DOMINICAN REPUBLIC ROLE OF THE CONTRACEPTIVE SECURITY COMMITTEE: ACHIEVEMENTS AND CHALLENGES IN FAMILY PLANNING Cándido Rivera Francisco Executive Director National Council for Family and Population Affairs (CONAPOFA) London, 28th April 2007

Location Population: 9.2 M (2007) TCaribbean América DOMINICAN REPUBLIC Population: 9.2 M (2007) 48,730 square kilometres, located in the Caribbean, on the eastern side of the Hispaniola Island, which shares with Haiti

STATUS OF FAMILY PLANNING DHS 2002 CPR: 70% Unmet need: 11% Private sector coverage: 53% Household expeditures in health: 48% Teenage pregnancy: 23%-30% Fuentes: Endesa 2002, Cuentas Nacionales 2005

CONTRACEPTIVE SECURITY COMMITTEE BACKGROUND Phase-out of donations and technical support Need to protect achievements in FP Target scarce resources on underserved populations, and address unmet need Support National Government “Zero Tolerance” strategy Reduce Maternal and Infant mortality Contribute to the MDG Weak Logistics System Stagnation of the FP program Contraceptive Stockouts at all levels

COMPOSITION OF THE CS COMMITTEE Created in May 2005 Multisectoral and multidisciplinary, provides counseling and technical support to the public and private sectors. The committee facilitates the discussions and promotes CS across all sectors Member Institutions PUBLIC SECTOR NGOs PROJECTS DONORS MOH PROFAMILIA CONECTA USAID CONAPOFA ADOPLAFAM UNFPA HIV\AIDS Program PSI Private Sector SS MUDE Armed Forces Public Sector Social Security National Health Council Association of National Pharmacies Others…

CS COMMITTEE Chaired by CONAPOFA One main Coordinator 3 Sub-committees, one coordinator each Funded by CONAPOFA (70%), USAID, UNFPA Monthly meetings The committee has: Statutes Internal regulatory document Work plan

ACHIEVEMENTS

ACHIEVEMENTS Assessment of the FP program, for the private and public sectors (2005) Redesign and implementation of the Logistics Management System, and information system for the Cervical Cancer Prevention Program MOU between MOH and UNFPA for the procurement of contraceptives (2005), resulting in significant savings. Development of National Health Accounts for FP and Reproductive Health. A budget for the purchase of contraceptives using national treasury funds

HOW DID WE DO IT? Multisectoral, and insterinstitutional CS Committee Leadership from CONAPOFA, in close coordination with M&C Health Division of MOH Clear and realistic mid-term action plan Empowered, committed key stakeholders and CS members Technical and financial support from USAID and UNFPA. Involvement of other key stakeholders: Ministry of Economic Affairs, Planning and Development, Ministry of Women´s Affairs

CHALLENGES

CHALLENGES Political support and commitment from the National Government to procure and finance contraceptives for the mid and long terms Long-term sustainability of the CS Committee Increase visibility of the Committee Sustainability and consolidation of the Logistics System A protected line item for contraceptive procurement in the national government budget