1 Manual Vacuum Aspiration Case Study Matthew Reeves, MD, MPH RHSC Membership Meeting 24 June 2011 Addis Ababa, Ethiopia

WCG Operates Globally Focusing on Developing Markets 2 Distribution in 110 countries currently

MVA Product Line 3 Aspirators: MVA Plus Single Valve Double Value Cannula: EasyGrip, Flexible Karman, Rigid Accessories: cannula adapters, silicon oil, collar stops, O-rings, caps, Pelvic models & Denniston Dilators Global distribution over last 5 years 500,000 aspirators 4 million cannulae Majority to Africa (34%), Asia (25%) and Latin America (11%) Ipas MVA Plus Aspirator Ipas EasyGrip Cannulas

MVA Global Supply Strategy Facilitate funds for MVA purchase Utilize market knowledge Bundling with new products Maximize partner activities & relationships Access & Sustainability 4

Channel Management Strategies in the Public and Private Sectors Can Have a Major Impact R&D Commercialization Channels Women Regulatory Affairs Quality Assurance Medical Affairs Marketing Business Development Supply Chain Logistics Regulatory Affairs Quality Assurance Medical Affairs Marketing Business Development Supply Chain Logistics Access & Affordability Channel Management NGOs Companies Gov’ts NGOs Companies Gov’ts Training Policy Advocacy Training Policy Advocacy MOH NGO Clinics Social Marketing Consolidators Private Clinics Private Distributors Pharmacies Market Women MOH NGO Clinics Social Marketing Consolidators Private Clinics Private Distributors Pharmacies Market Women Distribution: Macro Impact Donors Collaborators: Improve family and community welfare 5

Zimbabwe Case Study: The Problem MVA out-of-stock for 2 full years Warehouses empty of MVA Clinics not offering MVA services Providers required “re-training” (per MoH) 6

Zimbabwe Case Study: The Solution WCG worked with the MoH To develop a training program that met their criteria WomanCare Global partnered with Ipas To conduct the approved training program 7

Zimbabwe Case Study: The Solution WCG worked with the MoH on MVA forecasting MVA Calculator utilized 8

Zimbabwe Case Study: The Outcome MoH ordered 5,000 MVA kits To ensure a continuous supply WCG assists MoH with Monitoring inventory levels Facilitating the order processing from facilities Monitoring correct usage of products 9

10 Failure you can do alone, but success always takes help.

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12 Case Study: Zimbabwe Problem WCG Role WCG Actions Outcomes MVA out-of-stock for 2 full years Providers required “re-training” Supply Facilitator Quantified the market need Worked with Ipas to re-train providers in-market Ministry of Health placed an order for 5,000 MVA kits to ensure a continuous supply Continuous monitoring of supply of MVA kits by close follow up