Abstract
In Eastern Europe and Central Asia (EECA), achieving reproductive health commodity security (RHCS) is a challenge due to poor commitment of the governments to invest in affordable and accessible reproductive health products, especially contraceptives. Progress toward RHCS is also challenged by political, economic, and structural changes including health sector reforms and privatization of health services. Since most of the countries in the region are middle income, very limited amounts of reproductive health commodities are provided by development partners. In general, the region is characterized by increasing unmet need, a high rate of abortion, low modern contraceptive use, and increasing inequity in contraceptive prevalence.
In June 2012, the United Nations Population Fund (UNFPA) Regional Office for EECA (EECARO) and the International Planned Parenthood Federation (IPPF) European Network Regional Office conducted a meeting of high-level government officials from 17 countries in order to bring attention to gaps, priorities, and measures for client-oriented RHCS strategy in middle-income countries (MICs). The meeting was based on findings and recommendations of a 2011 survey in seven MICs. During the two-day meeting, participants revisited the survey recommendations and validated them for their respective countries. Several of the endorsed recommendations applied to total market initiatives; specifically:
• To coordinate efforts of all stakeholders from different sectors (nongovernmental organizations [NGOs], private and public sector) with clear division of roles and responsibilities;
• To introduce sustainable financing mechanisms (such as the total market approach) including applying government funding to prioritize the affordability of contraceptives for vulnerable populations.
Based on these recommendations, EECARO initiated activities for “road-mapping” implementation of total market approaches (TMA) in the region. A letter of understanding was signed with PATH, a global health organization and technical partner with extensive experience in TMA. After several consultations during 2012 and analysis of 2013 online survey findings, EECARO and PATH developed materials for regional workshops.
