MAKING IT TO THE LAST MILE

Family planning is recognized as one of the most effective ways to lower the rate of maternal deaths. If women were able to plan and adequately space their pregnancies, up to one third of maternal deaths could be averted. However, a major barrier to family planning in many countries is lack of availability of contraception.

A few years ago, nearly 30% of married women in Senegal who wanted to prevent pregnancy were not using modern contraception. Products were available, but they sat inside central warehouses, never making it to the “last mile” primary care facilities where women of reproductive age seek care.

Women were being turned away empty handed.

— Dr. Bocar Mamadou Daff, Director of the Reproductive Health and Child Survival Unit at the Senegalese Ministry of Health

How do we reach these rural communities?

In response, Merck for Mothers partnered with the Bill & Melinda Gates Foundation, IntraHealth International, and the government of Senegal to scale up an innovative supply chain model adapted from the private sector, known as the Informed Push Model (IPM). This model has improved the logistics, forecasting, and delivery of contraceptives at health facilities throughout the country, making “stock outs” a problem of the past. In only three years, the partnership has provided an estimated 3.2 million women with consistent access to a full range of contraceptive methods.

Over the last few years, stock-out rates of contraceptives have dropped to less than 2% nationally from up to 80% (based on a study in Dakar region).

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What does scaling this success look like?

The government of Senegal has adopted the model so that women — and men — always have a broad range of contraceptive choices available. Given the model’s success in transforming the supply chain, the model has been expanded to 90 essential medicines to treat patients with malaria, HIV, and other diseases.