The DELIVER/PSP-One/UNFPA Team modified the SPARHCS Framework to carry out the contraceptive security assessment.
PSP-One conducted spot visits of multiple pharmacies to identify prices, affordability and how far the private sector reached into rural areas. Moreover, they used elements of their Legal and Regulatory Guide to interview public sector authorities to determine supportive and obstructive policies.
DELIVER’s Logistics Indicator Assessment Tool (LIAT) provided the basis for the clinic surveys. (Please see Appendices x and x, respectively for sample interview guides).
The team partnered with and relied heavily on key in-country stakeholders including USAID, ACQUIRE, PHC Strengthening, UNFPA/Azerbaijan. The team interviewed both public and private sector individuals and organizations and visited hospitals, clinics and pharmacies, and conducted a review of key documents, data and systems.
2.3.1Site Visit Approach
After an initial joint visit to the Baku reproductive health center (RHC), the public sector assessment team split into two further teams to visit service delivery points in different districts. One team combined with UNFPA to visit Imishili, Salyan and Jalilabad Rayons in the south while the second team was joined by ACQUIRE field office staff and USAID to visit Shamaxi, Goychay, Ismaili and Sheki Rayons in the west.
The purpose of these site visits was to review service provision and product availability at the Central Rayon Hospital (CRH) and RHC attached to the CRH where these existed. In addition, various rural service delivery points (SDP) were visited including rural hospitals with inpatient beds as well as Feldsher (FAP) and D A C? ((DAC). The districts surveyed included a mix of those that had UNFPA supported reproductive health centers and those that did not, those targeted to receive ACQUIRE support and those with no support. One rural facility not receiving ACQUIRE support was also visited in each ACQUIRE target district. In total 18 facilities were visited between August 8th and 12th.
TABLE: XX
Rayon (number of SDPs visited)
CRH
UNFPA RHC
ACQUIRE
Target Rayon
ACQUIRE FAP/DAC
Non ACQUIRE FAP/DAC
TOTAL by Rayon
Baku (1)
2
Imishili (2)
3
Masalli (1)
2
Jalilabad (1)
1
Shamaxi (4)
5
Goychay (5)
4
Ismaili (3)
5
Sheki (1)
Planned
2
TOTAL by Site
8
6
3
3
4
24
The visit to each facility and district sought to collect information on:
A formal commodity assessment tool had been developed to guide the assessment but the paucity of product availability and the general dysfunction of the logistics management information system (LMIS) made this redundant.
DELIVER staff also intended to conduct client interviews but actually saw so few clients that this was not possible. Separate confidential discussions with community workers and midwives were possible and these provided some consistent anecdotal evidence on Azeri women’s struggle to receive family planning services. Pharmacies in each district were also visited and information on contraceptive sales price and volumes collected.
2.3.2Stakeholder Meeting or WORKSHOP
In addition to individual meetings with stakeholders, a workshop was organized to present information on commodity forecasting methodologies and to glean opinion on CS strengths and weaknesses. Participants in the meeting included representatives from the MOH, NRHO, UNFPA, USAID, ACQUIRE, and PHC. The full list of attendees is provided in Appendix x.
