Introduction of female condoms in Cameroon Universal Access to Female Condoms (UAFC) Joint Programme Bertrand Dimody, ACMS & Nienke Blauw, Rutgers WPF RHSC Membership Meeting, 24 June 2010, Addis Abeba

Overview presentation: Context –Female Condoms –UAFC Joint Programme –SRH situation Cameroon UAFC Country Programme Cameroon –Lesson learned – Issues – Solutions –Results Conclusion

CONTEXT Female condoms UAFC Joint Programme –Procurement, Research & Development –International Advocacy, Linking & Learning, Communication –Country Programmes SRH situation Cameroon

UAFC Country Programme Cameroon – Lessons learned 1 Issue: ‘heritage’ from previous programs and global situation. Solution: Integrated approach, including: –Advocacy, –the social marketing of female condoms, –Operational research for the (monitoring of the) project implementation –Fundraising and continued advocacy towards international donor agencies and multilateral organizations for sustainable procurement and programming Lesson: Large scale, integrated programming (not just procurement!) needed to overcome supply side barriers

UAFC Country Programme Cameroon – Lessons learned 2 Issue: Difficulties within distribution system set-up: lower than expected distribution and sales at certain sales/ distribution points and high turn-over of peer educators Solutions: –The training of peer educators for community awareness, monitored by ACMS; –Change within set-up of distribution system to increase accessibility and targeted IEC: more independent peer educators and hair dressers; –Linking with and learning from other female condom program (Nigeria, Zimbabwe, Mozambique)

UAFC Country Programme Cameroon – Lessons learned 2 (Continued) Lesson: Women oriented sales points such as hair dressing salons turn out to be better at combining education and sales than CBOs and are at the same time safer spaces for women to buy the product than health care providers or general commercial stores.

UAFC Country Programme Cameroon – Lessons learned 3 Issues: High procurement price & lack of choice Solutions: –More bulk procurement for lower prices and less clearance instances (by I+ solutions) –Introducing a second female condom to increase competition and choice –Support to manufacturers in prequalification process Lesson: Establishing good communication and cooperation between procurement agents, manufacturers and regulatory agencies is essential to ensure successful introduction of female condoms.

UAFC Country Programme Cameroon – Lessons learned 4 Issue: regulatory obstacles relating to procurement of non- prequalified female condoms. Solution: Strengthening the Ministry of Health’s National Laboratory of Quality Control & Assurance – LANACOME Lesson: Establishing good communication and cooperation between national ministries of health, social marketing organizations and procurement agents is essential to ensure successful introduction of female condoms.

Results To date, a total of 3.7 million female condoms have been procured in bulk for Cameroon at below-average prices, of which over 1.1 million have been distributed or sold since 2009 Interest of donors to continue funding the program after 2011 Technical and in-kind support for LANACOME has increased the testing capacity of a variety of female condoms and strengthened commitment from the Cameroonian government

Recommendations for other technologies: Innovative social marketing including IEC and women oriented sales points can increase distribution and Large scale, integrated programming, including advocacy and IEC, is critical to ensuring long term success Program needs: a system to link & learn more investment in large scale, integrated programming of new and underused technologies, including investment in bulk procurement to lower prices