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

This presentation highlights the case of Ghana's national coordination mechanisms for managing contraceptive commodity security. It discusses the strategies, challenges, and achievements in ensuring the availability, accessibility, and affordability of contraceptive products and services in Ghana.

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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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