Family planning (FP) has enormous untapped potential to transform the lives of women and their families, to improve health outcomes and to foster economic growth. However, hundreds of millions of women in low- and low-middle income countries are currently unable to access contraception.
The market for family planning products is unique in that it is not enough to simply deliver a single best product to consumers. They need a range of options to enable women to choose for themselves how to best fulfil their individual reproductive needs. Ensuring that all people have access to their preferred contraceptive method also advances several human rights, including the right to life, expression and choice, and brings significant health and other benefits.
The 20th General Membership Meeting of the Reproductive Health Supplies Coalition (RHSC), which is taking place in Accra, Ghana from 16 to 20 October 2023, provides a fantastic opportunity to reflect on how to strengthen contraceptive markets so that they meet the needs of everyone, particularly the poor, alongside commodity security experts from around the world.
At Options, a key challenge that we have been grappling with over the last number of years is how to make contraceptive markets more effective and equitable to minimise distortions and to leverage the strengths of both the public and private sector to meet the needs of all users according to their ability to pay. A way to achieve this is through a total market approach (TMA), with the government in the driver’s seat, to ensure effective coordination across sectors.
In Kenya, we have been supporting the Ministry of Health since 2019 to ensure a conducive policy and regulatory environment for effective private sector engagement in the commodity market. As a result, the Ministry of Health developed a TMA for the FP National Strategy (2020-2025), which sets out to achieve four key outputs: (1) better quality regulation and compliance, (2) diversified FP supply, (3) increased number of FP players operating in segmented market, and (4) improved stewardship of FP market. This was all initiated against the backdrop of reduced donor funding and phasing out of commodity donations, the presence of social marketing programmes using donor funding and a high unmet demand for family planning.
One of the key factors for success was involving the private sector early in the planning to ensure that private sector voices and data were available to policy makers. This meant that the Ministry of Health had a more complete understanding of the family planning markets and could make more informed plans and strategies.
A national TMA Implementation committee, which included the private sector, was established to ensure that key priority activities were delivered against an agreed road map. This also led to the inclusion of the private sector into the existing national coordination mechanisms, such as the Family Planning Technical Working Group.
Implementing a TMA has meant that both the private and public sectors have been able to change their perspectives and behaviors to create an enabling environment for sustained and collaborative coordination. The result is the availability of a broader choice of high quality, safe and efficacious reproductive health products, including Sayana Press, which was not previously available through private pharmacies.
Within the reproductive health space, there is broad consensus that increasing the role of the private sector has the potential to reduce the burden on the public sector budget for commodities, therefore allowing fiscal space for other priorities. Kenya has demonstrated how donors and implementing partners including the private sector can work together to address challenges through a TMA approach by supporting partnerships to improve planning and coordination to better steward family planning markets.