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India: Protecting reproductive choice through stronger supply chains

April 10, 2020 by Dr. Sudhir Maknikar

PATH helps sustain a reliable supply of condoms, oral contraceptives, and IUDs in India.

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PATH is providing support to eight states in India to strengthen supply chains for family planning commodities such as condoms and oral contraceptives. Photo: Reproductive Health Supplies Coalition.

Empowering women and men to define the terms of their own sexual and reproductive lives, and to decide whether and when they’ll have children, is an essential building block for healthy families and thriving societies.

Over the years, access to reproductive health services and contraception has increased throughout the world. However, health inequities persist by geography and socioeconomic status. In India, many people who want to use modern contraceptives are unable to do so. They either lack access due to inadequate supplies in public health systems or face social, cultural, and economic barriers in using contraceptives. It is estimated that nearly one out of every five women in India have unmet contraceptive needs.

A crucial factor that limits wider access to contraception is the availability of family planning commodities. In India, there are critical gaps in the supply chain for these resources, resulting in gaps in sustainable contraceptive access and usage.

PATH is at the forefront of increasing access to affordable, high-quality reproductive health choices

As one of the founding members of the Reproductive Health Supplies Coalition (RHSC), the largest network of its kind, we provide global leadership in reducing or eliminating stockouts of supplies that can disrupt a couple’s ability to maintain consistent contraceptive practices, according to their preferences.

Leveraging PATH’s global expertise in reproductive health, family planning, supply chain and procurement, digital health, and applied analytics, our India country program is working with state systems and partners to address the gaps across supply chain mechanisms that lead to non-availability of family planning commodities. With support from the Bill & Melinda Gates Foundation, the program is providing technical support to eight states in India for strengthening supply chain mechanisms of family planning commodities such as condoms, oral contraceptive pills, injectable contraceptives, and intrauterine devices (IUDs).

Key challenges across the family planning supply chain and how we are helping address them

Establishing and maintaining a well-functioning supply chain that meets the needs of health professionals at all levels in the family planning program plays a critical role in reducing the unmet need for modern contraception.

Improving family planning supply chain in India

PATH has identified key challenges that supply chain systems are facing while delivering family planning commodities.

Need for development of core supply chain skills: Storekeepers in the facilities are entrusted with carrying out various responsibilities like managing inventory and estimating demand. Some of them may need the opportunity to build upon their existing supply chain management skills to efficiently manage stocks of commodities. We are facilitating capacity-building opportunities for key human resources in family planning supply chain inventory management. We are also working with state officials and partners to provide support for monitoring stock availability across more than 300 warehouses in states where more than half of India’s population resides.

Delays in transportation: In the majority of cases, downstream health facilities are required to send vehicles to pick up stocks from centralized district warehouses. In most instances, there are no dedicated vehicles for family planning commodities, and the facilities are forced to pick up stocks when the vehicles visit districts for other work. Sometimes, these vehicles are not of appropriate size, leading to partial pickup. This in turn leads to frequent stockouts and delays. To address these challenges, we are providing technical support on the introduction of reliable, consistent, and low-cost options for transportation. We are also ensuring supply chain network optimization to reduce layers of distribution and supply chain points.

Improved use of logistics systems: The Ministry of Health has developed a Family Planning Logistics Management Information System (FP-LMIS) application to monitor and manage family planning commodities at all levels. The application is used to display, aggregate, analyze, and validate data from all levels of the logistics system of commodities, thereby enabling strategic logistics decision-making. We are supporting the government in effective rollout and operationalization of FP-LMIS. Once fully operationalized in the project states, FP-LMIS will provide quicker visibility of stocks in nearly 16,000 facilities to key decision-makers for planning and implementation.

Store

A store in a community health center in Jajpur district of Odisha state, used for storage of family planning commodities. Photo: PATH.

Improved last-mile delivery shows the potential to benefit millions

Around 4 million eligible couples in India are expected to benefit from improved availability of contraceptive commodities. This increased access will allow people to choose a contraceptive method that suits them best while giving them confidence that they can use this method consistently. PATH’s efforts in India to strengthen the supply chain for these commodities is a crucial part of maintaining access and choice in family planning.

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