I’ve arrived at the Global Maternal Health Conference in Tanzania to present the results of two years of private-public partnership for Pakistan supply chain systems and to learn from other programs.
Over the past three years, the United States government has made an unprecedented investment in supply chain management and logistics to improve access to family planning across Pakistan. The result has been a huge improvement in the lives of Pakistani women and children.
We have very strong evidence that the intervention has had a far reaching impact. The 2010-2011 investment around Pakistan’s systems responsiveness has prevented 3.2 million unintended pregnancies, more than 81,000 infant deaths, and 3,300 maternal deaths.
While previous development investments have focused on a limited number of districts, this effort has been a country-wide initiative. All 143 districts of Pakistan and more than 85 percent of the public sector’s service delivery points are well-stocked with contraceptive products. This is a cross-cutting intervention that is responsive to the whole system. Such equitable distribution has never happened in the history of Pakistan. We know that expanding the number of contraceptive methods available and ensuring a reliable supply, even in remote areas, increases use, and we have seen that happening.
The US government-assisted USAID | DELIVER PROJECT has invested over $100 million into health commodities and supply chain management. The project worked with the government of Pakistan to introduce a comprehensive restructuring of the supply chain reporting system, which included a web-based logistics management information system (LMIS) and an integrated reporting and requisition form that both departments use to report data and to request contraceptive supplies. The web-based LMIS also has the ability to incorporate contraceptive data from nongovernmental organization partners. In this way, the needs of even the most remote clinics are met in a timely way. The new LMIS in Pakistan is already showing that in-sourcing can build country ownership and long-term sustainability, while realizing cost savings in the process.
Until recently, Pakistan’s Central Warehouse, which provides contraceptive supplies to the entire country, followed labor-intensive manual processes for all its transactions. A new automated warehouse management system is changing this and eliminating many of the problems that can arise from tracking commodities by hand, such as delays in reporting and distribution, wastage from expirations, and stock-keeping errors. Also, the storage capacity of the warehouse was increased from 18,000 square feet to 50,000 square feet.
Together, all of these improvements ensure that, for the first time, supplies are being delivered according to demand, to the last mile. Rural women can obtain the contraceptives they want. They will be able to live a healthy life, space the births of their children, and have healthy babies. The health and ecological advantages are huge.
But even beyond that, the economic advantages that Pakistan will see are significant. The economic advantages of family planning investments have not received much attention in the past in this country. But as we have made the case very strongly to the government of Pakistan, the economic advantages are now being taken very seriously.
USAID has now pledged additional financial support of $44 million for the next two years. I am confident that with USAID’s continuing commodity support, in addition to Pakistan’s own financing, we will be able to meet increasing demand over the next two years, even as the population grows. With this commodity support, which will build upon infrastructure investments now in place, we will prevent another 4.7 million unintended pregnancies, saving the lives of another 122,000 infants and 5,000 mothers.
This has been a very timely investment, and the benefits to Pakistan will go far.