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WDI is part of two separate grants awarded by the Reproductive Health Supplies Coalition (RHSC) Innovation Fund, the organization’s flagship initiative to spur and finance promising new ideas and strategies. The coalition, which is the largest network of reproductive health organizations, aims to ensure that a range of quality reproductive health supplies are available equally to all people who need them regardless of income.

Both grants were awarded in March at RHSC’s meeting in Brussels. The first grant was awarded to WDI’s Healthcare Initiative to study and make recommendations to improve commercial distribution of family planning products in remote and underserved populations in low- and middle-income countries (LMICs).

The project, “Total Market Approach: Private Sector Distributor Landscape Analysis,” is being funded by the RHSC, a global partnership of public, private and non-governmental organizations dedicated to ensuring that all people in LMICs can access and use affordable, high-quality supplies to improve reproductive health. It will be led by WDI Senior Advisor Andrea Bare and Research Associate Erika Beidelman.

Historically, low-income people living in rural areas have less access to family planning products and services partly due to market distribution barriers. Social marketing organizations (SMOs) play a vital role in improving access to, and choice of, an assortment of family planning products at a variety of prices in underserved markets. SMOs provide product-based contraceptive social marketing programs, which are funded in part by donors, making products and/or services subsidized. As donor support begins to phase out and SMOs pursue transition to greater sustainability with less dependence on subsidies, existing distribution models will be impacted.  

 

Global indicators suggest that the donor resource base for family planning supplies will decrease in the future, widening the existing funding gap. Further complicating the market, demand will continue to grow as countries strive to meet global family planning goals by 2020 – increasing total commodity costs required to meet women’s needs. A RHSC gap analysis showed that in 135 LMICs there will be a $238 million funding gap in 2018 which will grow to $290 million for 2020. For the years 2018-20, the combined funding shortfall is estimated to be $793 million. WDI’s research project will address the urgency of engaging the private sector and commercial distributors as part of the global effort to address the widening funding gap and ensure availability of family planning products.

Bare and Beidelman will take an in-depth look at Malawi as an example country with high donor involvement, strong SMO presence and limited commercial presence. They will then contrast what is occurring in Malawi with countries such as Vietnam, Cambodia, Guatemala or Morocco where donor funds and SMO presence are lower and the commercial distribution sector is more mature. This assessment will map what is currently working and not working for commercial distributors, with insights into their current business and service models, barriers to participation and opportunities for improvement.

By examining Malawi against the other countries, market needs, policy conditions and opportunities can be identified to foster commercial investment and participation within the distribution sector. WDI researchers are then able to develop a set of hypothetical solutions to remedy the challenges and “concept test” them with stakeholders.  

The goal is to deliver a final set of potential, recommended solutions for increasing the role of the commercial sector in family planning products distribution to rural and other underserved populations.

WDI has partnered with RHSC on a past project. In 2017, WDI, RHSC and the U.S. Agency for International Development (USAID) collaborated on Market Bookshelf, an easy-to-navigate online platform to facilitate the dissemination and sharing of global health market knowledge. The goal of the platform is to increase returns on donor and other stakeholder-funded research and help advance global health objectives through knowledge-sharing.

In the second project funded by RHSC’s Innovation Fund, WDI will partner with VillageReach on a six-month project to help improve reproductive health supply chains to increase the availability of family planning products.

Many LMIC governments own and directly operate thousands of public health clinics, and spend money to get health commodities out to the clinics. But this becomes a big challenge to reliably get products out there. As a result, governments have paid more attention to more effectively design well-functioning supply chains that align with health policy.

But designing efficient and effective supply chains often requires specialized software and data-intensive analyses, which can be expensive and difficult to manage in LMIC healthcare settings. Additionally, reproductive health commodities are unique because of the need to provide multiple product options to ensure that women are able to choose the products that best suit their specific needs.

WDI developed two different tools to simplify the process of supply chain design by addressing these software and data needs challenges. Both tools use Microsoft Excel, which is widely available, and are designed to operate without requiring intensive data collection.

The first tool uses benchmark and proxy data to help health program managers quickly estimate the cost of operating their supply chain. It can also be used to examine the cost impact of any design changes they are considering, such as delivering products more or less frequently, or  integrating family planning product deliveries with other types of products, like HIV malaria medicines.

“The tool allows health program managers to quickly explore these types of supply chain design questions at a high level – questions that would otherwise require a difficult and resource-intensive analysis,” said Michael Krautmann, a senior research associate for the Healthcare Initiative.

The second tool is more strategic in nature, helping health system leaders quickly assess a wide range of factors in their country that affect supply chain performance – geography, politics, financing, human resources – and identify the types of supply chain strategies that are most aligned with that context. Again, WDI helped minimize barriers to using the tool by designing it in Excel and using data that already exists in the global health space. Together these tools allow governments or donor agencies to quickly get answers that aid in improving supply chain design.

WDI and VillageReach have been longtime partners. VillageReach has supported the work of several WDI summer interns, and the Institute’s Healthcare Initiative partnered with the global nonprofit from 2014-16 to enhance vaccine supply chain performance by evaluating  mechanisms to improve accountability of vaccine program staff in three provinces in Mozambique.

Also announced at the Brussels meeting was Bare’s election as chairwoman of the RHSC’s Market Development Approaches Working Group (MDAWG). As one of RHSC’s several mechanisms through which coalition members collaborate, MDAWG is focused on the “total market,” striving to facilitate wider private sector involvement and overall market growth. RHSC uses these working groups, along with several caucuses, to bring members and partners together to build sustained, coordinated action toward specific and agreed-upon goals.

Bare’s two-year term involves several duties, including pursuing the objectives of MDAWG to:

• Advance global understanding of the role of market development approaches in improving the availability, equity, quality and choice of reproductive health supplies;
• Provide a neutral venue for members to propose and seek partnerships for developing and pilot-testing innovations in market development;
• Facilitate networking and collaboration among member organizations and individuals interested in applying market development approaches to improve reproductive health supplies.

Bare will work closely with RHSC secretariat staff to provide leadership for the group’s workstreams and activities, to ensure the visibility of its work both internally and externally and to collaborate with other RHSC working groups.

“I am grateful for this opportunity and excited to work my coalition colleagues in MDAWG,” Bare said. “Through our individual organizations and together as a group, we aim to contribute to the private sector’s development and sustainability in order to increase reproductive health access and supply security.”

 

Homepage image credit UNFPA Flickr