By Barbara Nalugonda
Reproductive Health Uganda (RHU) and partners, with support from the United Nations Population Fund (UNFPA), are reviewing the Alternative Distribution Strategy (ADS) III for 2021 to 2026 to increase uptake of family planning (FP) and reproductive health (RH) commodities in Uganda.
Dr. Sematiko Gordon Katende the lead Consultant in the ADS III review process says that whereas in the current ADS the standard operating procedures are fine, the Ministry of Health (MoH) needs to periodically review and update the FP and RH ADS list to track the needs, priorities, and demands from various regions, districts, health centers and clients in Uganda.
He says that the National Medical Stores (NMS) under ADS III will handle customs clearance, National Drug Authority (NDA) clearance, commodity insurance, warehousing, distribution, last-mile delivery, capacity building on supply chain management, participation in forecasting and quantification of the FP products and selected RH commodities, and will support entities to acquire the technical capacity to use the Electronic Logistics Management Information System (MIS).
The Joint Medical Stores (JMS) under ADS III will sign a Memorandum of Understanding with the Ministry of Health giving them the mandate to clear from customs, insure, store, and distribute FP and reproductive health commodities to MOH accredited NGOs, IPs, and private not-for-profit (PNFP) facilities through the Alternative Delivery Strategy (ADS III). JMS will also provide technical assistance to ADS accredited facilities and participate in forecasting, quantification, and weekly monitoring of stock. MoH will pay for JMS to store and distribute the commodities at a cost recovery venture for service handling fees that will be agreed upon with MoH and payable by MoH.
Walukamba Aldon G, a Media Advocacy and Documentation Coordinator on behalf of RHU suggested that the list of products and accredited distributors be agreed upon from time to time with MoH. The JMS should also support health facilities to achieve the capacity to use MIS targeting real-time reporting about the delivery of FP and RH commodities and stock outs.
He believes that the current FP and RH funding of $ 4.2 million, which according to MoH, was allocated to Maama kits is below the Abuja declaration minimum of $ 5 million and the government should improve on this to cater for FP and RH commodity categories.
Roselline Achola, UNFPA Program Analyst, calls for a stronger and enabling environment to provide FP and RH commodities by revisiting the existing policies, acts, statutes, guidelines, and other legal frameworks that impede access to proper medications in Uganda.
In Uganda the modern Contraceptive Prevalence Rate (mCPR) stands at 29%, the unmet Need for Modern Contraception stands at 11%, while the demand Satisfaction for Modern Contraception is 57%. The ADS II 2016 to 2020 had its unmet target of 50% mCPR.
Martha Grace Ajilong MoH Assistant Commissioner for Public Health Supply Chain recommends that quarterly meetings among stakeholders must take place to keep track of the ADS III and increase supply and uptake of FP and RH commodities.