Building a South-to-South Exchange Network in the Latin America and Caribbean Region

1. Building a South-to-South Exchange Network in the Latin America and Caribbean Region Nora Quesada Nadia Olson Anabella Sanchez Wendy Abramson June 24, 2011 Addis Ababa, Ethiopia

2. In the summer of 2003, the USAID LAC BUREAU launched a Regional Initiative…

3. In Eight Countries: Guatemala, El Salvador Dominican Republic, Bolivia… …Honduras, Nicaragua, Paraguay, and Peru

4. The inaugural event, Contraceptive Security Advocacy Conference, Managua, Nicaragua, July 2003 • Completed country/ regional assessments • Formed most of LAC CS committees

5. The Road Has Been Long and Winding…

6. We Learned Four Essential Principles Along the Way… • Ensure Harmonization • Leverage Resources • Use Data for Decisions • Focus on Sustainability

7. We Have Come a Long Way… 2003 • Phase-out process begins • Countries depend on contraceptive donations • Family planning mainly supported by donors 2011 • Six countries financing 100% of contraceptives • Six countries procuring quality contraceptives at internationally competitive prices • Five countries managing integrated supply systems 2006 • Country assessments show CS challenges remain • CS committees active in eight countries • Various countries financing & procuring contraceptives

8. We Built Roads Between Countries… • 3 countries passed laws to protect financing and access to family planning • 3 countries are better coordinating service provision • 6 countries finance their contraceptives 100 percent • 6 countries realize significant cost savings by procuring through UNFPA and other innovative options • 5 countries are building integrated supply chains, based on the contraceptive model • 2 countries manage their supply chains on their own, and one with minimal external assistance.

9. Contraceptive Financing from Country Governments 2006–2010 Contributed to Great Achievements… Source: Olson, Nadia, Anabella Sánchez, Ángel Reynoso, y Nora Quesada. 2010. La Adquisición de Anticonceptivos en América Latina y el Caribe: Un Análisis de Opciones Actuales y Futuras en Ocho Países. Arlington, Va.: USAID | PROYECTO DELIVER, Orden de Trabajo 1. Notes: Donors provide the remaining funds to cover total public sector need in each country.

10. That Were Led by Local Leaders… “The initiative helped me to develop a vision for closer collaboration between Ministries of Health and Social Security Institutions. We are working towards achieving the same objective but through different channels.” - Dra. Yesenia Díaz, Deputy Director of Health Services for the Insurance Department, SSI, Dominican Republic “The regional initiative provided crucial assistance. We had the opportunity to share experiences with other countries and this helped us to broaden our approach to the topic and allowed us to move forward. Having this support strengthens us..” - Dr. Esmeralda Ramirez, Director RH Department, MOH, El Salvador

11. Who Helped Fuel Improved Outcomes… Modern Contraceptive Use in LAC Countries (Women in Union)

12. But We Still Have a Long Way to Go… • Health sector reform is still a major challenge • Developing lasting procurement options will be difficult • The fight for financing to distribute contraceptives and other essential medicines never ends • Huge disparities in access still exist in every country, especially among our adolescents, our indigenous, and our rural populations • These supply systems still need to be fully embedded in the health system and used as a strategic pillar for delivering health services

13. Thank You! nora_quesada@jsi.com