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National Coordination Mechanisms for Managing Contraceptive Commodity Security: The Case of Ghana

National Coordination Mechanisms for Managing Contraceptive Commodity Security: The Case of Ghana. Presented at the 7 th Semi-Annual Membership Meeting of the RH Supplies Coalition April 27-28, 2007 London.

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National Coordination Mechanisms for Managing Contraceptive Commodity Security: The Case of Ghana

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  1. National Coordination Mechanisms for Managing Contraceptive Commodity Security: The Case of Ghana Presented at the 7th Semi-Annual Membership Meeting of the RH Supplies Coalition April 27-28, 2007 London

  2. TFR and use of any and modern contraceptive methods (1988-2003) & Unmet need in 2003 - Ghana • Inter Agency Committee on Contraceptive Security (2002) • Development of the National CS strategic plan (2004 -2010) • Financial Sustainability Plan supports the National CS strategy plan.(2007-2011)

  3. Short term Condoms (male and female) Spermicides Oral Contraceptive pills (Combined & Mini-pill) Injectables – (3 monthly) Injectable (Monthly) Lactational Amenorrhoea Method (LAM) Long Term (Reversible) Intra Uterine Device Implants Natural Family Planning Method (Permanent /Irreversible) Tubal Ligation ♀ Vasectomy ♂ Family planning methods available in Ghana • Emergency Contraception

  4. Method Mix

  5. Provision of Family Planning • Three major programs provide family planning • -MOH / GHS • PPAG (IPPF Affiliate) • GSMF (Ghana Social Marketing Foundation) and others

  6. Why RH Commodity Security? • Success of FP Programs • Generated Demand for Contraceptive Commodities • Unmet Need for FP still high • Shift of resources to HIV/AIDS Programming • Inadequate Donor Coordination • Donor Fatigue • Weak Logistics Systems • Need to go beyond Contraceptives to RHCS

  7. Strategic Planning Process GoG Policy Decision to Address CS Sogakope CS Workshop (May 2002) ICC/CS (August 2002) Core Technical Group (Oct. 2003) Ghana National Contraceptive Security Strategy (April 2004)

  8. Mandate to Ensure CS • ICPD+5 Programme of Action - mandated access to contraceptives and ratified by Ghana • Ghana: Vision 2020 - Improve quality of life • Ghana Poverty Reduction Strategy • Revised Population Policy - TFR and CPR targets • 5 Year Programme of work and Annual Health Sector Programme • Provide vision, policy framework and mandate to achieve contraceptive security

  9. Inter Agency Coordinating Committee on Contraceptive Security (ICC/CS) Representation includes • Government • MOH, Ghana Health Service, National Population Council, Food & Drugs Board, Customs Excise and Preventive Service (CEPS), Ghana AIDS Commission, National AIDS Control Programme), others • Donors and Partners • USAID, JSI DELIVER (TA), DFID, UNFPA, World Bank, EU, The Royal Netherlands Embassy, DANIDA, JICA others • NGOs/Civil Society • PPAG, GRMA • Private Sector Organizations • GSMF, Society of Private Medical & Dental Practitioners, Representative of Private Pharmaceutical Firm • Individuals

  10. MEETING THE COMMODITY CHALLENGE : The Ghana National Contraceptive Security Strategy2004 -2010

  11. Contraceptive Security (CS) in Ghana Definition: • Contraceptive Security is achieved when: every woman, man and youth can choose, obtain and use contraceptives.

  12. CS Strategic Framework Contraceptive Security Financing M & E Package of Health Interventions M & E Financing Quality Efficiency Partnerships

  13. Strategic Objectives • To improve availability of qualityand affordable contraceptive products and services • To strengthen public-private partnerships in the supply and delivery of contraceptive products and services • To implement reliable and efficient systems for the supply of contraceptive products and services • To achieve sustainable financing of contraceptive products and services • To ensure a national capacity to monitor and evaluate the progress on the attainment of CS targets

  14. - STRATEGY INSTITUTIONAL FRAMEWORK • The consensus achieved regarding the institutional framework were as follows ( from April 26, 2004 CS Conference): • MOH : Coordinating role • ICC/CS : Advocacy role • Ghana Health Service (PHD, RCHU) : implementation role.

  15. Funding Commitments 2004 • MOH (Health Funds) ===> $1.5 million • MOH (GoG) ==> $280,000 • Partners (USAID, DFID)===>$4.9 million • (USAID added $2.8 million to the 2003 balance for 2004/2005)

  16. 2007-2011 Funding requirements, commitments & Gap

  17. Needs, Commitments and Gaps (2007 – 2011) Total requirements = $36.6 Total commitments = $2.0 Total funding gap = $34.6million

  18. Recommendations at Adoption Meeting 2004 • Integrate “the strategy into the 2005 Programme of Work” • Resource allocation between health partners need to begin • Advocacy to increase MOH commitment to financing contraceptives • Advocacy to include contraceptives and Family Planning services in the National Health Insurance

  19. - Financial Resources to implement the CS Strategy • No specific commitments were made • Two primary sources identified: - Public Health Division - Health Funds.

  20. Planning within health sector program of work National coordinating body Strong partnerships with social and private sector IEC/BCC Advocacy Increasing Government Contribution to Procurement of Commodities Ghana – RHCS Strengths

  21. CS Experience has contributed to • Development of HIV/AIDS Commodity Security (HACS) in 2005 Definition of HACS “Ensuring a secure supply and choice of quality commodities to meet the need of PLWHAs at the right time and the right place and at affordable cost.” • Contribution to RHCS for West African Region Facilitated by WAHO

  22. General CS Challenges • High Donor dependence for procurement • Develop sub national LMIS capacity • Public private partnership • Funding to implement strategy • Limited support for demand creation & sustainability e.g. IEC/BCC, training • New integrated logistics system • User fee pressure • FP commodities not included in NHIS and pro poor schemes e.g. exemptions • Representation at meetings

  23. Way Forward • Funding to fully implement strategy • Continued coordination • Addressing unmet need – • Implement Repositioning Family Planning Road Map (2006 – 2010) • Operationalize new LMIS • Finalize and Implement Financial Sustainabilty Plan • Further advocacy • Commitment at all levels

  24. Advocacy • ICC/CS will initiate high-level advocacy discussions to determine start and rate of phase-down of donor funding • Raise profile of Family Planning • Advocate for FP through collaborating with the MOH/GAC/NPC as one voice for funds outside of the MoH budget • Create a contraceptive development fund within the MoH • Repositioning Family Planning (multi-sectoral response) • National Health Insurance • Cover all FP commodities and condom for STI and HIV prevention • In-country partnerships • Engage District Assemblies and others in seeking additional funds for contraceptives and condom for STI and HIV prevention • Diversification of Funding Sources • Self Procurement • Monitoring & Evaluation

  25. NO MONEY, NO PRODUCT ? NO PROGRAMSlogan by DELIVER JSI Integration of programmes likely to improve efficiency and funding ! Conclusion

  26. Thank You Presented by Dr. Gloria J. Quansah Asare Family Planning Programme Manager

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