Total Market Approach to Improving Family Planning Access in the Republic of Georgia

Total Market Approach to Improving Family Planning Access in the Republic of Georgia

Presentation Outline Country context and FP/RH background Key strategies to improve family planning access Accomplishments Challenges and conclusions

Georgia FP Situation 2004 1. FP is not part of primary health care 2. Only OB/GYNs provide FP services and counseling 3. Rural population have limited or no access to FP services and contraceptive products 4. Low use of modern family planning 5. High number of abortions

Total Abortion Rate and Prevalence of Modern Contraceptive Methods Abortions per Woman 4 Georgia 3 Azerbaijan Armenia 2 1 Romania U.K. Belarus Bulgaria Russia Moldova Turkmenistan Kyrgyzstan Kazakhstan Hungary Uzbekistan U.S. 0 0 10 20 30 40 50 60 70 80 90 Percent of Married Women Using Modern Contraception Westoff, 2005. Total Abortion Rate and Prevalence of Modern Contraceptive Methods, selected countries, selected years

Key Strategy (1) Organized a health provider (family doctors, pediatricians, nurses, midwives) training in parallel with pharmacist training in evidence-based family planning Worked with the Government of Georgia to eliminate policy barriers to FP counseling and service provision - Develop and approve evidence-based FP clinical practice guidelines and protocols (WHO recommendations - Authorize Primary Health Care professionals to provide FP services and free contraceptives

Used Market Segmentation strategy to target free contraceptives to most in need Economic Segments Key Strategy (2) High Delivery Mechanism Commercial Middle Social Marketing, Private Public Partnership 40% Public Low

Key Strategy (3) Developed a functional Logistics Management Information System for free supplies Getting Contraceptives to the Right Place and the Right Time!

Key Strategy (4) Designed Evidence-Based Social Marketing Campaign Contraception Your Modern Choice

Key Strategy (5) Established innovative Public-Private Partnership to address contraceptive availability and affordability Signed Memorandum of Understanding with contraceptive manufacturers and distributors Made low cost products widely available Expanded product lines to rural areas Worked with Shering, Gedeon Richter on evidence- based contraceptive technology updates for health providers and pharmacists

Key Accomplishments: Expansion of Access to FP Services

Evolution of Private Sector Oral Contraceptives Total Sales 2003-2008 1,200,000 1,150,000 1,100,000 1,050,000 USD 1,000,000 950,000 900,000 sales2008 sales 2007 sales2006 sales2005 sales2004 sales2003 USD 1,174,150 1,047,474 1,040,890 1,007,830 1,020,785 1,013,418

Contraceptives Total Sales USD 1200000 1150000 1100000 $1,174,150 USD 1050000 1000000 950000 $1,047,474 SALES 2007 SALES 2008 Neparidze K. Et All. 2008 Report on Pharmaceutical Sale, GPC Electronic Record System

Abortion Reduction Evidence of Change TFR and TAR among all women 15-44 years of age, and current use of modern contraceptives among ever-married women in Kakabeti village (Mini RHS 2009)

Abortion Reduction Evidence of Change TFR and TAR among all women 15-44 years of age, and current use of modern contraceptives among ever-married women in Rodinauli village (Mini RHS 2009)

Challenges for Building Public-Private Private Partnerships Achieving a common vision: public health objectives vs. corporate objectives Identifying and leveraging areas of common interest building the trust Understanding motivating factors and modus operandi FP requires long-term investments, while private and public are pressured for quick results

Conclusions A Total Market Approach is a best practice that can involve the private sector at (almost) every level of intervention Collaborate and coordinate: always look for partners from all sectors Work in context health system structure and public health priorities, market development