Landscape Assessment: Leveraging the role of national distributors to increase access to MA combi-packs in Africa

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An estimated 56 million abortions occur each year, and more than half of them are unsafe.1 Medical Abortion (MA) using a combination of mifepristone and misoprostol is a safe and effective alternative to surgical abortion. It is non-invasive, with fewer side effects and fewer provider visits, and, with the ability to be completed at home, is a game changer for women’s health. While MA is a low-risk regimen that can be managed by different levels of healthcare providers and patients, few countries in sub-Saharan Africa have made MA combi-packs accessible to women. National commercial distributors are improving access to this important product, and have the potential to do so in a more sustainable way in the future. Market development that enables and fosters commercial distribution is necessary in order to maintain a sustainable and diverse supply of the highest quality MA products so that women have options for safe, effective abortions.

The purpose of this landscape assessment is to provide the Reproductive Health Supplies Coalition (RHSC) with a better understanding of the current challenges and opportunities for engaging nationally-based commercial distributors to introduce, register, and/or distribute medical abortion (MA) combi-packs in select sub-Saharan African countries. Mann Global Health (MGH) was contracted by the RHSC to undertake this assessment in partnership with Marie Stopes International (MSI) and WCG Cares. Based on an initial desk review and discussions with partners, we developed a 10-country list and segmented countries for different levels of assessment: Deep Dive: Burkina Faso, Senegal, Uganda, Zambia; Remote Interviews: Ethiopia, Malawi, Mali, Sierra Leone; Limited Assessment: Zimbabwe and Mozambique.