By: Rebecca Fishman

Overview

In the developing world, approximately 214 million women and girls who want to avoid getting pregnant are not using safe and effective family planning methods. In large part, this is due to barriers that limit access to sexual and reproductive health and rights (SRHR) information, services, and products. These barriers persist across Africa, particularly for young girls, and particularly in the Sahel, which lags further behind. The modern contraceptive use rate in the Sahel is only 9%, compared to 29% across Africa and 57% globally. This blog examines the challenge of contraceptive supply and access in the Sahel and identifies tangible ways the private sector can contribute to addressing it.

Why can’t women and girls get the contraceptives they need?

Stockouts and shortages are a frequent problem in developing countries with multiple causes, including long lead-times for procurement and delivery, restrictive regulatory regimes, insufficient funding for supply chain operations, lack of supply chain training for healthcare providers, lack of information and education on SRHR, and inadequate systems for monitoring inventory and forecasting demand. Declining donor support for SRHR, widespread food insecurity, and political and social unrest compound the challenges in the Sahel.

Dr. Mary-Ann Etiebert, Executive Director of Merck for Mothers recently recounted to GBCHealth a story about Fatou Binetou Badji, a midwife and Head Nurse at a Senegalese medical center. Ms. Badji regularly saw patients at her facility who would request their preferred contraceptive method when it was unavailable. “It was very difficult when a patient was already used to using one method came in and was told that her method was out of stock. We may have referred them to a pharmacy, but it’s more expensive,” she said. “We would ask if her husband would accept using condoms until the product was available again. That’s how we used to handle those situations.”

How can the private sector help address access and supply issues?

Opportunities for private sector engagement to help optimize commodity supply and access are plentiful, and include addressing challenges around procurement, delivery, supply chains, training, access to information and education, and systems for monitoring and forecasting. Businesses can also lend their voice and manufacturing experience to help shape national and sub-national policy around these issues.

Some businesses are already leading the charge:

• Merck for Mothers uses an Informed Push Model hiring third-party logistics providers (IPM-3PL) to optimize last mile delivery of contraceptives directly to government health facilities. Results have been significant: a decrease in the stockout rate in government facilities from 80% to an average of under 2%, and reliable access to modern contraception for over 3.2 million women.
• Novartis, through its SMS for Life Program, has partnered with Vodafone and data start up Greenmash to deploy mobile-enabled surveillance for malaria, maternal and newborn mortality, and other diseases. Local health workers, who receive training through online modules, use their phones to track inventory and send notifications to district medical officers when levels are low. SMS for Life is currently being used in over 10,000 public health facilities in Kenya, Ghana, the Democratic Republic of Congo, and Cameroon.
• Cycle Technologies creates simple family planning solutions to help address women’s reproductive needs. Under the SUN-FP program, Cycle has made the Standard Days Method® accessible to women in poor countries preventing more than 5.5 million unwanted pregnancies.

How can you support?

Good health remains key to reducing youth vulnerability, improving workforce productivity and creating an environment for youth to realize their full potential. Smart investments in key areas like sexual and reproductive health (SRHR) including family planning will have an outsized impact on accelerating the demographic change and driving economic growth.

GBCHealth is working with UNFPA’s West and Central Africa Regional Office to motivate businesses to support Sahel countries optimize supply chains and improve access to high-quality family planning products and services.

Companies that want to participate can:

• Help set the agenda for engagement in support of the demographic dividend in SWEDD and at the African Union;
• Work directly with Ministries of Health and other government agencies and representatives. GBCHealth is working longer-term to help broker public-private partnerships in priority countries;
• Gain visibility for their programs and initiatives in the region; and
• Participate in observation trips to meet key stakeholders and witness interventions in the field as well as lead roundtables with other global business leaders.

If you are interested in learning more about any of the programs detailed here, contact Ian Matthews at .