By Joan Komsoon, African Women's Development Fund
March 30, 2015
The Director of the Central Medical Stores in Zanzibar, Tanzania directed a total of 66 staff at the Ministry of Health across all 10 districts to be re-trained in November 2014 as a result of African Women Leaders Network for Reproductive Health and Family Planning (AWLN) members' advocacy. The re-training led to a 70% drop in family planning commodity forecasting errors at the facility level.
This significant reduction is a direct result of AWLN’s advocacy activities over the last 10 months, which focused on identifying the delays in the flow of commodities from the Central Medical Stores (CMS) to the facilities. The delays often resulted in stock-outs and lack of access to contraceptives for women and youth in the 10 districts of Zanzibar. Zanzibar has an average contraceptive prevalence rate (CPR) of 17%. [1]
A 2014 assessment revealed that reproductive health officers at the facility level responsible for providing stock level information were not providing accurate requirements. This created an artificial shortage at the facility level, while creating a backlog of supplies in the medical stores. The CMS customer care officers cite frequent and long periods of stock-outs at facility level, which led to women and girls’ eventual disinterest in using contraception, contributing to low CPR in most of the districts.
After the presentation of the AWLN assessment’s evidence, the Director of Medical Stores (DMS) ordered all reproductive health and family planning staff in the Unguja North and Pemba North districts to be re-trained on how to accurately complete the necessary documentation. As previously reported, 22 staff were trained in October 2014.
A follow-up by AWLN shows that beyond the staff training in the two targeted districts, the DMS further directed to scale-up the training on the proper provision of commodity forecasting to include all related staff in the remaining eight districts of Zanzibar. The entire state’s reproductive health and family planning staff is now familiar with and is using the newly installed integrated logistics systems (ZILS) to more accurately schedule stock replenishment at the district level.
AWLN worked in a coalition including the Zanzibar Nurses Association, the Ministry of Women and Children, Zanzibar AIDS Commission, and civil society organizations such as UMATI, Marie Stopes, Association of NGOs in Zanzibar, Zanzibar NGO Coalition, and the Youth Advisory Panel to assess CMS challenges.
Despite this progress, challenges remain at the facility level. Although the staff has been trained on the use of the electronic systems, lack of equipment and internet connectivity has made it difficult to implement newly-acquired skills. They are still using manual entry systems. AWLN members are hopeful that the Ministry will soon find a way to rectify this and enable more efficient practices.
AWLN members are currently working on a strategy to rebuild the confidence of family planning clients by encouraging them to access family planning services through district and community outreach programmes in Zanzibar.
[1] National Bureau of Statistics (NBS) and ORC Macro. 2005. Tanzania Demographic and Health Survey 2004-5. Dar es Salaam, Tanzania.