ccih 2015 amy metzger breakout 4a
TRANSCRIPT
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Building the Evidence: Unique Stockout Challenges of
FBO Health Facilities: Email Survey &
Phone Interview Findings
Amy Metzger, MPH Consultant to CCIH
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Study Goals 1. To identify distinct typologies of FBO supply chains 2. To identify associated challenges resulting in
stockouts (when products are out of stock) 3. To recommend solutions
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Objectives
• Identify and describe the basic characteristics and challenges of FBO supply chains at the service delivery level.
• Deepen understanding of the types of supply chains used by FBOs to access vital reproductive health commodities, including contraceptives.
• Identify potential FBO partners and design strategic interventions to improve RH supply chain at the service delivery level.
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Methodology • Email survey - baseline data on products carried,
stockouts rates, etc 46 completed in 13 countries • In-depth follow-up to 6 countries yielded 16
completed phone interviews Topic covered: 1. Ordering 2. Transport 3. Storage and Product Quality Assurance 4. Cost Recovery and Financing
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Email Survey Responses by Country (% of FBO facilities who responded)
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Daily Average of FP Clients by Size and Location
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Characteristics of Facilities Responding to Email Survey
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Products Managed By FBO Facilities
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Sources of Products Managed By Facility
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0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Cycle beads
Combined Pills
Progestin-only Pills
Male Condoms
Implants
Injectables
Magnesium Sulfate
Oxytocin
% of Facilities that Reported Being Stocked Out/Not Stocked Out of the Product in Last 3 Mos (preceding survey):
Stocked Out Not Stocked Out No Response or DK
Stockout of Products
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Phone interviews - FBO Facilities’ Logistics Practices,
Strengths & Challenges
Ordering Facilities generally make ordering decisions for FP/RH products When dependent on Ministry of Health (occasionally other donors), MOH decides on quantity and sometimes the product Most consider safety stocks when determining quantities Challenges 69% experienced stockouts of contraceptives in prior 3 months Ordering practices inconsistent – in large part related to irregular supply and delivery MOH orders were not always complete
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FBO Facilities’ Logistics Practices, Strengths & Challenges
Transport: Wide spectrum of answers on how products delivered and if on time and complete Most common scenario – Facility collects products with own vehicle (or rents a vehicle, truck, motorcycle) Faith Based Supply Organizations typically deliver to facility on a regular schedule Challenges: Rural facilities are many hours from MOH and FBSO
depots
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FBO Facilities’ Logistics Practices, Strengths & Challenges
Storage and Product Quality Assurance: Some use general stores & some keep supplies close to point of use 87% reported at least 1 person designated to deal with QA issues An equally high percentage had procedure for incidents Strengths: Almost all facilities: storage capacity did not affect quantities ordered Low evidence of expiry or quality issues Challenges: A few reported issues regulating temps & maintaining cold chain Less often mentioned – insufficient space, poor security & lack of steady electricity A few had compromised quality of Misoprostol, Oxytocin & Magnesium Sulfate
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FBO Facilities’ Logistics Practices, Strengths & Challenges
Cost Recovery and Financing: Fees charged varied widely If contraceptives free from MOH, typically can’t charge the patient In most facilities with single faith-based source – patients pay for all products including contraceptives The facility’s main source of financing is through: Patient fees External funds or donations Subsidies from government –salary payments or direct subsidies
Challenges: A few facilities noted contraceptives from FBSOs are too expensive
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Thank you for attending!