures bottleneck. Funding for 2010 ($675,674) will cover 86% of total needs. The MOH needs to mobilize more resources to cover 100%. Contraceptive availability improved compared to previous years. Stockouts at service delivery points are below 10% for most tracer contraceptives (injectables, combined orals). Regarding condoms, stockout at service delivery points was a little bit higher (17%) because condoms were procured by PEPFAR HIV/AIDS funds and directly distributed to ART sites. But very recently UNFPA procured 7.5 million condoms and we're hoping stockouts will decrease this quarter (Jan-March 2010). The Ministry's plan for Implanon significantly increased the financial demand for contraceptives for 2010. A stockout anywhere of any duration is a serious issue insofar as someone is prevented from exercising a choice that impacts on socioeconomic development and wellbeing. Guatemala has a strong legal framework that supports the National Commission for Contraceptive Security. Nonetheless, securing funding for payment allways comes at the last minute. Funding must be made available in a more expedituous manner to avoid delays in the procurement process The political crisis last year disrupted the flow of funds for contraceptive procurement. Last year is not considered a typical one in terms of commitment from the Ministry of Health to allocate funds for contraceptive procurement. Monitoring of specific budget allocations should be conducted this year in order to determine commitment from the MOH toward ensuring contraceptive security in Honduras. India is a contraceptive secure country. Various activities are being carried out to implement the National Contraceptive Commodities Security Strategy under the focus areas of commitment, capital, coordination, capacity, client utilization and demand. The procurement plan is only implemented hand in hand with revised annual quantification and forecasts. The National Contraceptive Commodities Security Strategy was developed in 2007 and included a forecast of country contraceptive requirements for 2007-2010, but these forecasted quantities are revised annually. Therefore, the procurement plan is implemented taking into consideration these revised annual requirements. The USAID | DELIVER PROJECT is working to get the contraceptive supply chain management of the MOHHSW/FHD to be effective and ensure data availability. Since July 2007, a free contraceptive policy has been in place and likely affects the logistic system regarding who is going to pay for the transportation of contraceptive products. In March 2009 a coup declaration suspended USAID support to the Government of Madagascar and impacted contraceptive security during the period from March to December 2009. The handling fee charged by Central Medical Stores continues to limit access of contraceptives, especially government-procured injectables and implants. The stockouts at service delivery points are also a result of low demand and a lack of qualified providers. New challenges are faced with meeting the contraceptive needs due to program expansion with new partners, especially for long-acting methods (IUD and Implants). Other challenges include commodity orders and shipment timelines not respecting the planned timeframe. Both of these issues have resulted in emergency procurements during this past year. Transport supported by UNFPA and DFID in 2009 resolved financial transport constraints. Pharmaceutical Logisitcs Master Plan when implemented will greatly improve distribution and increase uninterrupted access in the Public Sector Donors' contribution in contraceptive commodities to the country has been decreasing . MoHP's share in contraceptives is increasing each year. MoHP is budgeted to procure 100% of contraceptives in this year, 2009/10. LMD is strengthening the supply and inventory management in the district and health facilities level to make FP commodities available throughout the year. Contraceptive security is a priority topic of the national strategy on reproductive health. For 2010, the MOH will cover 52% of the total need for contraceptives with internally generated funds. It will procure with public funds. A revised national strategy for commodity security is pending. The USAID | DELIVER PROJECT has worked with FMOH to develop a multi-year commodity forecast which forms the basis for its continued advocacy for resources to fund the procurement plans. As a result, UNFPA plans to procure commodities worth $2 million, and DfID plans to spend about $4.2 million USD to procure commodities for 2010. The FMOH has requested for a total of $600,000 USD in its budget for 2010 and it's currently undergoing administrative processing. USAID | DELIVER PROJECT, Pakistan conducted CPT development in December 2009, which helped logistics based modelling and development of consensus on National Forecast as concrete inputs to CCS. Collective good advocacy work has mobilized $1.7m from GOP and $10m from USAID. USAID/Pakistan made a request to USAID/CSL for commodity support to the public and private sectors and some consignments have already reached the CW&S, Karachi. Laws need to facilitate most effective procurement processes. 1) Contraceptive Security vs. Contraceptive Self-Reliance. The Philippines addresses Contraceptive Security in the context of eliminating unmet need for family planning given the phase out of USAID contraceptive donation. This requires broadening the definition to include the support systems for the implementation of the family planning program and addressing issues of sustainability. Hence, the DOH has embarked on Contraceptive Self-Reliance, rather than Contraceptive Security. This strategy includes, in addition to government financing and procurement of commodity based contraceptive methods (pills, injectables, IUDs, condoms, and others) promotion and financing of other methods (bilateral tubal ligation, vasectomy, lactational amenorrhea, natural family planning, and others), expanding distribution coverage, and mobilizing private sector resources in the provision of family planning services and commodities. This approach to Contraceptive Security may have contributed to maintaining the Contraceptive Prevalence Rate in the Philippines steady despite USAID's phase out of contraceptive donation. And since the Government's objective is to ensure the country's self-sufficiency in the provision of family planning services and commodities, the prospect for sustainability is high even without external contraceptive donations. 2) Protecting the Poor. The poor should be protected in the process of achieving Contraceptive Self-Reliance. The issue of targeting financing and provision for the poor is not just an issue of commitment and willingness to fund. It also involves many operational issues such as determining who are poor and entitled to free services, how the non-poor should be served, and how will these issues be handled by local health systems that are supposed to be for everyone in the community. 3) Even the poor go to the private sector for contraceptives. The private sector is becoming more interested in participating. DKT provides a large quantity of contraceptives. Before there were few choices in the country - there were free contraceptives in the public sector and expensive contraceptives in the private sector but little in between. Now with the USAID phase out and a pharmaceutical project to help the pharmaceutical industry get in the middle of the market there's more subsized, affordable choices. 4) The FP issue is more prominent now. There's a RH bill saying that the government is to be responsible for RH (including FP); this bill hasn't been passed yet, but discussion has increased and the issue is prominent. There's more openness politically now to discuss providing FP choices. Contraception in Russia continues to be a sensitive topic due to the demographic crisis and other reasons such as traditionally negative perception of hormonal contraception among policy makers, professionals, and the general population. At SDP level, contraceptive stock outs are estimated at less than 5%. At Central and District level, there were no stockouts. Public (government) funding has not yet been provided and thus contraceptive security is unsustainable. During the last two years, USAID and UNFPA have supported contraceptive procurement. Intense advocacy continues with the MOH for public resources to be mobilized for contraceptive procurement. Unfortunately, this is yet to occur despite assurances of increasing the RH budget. While there are no stock-outs at the central level, smaller health posts and sometimes health centers continue to be plagued with stock-outs. There have also been difficulties keeping pills stocked at the community health huts during this initial pilot phase of CB combined oral pill distribution. (Pills are supplied by the supervising health post.) This could be a serious problem when the pilot is scaled up nationally. Central level stock outs were caused by delays in donor shipments. High unexpected demand and limited global supply especially for long term methods caused the stock outs. Facility level supply issues are related to poor planning and ordering. Issues to be addressed in terms of contraceptive security in Ukraine are still the same ones, i.e., a) expansion of method mix (the majority of current users of modern FP methods are using condoms and IUDs); b) decreased affordability contraceptives as a result of the current economic crisis; c) lack of capacity and experience on the part of the GOU (especially national government) to procure contraceptives (despite some recent improvements in the procurement process); d) absence of centrally managed procurement system (LMIS); e) scarce funding allocated to FP/RH in the country with pro-natalist environment and recent budget deficit. The funding commitment made by Zambia MoH for the procurement of contraceptives is not adequate. Currently the logistics system for contraceptive commodities is not functional. MoH with financial and technical support from the World Bank and USAID | DELIVER PROJECT are currently working to strengthen the essential drug logistics system which includes malaria and contraceptive commodities. Contraceptives are in full supply. No significant issues with commodity security. Region Europe and Asia Europe and Asia Europe and Asia Europe and Asia Europe and Asia Africa LAC LAC Africa Europe and Asia Africa LAC LAC Europe and Asia Africa Africa Africa Africa Africa Africa Europe and Asia LAC Africa Europe and Asia LAC Europe and Asia Europe and Asia Africa Africa Africa Africa Europe and Asia Europe and Asia Africa Africa Year of Survey Data Collection 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 2010 Notes: N/A = not applicable, No data = data not available Commonly used acronyms include: CPT - contraceptive procurement table, LMIS - logistics management information system, MOH - Ministry of Health, RHI - RHealth Interchange (http://rhi.rhsupplies.org) To jump to the Introduction sheet, click here. ALL countries, filtered grouped Note: Click on "1" in the top lefthand corner to see just the main questions and "2" to see all of the questions. (This toggle is above and to the left of cell A1.) To jump to the Introduction sheet, click here. Note: Click on "1" in the top lefthand corner to see just the main questions and "2" to see all of the questions. (This toggle is above and to the left of cell A1.) Note: Click on "1" in the top lefthand corner to see just the main questions and "2" to see all of the questions. Note: Click on "1" in the top lefthand corner to see just the main questions and "2" to see all of the questions. Note: Click on "1" in the top lefthand corner to see just the main questions and "2" to see all of the questions. Contraceptive Security Indicators 2010 All Surveyed Countries, with Data Filters A. Leadership and Coordination A1. Is there a national committee that works on contraceptive security? A1a. What is the name of the committee? A2. Are the following organizations represented on the committee? A2a. Are social marketing organizations on the committee? A2ai. Names of social marketing organizations on the committee A2b. Are NGOs on the committee? (e.g. service delivery, advocacy, Planned Parenthood afiliate, Marie Stopes afiliate, faith-based organizations) A2bi. Names of NGOs on the committee A2c. Are commercial sector organizations on the committee? (e.g. pharmacy associations, manufacturers) A2ci. Names of commercial sector organizations on the committee A2d. Are donors on the committee? A2di. Names of donors on the committee A2e. Are UN agencies on the committee? A2ei. Names of UN agencies on the committee A2f. Are Ministry of Health units on the committee? (e.g. logistics, RH, FP, MCH, HIV/AIDS, pharmacy units) A2fi. Names of Ministry of Health units on the committee A2g. Is the Central Medical Store or Central Warehouse on the committee? A2gi. Specify Central Medical Store or Central Warehouse on the committee A2h. Is the Ministry of Finance or Ministry of Planning on the committee? A2hi. Specify Ministry of Finance or Planning on the committee A3. How many times did the committee meet during the last year? (responses from dropdown list choices: 0, 1-2, 3-5, or 6+) A4. Does committee have legal status? A5. Is there a Contraceptive Security "champion"? A5a. "Champion's" organization A5b. "Champion's" job title B. Finance and Procurement (Capital) B2. Is there a health basket funding mechanism? B3. Is there a government budget line item for the procurement of contraceptives? B4. Were government funds spent on contraceptive procurement for the public sector in the most recent complete fiscal year? (including internally generated funds, basket funds, World Bank credits or loans, and other donor funds given to the government) B4a. Did the government spend internally generated funds for contraceptive procurement for the public sector (for example, from public sector sources, taxes, or user fees)? B4ai. What was the amount of internally generated funds spent on contraceptive procurement? (in US$) B4aii. Time period for internally generated funds (mm/yy-mm/yy) B4aiii. Data source for information on internally generated funds B4aiv. Comments regarding internally generated funds B4b. Did the government spend other government funds for contraceptive procurement (for example, basket funds, World Bank credits or loans, or other donor funds given to the government, such as from UNFPA, CIDA, DANIDA, etc.)? (This does NOT include in-kind donations.) B4bi. Specify source(s) of funding from donors B4bii. What was the amount of these other government funds spent on contraceptive procurement for the public sector? (in US$) B4biii. Time period for these other government funds (mm/yy-mm/yy) B4biv. Data source for information on these other government funds B4bv. Comments regarding these other government funds B4c. In total, how much funding did the government spend on contraceptive procurement for the public sector? (in US$) This will auto-calculate. (It will sum internally generated funds and all other government funds.) B4ci. Comments on total government funding B5. In-kind donations B5a. Were in-kind donations of contraceptives provided for the public sector (including emergency supplies)? B5ai. Source(s) of in-kind donations B5aii. What was the value of in-kind donations of contraceptives for the public sector? (in US$) B5aiii. Time period for in-kind donations (mm/yy-mm/yy) B5aiv. Data source for information on in-kind donations B5av. Comments regarding in-kind donations B6. Government share of spending on contraceptive procurement for the public sector - Of the total amount of financing spent on public sector contraceptives in the most recent complete fiscal year, what percent was covered by government funding (including internally generated funds, basket funds, World Bank credits or loans, and other funds given to the government.)? This will autocalculate -Total government funding (Question B4c) / Grand total of all funding for public sector contraceptives (Questions B4c+B5) B6a. Comments about government share of spending on contraceptive procurement for the public sector B7. If the government is financing contraceptive procurement, which entity does procurement? (responses from dropdown list choices) B7a. Specify entity that does procurement B7ai. Is this procurement entity a parastatal? B9. Comments about finance and procurement C. Commodities C1. Are the following contraceptive methods offered in private sector facilities? (Please indicate which methods are intended to be offered. This question is not asking whether the method is in stock.) C1a. Combined oral hormonal pills offered in private sector facilities? C1b. Progestin-only oral hormonal pills offered in private sector facilities? C1c. Hormonal injections offered in private sector facilities? C1d. Hormonal implants offered in private sector facilities? C1e. Intrauterine devices (IUDs) offered in private sector facilities? C1f. Male condoms offered in private sector facilities? C1g. Female condoms offered in private sector facilities? C1h. Emergency contraceptive oral hormonal pills offered in private sector facilities? C1i. Long-acting permanent method for males (e.g., vasectomy) offered in private sector facilities? C1j. Long-acting permanent method for females (e.g., tubal ligation) offered in private sector facilities? C1k. CycleBeads offered in private sector facilities? C1l. Specify other contraceptive(s) offered in private sector facilities C2. Are the following contraceptive methods offered in public sector facilities? (Please indicate which methods are intended to be offered. This question is not asking whether the method is in stock.) C2a. Combined oral hormonal pills offered in public sector facilities? C2b. Progestin-only oral hormonal pills offered in public sector facilities? C2c. Hormonal injections offered in public sector facilities? C2d. Hormonal implants offered in public sector facilities? C2e. Intrauterine devices (IUDs) offered in public sector facilities? C2f. Male condoms offered in public sector facilities? C2g. Female condoms offered in public sector facilities? C2h. Emergency contraceptive oral hormonal pills offered in public sector facilities? C2i. Long-acting permanent method for males (e.g., vasectomy) offered in public sector facilities? C2j. Long-acting permanent method for females (e.g., tubal ligation) offered in public sector facilities? C2k. CycleBeads offered in public sector facilities? C2l. Specify other contraceptive(s) offered in public sector facilities C3. Are the following contraceptive methods offered in NGO facilities? (Please indicate which methods are intended to be offered. This question is not asking whether the method is in stock.) C3a. Combined oral hormonal pills offered in NGO facilities? C3b. Progestin-only oral hormonal pills offered in NGO facilities? C3c. Hormonal injections offered in NGO facilities? C3d. Hormonal implants offered in NGO facilities? C3e. Intrauterine devices (IUDs) offered in NGO facilities? C3f. Male condoms offered in NGO facilities? C3g. Female condoms offered in NGO facilities? C3h. Emergency contraceptive oral hormonal pills offered in NGO facilities? C3i. Long-acting permanent method for males (e.g., vasectomy) offered in NGO sector facilities? C3j. Long-acting permanent method for females (e.g., tubal ligation) offered in NGO sector facilities? C3k. CycleBeads offered in NGO sector facilities? C3l. Specify other contraceptive(s) offered in NGO sector facilities C4. Comments about methods offered C4a. Comments about combined oral hormonal pills offered C4b. Comments about progestin-only oral hormonal pills offered C4c. Comments about hormonal injections offered C4d. Comments about hormonal implants offered C4e. Comments about intrauterine devices (IUDs) offered C4f. Comments about male condoms offered C4g. Comments about female condoms offered C4h. Comments about emergency contraceptive oral hormonal pills offered C4i. Comments about long-acting permanent method for males (e.g., vasectomy) offered C4j. Comments about long-acting permanent method for females (e.g., tubal ligation) offered C4k. Comments about CycleBeads offered C3l. Comments about other contraceptive(s) offered D. Policy (Commitment) D1. Is there a contraceptive security or reproductive health commodity security strategy or is contraceptive security explicitly included in a country strategy? D1a. Strategy name D1b. Years strategy covers D1c. Is the strategy formally approved by the Ministry? D1d. Is the contraceptive security strategy being implemented? D2. Are any family planning commodities subject to duties, import taxes, or other fees? D2ai. If yes, for which method(s) are there duties, taxes, or fees? D2aii. For which sector(s) (public, NGO, commercial sector) are there duties, taxes, or fees? D2b. How much are the duties, taxes, or fees? D3. Are there policies that affect the ability of the private sector (commercial sector or NGOs) to provide contraceptives? (e.g. price controls, distribution limitations, taxes/duties, advertising bans) D3a. Policy description D4. Do policies or regulations exist that restrict who can dispense or sell particular contraceptive methods? D4a. Name of contraceptive method 1 D4ai. Description of public sector restriction regarding who is allowed to dispense or sell method 1 D4aii. Description of private sector restriction regarding who is allowed to dispense or sell method 1 D4b. Name of contraceptive method 2 D4bi. Description of public sector restriction regarding who is allowed to dispense or sell method 2 D4bii. Description of private sector restriction regarding who is allowed to dispense or sell method 2 D4c. Name of contraceptive method 3 D4ci. Description of public sector restriction regarding who is allowed to dispense or sell method 3 D4cii. Description of private sector restriction regarding who is allowed to dispense or sell method 3 D5. Does the country have laws, regulations, or policies that make it difficult for the following sub-populations to access effective family planning services? D5a. Laws/regulations/policies limiting access to family planning services for unmarried women? D5ai. Description of the rules or policies limiting access for unmarried women D5aii. Are the rules/policies limiting access for unmarried women implemented? D5b. Laws/regulations/policies limiting access to family planning for young people? D5bi. Description of the rules or policies limiting access for young people D5bii. Are the rules/policies limiting access for young people implemented? D5c. Other laws/regulations/policies limiting access to family planning services? D5ci. Specification of other policies limiting access D5cii. Are the other rules/policies limiting access implemented? D6. Are there charges to the client in the public sector for family planning services or commodities? D6a. Charges to client in public sector for family planning services? D6b. Charges to client in public sector for family planning commodities? D6c. If there are charges, are there exemptions for those who cannot afford to pay? D6ci. Description of exemptions D7. Information in country's Poverty Reduction Strategy Paper (PRSP) D7a. Year of Poverty Reduction Strategy Paper (PRSP) (most recent actual PRSP on IMF's site (not progress or summary report) D7b. Is family planning or reproductive health a priority in the PRSP? D7c. Is contraceptive security included in the PRSP? D7d. Is contraceptive prevalence rate (CPR) included as an indicator in the PRSP? D7e. Are contraceptive supply indicators included in the PRSP? D7f. Notes about the PRSP D8. Inclusion of contraceptives in country's National Essential Medicine List (NEML) D8a. Is a combined oral hormonal pill included on the NEML? D8b. Is a progestin-only oral hormonal pill included on the NEML? D8c. Is a hormonal injection included on the NEML? D8d. Is a hormonal implant included on the NEML? D8e. Is an IUD included on the NEML? D8f. Is a male condom included on the NEML? D8g. Is a female condom included on the NEML? D8h. Is an emergency contraceptive oral hormonal pill included on the NEML? D8i. Is any other contraceptive included on the NEML? D8ii. Name of other contraceptive on NEML D9. Year of National Essential Medicine List (NEML) D10. Notes about the NEML E. Supply Chain (Capacity) E1. Have stockouts occurred for any contraceptive at the central level in the last 12 months? (The central level refers to the central level warehouse for the public sector.) E2. In the last 12 months, has there ever been a stockout at the central level of any of the following contraceptives? E2a. Combined oral hormonal pills stocked out at central level in last 12 months? E2b. Progestin-only oral hormonal pills stocked out at central level in last 12 months? E2c. Hormonal injections stocked out at central level in last 12 months? E2d. Hormonal implants stocked out at central level in last 12 months? E2e. Intrauterine devices (IUDs) stocked out at central level in last 12 months? E2f. Male condoms stocked out at central level in last 12 months? E2g. Female condoms stocked out at central level in last 12 months? E2h. Emergency contraceptive oral hormonal pills stocked out at central level in last 12 months? E2i. CycleBeads stocked out at central level in last 12 months? E2j. Time period of stockout information E2k. Data source for stockout information E3. Do you think stockouts are a serious problem at the following levels? E3a. Do you think stockouts are a serious problem at the service delivery point level? E3b. Do you think stockouts are a serious problem at the central level? F. Overall comments about issues with contraceptive security Region Year of Survey Data Collection Afghanistan No N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No No Data No Data No Data No Data No Data No Data No Data No Data No Data No Data No Data No Data No Data No Data No Data No Data No Data Yes Yes Yes No Yes Yes No No No Yes No N/A Yes Yes Yes No Yes Yes No No No Yes No N/A Yes No Yes No Yes Yes No Yes No Yes No N/A No No No Yes Injectables Community health workers are not authorized to administer injectable contraceptives. N/A No No No No N/A 2008 Yes No Yes No Yes Yes Yes No Yes Yes No No No N/A 2007 No No No No N/A No No N/A N/A N/A January - December 2009 Warehouse reports from partners No No Europe and Asia 2010 Albania Yes National Reproductive Health Committee Yes NESMARK Yes Albanian Association for Population Development Yes Bayer-Schering Yes USAID Yes UNFPA, UNICEF, WHO Yes Directorates of Public health, Hospitals, Pharmacies, Health Statistics, Economy N/A There is no such organization in Albania No 3-5 times No Yes IPH LMIS Project coordinator Yes Yes Yes Yes $21,931 1/09-12/09 Expenses for Purchase of Contraceptives, Public Sector year 2009 UNFPA and IPH finance No N/A 0.0 1/09-12/09 21931 Yes UNFPA $17,206 1/09-12/09 UNFPA and IPH finance 56% Third-party agent (e.g., UNFPA, Crown Agents) UNFPA N/A Yes Yes Yes No Yes Yes No Yes No Yes No Yes Yes Yes No Yes Yes No No Yes Yes Yes No Data No Data No Data No No Data Yes No No No No No Data not available in Albania not available in Albania Available in the pharmacies. Currently there is a stockout of Postinor - EC is not available in public sector not well accepted in Albania, practically non-existent only in one region (Diber), not common Yes National Strategy of Contraceptive Security 2003-2010 Yes Yes Yes 1) For Public Sectors: VAT (20%) Condoms, syringes, IUD (Non Drugs) 2) From March 2010 the Albanian Government has decided that every medicine shipment must be accompanied by an export declaration from the country of origin. Public Sectors (VAT) VAT: 20% Yes IUDs are only provided by OB/GYN in the public sector. No No No No No No N/A 2008 No No No No Yes Yes No No Yes No No Yes No Data No Data 2009 Reviewed registered drug list and was told contraceptives not on reimbursable drug list either. (Since the registered drug list is not separated into categories, it is possible that a contraceptive listed here was included on the list for a different purpose. In addition, there could be more contraceptives that were inadvertently overlooked.) Yes No No No N/A Yes No N/A N/A No January - December 2009 Logistics Management Information System, periodic physical inventory, warehouse reports Yes Yes The government will start working on the extension of the contraceptive security strategy beyond the year 2010. Europe and Asia 2010 Armenia No N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No No No 0.0 1/09-12/09 No N/A 0.0 1/09-12/09 0 Yes UNFPA $12,628 1/09-12/09 UNFPA 30 FP units have been supplied with contraceptives worth $12,628 USD. 0% N/A N/A N/A Yes Yes Yes No Yes Yes No Yes No Data No Data No Spermicides Yes Yes No No Yes Yes No Yes No Data No Data No No No No No No No No No No No No N/A Yes National Strategy, Program and Actions Timeframe on Reproductive Health Improvement 2007-2015 Yes Yes Yes All methods Commercial 20% VAT Yes There are advertising ban policies. In particular, contraceptive pills and spermicides are not among the "over the counter" medicines and cannot be advertised. For the advertisement of other contraceptives, Ministry of Health permission is required. Yes Pills, IUDs, spermicides Only OB/GYNs can prescribe and dispense all methods, including IUD insertion. Family doctors (FDs) provide FP counseling and dispense all contraceptives, except for hormonal pills and IUD insertion. Nurses can only refer for FP counseling and dispense condoms. N/A No No No No No N/A 2008 Yes No No No Yes Yes Yes No No No No Yes No Data No Data No Data IUDs, condoms, and spermicides are not on the list since they're not drugs. Implants are not registered or popular. The list is available online on the MOH website. No No No N/A N/A No No N/A No N/A January - December 2009 UNFPA and Institute of Perinatology, Obstetrics, and Gynecology Yes No Europe and Asia 2010 Azerbaijan No N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A No No Data No No No 0.0 1/09-12/09 No N/A 0.0 1/09-12/09 0 No N/A 0.0 1/09-12/09 N/A N/A N/A N/A Yes No No No Yes Yes No Yes No Data No Data No No No No No No No No No No No No No No No No No No No No No No No Just a limited amount of COCs and IUDs are available due to the UNFPA donation. Otherwise providers write a prescription and clients go to pharmacies to buy the method. Only small amount of free UNFPA commodities are available just in a few clinics. Very rarely is available in private pharmacies Just a limited amount of COCs and IUDs are available due to the UNFPA donation. Otherwise providers write a prescription and clients go to pharmacies to buy the method. Only small amount of free UNFPA commodities are available just in a few clinics. Tubal ligation is sometimes performed during surgeries for other medical reasons. Yes Reproductive Health Strategy 2008-2013 Yes No Yes All Import taxes for commercial sector 18% No Yes IUD, pills Since September 2009, health providers (including primary level providers*) who received training on FP standard protocols are also allowed to prescribe hormonal contraceptives. (*This mainly refers to non-gynecologist MDs. If there is no doctor at a primary level facility though, trained midwives can also prescribe.) Only pharmacies sell contraceptives. No No No N/A N/A 2003 Yes Yes No No Yes No No No Yes Yes No No No N/A 2009 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A January - December 2009 Personal communication with the MOH/warehouse staff. There were no contraceptives in the public sector warehouse in 2009. Yes Yes CS is a serious issue in Azerbaijan. Available only in private pharmacies, contraceptives are quite expensive. Some contraceptives are not available even in private setings (e.g., progestin-only pills, injectables). Inclusion of contraceptives into the Essential Drug List does not mean they are going to be subsidized by the government and provided free of charge. In other words they will not necessarily be offered in public health facilities. Europe and Asia 2010 Bangladesh Yes Logistics Coordination Forum (LCF) Yes Social Marketing Company (SMC) Yes Family Planning Association of Bangladesh No Yes USAID, World Bank, CIDA, KfW, DFID, JICA, EU Yes UNFPA Yes Directorate General Family Plannning (DGFP) Yes Central warehouse of DGFP No 3-5 times Yes Yes USAID Yes Yes Yes No $700,000 2008-2009 DGFP Yes World Bank credit $20,342,200 2008-2009 DGFP 21042200 Yes CIDA $800,000 2008-2009 UNFPA CIDA-donated implant 96% The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) DGFP No DGFP, under MOHFW, procures all FP-RH commodities, using WB credit money, through open bidding following GOB and IDA procurement guidelines. Yes Yes Yes Yes Yes Yes No Data No Data Yes Yes No Yes No Yes Yes Yes Yes No No Yes Yes No Yes Yes Yes Yes Yes Yes No No Yes Yes No Yes Health and Nutrition Sector Plan 2006-2011 Yes No Yes All commodities imported directly by private sector, including social marketing. Private sector (including social marketing) 2.25% VAT, payable in advance Yes Private sector organizations currently not allowed to import IUDs. Yes Injectables Community workers can't give first dose Data not available Yes Unmarried women can't receive IUDs, injectables, implants, or tubal ligation. Yes No Yes Low parity women and men can't receive IUDs, tubal ligation, or vasectomy. Non-parous women cant receive injectables or implants. Yes No No N/A 2005 Yes No Yes No Yes No No No No Yes No No No Data No Data No Data Yes No N/A Yes Yes Yes No N/A Yes N/A various times throughout the year Logistics Management Information System (LMIS) Yes Yes There is still a significant bottleneck in the procurement end of the supply chain. Europe and Asia 2010 Burkina Faso Yes Contraceptives Security Strategy Plan Implementation follow up Committee (Comité de suivi du Plan de Stratégique de Sécurisation des Produits Contracepifs) Yes PROMACO Yes ABBEF (IPPF Affiliate) Yes Pharmacist Association Yes UNFPA Yes UNFPA Yes Reproductive Health Directorate, Pharmacy and Lab. Directorate, General Directorate of Health, Study and Planning Directorate Yes CAMEG No 1-2 times Yes Yes Family Heath Directorate (FHD) FHD's Director Yes Yes Yes Yes $138,579 1/09-12/09 CPTs, FHD, CAMEG Cost recovery funds Yes Basket funds and World Bank poverty fund $872,902 1/09-12/09 CAMEG Ordered by CAMEG with Government Funds (Basket Fund) and World Bank poverty fund 1011481.21 Yes UNFPA, USAID $1,793,046 1/09-12/09 CPTs Quantity ordered and received in country in 2009 from UNFPA and USAID 36% The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) CAMEG Yes In 2009, there was a shortage of Lo-femenal at the central level; then the Family Health Directorate (FHD) requested to CAMEG to use part of the funds generated by contraceptive distribution to procure 600,000 cycles of combined oral pills. The FHD also uses part of the contraceptive-generated funds to support the CPTs (contraceptive procurement tables) exercise workshops. Yes Yes Yes No No Yes Yes Yes No No No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Plan Strategique de Securisation des Produits contraceptifs (PSSCS) 2006-2015 Yes Yes No No Yes Implants Nurses, Midwives and Doctors No data IUDs Nurses, Midwives and Doctors No data Long-acting permanent methods Only the Medical Doctors can provide this service No data No No Yes Yes Yes The service provider appreciates the situation of unaffordability of the client. There is no official law for exemptions for clients who cannot afford to pay. 2005 Yes No No No Yes Yes Yes Yes Yes Yes Yes Yes No N/A 2008 Yes Yes No No Yes Yes No No No No December 2009 - January 2010 Central Warehouse report, Procurement Planning and Monitoring Report No Yes With the Marie Stopes strategy focusing on long-lasting methods (IUD, implants), the consumption of these two methods is really increasing and the level of stock at the central level is not sufficient to support this strategy. The contraceptives ordered by the Government through CAMEG for 2009 (implant, pills) were delayed due to the procurement procedures bottleneck. Africa 2010 Dominican Republic Yes Comite para la Disponibilidad Asegurada de Insumos y Planificacion Familiar (Contraceptive Security Committee) Yes PROFAMILIA, ADOPLAFAM, MUDE Yes PROFAMILIA, ADOPLAFAM, MUDE and 30 more institutions No Yes USAID Yes UNFPA, OPS/OMS Yes Reproductive health, logistics, HIV program, pharmacy units. Yes Central Warehouse MOH No 6 or more times Yes Yes Reproductive Health department Subdirector No No Yes Yes $486,204 1/09-12/09 Contraceptive procurement table No N/A 0.0 1/09-12/09 486204 Yes USAID $418,510 1/09-12/09 Contraceptive Procurement table 54% The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) Direccion Materno Infantil y Adolescentes/PF program No Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Vaginal spermicides Yes Yes Yes Yes Yes Yes No Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Vaginal spermicides No Yes All Commercial methods, NGO 16% VAT No No No No No No No N/A N/A N/A N/A N/A N/A Yes Yes Yes No Yes Yes No No Yes Cycle beads and vaginal spermicide 2007 Yes Yes No Yes No No Yes N/A N/A N/A July 2009 - September 2009 Logistics Management Information System, Monitoring Report Yes Yes LAC 2010 El Salvador Yes Contraceptive Security Committee Yes Asociación Demográfica Salvadoreña (ADS) Yes Asociación Demográfica Salvadoreña (ADS) No Yes USAID Yes UNFPA Yes Women's Health Unit, Planning Unit, Financial Unit No No 6 or more times Yes Yes MOH Family Planning Coordinator No Yes Yes Yes $784,000 1/09-12/09 Women's Health Unit, and Financial Unit No N/A 0.0 1/09-12/09 784000 Yes USAID $150,000 1/09-12/09 USAID files 84% Third-party agent (e.g., UNFPA, Crown Agents) UNFPA N/A Yes No Data Yes No Data No Data Yes No Data No Data No Data Yes No Data Yes No Yes Yes Yes Yes No No Yes Yes No Yes Yes Yes Yes Yes Yes No No Yes Yes No Yes Contraceptive Security Strategic Plan 2008 Yes Yes Yes All methods Private and NGO sectors Don't know No Yes Injectables Only trained staff, including promoters in rural and peri-urban areas Only pharmacists IUDS Only trained staff, including nurses Only physicians and trained clinical staff Implants Only trained staff Only physicians and trained clinical staff No No No No No N/A N/A N/A N/A N/A N/A Yes No Yes No Yes Yes No Yes No Data No Data 2006 No No N/A No No No No No N/A N/A No data LMIS No No Funding for 2010 ($675,674) will cover 86% of total needs. The MOH needs to mobilize more resources to cover 100%. LAC 2010 Ethiopia Yes Family Planning and Logistics Technical Working Group Yes DKT Ethiopia Yes CARE, EngenderHealth, Family Guidance Association of Ethiopia (FGAE), Family Health International (FHI), Integrated Family Health Program (IFHP), IPAS, Marie Stopes International No Yes UNFPA, USAID, Packard Yes UNFPA Yes Health Promotion & Disease Prevention directorate No (expecting Pharmaceutical Fund and Supply Agency [PFSA] in the future) Yes Population Department of Ministry of Finance and Economic Development (MOFED) 6 or more times No Yes FMOH Health Promotion and Disease Prevention (HPDP) Directorate, DELIVER, IFHP, EngenderHealth, FGAE Yes Yes Yes Yes $889,000 7/08-6/09 Ministry financial transaction records Includes regional funds (SNNP and Oromia) Yes PBS II (Protecting Basic Services II) $20,000,000 7/08-6/09 Ministry financial transaction records 20889000 Yes USAID and UNFPA/Global Program. (DKT also donated in-kind to the public sector for Regional Health Bureaus (RHBs), but the exact amount is not known.) $9,500,000 7/08-6/09 Donor records $6 million's worth from USAID and $3.5 million's worth from UNFPA/Global Program 69% Third-party agent (e.g., UNFPA, Crown Agents) UNFPA (but PFSA - a parastatal - is likely to procure in the future) N/A UNFPA was delegated on the Ministry's behalf for the procurement of contraceptives funded by PBS I and PBS II. However, experience from PBS I procurement indicates that the procurement process is extremely lengthy. PFSA is a newly established government procurement entity and is expected to take on procurement responsibilities in the future. DELIVER continues to support the facilitation of contraceptive procurement by sharing information with the FMOH through the FPTWG. Regarding financing, even though the amounts are not significant, the central Government and some of the Regional Government’s continue to finance contraceptive procurement from internally generated (budget) funds. The existence of basket funds and the possibility of future funding as well as an overall increase in donor support for FP have put the country in a better position when compared to previous years. Yes Yes Yes Yes Yes Yes No Data Yes No Data No Data No N/A Yes Yes Yes Yes Yes Yes No Yes Yes Yes No N/A Yes Yes Yes Yes Yes Yes No Data Yes Yes Yes No N/A Available in private sector through USAID public/private partnerships (providing long-acting methods in 70 higher clinics in 5 major regions in private facilities) and DKT (who started distributing Sinoimplant). Available in NGO facilities through Marie Stopes and FGAE. Available in most public central and regional referral hospitals in cities. Available in NGO facilities through Marie Stopes and FGAE. Available in public referral hospitals in cities. Available in NGO facilities through Marie Stopes and FGAE. Yes National Reproductive Health Strategy 2006-2015 Yes Yes No In late 2008 the government announced that there would not be any taxes/duties for contraceptives in any sector. No Yes One-rod implants Task-shifting policy positively affects the family planning program. Midwives, nurses, health officers, and doctors can provide any kind of implant (1 or 2 rods). Trained health extension workers (HEWs) can provide 1-rod implants (i.e., Implanon). (They can also provide injectables, pills, and condoms.) N/A IUDs Trained midwives, nurses, health officers, and doctors can provide. N/A Permanent methods Only doctors can provide surgical methods. N/A No No No No No N/A There are no charges now, but in the future the health care financing (HCF) policy will be implemented for hospitals to charge (in order to promote clients to access contraceptives from health centers instead of from hospitals). There will be a fee waiver for those who cannot afford to pay. 2007 Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes No Yes Diaphragms with spermicide 2004 Emergency contraceptives are not confirmed- the list is under revision since 2007 and comments have been made to incorporate emergency contraceptives. Yes No Yes No No Yes No N/A Yes N/A January - December 2009 Procurement Planning and Monitoring Report (PPMR), which for Ethiopia includes central, regional, and IFHP data. No No Contraceptive availability improved compared to previous years. Stockouts at service delivery points are below 10% for most tracer contraceptives (injectables, combined orals). Regarding condoms, stockout at service delivery points was a little bit higher (17%) because condoms were procured by PEPFAR HIV/AIDS funds and directly distributed to ART sites. But very recently UNFPA procured 7.5 million condoms and we're hoping stockouts will decrease this quarter (Jan-March 2010). The Ministry's plan for Implanon significantly increased the financial demand for contraceptives for 2010. Africa 2010 Georgia Yes Natonal Reproductive Health Committee No Yes JSI No Yes USAID Yes UNFPA, UNICEF, WHO Yes Policy Unit, Quality Control and Licensing, Advisor to the Minister in Reproductive Health No No 6 or more times Yes No No No No No 0.0 1/09-12/09 No N/A 0.0 1/09-12/09 0 The Government of Georgia has never spent funds on contraceptives. Yes USAID & UNFPA $86,555 1/09-12/09 Reproductive Health Supplies Coalition website at http://rhi.rhsupplies.org 0% 0 N/A N/A N/A Yes No No No Yes Yes No Yes No Yes No Yes Yes No No Yes Yes No Yes No Yes No No No No No No No No No No No No N/A Yes National Reproductive Health Strategy 2005-2015 Yes Yes Yes Oral Pill, Injectables, IUD, Condom, Implant Commercial Sector 1) If the commodity is humanitarian it is not subject to any taxation and documentation fee should not exceed 100GEL 2) If the commodity is commercial (intended to be sold) it is subject to taxation and the fees are: Registration in Drug Agency 500 GEL Custom Tax 18% from the total price (gross including transportation) Custom Fee 60 EU After sales revenue tax 10% Yes See previous information about taxes and fees Yes IUDs Only OB/GYN and Reproductologist can dispense Only OB/GYN and Reproductologist can dispense No No No No N/A 2003 No No No No No No No No No No No No No N/A N/A No legally approved essential drug list exists at the national level, however most insurance companies have their own lists. Neither the list of generics prepared as the national essential drug list (draft, which includes just 200 drugs), nor any of the essential drug lists elaborated by the insurance companies contain any kind of contraceptive. (Two years ago, under one of the Word Bank funded programs, the essential drug list was drafted but was never approved by the MoH or Parliament.) No No No N/A N/A No No N/A N/A N/A September 2008 - September 2009 Healthy Women in Georgia Program Logistics Management Information System (LMIS) Yes Yes Europe and Asia 2010 Ghana Yes Inter-Coordinating Committee for Contraceptive Security (ICC/CS) Yes EXP Social Marketing (SM), Ghana Social Marketing Foundation (GSMF) International Yes Planned Parenthood Association of Ghana (PPAG), MSIGh Yes Ghana Registered Midwives Association, Society of Private Medical and Dental Practitioners, Pharmaceutical Society of Ghana Yes USAID, UNFPA, Royal Netherlands Embassy (RNE), DANIDA, UNAIDS, WHO, JICA Yes WHO, UNAIDS,UNFPA Yes Ghana Health Service (Stores, supplies and drug management, family health division, public health directorate, policy planning monitoring and evaluation, regional medical stores, finance), MOH (procurement and supplies, CMS, Food and drugs board, pharmacy Yes Central Medical Store Yes Ministry of Finance and Economic Planning - Health desk officer 1-2 times Yes Yes USAID, UNFPA, Family Health Division, USAID | DELIVER PROJECT FP advisors, Director of the FHD and the COP No Yes Yes Yes $800,000 1/09-12/09 ICC/CS minutes, Financial sustainability report and PPAG "time to take charge" fact sheet Yes DANIDA $600,000 1/09-12/09 Ministry of Health 1400000 Yes USAID and UNFPA $1,952,272 1/09-12/09 RHI and USAID "My Commodities" 42% The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) MOH Procurement Unit, Stores Supplies and Drug Management Directorate of GHS. (GHS is under MOH.) (MOH contracts with Crown agents for support.) No So far three condom tenders have been made - the 1st one has been completed, the 2nd one has seen the award done but supplies have not arrived, and the 3rd one has the tender results under evaluation. Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Ghana National Contraceptive Security Strategy 2004 - 2010 2004-2010 Yes Yes No No Yes Injectables Community-based distributors (CBDs) cannot provide. Nurses and community health officers can provide. Same as in the public sector. Implants and IUDs Doctors and midwives can provide. Chemical sellers are restricted; they can only provide condoms and oral contraceptives. No No Yes Yes Yes indigent populations (very poor as determined by the dept of social welfare) 2005 Yes No No No Yes Yes Yes Yes Yes Yes Yes Yes No Data No Data 2009 The list is derived from the Standard Treatment Guidelines. The list is reviewed every two years. Yes No Yes Yes Yes Yes No No Yes N/A January - December 2009 PPMR, CMS stock reports (micronor, norigynon and postinor were out of stock at various times) Yes Yes A stockout anywhere of any duration is a serious issue insofar as someone is prevented from exercising a choice that impacts on socioeconomic development and wellbeing. Africa 2010 Guatemala Yes Comision Nacional para el Aseguramiento de Anticonceptivos (CNAA) (National Contraceptive Security Committee) Yes PASMO Yes APROFAM No No No Yes National Reproductive Health Program, logistics management unit Yes Logistics unit in charge of central warehouse is a key member Yes Ministry of Finance 3-5 times Yes Yes National Reproductive Health Program Coordinator of the National Reproductive Health Program No No Yes Yes $1,325,301 1/09-12/09 Report from the National Committee for Contraceptive Secuirity No N/A 0.0 1/09-12/09 1325301 No N/A 0.0 1/09-12/09 100% Third-party agent (e.g., UNFPA, Crown Agents) UNFPA N/A By law, 15% of all taxes on alcoholic beverages sold in the country should go to finance reproductive health interventions. It is not clear how much is contributing to financing contraceptives. Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Foam, Jelly, vaginal tablets Yes No Yes Yes Yes Yes No No Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Patch, Silastic Rings, Low-dose oral (Marvelon) Yes Law of Universal Access to Family Planning Many Yes Yes Yes Condoms, IUDs, Orals, Injectables, Implants All sectors 5% duty fees and 12% taxes. MOH commodities are exempt through their procurement agreement with UNFPA. No No No No No No No N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A No NEML at the national level. Yes Yes N/A Yes No No No N/A N/A No October 2009 - December 2009 Logistics Management Information System No No Guatemala has a strong legal framework that supports the National Commission for Contraceptive Security. Nonetheless, securing funding for payment allways comes at the last minute. Funding must be made available in a more expedituous manner to avoid delays in the procurement process LAC 2010 Honduras Yes Comite Interinstitucional para la Disponibilidad Asegurada de Insumos Anticonceptivos (CIDAIA) (Inter-institution Committee for Contraceptive Security) Yes PASMO Yes ASHONPLAFA Yes Pfizer, Vijosa, ARSAL Yes USAID Yes PAHO, UNFPA Yes Vice-Minister of Health Services Network, Logistics Unit, Women's Health Unit, Essential Drugs Unit Yes Central warehouse manager No No Data No Data Yes Ministry of Health Advisor to the Vice-Minister No No No No 0.0 8/09-7/10 CPT, Ministry of Health's reports The government did not provide funds in 2009 due to the political situation. In the previous year they made 1.2 million USD available. No N/A 0.0 8/09-7/10 0 Yes UNFPA $900,000 8/09-7/10 UNFPA Donation 0% During the most recent fiscal year, the GOHO did not allocate funds for contraceptive procurement Third-party agent (e.g., UNFPA, Crown Agents) UNFPA N/A During the most recent fiscal year, the government did not allocate any funds for contraceptive procurement, due to the economic crisis. This year, they have requested around $800,000, which won't cover total needs (estimated at $1.4 M for 2011). Yes No Yes No Yes Yes No No Yes Yes No Patch Yes No Yes No Yes Yes No No Yes Yes No Yes No Yes No Yes Yes No No Yes Yes No Yes Estrategia CIDAIA 4 years Yes No No No Yes Emergency Contraception In April 2009, the Parliament of Honduras approved a bill prohibiting the promotion, commercialization, free distribution and use of EC pills. The bill also prohibits the dissemination of information about the use of contraceptive pills like EC. In April 2009, the Parliament of Honduras approved a bill prohibiting the promotion, commercialization, free distribution and use of EC pills. The bill also prohibits the dissemination of information about the use of contraceptive pills like EC. No No No No No N/A 2001 Yes No No No Yes Yes Yes No Yes Yes No No No Data No Data 2007 Yes Yes N/A Yes N/A Yes Yes N/A N/A N/A May - September 2009, February - May 2010 Central warehouse data No Yes The political crisis last year disrupted the flow of funds for contraceptive procurement. Last year is not considered a typical one in terms of commitment from the Ministry of Health to allocate funds for contraceptive procurement. Monitoring of specific budget allocations should be conducted this year in order to determine commitment from the MOH toward ensuring contraceptive security in Honduras. LAC 2010 India Yes Supply and Social Marketing Division of Ministry of Health and Family Welfare No No No No No Yes Supply and Social Marketing Division of Ministry of Health and Family Welfare No No 3-5 times Yes Yes Government of India, Secretary Health Key person for planning health activities / procurements, programs No Yes Yes Yes No Data 4/09-3/10 Government of India, Ministry of Health and Family Welfare No N/A 0.0 4/09-3/10 Government of India is self-sufficient in procuring contraceptives. Contraceptives are supplied for free in the government programs. No Data No N/A 0.0 4/09-3/10 Government of India is self-sufficient in procuring contraceptives. They are supplied for free in the government programs. 100% The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) Supply and Social Marketing Division of Government of India No The family planning program of the Ministry of Health and Family Welfare is a priority program and the government of India is self-sufficient in procuring contraceptives. Contraceptives are supplied for free in the government programs. Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes No No No Yes Yes No Yes Yes Yes No Yes No Yes No Yes Yes Yes Yes Yes Yes Yes Available in private sector including through social marketing Not yet available in government program Not yet available in government program Some studies are occurring but implants are not yet in the government program Not included in the government program Yes National Population Policy 2000-2016 Yes Yes No No Yes Injectable contraceptives and progesterone-only pills N/A (Product not available through public sector) Only qualified, certified allopathic medical practitioners are allowed to provide and only qualified pharmacists (with pharmacology degree) are allowed to sell. No No No No No N/A N/A N/A N/A N/A N/A Yes No No No Yes Yes No Yes No N/A 2003 No No N/A N/A N/A No No N/A No N/A April 2009 - March 2010 Government of India No No India is a contraceptive secure country. Europe and Asia 2010 Kenya Yes Family Planning Logistics Working Group Yes Population Services International (PSI) Yes Management Sciences for Health (MSH), Marie Stopes, Family Health Options Kenya, John Snow Inc. (JSI) No Yes USAID, KfW Yes UNFPA Yes Division of Reproductive Health, Family Planning Program Yes Kenya Medical Supplies Agency (KEMSA) No 3-5 times No Yes Public Health and Sanitation Director of Public Health and Sanitation No Yes Yes Yes $6,106,555 7/08-6/09 KEMSA GoK funded procurement Yes KfW $2,519,694 7/08-6/09 KEMSA KfW funded procurement 8626248.82 Yes Donations from UNFPA and USAID $3,028,363 7/08-6/09 RH Interchange 74% The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) Kenya Medical Supplies Agency (KEMSA) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Data Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes National Contraceptive Commodity Security Strategy 2007-2012 Yes Yes Yes Progestin-only pills, combined oral pills, implants (Jadelle), IUCDs (Copper T), DMPA injectables, emergency contraceptive pills, male and female condoms Public Sector UNFPA pays 5% of commodity cost to KEMSA for handling, warehousing, and distribution. The fee paid is intended to add onto KEMSA’s resource envelope for warehousing and distribution. UNFPA only pays for the products it donates. No Yes Progestin-only pills, combined oral pills, DMPA injections, emergency contraceptive pills All facility levels are allowed to dispense these methods as long as there are skilled health workers. Only registered pharmacies, clinics, and hospitals are allowed to sell or dispense these methods. Implants and IUDs DRH limits provision of these methods to higher level health facilities due to limited availability of skilled health workers at dispensary level. Only registered pharmacies, clinics, and hospitals are allowed to sell or dispense these methods. No No No No No N/A 2005 No No Yes No Yes No Yes No No No No Yes No N/A 2003 Revision of the essential drugs list is currently ongoing. It is expected that implants, IUDs, and barrier methods will be added to the list. Yes No Yes Yes Yes Yes No Yes Yes Yes January - December 2009 KEMSA Monthly Stock report Yes Yes Various activities are being carried out to implement the National Contraceptive Commodities Security Strategy under the focus areas of commitment, capital, coordination, capacity, client utilization and demand. The procurement plan is only implemented hand in hand with revised annual quantification and forecasts. The National Contraceptive Commodities Security Strategy was developed in 2007 and included a forecast of country contraceptive requirements for 2007-2010, but these forecasted quantities are revised annually. Therefore, the procurement plan is implemented taking into consideration these revised annual requirements. Africa 2010 Liberia Yes National Reproductive Health Commodity Security Committee No Yes Family Planning Association of Liberia No Yes USAID Yes UNFPA Yes Ministry of Health and Social Welfare Yes National Drug Service No 1-2 times No Data Yes MOH Head of Family Health Division No No No No 0.0 1/09-12/09 No N/A 0.0 1/09-12/09 0 Yes For 2009, UNFPA ($414k) and USAID ($516k) $930,434 1/09-12/09 RHI 0% N/A N/A N/A Yes Yes Yes No Yes Yes Yes Yes No No Yes Yes Yes Yes No Yes Yes Yes No No No Yes Yes Yes Yes No Yes Yes Yes No Yes No Yes Yes National Reproductive Health Commodity Security Strategy and Operational Plan 2008-2012 Yes Yes No No No No No No No No N/A 2008 No No Yes No Yes Yes Yes No Yes Yes Yes No No N/A 2007 Yes Yes No Yes N/A Yes No No N/A N/A January - December 2009 stock management report (central level) No Data No The USAID | DELIVER PROJECT is working to get the contraceptive supply chain management of the MOHHSW/FHD to be effective and ensure data availability. Africa 2010 Madagascar Yes "Reproductive Health/Family Planning Partners Committee" and sub-committee "RH/FP Logistics Committee" Yes Population Services International Yes FISA (IPPF affiliate), Marie Stopes Madagascar, Religious platform represented by (1) SAF-FJKM - the Health Department of Protestant church and 2) SALFA -- health department of Lutheran Church), Voahary Salama (the NGO platform) Yes ORGANON Yes USAID, UNFPA, JICA Yes UNFPA, UNICEF, UNAIDS, World bank, WHO Yes Family Planning Directorate (FPD) Yes SALAMA, the national essential drug purchasing agency Yes Ministry of Finance (sometimes) 1-2 times No Yes The Directorate of Family Planning Director No Yes Yes Yes $125,127 1/09-12/09 FPD No N/A 0.0 1/09-12/09 125126.5 Yes UNFPA $2,927,412 1/09-12/09 RHI 4% Other SALAMA - Central Essential Drugs Purchasing Agency Yes 90% of the total funds for contraceptive procurement used to come from donors including USAID who provided 60% of the contraceptives before the March 2009 coup declaration and suspension of the USG assistance to the Government. Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes No No No Data No Data Yes Yes No Yes Yes Yes Yes Yes No No Data No Data No Data Yes Contraceptive Security Strategy 2007-2012 Yes Yes Yes Private Tax: 20% VAT: 20% Yes Tax for contraceptives imported by private sector No No No No No No N/A 2007 Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes No Yes VFTs 2008 Expecting new NEML in 2010. Yes Yes Yes Yes Yes No No Data N/A N/A Yes January - December 2009 Logistics Management Information System, SALAMA report No No Since July 2007, a free contraceptive policy has been in place and likely affects the logistic system regarding who is going to pay for the transportation of contraceptive products. In March 2009 a coup declaration suspended USAID support to the Government of Madagascar and impacted contraceptive security during the period from March to December 2009. Africa 2010 Malawi Yes Reproductive Health Technical Working Group Yes PSI No No Yes USAID, Clinton HIV/AIDS Initiative (CHAI) Yes UNFPA Yes Reproductive Health Unit, Health Technical Support Services - Pharmaceutical and HIV/AIDS Unit, National AIDS Commission No No 3-5 times No No Yes No Yes No 0.0 10/08-9/09 Yes Swap funds $900,000 10/08-9/09 CMS and PipeLine for 1 million DMPA vials (received in the country in November 2009) 900000 Yes USAID ($2,316,905.74) and UNFPA ($1,289,119.22) $3,606,025 10/08-9/09 USAID | DELIVER PROJECT My Commodities & PipeLine Records 20% The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) CMS No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes No Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Reproductive Health Commodities Security Strategy 2006-2010 Yes Yes No Yes The largest NGO in Malawi is Banja La Mtsogolo (BLM), an affiliate of Marie Stopes International (MSI). Until now, they have not been able to access the USAID donated contraceptives through the government system (because of the Mexico City policy). Mechanisms are being worked out to change this. Yes IUCDs, implants and injectables Only in facilities with trained personnel. Health Surveillance Assistants are allowed to administer injectable contraceptives. Only in accredited premises and by registered personnel Oral contraceptives Only by trained personnel. Community Health Workers provide oral contraceptives (and condoms). Only by trained and registered personnel No No No No No N/A 2007 No No Yes No Yes Yes Yes Yes Yes Yes Yes No No Data No Data 2009 Yes No No No Yes No No Yes N/A N/A likely October 2008 - September 2009 LMIS Yes No The handling fee charged by Central Medical Stores continues to limit access of contraceptives, especially government-procured injectables and implants. The stockouts at service delivery points are also a result of low demand and a lack of qualified providers. Africa 2010 Mali Yes Commision de Suivi de la Mise en Oeuvre du Plan d'Action a long terme pour la Contraception Securisee au Mali (committee for follow-up to the implementation plan for long-term contraceptive security) Yes Centrale d'Achat des Generiques (C.A.G.) PSI Yes Groupe Pivot Sante et Population (GPSP), AMPPF (IPPF affiliate), Marie Stopes Yes Centrale d'Achat des Generiques (C.A.G.) Yes USAID, UNFPA, KFW Yes UNFPA Yes Direction Nationale de la Sante (DNS), Direction de la Pharmacie et du Medicament (DPM), Pharmacie Populaire du Mali (PPM) Yes Pharmacie Populaire du Mali (PPM) No 1-2 times Yes No Yes Yes No No 0.0 7/09-6/10 No N/A 0.0 7/09-6/10 0 Yes USAID, UNFPA $2,348,095 7/09-6/10 RHI 0% N/A N/A N/A Yes Yes Yes Yes Yes Yes No Yes No Data No Data Yes foaming vaginal tablets Yes Yes Yes Yes Yes Yes No Yes No Data Yes Yes foaming vaginal tablets Yes Yes Yes Yes Yes Yes Yes Yes No Data Yes Yes foaming vaginal tablets Yes Plan pour la Contraception Securisee au Mali 2002-2012 Yes Yes Yes All products brought into the country are taxed USAID-donated products are tax-exempt 2.5% tax Yes All products brought into the country are taxed. Yes IUDs and implants Non-qualified personnel (not trained) are not allowed to provide certain methods such the Long Acting Methods (IUDs, Implants) No No No Yes Yes No 2008 No No No No Yes Yes Yes Yes Yes Yes Yes No Yes Spermicide 2004 Yes No No No Yes Yes Yes N/A No No December 2009 and March 2010 PPMR based on reports for Dec 31, 2009 and Mar. 31, 2010 Yes Yes New challenges are faced with meeting the contraceptive needs due to program expansion with new partners, especially for long-acting methods (IUD and Implants). Other challenges include commodity orders and shipment timelines not respecting the planned timeframe. Both of these issues have resulted in emergency procurements during this past year. Africa 2010 Mozambique Yes Reproductive Health Commodity Security (CS) Committee No No No Yes USAID Yes UNFPA Yes MOH RH Unit Yes CMAM No 3-5 times No No No No No No 0.0 10/08-9/09 No N/A 0.0 10/08-9/09 0 Yes UNFPA, USAID $2,604,765 10/08-9/09 CPTs 0% N/A N/A N/A Donors have provided 100% of needs. There has not been a shortage of available funding for contraceptives and condoms. While CMAM has received significant TA to conduct procurement, and theoretically could procure contraceptives and condoms, funds the MOH manages have been used for other priority health commodities. Yes Yes No Data No Data Yes Yes Yes No No Data No Data No N/A Yes Yes Yes No Yes Yes No No No Data No Data No N/A Yes Yes No No No Yes Yes No No Data No Data No N/A provided by AMODEFA (IPPF affiliate) provided by AMODEFA (IPPF affiliate) PSI Exploring Yes RH Commodity Security Strategy 2009-2012 No No No Yes Reportedly lengthy process for registration and MOH approval to launch socially marketed FP products. Yes IUDs Only trained MCH Nurses can insert (basic nurses cannot) Injectables Only MCH Nurses can provide injections Orals MCH Activists after the first consultation with SMI nurse No No No No No N/A 2007 Yes No No No Yes Yes Yes No Yes No No Yes Yes Spermicide 2007 National Formulary of Medications was the list reviewed. No No No No N/A No No N/A N/A N/A January - December 2009 CPTs, Physical Inventory Yes No Transport supported by UNFPA and DFID in 2009 resolved financial transport constraints. Pharmaceutical Logisitcs Master Plan when implemented will greatly improve distribution and increase uninterrupted access in the Public Sector Africa 2010 Nepal Yes Reproductive Health Commodities Security Working Group (also known as Contraceptive and Essential Commodities Security Working Group) Yes Nepal Contraceptive Retail Sales (CRS) Company Yes Family Planning Association of Nepal (IPPF affiliate) No Yes USAID, KfW, DFID, World Bank Yes UNFPA, UNICEF Yes Family Health Division, Logistics Management Division, Child Health Division, National Center for AIDS and STD Control, Ministry of Health and Population Yes Central Warehouse, Teku Yes National Planning Commission 1-2 times Yes Yes Logistics Management Division Director Yes Yes Yes Yes $1,691,440 7/08-6/09 National Pipeline report, LMD Yes Pooled funds - World Bank, DFID, AusAID $422,860 7/08-6/09 National Pipeline report, LMD 2114300 Yes USAID, KfW $309,100 7/08-6/09 National Pipeline report, LMD 87% The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) Logistics Management Division/MoHP. (Crown Agents provides quality assurance.) Yes The government is committed to financing the procurement of contraceptives; the increase in budget from 2008/09 to 2009/10 is by 87%. In the FY 2009/10, the government has committed 100% of the public sector procurement needs for contraceptives. Kfw has commited to provide condoms and injectables to the public and NGO sectors and oral pills to social marketing for the coming 3 years, till 2011. The government procures through international competitive bidding, and it is working well. LMD recently made a multi-year procurement contract for Condoms and Injectables. Yes No Yes Yes Yes Yes Yes Yes Yes Yes No N/A Yes No Yes Yes Yes Yes No Yes Yes Yes No N/A Yes No Yes Yes Yes Yes No No Yes Yes No N/A Public sector - piloting in 4 (out of 75) districts Yes National Reproductive Health Commodity Security (RHCS) Strategy 2007-2011 Yes Yes Yes All FP methods Commercial sector A 1% tax is charged for the commercial sector. (There is no tax for contraceptives for the public sector or social marketing sector.) No No No No No No No N/A 2003 Yes No Yes No Yes No Yes Yes Yes Yes No Yes No Data No Data 2009 No No N/A No No No No N/A N/A N/A January - December 2009 LMIS No No Donors' contribution in contraceptive commodities to the country has been decreasing . MoHP's share in contraceptives is increasing each year. MoHP is budgeted to procure 100% of contraceptives in this year, 2009/10. LMD is strengthening the supply and inventory management in the district and health facilities level to make FP commodities available throughout the year. Europe and Asia 2010 Nicaragua Yes Comité Nacional para la Disponibilidad Asegurada de Insumos y Anticonceptivos DAIA Nicaragua (National Contraceptive Security Committee) Yes PASMO Yes PROFAMILIA. MOH wants to include other NGOs (for example IXCHEN). No Yes UNFPA, USAID Yes UNFPA Yes DAIS (Direction of logistics and supplies), DGSS (Direction of Health Services, FP), DGPD (Division of Planning and Development and External Cooperation) No No 6 or more times Yes Yes MOH, in the DGSS and DAIS General Directors Yes Yes Yes Yes $227,120 1/09-12/09 Contraceptive procurement table of MOH Yes UNFPA, public sector, and other donors $1,106,618 1/09-12/09 Contraceptive procurement table of MOH UNFPA puts its funds into the basket and also donates some other RH supplies (not contraceptives) to the public sector through in-kind donations. 1333738 Yes USAID $577,833 1/09-12/09 Contraceptive procurement table of MOH 70% Third-party agent (e.g., UNFPA, Crown Agents) UNFPA, through cost-sharing agreement N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes No Yes No Yes Yes No No Yes Yes Yes Yes No Yes No Yes Yes No Yes Yes Yes No The MOH prescribes but does not provide the packaged product itself. Yes National strategy reproductive health 2007-2011 Yes Yes No Yes The national procurement law creates preferences for local procurement. This limits the public sector from accessing a cost-effective supplier. An exception is made that allows the government to procure through UNFPA. No No No No No No N/A 2005 Yes No No No Yes No Yes No Yes Yes No No No Data No Data No Data Yes Yes N/A No N/A No No N/A N/A Yes January - December 2009 Warehouse reports No No Contraceptive security is a priority topic of the national strategy on reproductive health. For 2010, the MOH will cover 52% of the total need for contraceptives with internally generated funds. It will procure with public funds. LAC 2010 Nigeria Yes Reproductive Health Commodity Security Stakeholder's Committee Yes Society for Family Health Yes Planned Parenthood Federation of Nigeria (PPFN) and Association for Reproductive and Family Health Yes Pharmaceutical Society of Nigeria (PSN), Society of Gynecologists and Obstetricians of Nigeria (SOGON), and Nigeria Medical Association Yes USAID, DFID, CIDA Yes UNFPA Yes 1. FP Division 2. Dept of Planning, Research and Statistics 3. National Agency for Food and Drug Administration and Control (NAFDAC) 4. National Population Commission 5. Federal Ministry of Women Affairs 6. States Ministries of Health 7. Ministry of Defence 8. National Health Insurance Services Yes Central Contraceptive Warehouse Yes Federal Ministry of Finance 1-2 times Yes Yes Association for Reproductive and Family Health CEO No Yes No No 0.0 1/09-12/09 No N/A 0.0 1/09-12/09 0 Yes UNFPA (There's a CIDA grant managed by UNFPA), & USAID $1,775,578 1/09-12/09 RHI 0% N/A N/A N/A Finance has historically been unable to keep up with procurement requirements. Until now, all commodities in the public sector have been donor funded. Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No Data Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes National Strategic Plan for Reproductive Health Commodity Security 2002-2007 but still being followed Yes Yes No No Yes Injectables Only trained personnel are allowed to administer injections (nurses, midwives, and community health extension workers). Only trained personnel are allowed to administer injections. Implants Only trained nurses and doctors are allowed to administer implants. Only trained personnel are allowed to administer implants. IUDs Only trained personnel are allowed to administer IUCDs (doctors and midwives). Only trained personnel are allowed to administer IUCDs. No No No No Yes No 2004 No No No No Yes Yes Yes Yes Yes Yes Yes No No Data No Data 2003 Yes Yes Yes Yes Yes No Yes No N/A N/A October 2008 - September 2009 Central Contraceptive Warehouse Stock Status Reports Yes Yes A revised national strategy for commodity security is pending. The USAID | DELIVER PROJECT has worked with FMOH to develop a multi-year commodity forecast which forms the basis for its continued advocacy for resources to fund the procurement plans. As a result, UNFPA plans to procure commodities worth $2 million, and DfID plans to spend about $4.2 million USD to procure commodities for 2010. The FMOH has requested for a total of $600,000 USD in its budget for 2010 and it's currently undergoing administrative processing. Africa 2010 Pakistan Yes Reproductive Health Commodity Security Committee (RHCS) - Currently the committee is inactive and the USAID | DELIVER PROJECT plans to revitalize it through CS inputs. Yes Greenstar Social Marketing, Pakistan Yes USAID | DELIVER PROJECT, USAID | FALAH PROJECT and USAID | PAIMAN PROJECT No Yes USAID, DFID Yes UNFPA Yes Director General (M&S) MOPW, Lady Health Worker Program, MOH No No 1-2 times Yes Yes MOPW Director General M&S, MOPW No Yes Yes Yes $9,257,171 7/08-6/09 MOH and RHInterchange Database Both the Ministry of Health and the Ministry of Population Welfare provided funding for contraceptives during their June 2008-July 2009 fiscal year. The MOH provided approximately 2.24 Million through the Lady Health Workers Program and the MOPW provided approximately 7.01 Million = 9.25 M Total. No N/A 0.0 7/08-6/09 9257171 Yes UNFPA $3,674,803 7/08-6/09 RHInterchange Database The data were obtained from the RHInterchange for the same date range as the public sector fiscal year. 72% Third-party agent (e.g., UNFPA, Crown Agents) UNFPA N/A Yes Yes Yes No Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes No Yes No Yes No Yes Yes No Yes Yes Yes Yes MSS/Pakistan Yes Draft Pakistan Population Policy (USAID | DELIVER PROJECT has agreed input to development of a National CS Strategy in FY 2010) 2010-2015 No No No No Yes IUD, Surgical/Permanent contraception, Implanon, Injectables Trained HCP Trained HCP Yes MOPW uses MWRA (Married Women of Reproductive Age) as the sub-population for contraceptive services among female population. No No No Yes Yes Ministry of Health provides contraceptives free of charge for both services and commodities, however a similar approach of free of charge is under review by the GOP for MOPW too. Exemption for poor people through structured "Baitul Maal"/Zakat system. 2004 Yes Yes Yes No Yes Yes Yes Yes Yes Yes No Yes Yes diaphragms 2007 No No No No No No No N/A No N/A No Data Contraceptive Performance Report Dec 2009, MOPW, GOP No Data No USAID | DELIVER PROJECT, Pakistan conducted CPT development in December 2009, which helped logistics based modelling and development of consensus on National Forecast as concrete inputs to CCS. Collective good advocacy work has mobilized $1.7m from GOP and $10m from USAID. USAID/Pakistan made a request to USAID/CSL for commodity support to the public and private sectors and some consignments have already reached the CW&S, Karachi. Europe and Asia 2010 Paraguay Yes Disponibilidad Asegurada de Insumos y Anticonceptivos (DAIA) Committee (Contraceptive Security Committee) Yes PSI Paraguay Yes CEPEP (Centro Paraguayo de Estudios de Poblacion) IPPF No Yes UNFPA, USAID Yes OPS, UNFPA Yes RH,PH, Logistic Yes Central warehouse No 6 or more times No Yes MOH Directors of logistics DGPS No Yes Yes Yes $566,000 1/09-12/09 No 0.0 1/09-12/09 566000 No N/A 0.0 1/09-12/09 100% Third-party agent (e.g., UNFPA, Crown Agents) UNFPA N/A Yes Yes Yes No No Yes No Yes Yes Yes No Yes No Yes No Yes Yes No Yes Yes Yes No Yes Yes Yes No Yes Yes No No Yes Yes No Yes Plan estrategico DAIA Paraguay (contraceptives security strategic plan) 2006-2010 Yes Yes Yes All Both 10% No No No No No No No N/A N/A N/A N/A N/A N/A Yes No Yes No Yes Yes No Yes No N/A 2010 IUD and male condom listed on Medical Supplies List instead of NEML. No No N/A No N/A No No N/A Yes N/A January - December 2009 PPMR No No Laws need to facilitate most effective procurement processes. LAC 2010 Philippines Yes Contraceptive Self-Reliance (CSR) Technical Working Group Yes DKT Phlippines, Family Planning Organization of the Philippines, League of Municipalities Yes Philippine NGO Council, Family Planning Organization of the Philippines, Cooperative Movement for Encouraging NSV (non-scalpel vasectomy), League of Provinces, League of Cities, League of Municipalities, Union of Local Authorities of the Philippines Yes Philippine Chamber of Commerce and Industry, Drugstores Association of the Philippines Yes USAID, UNFPA Yes WHO Yes DOH: National Center for Disease Prevention and Control (includes FP and HIV/AIDS), Bureau of Local Health Development, Bureau of International Health Coordination, Health Policy Development and Planning Bureau, National Drug Program, Center of Health Development Region 4A and National Capital Region; DOH attached agencies: Bureau of Food and Drugs, Population Commission, Philippine Health Insurance Corp (PhilHealth).; Local Government Unit (LGU): Pangasinan Provincial Population Office Yes DOH Materials Management Service No 0 times Yes Yes NGOs & Philippine Legislative Committee on Population & Development (PLCPD - an NGO of legislators), Forum, & Reproductive Health Advocacy Network Whole organizations & Executive Directors. For Forum, the chairman. Yes No Yes Yes No Data 1/09-12/09 Internally generated funds came from the Maternal Neonatal Child Health and Nutrition grant from the National Department of Health. This fund was drawn down to or received by specific local government units not at the same time and not all of the amount is for contraceptives. As a result, specific data as to how much is not available. No N/A 0.0 1/09-12/09 No Data Yes UNFPA No Data 1/09-12/09 No Data The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) Local Government Unit’s General Property and Supplies Office No The line item for procurement of contraceptives is at the LGU level. LGUs fund and procure their contraceptive requirements. Prices of contraceptives, even for the same contraceptive method and brand, are not uniform across LGUs. Currently, there is no systematic data that provides report on LGU procurements. PhilHealth enrollment is another mechanism for LGU financing of contraceptives. When an LGU enrolls its constituents (indigent constituents) with PhilHealth, it is indirectly financing its contraceptive requirements, through: a) the enrolled constituent can avail of the PhilHealth benefit packages that cover the costs of some contraceptive methods (as described previously in this survey); and/or (b) using part of the capitation fund received from PhilHealth (for enrollments made) to procure contraceptives. USAID/Philippines, through the Health Policy Development Project assisted the DOH to conduct a rapid assessment survey on 2007 LGU (local government unit) procurements covering all provinces and cities (N: 122). The result of the survey showed that 55% of the LGUs (N: 67) procured contraceptives at or above the level of donated contraceptives they used to receive before the phase out of USAID's donation. The remaining 45% (N: 55) did not procure. In 2004, the DOH issued the guidelines on the management of the donated commodities under the Contraceptive Self-Reliance Strategy which includes the guidelines and schedule for phasing out of contraceptive donations at the national and local level. The LGUs were divided into three batches, the first being the richest LGUs and the last being the poorest LGUs. While the last shipment of USAID donated contraceptives (excluding IUDs) was in September 2007, the last DOH shipment to the third batch of LGUs to be phased out was in the quarter October-December 2008. Yes Yes Yes No Yes Yes No No Yes Yes No patch, spermicide Yes Yes Yes No Yes Yes No No Yes Yes Yes N/A Yes Yes Yes No Yes Yes No No Yes Yes Yes N/A Yes National Family Planning Policy and others (National Family Planning Policy (DOH Administrative Order No. 50-A s. 2001, dated September 17, 2001) Guidelines on the Management of Donated Commodities under the Contraceptive Self-Reliance Strategy (DOH Administrative Order No. 158 s. 2004, dated July 9, 2004) Guidelines on Public-Private Collaboration in Delivery of Health Services Including Family Planning for Women of Reproductive Age (DOH Adminstrative Order No. 2006-0008, dated May 20, 2006) Implementing Health Reforms for Rapid Reduction of Maternal and Neonatal Mortality (Administrative Order No. 2008-0029, dated September 9, 2008)) Yes Yes Yes All methods All sectors - however, if an NGO has obtained tax exemption, payment of taxes and duties may be waived. The Department of Health (DOH) pays for taxes & duties for donations and social marketing. Customs duties on condoms and hormonal contraceptives is 3% of total value. Customs duties on Copper T IUDs is 15% of total value. All contraceptives are subject to 12% Value Added Tax (VAT). However, if an NGO has obtained tax exemption, payment of taxes and duties may be waived. Yes Taxes/duties. Donated commodities, socially marketed commodities and commercially marketed contraceptives are subject to taxes and duties. Taxes/duties on donated contraceptives consigned to the Department of Health (such as those donated by USAID) are shouldered by the Government of the Philippines through automatic appropriations of the Department of Budget Management. Taxes/duties of socially marketed contraceptives consigned to the Department of Health are paid by the Department of Health. Taxes/duties on socially marketed contraceptives that are not consigned to the Department of Health are paid by the organizations (NGOs) marketing those contraceptives. Taxes/duties on commercially marketed contraceptives are paid by the manufacturer, importer or trader. Pharmacy Law. This law bans brand advertising of ethical/regulated drugs. Hormonal contraceptives (oral pills, injectables and hormonal IUDs) are classified as ethical/regulated drugs, therefore, brand advertising is banned. Copper T IUDs are classified as medical device and registered as unregulated product and not subject to the same restrictions. There is no prohibition on brand advertising of Copper T IUDs. The pharmacy law also prohibits dispensing of ethical/regulated drugs without prescription. Yes Oral contraceptive pills & injectables Only trained health workers are allowed to dispense. Dispensing without prescription is not allowed. However, since public facilities are headed by doctors who supervise all health workers in the facilities, prescriptions are easy to obtain. However, in practice, OCPs can be obtained without prescription from pharmacies/drugstores. Only trained health service providers are allowed to dispense. Service providers other than physicians, such as midwives, cannot dispense without a prescription. However, most midwives, and all PhilHealth (Phil. Health Insurance Corp) accredited midwives have back-up physicians who write the prescriptions. IUDs Only trained health workers are allowed to dispense. Dispensing of hormonal IUD without prescription is not allowed. However, since public facilities are headed by doctors who supervise all health workers in the facilities, prescriptions are easy to obtain. Barangay Health Station (the lowest level of public health facility) health service providers do not dispense IUDs. Only trained health service providers are allowed to dispense. Service providers other than physicians, such as midwives, cannot dispense without a prescription. However, most midwives, and all PhilHealth (Phil. Health Insurance Corp) accredited midwives have back-up physicians who write the prescriptions. No No No Depends Depends Depends Because of devolution, LGUs craft their own policies. Policies are not uniform across LGUs. In general, services in public sector facilities are provided for free but there are some LGUs that have fee for service policies in some of their facilities. In general, commodities in public sector facilities are provided for free but there are some who charge at full or subsidized prices. Only a few LGUs have policies on client segmentation. While this is the case, other funding mechanisms for paying of contraceptives are available to public sector clients. If the client is a PhilHealth member, the client can avail of three PhilHealth benefit packages: (1) Maternity Care Package for normal deliveries that includes the first cycle of oral contraceptives and the first dose of injectable postpartum; (2) IUD Package; and (3) Voluntary Surgical Sterilization Package for bilateral tubal ligation and vasectomy. A significant number of LGUs have enrolled their poor constituents with PhilHealth. N/A N/A N/A N/A N/A Yes Yes Yes No No No No No No N/A 2008 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A No N/A 1) Contraceptive Security vs. Contraceptive Self-Reliance. The Philippines addresses Contraceptive Security in the context of eliminating unmet need for family planning given the phase out of USAID contraceptive donation. This requires broadening the definition to include the support systems for the implementation of the family planning program and addressing issues of sustainability. Hence, the DOH has embarked on Contraceptive Self-Reliance, rather than Contraceptive Security. This strategy includes, in addition to government financing and procurement of commodity based contraceptive methods (pills, injectables, IUDs, condoms, and others) promotion and financing of other methods (bilateral tubal ligation, vasectomy, lactational amenorrhea, natural family planning, and others), expanding distribution coverage, and mobilizing private sector resources in the provision of family planning services and commodities. This approach to Contraceptive Security may have contributed to maintaining the Contraceptive Prevalence Rate in the Philippines steady despite USAID's phase out of contraceptive donation. And since the Government's objective is to ensure the country's self-sufficiency in the provision of family planning services and commodities, the prospect for sustainability is high even without external contraceptive donations. 2) Protecting the Poor. The poor should be protected in the process of achieving Contraceptive Self-Reliance. The issue of targeting financing and provision for the poor is not just an issue of commitment and willingness to fund. It also involves many operational issues such as determining who are poor and entitled to free services, how the non-poor should be served, and how will these issues be handled by local health systems that are supposed to be for everyone in the community. 3) Even the poor go to the private sector for contraceptives. The private sector is becoming more interested in participating. DKT provides a large quantity of contraceptives. Before there were few choices in the country - there were free contraceptives in the public sector and expensive contraceptives in the private sector but little in between. Now with the USAID phase out and a pharmaceutical project to help the pharmaceutical industry get in the middle of the market there's more subsized, affordable choices. 4) The FP issue is more prominent now. There's a RH bill saying that the government is to be responsible for RH (including FP); this bill hasn't been passed yet, but discussion has increased and the issue is prominent. There's more openness politically now to discuss providing FP choices. Europe and Asia 2010 Russia No N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A No No No No No 0.0 1/09-12/09 No N/A 0.0 1/09-12/09 0 No N/A 0.0 1/09-12/09 N/A N/A N/A N/A The Russian federal government stopped its federal family planning program back in 1998 including the procurement of contraceptives. However, some regions and municipalities provide limited contraceptives (both in range and number) to vulnerable groups of population mostly under mandatory health insurance programs and small donations from pharmaceutical firms. However, a range of modern contraceptive methods are widely avaiable through pharmacies, including in the public health care facilities for a fee/purchase. Even though FP is not included in the provision of health services, some USAID target regions cover/reimburse FP counseling under the regional mandatory health insurance plans. Yes Yes Yes Yes Yes Yes No Yes No Yes No contraceptive patch Evra and vaginal ring Novaring Yes Yes Yes Yes Yes Yes No Yes No Yes No contraceptive patch Evra and vaginal ring Novaring N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A No Yes All All 10% custom/import duties, 10%VAT Yes It's illegal to advertise a specific contraceptive brand as well as any other prescription drug. However, they can be promoted and advertised in professional health care literature and facilities. Public campaigns on contraception in general are allowed. Yes All except condoms Only pharmacies are allowed to sell contraceptives and only OB/GYNs can prescribe them Only pharmacies are allowed to sell contraceptives and only OB/GYNs can prescribe them No No No No Yes Yes Some regions provide free contraception for vulnerable groups. N/A N/A N/A N/A N/A No Yes No No No No No No No N/A 2009 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Contraception in Russia continues to be a sensitive topic due to the demographic crisis and other reasons such as traditionally negative perception of hormonal contraception among policy makers, professionals, and the general population. Europe and Asia 2010 Rwanda Yes Family Planning Logistics Committee Yes PSI Yes Association Rwandaise pour le Bien-Etre Familial's (ARBEF) Yes Associations of Private Pharmacists and Physicians Yes USAID , UNFPA,GFTAM,GTZ/KFW Yes UNFPA Yes Maternal Child Health and Pharmacy Task Force Yes Rwanda Drug, Consumables and Equipments Central Procurement Agency (CAMERWA) No 3-5 times Yes Yes MOH MCH task force coordinator Yes Yes Yes Yes 1/09-12/09 Rwanda does not track its internally generated revenue independently of basket. Yes basket and GFATM $2,347,048 1/09-12/09 Pipeline USD1.512 from Basket funds (Rwanda does not track its internally generated revenue independently of basket). USD834k from GFATM funds 2347048.28 Yes UNFPA and USAID $3,479,377 1/09-12/09 Pipeline A total 1,407,195.87$ from UNFPA and 2,072,181.68 from USAID donations 40% The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) CAMERWA Yes Yes Yes Yes Yes Yes Yes Yes Yes No Data No Data Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No Yes IPPF/ARBEF Yes RHCS November 2008- December 2012 No Yes Yes For all methods in the public sector, MOH pays storage for the central warehouse. Public sector 9% value of the product No No No No No No No N/A 2008 Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes No N/A 2010 The printed version will be available shortly (in 2010). The tender for printing is over and printer identified. No No No No No No No No No No Procurement planning and monitoring report, LMIS, annual national physical inventory, warehouse reports No No At SDP level, contraceptive stock outs are estimated at less than 5%. At Central and District level, there were no stockouts. Africa 2010 Senegal Yes Comité National de Sécurisation des Produits Contraceptifs (National Contraceptive Security Committee) Yes Agence pour le Développement du Marketing Social (ADEMAS). USAID Implementing Partner (IP) Yes Association sénégalaise pour le Bien-etre Familial (ASBEF). IPPF affiliate - IntraHealth (USAID IP) - Child Fund & Consortium (USAID IP) No Yes USAID - UNFPA - JICA - KFW Yes WHO - UNFPA Yes Division de la Santé de la Reproduction(FP/RH/MCH Division) - Direction de la Pharmacie et du Medicament, Laboratoire Nationale de contrôle des Médicaments. Yes Pharmacie Nationale d'Approvisionnement (PNA) No 1-2 times No Yes USAID & Implementing Partners USAID MD and Health Team No Yes No No 0.0 1/09-12/09 CPTs It has been reported that funding was allocated at central medical store but returned to treasury unspent. No N/A 0.0 1/09-12/09 CPTs 0 Yes USAID. UNFPA also provided (only for emergency contraceptives), but the amount is not included here. $1,600,000 1/09-12/09 Deliver/JSI shipment report USAID fiscal year 08 budget (spent in 2009) 0% The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) Pharmacie Nationale d'Apprivisionnement (PNA) Yes During the last 3 years, funding was allocated for contraceptives but wasn’t spent. Many reasons have been given; central store mismanagement, non-response to solicitation, funding taken back by treasury secondary to financial crisis. When funding is availlable, the PNA does the procurement Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes in non-profit private sector facilities and at community level (health hut with CHW) supported by NGO Yes Programme National de Developpement Sanitaire et Social. Strategie Nationale de Sécurisation des Produits Contraceptifs 2009-2014, 2007-2011 Yes Yes Yes All methods All sectors For private sector - 20% duties 18% VAT for IUD only. 2.7% for all goods entering in UEMOA area (Taxe commun à l'importatation), but the government can do a tax exemption for the public sector. $0,30 to $3 fees in public sector. Yes Advertising for specific brands of products is forbidden. Private doctors connot prescribe and distribute drugs in the same premises. Pharmacists cannot dispense most methods without doctors' prescription. (emergency contraception is available without a prescription in private pharmacies) Yes Oral Contraceptives Only doctors, midwives and nurses are allowed. We are currently piloting community-based distribution (CBD) of pills with community health workers (CHWs). Pharmacists cannot dispense and cannot distribute without prescription Implants and IUDs Doctors, midwives and nurses are allowed Private doctors can insert, but they cannot keep stock in their offices. Patients must procure from pharmacies. No No No Yes Yes Yes The local health committee determines who cannot pay. There are no specific group exemptions. 2007 Yes No No No Yes Yes Yes Yes Yes Yes Yes Yes Yes Spermicide No data on exact year, but was updated after 2003. No No No No No No No No No No January - December 2009 CPTs, logistics management information system and reports Yes No Public (government) funding has not yet been provided and thus contraceptive security is unsustainable. During the last two years, USAID and UNFPA have supported contraceptive procurement. Intense advocacy continues with the MOH for public resources to be mobilized for contraceptive procurement. Unfortunately, this is yet to occur despite assurances of increasing the RH budget. While there are no stock-outs at the central level, smaller health posts and sometimes health centers continue to be plagued with stock-outs. There have also been difficulties keeping pills stocked at the community health huts during this initial pilot phase of CB combined oral pill distribution. (Pills are supplied by the supervising health post.) This could be a serious problem when the pilot is scaled up nationally. Africa 2010 Tanzania Yes National Contraceptive Security Committee Yes Tanzania Marketing and Communications for AIDS, Reproductive Health and Child Survival (T-MARC) project, Population Services International (PSI) Yes John Snow Inc., Engender Health, Chama Cha Uzazi na Malezi Bora Tanzania (UMATI) - IPPFaffiliate, Marie Stopes, Pathfinder Yes World Wide Movers (Aglity's local rep) Yes USAID Yes UNFPA Yes Reproductive and Child Health Service (RCHS), National AIDS Control Programme (NACP) Yes Medical Stores Department (MSD) No 3-5 times No No Yes Yes Yes Yes $2,850,531 7/08-6/09 RCHS Yes basket $3,912,593 7/08-6/09 RCHS All this comes from the Basket money. None of the products bought from this have arrived. 6763124 Yes USAID $2,034,090 7/08-6/09 CPT memo 77% The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) MSD Yes In previous years, what was released was always much lower than what was allocated or promised and beyond that, what was allocated is historically less than what is requested or needed. Last year however, after much advocacy for increased allocation and release of funding, the amount released topped the amount of forecasted need. Each of the previous years however did not even come close to the forecasted need, so while there was technically 129% of forecasted need, the previous years had only seen a small percentage of the funding need met. Yes Yes Yes Yes Yes Yes No Data Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes No Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No No Yes Brand specific advertising for oral contraceptives is not allowed since they are considered a prescription-only product. Yes Oral contraceptives N/A Pharmacies and accredited drug dispensing outlets (Addos) Implants and IUDs Restricted to Public Health Nurse of Higher Grade MOH staff N/A No No No No No N/A 2006 Yes No No No Yes Yes Yes Yes Yes Yes Yes No No Data No Data 2007 Yes No Yes Yes Yes No No N/A N/A N/A March 2009 - February 2010 MSD, quarterly reports Yes Yes Africa 2010 Uganda Yes Reproductive Health Commodity Security Committee Yes AFFORD/Uganda Health Marketing Group, PSI, Marie Stopes Uganda Yes Reproductive Health Uganda (RHU), Marie Stopes Uganda (MSU) No Yes USAID Yes UNFPA Yes RH Division Yes National Medical Stores No 3-5 times No No Yes Yes No No 0.0 1/09-12/09 No N/A 0.0 1/09-12/09 0 Yes USAID and UNFPA $4,700,000 1/09-12/09 CPT Amount is an estimate and could not be verified. 0% N/A N/A N/A GoU has ring-fenced budget line item for RH commodity procurement but is not successful in spending it, partly because of quarterly fund releases which do not allow for advance procurement arrangements. No Data No Data No Data No Data No Data No Data No Data No Data No Data No Data No Data Yes Yes Yes Yes Yes Yes No Yes Yes Yes No Data Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes UNFPA doing pilot to re-activate female condoms w/ NGOS Yes RH Commodity Security Strategic Plan 2010-2015 Yes Yes Yes A 2% verification fee must be paid on all drug imports, including contraceptives All 2% FOB value No Yes Injectables N/A Drug shops cannot dispense injectables No No No No No N/A 2005 Yes No No No Yes Yes Yes Yes Yes Yes Yes No No Data No Data 2010 Emergency contraceptive oral hormonal pills listed as "pending". Yes Yes No No Yes Yes No Yes No Data No Data January - December 2009 Periodic stock status reports from National Medical Stores and Procurement Planning and Monitoring Report (PPMR) Yes Yes Central level stock outs were caused by delays in donor shipments. High unexpected demand and limited global supply especially for long term methods caused the stock outs. Facility level supply issues are related to poor planning and ordering. Africa 2010 Ukraine Yes National Committee for Implementation of the State Program "Reproductive Health of the Nation up to 2015" (SPRHN) No Yes All-Ukrainian Federation of Young Doctors, All-Ukrainian Women's Society No Yes USAID (represented by the staff of the Together for Health Project and Maternal & Infant Health Project) Yes UNFPA Yes MCH Department/RH Division, Finance and Economic Department, Academy of Science, National Academy of Post-Graduate Education No No 1-2 times Yes No No Yes Yes Yes $235,000 1/09-12/09 Ministry of Health of Ukraine, Report on SPRHN implementation in 2008 No Data No Data No Data 1/09-12/09 No Data No data on complete total. Yes USAID/Washington $200,000 1/09-12/09 Records of HIV/AIDS Alliance and TfH projects supported by USAID No Data The government (e.g., Central Medical Stores, MOH logistics unit, MOH procurement unit) Ministry of Health at central level in Kyiv (MCH Department in collaboration with Procurement Department) and Oblast Health Administrations (Oblast Health Departments in collaboration with Oblast FP/RH Centers) Yes The "Together for Health" (TfH) project funded by USAID continues working with the national (MOH) and local governments in 13 regions of Ukraine on implementation of the SPRHN, including related to the procurement of contraceptives. The Government of Ukraine (GOU) continued to mobilize budgeted resources for the procurement of contraceptives in 2008-2009 with the bulk of these resources coming from the local level budgets. As an example, $226,400 was spent from local budgets in 13 TfH participating regions versus $94,600 from the national level budget. However, the GOU commitment to finance the SPRHN in FY10 is not clear with a reported planned 60% decrease in funds for contraceptive procurement. TfH project supported by USAID has limited ability to influence the GOU contraceptive procurement process. Regional councils that make decisions on funding of regional RH programs are reporting decreases in social and health budgets amidst other competing health priorities (like HIV/AIDS, TB, pandemic flu, etc.) The ongoing economic crisis that hit Ukraine severely resulted in significant increases in prices for contraceptives for the population. In addition, according to the WB "Human Development: Eastern Europe and Central Asia, December 2009", accumulated wage arrears doubled and tripled in Ukraine, the working hours for the population decreased, and unemployment increased; this all resulted in a significantly decreased purchasing power of the population. Yes Yes Yes No Yes Yes No Yes Yes Yes No Vaginal ring, patch, spermicides Yes No Yes No Yes Yes No No Yes Yes No Vaginal ring, patch, spermicides No No No No No No No No No No No Public sector providers are trained on using combined orals as emergency contraception. There are no NGOs or social marketing programs in Ukraine supporting provision of contraceptives. No Yes All methods Commercial sector Custom taxes, VAT (VAT is 20% of the total cost) Yes The current law of Ukraine "On Advertising", article 21 prohibits advertising of prescription-based medicines. This prohibition affects contraceptives as they are prescription-based medicines. In addition, the former Government of Ukraine (GOU) led by Yuliya Timoshenko was trying to regulate the prices for medicines sold through private pharmacies and increase the number of state pharmacies in the country. However, this GOU "initiative" received strong resistance from the private sector employees and did not go very far. Yes Hormonals (oral, injectable, patch, ring, etc.) Only public clinics can either dispense them or prescribe them for purchase in state pharmacies. Both the public and private sectors limit contraceptive prescriptions to highly trained medical professionals - medical doctors. Nurses and midwives are not allowed to prescribe hormonals nor insert implants or IUDs, but they can provide the Depo injections, in a health facility, upon the recommendation from a doctor. Licensed private pharmacies can sell them based on physician prescription. IUDs Only specially trained Ob/Gyns can insert IUDs. The other medical specialties, like family doctors and pediatricians, cannot insert IUDs; they can only prescribe them to clients, who then have to go to an Ob/Gyn for IUD insertion. Only specialy trained Ob/Gyns can insert IUDs. The other medical specialties, like family doctors and pediatricians, cannot insert IUDs; they can only prescribe them to clients, who then have to go to an Ob/Gyn for IUD insertion. No No No No No N/A 2005 Yes No No No Yes Yes Yes No No No No Yes No N/A 2009 The list does not include condoms or IUDs because the Ukrainian legislation considers them medical devices, and there's no list of essential medical devices. They are though regulated for import, procurement and distribution. No Data No Data No Data N/A N/A No Data No Data N/A N/A N/A N/A N/A. There is no concrete data on how the MOH and central warehouse handles the procured contraceptives. Some methods are N/A because they aren't registered in Ukraine or they weren't procured by the government. Yes No Data Issues to be addressed in terms of contraceptive security in Ukraine are still the same ones, i.e., a) expansion of method mix (the majority of current users of modern FP methods are using condoms and IUDs); b) decreased affordability contraceptives as a result of the current economic crisis; c) lack of capacity and experience on the part of the GOU (especially national government) to procure contraceptives (despite some recent improvements in the procurement process); d) absence of centrally managed procurement system (LMIS); e) scarce funding allocated to FP/RH in the country with pro-natalist environment and recent budget deficit. Europe and Asia 2010 Yemen Yes Reproductive Health Commodity Security (RHCS) Yes Marie Stopes International Yes Yemen Family Care Association, Yamaan Foundation No Yes USAID,GTZ Yes UNFPA, UNICEF Yes Supply directorate, Family planning directorate, National drug supply programme Yes Central warehouses No 3-5 times No Data No No Data No Yes No 0.0 FY 2008 Yes World Bank & Netherlands embassy $2,488,515 FY 2008 Supply directorate - Population sector (MoPHP) This amount is for 2008 and covered the 2009 supply as well

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