Together for Health in Ukraine Builds Innovative Public-Private Partnership
Together for Health in Ukraine, funded by USAID/Ukraine and implemented by JSI Research & Training Institute, Inc. in partnership with the Academy for Educational Development, has built an innovative Public-Private Partnership with the Ministry of Health and international and Ukrainian contraceptive manufacturers and distributors. The aim is to improve the provision of quality, affordable family planning and reproductive health services through public-private collaboration. One of the partnership’s strategies to reach low and middle-income populations through pharmacies has been to develop and promote a “Contraceptive Availability Minimum Package”–or CAMP—comprised of a range of mid- and low-priced contraceptive brands commercially available in Ukraine.
Project interventions include trainings on family planning/reproductive health for health workers and pharmacists and public education activities, which are supplemented by continuous medical education and promotional efforts by the Private Sector Partners (PSPs). For the past year and a half the project has implemented a pharmacy certification program that includes a one-day training, provision of a “FP-friendly” certification logo, information, education, and communication (IEC) materials for clients and follow-up activities, including promotion of certified pharmacies through local mass-media. Certified pharmacies are asked to stock the CAMP “package” of contraceptives and to display IEC materials for their clients.
To assess progress to date, the project conducted its first monitoring of contraceptive availability in pharmacies in two project oblasts (regions), Lviv in Western Ukraine and Kharkiv in the East, in September 2007, and compared the findings with the results of baseline pharmacy assessments the previous year.
The percentage of monitored pharmacies in the two oblasts carrying low to mid-priced brands improved quite noticeably between 2006 and 2007 (see graph). All lower-priced oral contraceptive brands showed improved availability, with the lowest priced brands, Rigevidon and Tri-Regol, available in two-thirds of pharmacies by 2007 compared with only half in 2006. The availability of injectables, progestin-only pills and emergency contraception also improved. There was not much change in the availability of the most affordable condom brands—but condoms were already widely available at the time of the baseline survey. The only method not to show improved availability was the intrauterine device (IUD) and this is thought to be due to the trend for local distributors to bypass pharmacies and sell IUDs directly to doctors. It should be mentioned that the majority of certified pharmacies are privately owned and are volunteering to partner with the project—they do not receive any of the incentives to carry a specific brand that are usually provided by commercial entities (special prices, discounts, brand-promotion materials, etc.).
While these early results of Together for Health’s innovative approach to improving contraceptive availability are encouraging, they also show the difficulty of getting pharmacies to carry the full CAMP package. In Kharkiv Oblast, where just one pharmacy out of 89 in the 2006 baseline assessment had the complete CAMP, seven pharmacies out of 124 (5.6%) had it by 2007. In Lviv, progress was more modest, with the number of pharmacies carrying the CAMP increasing from none (out of 85 surveyed in 2006) to one out of 78 in 2007. These very modest improvements in CAMP availability are probably due to the lack of commercial interest—no immediate profits or incentives—deriving from participation in the certification program, other than promotion by the project.
