Declining Contraceptive Donations in Latin America and the Caribbean: Assessing Country and Regional Needs

Patricia A. Taylor, MPH, John Snow, Inc., 1616 N. Fort Meyer Drive, 11th Floor, Arlington, VA 22209, 703-528-7474, ptaylor@jsi.com, Varuni Dayaratna, Planning and Finance, The POLICY Project, Futures Group, 1050 17th Street NW, Suite 1000, Washington, DC 20036, and Nora Quesada, John Snow Inc, 1616 N. Fort Meyer Drive, 11th Floor, Arlington, VA 22209.

Countries in the Latin America and Caribbean (LAC) region have increased their family planning coverage dramatically over the past decade and donated contraceptives have played an important role. USAID continues to be the largest single donor of contraceptives in the region, but its donations are expected to end in all remaining LAC countries by the end of this decade. Mexico, Brazil, Colombia and Chile have already graduated from USAID and UNFPA donations and they are now self-financing. The Dominican Republic, Ecuador, El Salvador, Guatemala, Honduras and Peru have also begun to purchase their own contraceptives.

This session presents highlights from a multi-country study of contraceptive security in the LAC region, which was carried out from July 2003-July 2004, for USAID's LAC Bureau. Study findings show the following barriers to contraceptive security across countries: 1) laws, regulations and policies that delay procurement and increase contraceptive costs; 2) lack of (government) contraceptive procurement experience; 3) market segmentation that places too much of the financial burden on government; 4) lack of policies and operational tools for targeting government resources to vulnerable populations; 5) health sector and governmental reforms that have a negative impact on contraceptive financing, procurement and/or logistics systems; 6) religious opposition that periodically threatens government commitment to family planning.

Recommendations addressing each of these barriers will be discussed, as will lessons learned using the Strategic Pathways to Reproductive Health Commodity Security (SPARHCS) approach to country assessment and stakeholder planning.

Learning Objectives: At the end of this session, the participant will be able to

Define contraceptive security and explain its significance in the LAC region
List at least three priority issues that countries in the region face as contraceptive donations decline and describe alternatives approaches to addressing each issue
Explain the components of the SPARHCS framework and describe how it is used to assess country needs and develop action plans with key stakeholders.

Keywords: Contraceptives, Sustainability

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: employment

Recorded presentation

Managing and Sustaining Family Planning and Reproductive Health Programs in the Face of Change: Funding Shifts, Health Reform, and Political Swings

The 132nd Annual Meeting (November 6-10, 2004) of APHA