Many developing countries are embracing health sector reform (HSR) through approaches such as integrating services, decentralizing decision making, implementing cost recovery, and privatizing parts of the health system. Various elements of the logistics cycle, such as financing, forecasting, procurement, storage, transport, and logistics management information systems (LMIS), can be affected by HSR or other major changes in the health system. In this study, we document the functioning of the contraceptive logistics system in the varying health reform environments of Zambia, Ghana, Kenya, and Bangladesh and assess the implications of their reform programs for contraceptive logistics. Qualitative data were collected through key informant interviews, document reviews, contraceptive and drug financing data, district operating budgets, and logistics data to examine how the central, regional, district and service delivery point levels have responded to health reform efforts in relation to their logistics management systems. Results show that HSR programs have not adversely affected the contraceptive logistics systems examined in this study, probably because they have retained much of their vertical character, including donor financing. Important HSR innovations, such as integration and decentralization have the potential to improve logistics services, but have not done so in some cases. LMIS, training, and supervision are all vulnerable to disruption. In addition to HSR consequences, issues related to planning for integrating logistics systems are explored through Bangladesh's and Kenya's experiences. Results from these country studies are important for government officials, donors, and technical assistance organizations to help promote favorable outcomes from the reform process for logistics systems.
Learning Objectives: At the conclusion of this session, participants will be able to: 1. Describe changes in the contraceptive logistics systems in countries undergoing health reform. 2. Discuss how logistics functions, such as procurement and transportation, are affected by different approaches to health sector reform, such as decentralization and cost recovery. 3. Discuss how the study findings can be used to promote positive outcomes for contraceptive logistics in the face of health reform efforts
Keywords: Family Planning, Contraceptives
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: John Snow, Inc
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employee of John Snow, Inc.