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  • Date

This publication was produced for review by the United States Agency for International Development. It was prepared by (First author’s First Name, Last Name), (Second author’s First Name, Last Name), (Third author’s First Name, Last Name) for Private Sector Partnerships-One project.





Contraceptive security assessment
Azerbaijan








Technical Report No.

  • Technical Report Series: PSP-One Technical Report Series addresses important issues relating to the private sector's role in reproductive health and family planning. Papers in the series may discuss lessons learned and best practices, highlighting PSP-One technical areas.

  • Recommended Citation: [First Author’s Last Name], [First Author’s First Name], [Second Author (First Last], and [Third Author (First Last]. [Report Date]. [Report Title].. Bethesda, MD: Private Sector Partnerships-One project, Abt Associates Inc.

Download: Download copies of PSP-One publications at: www.psp-one.com

  • Contract/Project No.: GPO-I-00-04-00007-00

  • Submitted to: Susan Wright, CTO
    Bureau of Global Health
    Global Health/Population and Reproductive Health/Service Delivery Improvement
    Center for Population, Health and Nutrition
    Bureau for Global Programs, Field Support and Research
    United States Agency for International Development

  • DELIVER

  • DELIVER, a six-year worldwide technical assistance support contract, is funded by the U.S. Agency for International Development (USAID).

  • Implemented by John Snow, Inc. (JSI), (contract no. HRN-C-00-00-00010-00) and subcontractors (Manoff Group, Program for Appropriate Technology in Health [PATH], and Social Sectors Development Strategies, Inc.), DELIVER strengthens the supply chains of health and family planning programs in developing countries to ensure the availability of critical health products for customers. DELIVER also provides technical management of USAID’s central contraceptive management information system.


  • John Snow, Inc.

    44 Farnsworth Street

    Boston, MA 02210-1211

    Phone: 1.617.482.9485

    Fax: 1.617.482.0617

    Internet: www.jsi.com





Abt Associates Inc. 4800 Montgomery Lane, Suite 600 

Bethesda, Maryland 20814  Tel: 301/913-0500. Fax: 301/652-3916

www.PSP-One.com  www.abtassoc.com
In collaboration with:

Banyan Global  Data Management Systems  Dillon Allman and Partners

Family Health International  Forum One Communications

 IntraHealth International  O’Hanlon Consulting  Population Services International  The London School of Hygiene and Tropical Medicine

 Tulane University’s School of Public Health and Tropical Medicine



contraceptive security assessment


azerbaijan




DISCLAIMER

The author’s views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development (USAID) or the United States Government




Contents



Contents iii

Acronyms vii

Acknowledgments ix

1. Executive Summary xi

1.1 Demographic Situation xii

1.2 Public Commitment and Policy xii

1.3 Public Service Provision and Access xiii

1.4 Product Availability and Supply Chain Management IN THE PUBLIC SECTOR xiii

1.5 The Private Distribution Network xiv

1.6 Private Contraceptive Product Supply xv

1.7 Private Sector Services xvi

1.8 Conclusions and Recommendations xvii

2. Introduction 1

2.1 Chronicle of a Death Foretold 1

2.2 Purpose 2

2.3 Methodology 3

2.3.1 Site Visit Approach 4

2.3.2 Stakeholder Meeting or WORKSHOP 5



3. Demographic Situation and Family Planning Demand 7

3.1 Desired family size and fertility in Azerbaijan 7

3.2 How Azeri familIES achieve their desired fertility levels 7

3.3 Low modern use, high abortion rates, and potential demand 9



4. Public Sector Findings 11

4.1 commitment 11

4.1.2 opportunities/Recommendations 13

4.2 service provision 14

4.2.1 Policies 14

4.2.2 provider bias 14

4.2.3 Access 15

4.2.4 Recommendations/Opportunities 16

4.3 Product Availability 17

4.3.1 Opportunities/recommendations 18

4.4 Supply Chain Management 19

4.4.1 Forecast 19

4.4.2 Finance 20

4.4.3 Procurement 20

4.4.4 Distribution/Storage/waste management 21

4.4.5 LMIS 22

4.4.6 opportunities/recommendations 24

5. Azerbaijan’s Private Pharmaceutical Distribution Network 25

5.1 Manufacturers 26

5.2 Distributors 27

5.3 Pharmacies 28

5.4 Sales in Private Clinics 29

5.5 Contraceptive Products 29

5.5.1 Oral Contraceptives 29

5.5.2 Injectable Contraceptives (IC) 31

5.5.3 Intra-Uterine Devices (IUDs) 31

5.5.4 Spermicides 32

5.5.5 Condoms 32

5.6 Private Sector Services 34

5.6.1 Legal Environment 34

5.6.2 Types of Facilities 35

5.6.3 Opening and Managing a Private Clinic 35

5.6.4 Private Clinic Patients 36

5.6.5 Services and Costs 36

5.6.6 Health Providers 37

5.7 Conclusions 38

6. recommendations 41

6.1 CONTRACEPTIVE SECURITY overview and conclusions 41

6.2 Short term Recommendations 43

6.2.1 Advocacy 43

6.2.1.1 Commitment and PoliciesPolicy Research 43

6.2.1.2 Advocacy Activities 44

6.2.2 Demand Creation and the Private sector 45

6.3 Longer Term 45

6.3.1 Provider training and service improvements 47

6.3.2 Public sector Supply for target populations 47

6.4 Using Demographic Data to Estimate Contraceptive Consumption 50

6.5 Methodology 50

6.6 Limitations 51

6.7 Findings 52

6.8 Costs 53

6.9 Recommendations 54

6.9.1 Product Management in the Rayons 55

6.9.1.1 Sheki 55

6.9.1.2 Ismaili 57




List of Tables

TABLE XX: Existing Market Segmentation in Azerbaijan – Neglected Rural poor xviii

TABLE XX: Proposed Market Segmentation in Azerbaijan – reaching the rural poor xviii

TABLE XX : Existing Market Segmentation in Azerbaijan – Neglected rural poor 41

TABLE XX: Proposed Market Segmentation in Azerbaijan – reaching the rural poor 43

List of Figures


Acronyms



AMC Average Monthly Consumption

ALS Automated Logistics System

CCM Contraceptive Commodity Manager

CHS

COC Combined Oral Contraceptive

CPT Country Procurement Tables

CRH Central Rayon Hospital

CYP Couple Years of Protection

DAC

EC Emergency Contraception

EDL Essential Drug List

ENT Ears, nose and throat (specialist)

EU European Union

FAP

GOA Government of Azerbaijan

IDP Internally Displaced Person

ISC Innovation and Supplies Centre

IUD Intrauterine Device

IVF Invetro Fertilization

FP Family Planning

LMIS Logistics Management Information System

MoH Ministry of Health

MOF Ministry of Finance

NRHO

OC Oral contraceptives

OTC Over the counter

PHC USAID-funded Primary Health Care Strengthening Project in Azerbaijan

POP Progestin only Pill

PSP-One Private Sector Partnerships-One Project (USAID-funded; 2005- 2009)

RH Reproductive Health

RHC

RHS Reproductive Health Survey

STI Sexually Transmitted Infection

SPARHCS Strategic Pathway to Reproductive Health Commodity Security

TFR Total Fertility Rate

UNFPA United Nations Family Planning Agency

USAID United States Agency for International Development

VFT

Acknowledgments




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