Contraceptive Security, Information Flow and Local Adaptations: Family Planning in the Philippines and Morocco

Abstract

Family planning programs, a vital ingredient of socioeconomic development, form a cornerstone of national policy in many developing countries. After the 1994 International Conference on Population and Development in Cairo, governments have increasingly acknowledged the importance of family planning, particularly in opening opportunities for socioeconomic development (UNFPA 1994). Government spending on health, however, tends to give priority to curative rather than preventive care, and scarce health resources are allocated for essential drugs rather than contraceptives (World Bank 1993). To ensure the security of family planning programs, therefore, donors have historically provided free contraceptives to governments and organizations that offer family planning services.Family planning programs depend on the uninterrupted flow of contraceptives through multiple levels of the supply chain, ranging from central warehouses to health clinics and community-based distributors. Failure of the supply chain-or logistics system -causes an erratic supply of contraceptives, which may result in loss of credibility and eventual failure of the family planning program. Ensuring the continuous availability of contraceptives at the client level is a key contributor to increasing the use of family planning services (Ngallaba et al. 1994).The driving force behind a logistics system is a well-functioning logistics management information system (LMIS) (Christopher 1994). Efficient management of the flow of information on stock levels and consumption from lower levels to the center stimulates the flow of contraceptives back down the supply chain. An LMIS helps determine what quantities of each product need to be sent to a particular location at the correct time, for the optimal cost. The flow of stock-level and consumption data along the same channels can inform decisions critical to meeting current and future family planning needs. BENEFITS AND CHALLENGES OF LMISsMost developing countries are eager to exploit the potential benefits of information systems, which typically increase productivity, organizational effectiveness, and business competitiveness (Avgerou 1995). Although deploying information systems should not be viewed as a panacea for solving problems inherent in any country, an effective LMIS that provides a flow of complete, accurate, and timely data can help health program managers improve their systems by:• Reducing commodity costs

The influence of local policy on contraceptive provision and use in three locales in the Philippines

“…Before 1999, the Philippines had never had to purchase contraceptives, but only pay the import taxes on donated commodities. 8 In 1999-2001, the main donor, USAID, supplied pills, male condoms, injectables and intrauterine devices worth US$40 million, covering 80% of the country's requirements. 9 These contraceptives were distributed free through the public health sector at provincial, municipal, city and village levels, which at that time was funded and managed by the Department of Health.…”

“…Having been informed well in advance that this was coming, the national government promulgated a 1999 Contraceptive Independence Initiative Policy "to ensure the availability of commodities for all segments through direct subsidy, health insurance, socialised pricing and/or commercial procurement". 8 In 2000, about US$1.5 million for contraceptive procurement was allocated in the Department of Health's yearly budget, but the amount was diverted elsewhere due to an abrupt change in the national leadership, in a "people power" revolution backed by the Catholic church in 2001. 10 In 2007, the Philippines Congress earmarked US$3.6 million for modern contraceptive purchase, but the funds were returned because of "disbursement failure".…”

Ensuring contraceptive security through effective supply chains

“…• Weak logistics management information systems and inadequate information about inventory, financing, and product flows to guide procurement (7,8,9,10).…”

ICTD state of the union: Where have we reached and where are we headed

“…For-profit initiatives have been deployed for specific kinds of diagnoses that can be reasonably well managed remotely , such as ophthalmology and dermatology [42].2 The second area of ICTO interest in health care is information gathering especially for epidemiological research. There have been a number of projects focusing either on general population health surveying, patient health monitoring, or healthcare aid impact assessment [43,44]. A third focus of ICTO was driven by expatriate doctor communities from developing countries who were interested in contributing back to their home countries through social initiatives.…”