Family Planning and UHC: The Role of a Healthy Marketplace

January 4th, 2016 | Viewpoint


On December 12, 2015, a coalition of more than 600 global partners marked Universal Health Coverage Day, the three year anniversary of the unanimous adoption of a UN General Assembly resolution that counseled governments to provide universal health coverage (UHC) to their people. Greater numbers of countries are pursuing UHC reforms, and we want these reforms to result in reliable access to high quality reproductive health commodities for all women.

A Healthy Family Planning Marketplace is Diverse

Over the years, we have learned that reliable access to reproductive health commodities for a country’s population depends on a healthy marketplace and on strengthening all women’s access to this marketplace. Research conducted with DHS data over the years illustrates that large numbers of women around the world seek reproductive health commodities from the private sector (including the private commercial, NGO, and social marketing channels). Research additionally shows us that the poorest segments of many countries’ populations receive substantial portions of their reproductive health commodities from the private sector.

It follows that a healthy marketplace must be diverse and offer choices: choices between public- and private-sector sources; choices between visiting a pharmacy/drug seller or health facility; choices between a range of family planning methods; and choices between innovator and generic products. These choices must be affordable and equitable, and include high-quality counseling, services, and products. Also, all segments of the population must have access, including adolescents, unmarried women, and those living in rural settings and urban slums.

A Healthy Family Planning Marketplace Promotes UHC

The evolution of healthy family planning marketplaces will directly support progress toward Sustainable Development Goal (SDG) Target 3.8, which states the need for access to quality essential health-care services and for access to safe, effective, quality, and affordable essential medicines for all.

Stewardship from the Public Sector is Critical

A healthy family planning marketplace includes public sector health facilities and pharmacies; private NGO and social franchise networks; private health facilities; private pharmacies and drug sellers; as well as retail and nontraditional outlets. Such a vision of a healthy family planning marketplace can only be realized with ongoing, capable stewardship from the public sector. As noted in “No Product? No Universal Health Coverage! Making the Case for RH Supplies,” this stewardship is decisive because governments must guide, shape, and oversee the policy direction and required financial, operational, quality assurance, and regulatory systems. Stewardship is critical for success in UHC; it is also vital to creating and maintaining a healthy family planning marketplace.

A UHC Program Can Support Creation of a Healthy Family Planning Marketplace

When designing a UHC program, total market considerations, or the needs and preferences of actors in the different market sectors as well as the needs and preferences of all segments of a country’s population, must be taken into account. These considerations must be applied toward designing comprehensive packages of health services and commodities; including the full range of providers in contracting arrangements; developing efficient procurement and pricing policies; and planning the financing and reimbursement mechanisms for the UHC program. This approach can be helpful from a pragmatic perspective, as well as a rights-based perspective, because of the need to make difficult decisions and to deal with limited resources and capacity constraints when developing a UHC program.

If the countries implementing UHC reforms will act with total market considerations over time, and under well-functioning stewardship from the public sector, we can and will see healthy family planning marketplaces evolve.

A variation of this post was published by the UHC Steering Team of the Reproductive Health Supplies Coalition (RHSC) on the RHSC Blog; Leslie Patykewich and Safia Ahsan serve on this UHC Steering Team.

Written by Safia Ahsan

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