To improve women’s health, supply chains for essential health products must be able to deliver medicines and supplies reliably to women when and where they need them.
Ensuring maternal health product availability requires well-functioning health supply chains and health staff who are trained to correctly forecast requirements, procure products on time, manage inventory, monitor supplies, maintain storage facilities, and distribute products securely. Along with these supply chain requirements, product availability depends on adequate financing, strong service delivery, coordinated efforts, and supportive policies.
Maternal health products, particularly magnesium sulfate, misoprostol, and oxytocin, are commonly classified as essential medicines. Unfortunately, that classification doesn’t mean that they are always available when they’re needed. Because they require special packaging (misoprostol is sensitive to humidity) and complementary supplies (magnesium sulfate and oxytocin are injectables), there are additional challenges getting these products to the women who need them.
Here are a few examples of supply chain constraints for misoprostol, magnesium sulfate, and oxytocin—
- Forecasts of product need are imprecise
- Existing vaccine cold chains are not designed to accommodate oxytocin
- Weak infrastructure and weak supply chains at the “last mile” make distribution down to households and peripheral health facilities difficult
- Weak regulation enables counterfeit, substandard, and unregistered medicines to reach local marketplaces.
These constraints and others contribute to a challenging environment for ensuring that maternal health medicines are consistently available. But they can be overcome.
Here are a few options for intervention—
Strengthen the Supply Chain
Increasing procurement quantities alone is not enough.
Supply chain capacity building activities may include training initiatives (including pre-service training), supervision, and mentoring. Community health workers and birth attendants must be included since they are often a woman’s key health provider when these products are needed.
Increase Financial Commitments
Advocate for adequately funded government budget line items for maternal health products, and monitor spending.
These line items and monitoring measures can increase accountability and promote government spending on life-saving products.
Expand Service Delivery
Ensure that the dispensing/prescribing roles for service providers are appropriate and understood throughout the system.
Confusion over who is allowed to administer which products often means that women do not receive the care they need. Care providers need clear guidance on what medicines they are allowed to administer.
Include maternal health supply issues on the agenda of coordinating committees.
Existing committees can support product availability. Key partners such as central medical stores, nongovernmental organizations, donors, UN organizations, pharmacies, manufacturers, civil society organizations, and Ministries of Health, Finance, and Planning can initiate and influence action and change. Committees can also monitor supply issues and coordinate funding sources and procurement.
Include indicators to monitor maternal health supplies in key health policies.
Monitoring the availability and use of maternal health medicines raises their profile and allows policy makers to evaluate policy implementation and ensure that their policies translate into action.
Investing in developing strong supply chains and building supportive environments will ensure that maternal health medicines are available and used to save women’s lives. This is surely an investment worth making.
Click on the image below to access JSI’s framework for integrated supply chain management in public health.
*This article was originally published by the Maternal Health Task Force on September 12, 2012