Alternative distribution strategy to increase access to Contraceptives and selected Reproductive Health Commodities in Uganda

Uganda is implementing an alternative distribution strategy to increase access to Reproductive Health Commodities across the country. The strategy is intended to increase uptake of contraceptives and other RH commodities at the public service delivery points by 50% annually; and to reduce the number of service delivery points experiencing stock outs of contraceptives and other selected RH commodities in both the public and private sector to less than 30% in five years.

The Uganda Demographic Health Survey of 2011 estimated that the unmet need for Family Planning in Uganda is 34% while the Contraceptive Prevalent Rate (CPR) is 30%. This implies that the total demand for contraceptives in Uganda is 64% but the previous distribution arrangement was reaching only 30% of the population. It was therefore noted that the distribution system had structural weaknesses which could be contributing to the low uptake of contraceptives in the public sector.

In response to this challenge, the Ministry of Health appraised the distribution systems and identified alternative distribution approaches that would increase availability and access to Reproductive Health Commodities. The Uganda Reproductive Health Commodity Security (RHCS) Strategic Plan 2009 – 2014 had recognized the need to engage the private sector as reflected in its objectives. However, it was not clear how this sector would be engaged. The alternative distribution strategy helped to clarify.

In line with this strategy, a private firm – Uganda Health Marketing Group (UHMG) distributes public commodities to private health facilities including NGOs. This has increased the quantity of commodities consumed by the country. It is anticipated that this increase in consumption of the commodities will help accelerate increase in CPR. We therefore learn that there are alternatives for distribution of contraceptives and Reproductive Health commodities that may be more efficient and cost effective. The potential alternatives remain under utilized until we deliberately explore and try them. Formally recognizing these alternatives and using them to distribute health commodities greatly enhances reach. Other countries can learn from this example to utilize existing private sector distribution systems as opposed to only relying on the public sector distribution system which commonly has various challenges.