Repositioning Family Planning in West Africa Repositionnement de la Planification Familiale en Afrique de l’Ouest Sponsored by: U.S. Agency for International Development (USAID), World Health Organization (WHO), Action for West Africa Region Project - Reproductive Health (AWARE-RH), Advance Africa, the POLICY Project The Role of Private Sector in the Supply of Contraceptives: Experience from Ghana, SEAM By Kwesi Eghan Management Sciences for Health SEAM Ghana

CONTRACEPTIVE SUPPLY Relationships + Partnerships Overall Management Operations Clinics GOI/ State Govt.NGO’s Private Sector Manufacturers Advertisers Priv. Clinics Pharmacies

Private Sector Players (PSP) in Contraceptive Supply in developing Countries Midwives, Private Clinics Pharmacy Chemical Sellers Patent Medicines Venders Manufacturers, Suppliers Distributors, Advertisers Long term methods Long term/Short methods Short Term

Role Private Sector Players in contraceptive supply To improve access the role of the private sector must be properly tapped … Co-ordination Role Referral points Treatment Centres Public Health services Manufacture and promotion

Private Sector Players KEY Success Factors Clear Communication of programme objectives Clear Understanding of the motivation of PSP Sound training Programme; Good monitoring and Evaluation schemes Leads to improved access

PSP Available but under-utilised “Almost sixty –six (66%) 1 of Ghanaians visit the over 8000 Licensed Chemical Seller ( LCS) and pharmacies as their first point of call when accessing health reproductive healthcare services” 3 3. MSH Country Assessment 2001

SEAM Strategy to Enhances Access to Medicines Funded by Bill and Melinda Gates Foundation 6 countries studied GHANA,TANZANIA,KENYA, El- SALVADOR PRIVATE NOT FOR AND FOR PROFIT SECTOR

MSH SEAM The Strategies for Enhancing Access to Medicines (SEAM) Program.Established in 2002 with a trinity of country-level public-private initiatives to improve access to essential medicines and commodities. The three (3) components are: Establishing a franchise of chemical seller shops that provide essential medicines and health supplies; Improving pharmaceutical supply and promoting more appropriate use of medicines in the Mission sector (Catholic) of Ghana; and Strengthening the Pharmacy Council’s capacity

What is a Franchise? Franchisee Franchisor Franchise Agreement  a network of privately owned facilities,  operating under a single brand,  to replicate a uniform operating model,  under supervision and monitoring,  for a predictable high level of service,  exploiting economies of scale to streamline operations.

Franchise Operation Discussion Franchise Concept About MSH Application in Public Health Care Relationships + Partnerships Catholic Pharma. Serv. Clinics Training Manufacturers Distributors licensed Practitioners 1.CARE shop Franchise 2.CFW Franchise 3. ADDO Program Regulators / Govt. Pharmacy Council Food & Drugs Board. Private Not profit Private Sector MSH SUPPORTS & STRENGTHENS GSMF TO ESTABLISH & OPERATE THE CARE FRANCHISE MODEL

The CAREshop Franchise Concept An Essential Medicines Franchise network – branded as CARE shops set up in the Volta Region & Eastern Region The Volta Region, with its 1.6 m people, is served by only 621(8.8%) and 17(1.5%) of the National 7000 LCS and 1028 Pharmacies 2 A Structured modular training programme including a full module on Family Planning and Reproductive Health.. A group purchasing program and a logistically sound distribution network was established by GSMFEL Regular monthly supervisory and mentoring visits were conducted with the CAREshop Periodic impact assessment of program is undertaken through - Review of Records, - Drug Availability and Affordability surveys, - Mystery shopping and Field observations

Franchising of Pharmaceutical Retail outlets in a Family Planning Programme Sales short-term contraceptive methods (condom, pill and vaginal foaming tab). First point of call when public thinks of using a modern contraceptive to prevent pregnancy

Benefit of franchising For a Family Planning Campaign to be successful, service providers have to be trained adequately It is difficult to maintain that level of education required throughout the over 8,000 pharmaceutical retail outlets currently operating in the country

Benefits of Franchising…. Centre to initiate discussions on the need for clients to consider family planning when they turn up in the shop for other services Improved level of competence; leading to proper referrals to clinical sites for longer- term contraceptives

Benefits of Franchising…. Provision of Counselling Areas Counselling people who are not sure about adopting FP. Ensure sustained use through effective counseling of those who are experiencing side effects and may be considering abandoning the contraceptive Therefore CAREshop crucial link in the service delivery of Family planning in Ghana.

Benefits of Franchising…. The franchise system allows us to collect data on trends of contraception and the type of contraceptives used in specific locations. The data is used for management decisions –Informs type of demand generation strategies to adopt in particular locations –Informs contraceptive distribution strategies

Key Success Factors Observations of the current interventions also show that working with the private sector requires an understanding of the motivations of private sector providers These motivations include, but in most cases are not limited to – financial benefits –image enhancement –increased skill and competence leading to increased commitment to proper sale and supply of medicines and family planning Commodities

Conclusion SEAM Ghana,Kenya and Tanzania experience show that Private Sector has a key but highly untapped role in enhancing Access to Medicines and Family Planning Commodities in Ghana

–THANKS TO YOU ALL – MERCI ADVANCE AFRICA –N’ DAASE GSMFEL – N’DAASE GSMFINT.