Why inadequate contraceptive forecasting capacity?

By AJAAT

The State of the World’s Children Report of 2008, in the National Road Map Strategic Plan, 2008-2015, affirms that spacing interval between pregnancies could reduce 20-25% of all maternal deaths.

Additional statistics reveal that about one third of 536,000 maternal deaths each year could be averted if women had access to reliable family planning methods and at least one third of the 190 million unintentional pregnancies could be avoided with availability of FP methods.

It is believed that nearly 50 million women who resort to abortion, of which, 19 million are performed under unsafe conditions, could be prevented had the women been accessible to reliable reproductive health services.

Statistics prove that an estimated 68,000 women that die every year as a result of unsafe abortions and the millions more who suffer infections and complications such as infertility as a consequence of these abortions could be saved had there been sufficient supplies of reproductive health commodities.

In spite of their importance, sufficient evidence exists to suggest that there is limited supply of reproductive commodities in those countries.

While some 200 million women in resource-constrained countries would have liked to have an interval of two years before giving another birth, such wishes are hard to come-by because of these women not having access to modern contraception.

The World Health Organization (WHO), 1997 report states that over 99% of 585,000 women death during pregnancy or immediately after giving birth or after an induced abortion occur in low-income countries yearly where unsafe abortion is named as the major contributor to maternal mortality.

Abortion is a procedure performed either by a person lacking the necessary skills or in an environment lacking minimal medical standards or both – is a major contributor to maternal mortality.

The WHO 1994 report states that unsafe abortions are responsible for 50000–100000 preventable deaths each year world-wide and in addition there are millions of women who are suffering from chronic morbidities and disabilities as a consequence of unsafe abortions.

Roke and Rogerson (2008), defining What Are Essential Reproductive Health Supplies; showed that despite large efforts in enhancing the supplies of reproductive commodities in the Pacific region, end-users still reported receiving them inconsistently besides the goods being unsuitable and lacking quality.

The United Nations Population Fund (UNFPA), statement on RHCS Challenges in 19^th October, 2000, shows that not only have poor countries left the task of funding for these commodities to development partners, but also that international donor support has been declining.

There are numerous reasons that are attributable to the situation of reproductive health commodities being insufficient. One is that of funding.  Donor support in the commodities dropped from $560 million in 1995 to $460 million in 2003.

The Global Programme to Enhance Reproductive Health Commodity Security reveals the same trend between 2007 and 2013, the amount needed was $750,000,000 only $208,528,277 was receives while $170,041,267 was pledged and still $371,430,456 was needed.

Because of such shortage, ‘Tracking Donor Support’ notes that donor support would nearly need to double if the current unmet need is to be met by 2015.

But equally important is the question of supply of the commodities, which is dependent on a number of things, including forecasting, financing, procurement, and distribution capacities.

The Reproductive Health Supply Chain report states that for each of the goods to be well-forecasted, well-financed, well-procured, and well-distributed, good data are needed on consumption on how much is required of those commodities and on stock status to how much is left.

To have the right consumption data and the right knowledge on the stock status, it requires effective systems of collecting and storing information, which in a word may be referred to as effective Logistics Management Information System to facilitate better forecasting of future needs.

Accurate determination of funding requirements, improved establishment of the right quantities to be ordered and procured and enhancing management of distribution so as to avoid shortages.

Why should resources allocated for contraceptive be limited? Is it because contraceptives are not prioritized in our development plan? Why is there inadequate forecasting capacity? Why is it that the coordination system is not well organized?

The emerging question is: could the situation be the same for the reproductive health commodities such as EMOC drugs (Oxytocin, Ferrous/Zinc Sulphate, Ergometrine, Misoprostol, SP for pregnant women) and vaccines for children under Expanded Programme for Immunization (EPI), including BCG, TT, Measles, and Low Osmolarity ORS, as it is for FP commodities; COC, POP, Implants, IUCD, Injectables, and condoms?

This column is a contribution by Advance Family Planning (AFP), a coalition of 10 local Non-Governmental Organizations (NGOs) advocating for family planning access to Tanzania. The project’s thrust is to contribute towards strengthening investments in family planning as a way towards attaining national and Millennium Development Goals (MDGs) 4 and 5 in Acceleration of the Reduction of Maternal, Newborn and Child Mortality.