Data-informed decision-making is the key for keeping

shelves full17th RHSC Meeting, Seattle, 2016

Mohammad Golam Kibria

Senior Technical Advisor-HIS, SIAPS BangladeshManagement Sciences for Health (MSH)

Bangladesh Committed Targets (FP 2020)

• Reduce total fertility rate (TFR) from 2.3 in 2014 to 2.0 by 2021

• Increase the contraceptive prevalence rate (CPR) from 62.4% in 2014 to 75% by 2021

• Increase the percentage of long-acting permanent methods from 8.1% in 2014 to 20% by 2021

• Reduce unmet need for FP commodities from 12.0% in 2014 to 10% by 2021

• Reduce the discontinuation rate to 20% by 2021 (currently 30%)

Reduced TFR and Increased CPR

Source: BDHS, CPS, BFS

Commitment: Bangladesh is the first country to commit to Take Stock!

Directorate General of Family Planning has been an active member (300th) of the RHSC since 2014.

Commitments:

1. Adopting the two FP2020 indicators of the Coalition’s harmonized suite of indicators and submitting data to FP2020 by 2016

2. Making all data relating to stockouts of reproductive health commodities publicly available by 2016 (https://scmpbd.org/index.php/lmis-dashboard)

3. Between now and 2017, reduce the stockout rate of reproductive health supplies from 2% to 1% at Service Delivery Point (SDP) Level

Key actions• Information on RHSC Take Stock commitments and Revised

FP2020 Indicators shared with Family Planning managers at all levels

• Routine Tracking through DGFP eLMIS to identify the SDPs having stock out and take immediate actions

• Discussion on Stockout is on the agenda of the monthly coordination meeting

• Assigned HR to track the stock status at all levels• Issuance of appreciation letter to the Successful District Mangers

for eliminating stock-out on monthly basis • Generation of Management Reports- Stock Status Report,

Logistics Report• Implementation of advocacy and sustainability plan to takeover

the eLMIS

Results: Bangladesh FP Commodity Stock-out*

*Data as of Aug 2016; Source: (https://scmpbd.org/index.php/lmis-dashboard)

Indicator Total (US $)

Couple Year Protection (CYP) 154,559,198

No. of pregnancies averted 88,319,608

No. of births averted 57,977,474

No. of infant mortalities averted 2,726,115

No. of under five mortalities averted 3,507,566

No. of maternal mortalities averted 330,448

No. of abortion averted 25,427,461

No. of unsafe abortion averted 16,951,589

Disability Adjusted Life Years (DALYs) averted22,119,585

Cost savings (US$) 18,832,410,000Total Cost CIP US $ (2016-2020) 1,377,360,000 (1:14)

Source: Costed Implementation Plan, Bangladesh, 2016-2010

Family Planning: Health and Demographic Projected Impacts

Challenges • Funding mechanism (public sector cost recovery is still an

underutilized approach)

• Government and donor-sustained commitment to ensure contraceptive security and potential collaboration to accelerate the progress toward good governance and accountability in pharmaceutical management

• Culture of data-driven policy decisions (Forecasting Working Group Meeting, Logistics Coordination Forum Meeting, etc.)

• Sustainability of the supply chain management tools

• Financial sustainability of the supply chain management system

Challenges • Ensuring feedback mechanism from upper tier/supportive

supervision visit

• Delay in taking actions based on information

• Retention of trained staff

• Improving the ICT infrastructure (IT equipment replacement) and maintenance cost

• Staff motivation

• Leadership from the policy makers is key to tackle stockout• Government needs to increase financial resources and ensure optimal use

of existing resources and HIS tools• Continuous commitment by the service providers at the field and facility

level• High visibility of data has profound motivating effects through both

recognition of excellence and accountability of poor performance • Pro-activeness of the policy makers in reviewing the SDP Dashboard

Module and tracking data is important to ensure evidence-based decisions• The push notification system (Mobile Short Message Service) has been

facilitating the transition process for local managers from having a “data producing role” to employing a “data use culture”, thus improving decentralized decision making

• Attention needs to be given towards high rates of discontinuations and unmet need

Thanks!!mkibria@msh.org