Modernizing the Family Planning Supply Chain in Pakistan .

Noor is a young woman studying to become a nurse in Lahore, Pakistan. She will get married in two months, but she still has a year and a half of school before graduating as a nurse and wants to wait until after that to have a family. Today, she is visiting a health facility to get some guidance on contraceptive methods. What are her options?

Although Pakistan was one of the first Asian countries to begin a family planning (FP) program in the 1960s, the decline in fertility rate has remained slow or stagnant when compared to neighboring countries. With a population of 207.7 million in 2017, Pakistan is the fifth-most-populous country in the world. Expected rapid population growth based on high birth and fertility rates means that the country is estimated to surpass 340 million people by 2050. This growth risks straining the already limited natural resources such as water, forests, and arable land and reversing economic gains made in recent years. To mitigate this, the government of Pakistan has set the ambitious goal of increasing the number of couples using birth control from 34% to 50% by 2030; it also signed the Every Woman Every Child pledge — Chemonics is also a signatory — to reduce maternal and infant mortality and ensure universal access to reproductive health services. As Chemonics’ Dr. Muhammad Tariq and Ambreen Khan wrote in a recent WHO journal article, lack of access and availability are among the principal reasons for contraceptive non-use and contraceptive discontinuation.

Since 2016, the USAID Global Health Supply Chain Program-Procurement and Supply Management (GHSC-PSM) project, implemented by Chemonics, has been working with provincial governments to holistically modernize supply chain systems to make contraceptive products and services more accessible. The project provides technical assistance to the government of Pakistan, including advocacy for sustainable public financing, executive dashboard management, contraceptive group purchase/pooled procurement, and contraceptive local production.

The first digital contraceptive logistics management information system (cLMIS) was launched in Pakistan in 2011, enabling supply chain data visibility from the federal level to health facilities. The cLMIS reduced paper-based reporting and optimized health systems data reconciliation at the health facility level to ensure that FP commodities are available. With the introduction of the web-based cLMIS, managers, logisticians, and donors have better visibility into the supply chain and can thus improve their management to ensure products reach consumers through Pakistan’s health care delivery system. By improving the timeliness and quality of logistics data and reducing the time needed to access the data, the cLMIS effectively enables evidence-informed decision-making for supply chain management.