"No commodity, no program" JSI
Access to good quality, affordable medicines and supplies would enable health workers to provide better care to girls, women, newborns and children. Currently, access is hampered by inefficient procurement and supply systems, poor partner collaboration, and the lack of crucial reproductive, maternal, newborn and child health (RMNCH) commodities on national essential medicines lists.1 There is evidence on how to ensure commodity security, particularly in relation to vaccines and contraceptives. Applying these lessons across the RMNCH continuum of care would help ensure that women and children have access to the essential interventions they need, when and where they need them.2
“Women without access to quality care and commodities face an increased risk of birth complications, unintended and mistimed pregnancies, infectious diseases and deaths.”3
Essential commodities and interventions needed to save the lives of women and children are known. However, medicines, devices and equipment for RMNCH often do not reach those who need them the most. National procurement and supply management (PSM) systems are often weak. Commodities are delivered in a vertical and uncoordinated fashion. This results in poor procurement, storage and distribution yielding for example overstocks in central medical stores and stock-outs in remote areas. Inefficient national procurement and supply systems lead to the development of parallel mechanisms to procure and distribute medicines, devices and equipment, thereby further reducing efficiency. Another challenge is the lack of coordinated implementation and information exchange between the private and public sectors, across countries, and between local, national and global levels.4
All of these factors compound poor availability of and compliance with effective RMNCH care. Achieving RMNCH commodity security, or the ability to choose, obtain and use products whenever needed will require concerted action at all levels.
- Choose: Choosing essential commodities is achieved where clients are afforded the opportunity to select them from a wider range based on adequate information. This implies that the products are always in stock and available at the various service delivery points and outlets, both public and private, within a country.
- Obtain: Obtaining essential commodities means that quality products should be available at any time at a site convenient to the clients and offered for free or at a price the clients can afford.
- Use: Using essential commodities is achieved when clients are able to freely use desired commodities as long as they desire; have adequate information and motivation for rational use of commodities and have access to services for any side-effects or complications.
The ability to choose, obtain and use are dependant on the availability of key interventions and commodities, which are in part reliant on effective planning and quantification, storage, inventory management and distribution, rational use and pricing.
1 Cambridge Economic Policy Associates Ltd. (2009). Scoping Study: MNCH commodity security. Discussion paper presented at the October 2009 meeting of PMNCH Priority Action 3 partners.
2 WHO. “Rethinking the vaccine supply chain – the right vaccine, in the right place at the right time.”
3 Facts about USAID/DELIVER Project. http://deliver.jsi.com/dhome/about/facts
4 Leahy E (2009). “Reproductive health supplies in six countries.” Report from Population Action International. www.populationaction.org/Publications/Reports/Reproductive_Health_Supplies_in_Six_Countries/Summary.shtml