Realities in the Field Reproductive Health Supplies Coalition Kampala, May 2010 Brief snapshot of the impact of shortages in the field --- example of MST, but consistent with lots of MSI programmes By Catherine Slater

Marie Stopes Tanzania 14 Static Centres 14 Outreach Teams operating within MoHSW facilities in 18 out of 21 regions of Tanzania Provide access to all family planning with a focus on long-term and permanent methods compliments MoHSW core FP efforts via two key channels -- gaps in PH system

Our Services in 2009 In support of MoHSW efforts, we delivered over 640,000 CYPs: Over XX Tubal Ligations Over 28,000 Implants Over 15,000 IUCD Over 12,000 Injectables Over 14,000 Pill Cycles Over 550,000 Male Condoms But this only reached 50% of our target, in the main, due to stock-outs and shortages Significant contribution to LTPM

Current Situation - IUCDs In Quarter 1, MST delivered 4700 IUCDs 50% came from MSI/UNFPA sources and 50% from LGA We need 14,000 IUD this year to meet our expected demand We have stock till end of June, and anticipate additional supplies from LGAs Look at two of the main commodities that we have challenges with……IUDs tight but manageable – slight dip

Current Situation - Implants In Quarter 1, MST delivered 7400 implants 81% came from MSI/UNFPA sources and 19% from LGAs We only delivered 44% of our target We need over 60,000 implants this year to meet our expected demand We recently received emergency supply from MSI/UNFPA, however a stock out at end of May is likely Situation with implants is critical

Key Challenges/Solutions Shortage of commodities at national level Unpredictable and decentralised distribution system. We are preparing to join the MoHSW Integrated Logistics System, though anticipate that planning, coordination and delivery will still be difficult Limited options for accessing supplies – Sino not yet registered and Jadelle registered but not approved to GoT Technical Advisory Body. We welcome GoT’s efforts in moving this forward, as well as option to access this high-turnover product centrally. Clearly the main issue – fellow panelists have given comprehensive response to this 2. exacerbated by unpredictable and decentralised distribution system - we are planning to join the MoHSW Integrated Logistics System sourcing direct from Medical Stores Departments at zonal level, but anticipate that planning, coordination and delivery will be difficult given the number of different areas that we operate in 3. welcome MoH strides in this area – included in costed plan. Would like to access centrally so that we can speed up distribution once they reach the country.

Working together to ensure that no one gets turned away……. As stated in recently launched National FP Costed Implementation Plan --- desire for FP is there……our wish like all the reps on this platform is that none who wants FP gets denied that choice