1. Assessing and Monitoring Maternal Health Commodity Security
Increasing Access to Lifesaving Commodities for Women and Children
Ellie Bahirai, John Snow, Inc.
Tabassum Firoz, PRE-EMPT/University of British Columbia
On behalf of the UNCoLSC Maternal Health TRT
Assessing and Monitoring Maternal Health Commodity Security

2. Provide background to Life Saving Maternal Health Commodities
Define Commodity Security (CS) and explain why it is important
Describe the Maternal Health Commodity Security (MHCS) framework
Apply the framework to a country case study
Webinar Objectives

3. TYPE your questions here!
How to ask a question
TYPE your questions here!

4. Life-Saving Commodities – Maternal Health
Oxytocin (prevention and treatment of postpartum hemorrhage)
Misoprostol (prevention and treatment of postpartum hemorrhage)
Magnesium sulfate (prevention and treatment of eclampsia)
Together, these conditions account for almost half of maternal deaths. If these three medicines were available to every woman giving birth, 1.4 million women could be saved over ten years.
The UN Commission on Life-Saving Commodities singled out three overlooked maternal health commodities that can treat and address the leading causes of death during pregnancy and childbirth:

5. Defining Commodity Security
Commodity security (CS) is broadly defined as the ability to choose, obtain, and use quality health commodities when and where they are needed.
MH CS focuses on MH commodities and the unique characteristics of these specific maternal health commodities.
MH category‐specific CS allows policymakers and implementers to better understand, evaluate, and design solutions based on the unique characteristics of MH commodities.

6. Guiding principles of the MHCS framework
Commodities must be accessible, available, and affordable throughout the continuum of care: (antepartum, intrapartum, and postpartum periods)
Women’s and their healthcare providers’ equitable access to and rational use of quality MH commodities are enabled by intersectoral collaboration and integrated service delivery.
Support rational use of the three key MH commodities (as defined by the UNCoLSC), so they are prescribed, dispensed, or sold appropriately and patients use them correctly (WHO 2012).
Note: Conceptualization of MHCS framework is simplified and does not address many other commodities required for safe motherhood (work of the MHTRT focused on the three MH commodities identified as key).
While these three commodities are necessary to improve MH outcomes, they are not sufficient to manage all causes of poor MH and mortality.

7. Q.1
Do you have experience working with Misoprostol, Magnesium Sulphate, and Oxytocin in MH programs?
Select
YES or NO

8. Q. 2
Have you been involved in a supply coordination committee, and if so, for which kind of products?
Select one

9. MHCS Framework

10. Macro Level

11. Meso (Intermediate) Level

12. Micro Level

13. Community/User Level

14. MHCS Framework

15. Maternal Mortality Ratio (MMR):
Fragiland Case Study
Location:
Sub-Saharan Africa
Maternal Mortality Ratio (MMR):
380
Main Causes of Death:
Pre-eclampsia/ eclampsia
and postpartum hemorrhage
MOH has determined that most of these maternal deaths are preventable.
Maternal deaths could be prevented by increased access to quality services, medicines, and other health commodities.

16. Fragiland Case Study
In order to work towards the 2030 Agenda for Sustainable Development's target 3.1, the MOH is focusing on three specific commodities:
magnesium sulphate
oxytocin
misoprostol.
The MOH has decided to use the maternal health commodity security (MHCS) framework to conduct a baseline assessment of Fragiland’s situation for MHCS.
Target 3.1: Reducing maternal deaths to 70 out of 100,000 live births

17. Macro Level Funding landscape Health system and policy
Fragiland has a weakened health system
The MOH has developed a National Strategic Plan for Maternal and Perinatal Mortality Reduction
The plan includes access to emergency obstetric care, child spacing and other reproductive health services.
Funding landscape
Significant parallel and project-based funding for maternal health commodities
72 organisations engaged in advocacy at national and sub-national levels
Many of these organisations focus on the implementation of interventions or on service provision.
Most organisations are concentrated at the central level

18. Health Supplies, Diagnostics and Devices Monitoring & Evaluation
Meso Level
Health Supplies, Diagnostics and Devices
Health supplies including diagnostics and devices are lacking
Quality Assurance
3 MH commodities are registered but not available in the specific dosages
Drug testing laboratories have limited manpower and logistics capacity
Service Delivery
Poor service provision
Supply Chain
MH supplies is co-mingled with other medicines
Stock outs and shortages of supplies
Human Resources
Migration of health workers
Inadequate training and education
Monitoring & Evaluation
No M&E plan in place

19. Community leaders and religious leaders are also very influential.
Micro level
In Fragiland:
There are low rates of facility delivery and skilled attendance at birth.
Community leaders and religious leaders are also very influential.
Decision making about pregnancy and delivery lies with the family rather than the woman alone.

20. Q.3
Is your country context similar to Fragiland?
Select
YES or NO

21. Q.4 Would the MHCS framework be useful in your country? Select
YES or NO

22. Additional Resources

23. Links to additional resources
Maternal Health Commodity Security Brief
Commodity-Security-Framework-for-Maternal-Health.pdf.pdf
A Commodity Security Framework for Maternal Health – White Paper
content/uploads/2015/01/CommSecuFramMateHeal.pdf

24. For more information, visit: lifesavingcommodities.org
Thank you!
For more information, visit: lifesavingcommodities.org
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