Note – content below is from an email update, October 2015
It is estimated that expanded access to and correct use of 13 priority life-saving commodities could prevent 6 million women and children dying by 2017*. What are the main challenges of making these commodities available?
In this third informal update in relation to our recently launched learning resource on Quality of Maternal & Newborn Services, HEART shares recent publications and discussions relating to improving access to essential commodities.
#1) Identifying barriers to access: promoted as a critical turning point, the 2012 UN Commission on Life-Saving Commodities for Women and Children (UNCoLSC) report* identified three main barriers to the required access: 1) market failures leading to an insufficient supply of quality drugs, 2) a weak regulatory environment leading to variability in drug formulation and quality, and 3) lack of provider and consumer awareness of drugs and/or their appropriate use. The report made a series of recommendations relating to the 13 priority commodities.
#2) Moving the UNCoLSC recommendations forward: between 2013 and 2015 UNCoLSC technical teams developed over 400 knowledge tools to support implementation of the recommendations. These are easily accessible and include quantification algorithms, best practice guidelines, training resources, demand-generation materials and advocacy documents.
#3) Developing a framework for maternal health commodity security: In 2014 the John Snow Research & Training Institute, Inc. (JSI) developed a white paper for UNCoLSC which reviewed and discussed emerging themes and evidence relating to inadequate access to the 3 essential maternal health drugs (oxytocin, misoprostol, and magnesium sulphate). The proposed framework aimed to help policy makers and implementers identify gaps and weaknesses in specific components of health systems, and to support the development of strategies to address these. It also allowed for ongoing monitoring of progress.
#4) Advocating for continued improvements: The 2015 PATH toolkit ‘Scaling Up Life-Saving Commodities for Women, Children, and Newborns toolkit’ aligned to the UNCoLSC recommendations and provided comprehensive guidance on advocating for implementing them. It also included examples of how they have been applied globally and nationally. Specific examples of quality improvement strategies include improved supply chain management in Malawi to integrate oxytocin into the cold chain.
#5) Illustrating the benefits of leveraging experience: The Reproductive Health Supplies Coalition’s brief series ‘Essential Medicines for Maternal Health: Ensuring Equitable Access for All, 2014’ (drafted by Family Care International) promoted the experience within the coalition and showcased successful interventions relating to the 3 essential maternal health drugs and cross-cutting issues such as policy and financing, supply, and demand-generation.
#6) Facilitating discussion and dissemination: In 2015 a blog series on ‘Increasing Access to Maternal & Reproductive Health Supplies’ was curated by the Maternal Health Task Force, in collaboration with the Reproductive Health Supplies Coalition / Maternal Health Supplies Caucus, Family Care International and the USAID-Accelovate program at Jhpiego. The series prompted discussion around seven key questions. The blogs provided a range of case studies and comments from sector experts on subjects such as supply chain management, use of community health workers, incentive schemes, e-health applications and market dynamics. It also included a review of progress since the UNCoLSC report.
#7) Signposting further resources: The WHO Essential Medicines and Health Products Information Portal provides links to a range of over 5,000 national and global publications including studies, procurement and forecasting exercises, practical guidelines and updated equipment lists for essential interventions.
- The resources highlighted above are just a selection of recent initiatives / publications – HEART does not endorse those mentioned.
- This update builds on the learning resource itself where access to essential commodities is identified as a cross cutting indicator of quality services and also as a structural dimension of quality.