Stronger Together: In South Sudan, an Innovative Program Pre-Packages Family Planning Products Into a Single Kit and Distributes Them With Essential Medicine Kits

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Date
June 10, 2019
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In South Sudan, the USAID Global Health Supply Chain Program-Procurement and Supply Management (GHSC-PSM) project collaborated with the United Nations Population Fund (UNFPA) and Health Pooled Fund (HPF) to ensure availability and access to family planning (FP) commodities through the packaging and distribution of family planning products in a single kit.

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Workers pack commodities into kits for distribution to health facilities. Photo Credit: GHSC-PSM
Workers pack commodities into kits for distribution to health facilities. Photo Credit: GHSC-PSM
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Workers pack commodities into kits for distribution to health facilities. Photo Credit: GHSC-PSM
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Due to a lack of donor funding, the government’s health supply chain was unable to reliably store individual products centrally and then distribute and properly track health facilities outside the capital of Juba. The government also lacks a robust logistics management information system and resupply system to ensure contraceptive availability.

To overcome these challenges, GHSC-PSM worked with UNFPA – which supports the procurement and storage of FP commodities – and HPF – a key provider of healthcare services that supports procurement and distribution of essential medicines – to create family planning (FP) kits. These kits are pre-packaged for distribution, combining different types of contraceptives into a single box at the UNFPA stores located at the Central Medical Stores in Juba. GHSC-PSM packs the UNFPA commodities and delivers them to the HPF, which then takes them to service delivery points across eight former states, per their distribution plan. Essential medicine kits and other health commodities are also included in the distribution.  

The basic FP kits contain a variety of contraceptives to meet patient needs, including injectables, oral contraceptives, and condoms. Supplemental kits contain the additional options of implants and intrauterine devices.

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The kits are delivered to 58 county health department stores and 48 hospital storage sites in the eight former states of Central, El Gazal, Lakes, Northern, Unity, Warrap, Western and Eastern Equatoria, and Western Bahar. The county health department stores are close enough to health facilities that implementing partners can quickly access them when needed. Stock levels at storage facilities are then monitored as much as possible and resupplied to avoid overstock, expiry, and stockout. Thanks to the RH kits, availability of reproductive health commodities at health facilities averages 80 percent. "For the first time in so many years we have had no partner requesting for RH commodities from the central level” said Stephen Mawa, UNFPA.
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For the first time in so many years we have had no partner requesting for RH commodities from the central level.
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FP kits departing Juba for a health facility. Photo Credit: GHSC-PSM
FP kits departing Juba for a health facility. Photo Credit: GHSC-PSM
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FP kits departing Juba for a health facility. Photo Credit: GHSC-PSM
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Central management of FP commodities is much easier, as supply chain managers focus on tracking just two kits rather than more than nine individual commodities. Management of commodities is also easier for health facilities, who now only need to track and store kits rather than individual products. Quantities of various items in the kits can be revised based on feedback from facilities about how much of each commodity they use.

Distributing these commodities as kits ensures that family planning clients have everything they need at one time, preventing the risk that health facilities will run out of some of the necessary components. This streamlined approach to distribution also saves some of the cost of operating the supply chain. 

This innovative approach also addresses the country-wide challenges associated with product and data visibility. Forecasting and supply planning future procurement is made easier, as tracking both distribution figures and stock remaining at health facilities is much simpler under this system.  

Before the launch of this program, there had been no active distribution of contraceptives in the country. Now, availability of FP commodities at health facilities averages 80 percent. Plans are underway to expand the delivery to the remaining 20% of the country.