I ntroduction of female condoms in Cameroon

1. Introduction of female condoms in Cameroon Universal Access to Female Condoms (UAFC) Joint Programme Bertrand Dimody, ACMS & Nienke Blauw, Rutgers WPF RHSC Membership Meeting, 24 June2010, Addis Abeba

2. Overview presentation: • Context • Female Condoms • UAFC Joint Programme • SRH situation Cameroon • UAFC Country Programme Cameroon • Lesson learned – Issues – Solutions • Results • Conclusion

3. CONTEXT • Female condoms • UAFC Joint Programme • Procurement, Research & Development • International Advocacy, Linking & Learning, Communication • Country Programmes • SRH situation Cameroon

4. UAFC Country Programme Cameroon – Lessons learned 1 • Issue: ‘heritage’ from previous programs and global situation. • Solution: Integrated approach, including: • Advocacy, • the social marketing of female condoms, • Operational research for the (monitoring of the) project implementation • Fundraising and continued advocacy towards international donor agencies and multilateral organizations for sustainable procurement and programming • Lesson: Large scale, integrated programming (not just procurement!) needed to overcome supply side barriers

5. UAFC Country Programme Cameroon – Lessons learned 2 • Issue: Difficulties within distribution system set-up: lower than expected distribution and sales at certain sales/ distribution points and high turn-over of peer educators • Solutions: • The training of peer educators for community awareness, monitored by ACMS; • Change within set-up of distribution system to increase accessibility and targeted IEC: more independent peer educators and hair dressers; • Linking with and learning from other female condom program  (Nigeria, Zimbabwe, Mozambique) 

6. UAFC Country Programme Cameroon – Lessons learned 2 (Continued) Lesson: Women oriented sales points such as hair dressing salons turn out to be better at combining education and sales than CBOs and are at the same time safer spaces for women to buy the product than health care providers or general commercial stores.

7. UAFC Country Programme Cameroon – Lessons learned 3 • Issues: High procurement price & lack of choice • Solutions: • More bulk procurement for lower prices and less clearance instances (by I+ solutions) • Introducing a second female condom to increase competition and choice • Support to manufacturers in prequalification process • Lesson: Establishing good communication and cooperation between procurement agents, manufacturers and regulatory agencies is essential to ensure successful introduction of female condoms.

8. UAFC Country Programme Cameroon – Lessons learned 4 • Issue: regulatory obstacles relating to procurement of non-prequalified female condoms. • Solution: Strengthening the Ministry of Health’s National Laboratory of Quality Control & Assurance – LANACOME • Lesson: Establishing good communication and cooperation between national ministries of health, social marketing organizations and procurement agents is essential to ensure successful introduction of female condoms.

9. Results To date, a total of 3.7 million female condoms have been procured in bulk for Cameroon at below-average prices, of which over 1.1 million have been distributed  or sold since 2009  Interest of donors to continue funding the program after 2011   Technical and in-kind support for LANACOME has increased the testing capacity of a variety of female condoms and strengthened commitment from the Cameroonian government   

10. Recommendations for other technologies: Innovative social marketing including IEC and women oriented sales points can increase distribution and Large scale, integrated programming, including advocacy and IEC, is critical to ensuring long term success Program needs: a system to link & learn more investment in large scale, integrated programming of new and underused technologies, including investment in bulk procurement to lower prices