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Logistics

To implement the service delivery components of the MISP (provide clinical care for survivors of rape; reduce HIV transmission; prevent excess maternal and newborn morbidity and mortality), the Inter-agency Working Group (IAWG) on Reproductive Health in Crises designed a set of kits containing drugs and supplies aimed at facilitating the implementation of these priority RH services: the interagency Reproductive Health Kits (RH Kits). The RH Kits complement the Interagency Emergency Health Kit (IEHK), which is a standardized emergency health kit that contains essential drugs, supplies, and equipment for the provision of primary health care services. In a humanitarian setting, the IEHK is often rapidly available. However, although it contains a midwifery kit, emergency contraceptive pills (ECPs), post-exposure prophylaxis (PEP) treatment to prevent transmission of HIV after rape, and supplies for the adherence to standard precautions, the IEHK does not have all the supplies needed to implement the MISP.

The RH Kits are designed for use at the onset of the humanitarian response and contain sufficient supplies for a three-month period for different population numbers, depending on the population coverage of the health-care setting for which kits are designed. The 13 RH Kits are divided into three blocks; each block targets a different health service delivery level.

  • Block 1: Community and primary health care level: 10,000 persons/3 months
  • Block 2: Primary health care and referral hospital level: 30,000 persons/3 months
  • Block 3; Referral hospital level: 150,000 persons/3 months

UNFPA is in charge of assembling and delivering the Interagency RH Kits. Order the Inter-agency RH Kits through UNFPA or identify other quality supply sources to ensure all necessary equipment and materials are available to provide the full range of priority RH services. Coordinate the ordering of supplies within the health sector/cluster to avoid waste.

For more information about the IAWG’s work on logistics, please see the Logistics Sub-Working Group page.

Key Messages:

Donors should support coordinated initiatives to address commodity management and security in humanitarian settings, in particular technical assistance for capacity development and coordination in supply chain management.

Implementing agencies with governments should strengthen commodity management processes by ensuring the availability of trained staff in supply chain management.

Implementing agencies should avoid dependency on one source for RH supplies, such as the Interagency Reproductive Kits, and include RH supplies in their overall medical supply procurement.

Facts & Stats

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Poor commodity security and supply chain management obstructed good quality service delivery in all three (Burkina Faso, Demcoratice Republic of Congo, South Sudan) settings of the IAWG 2012-2014 global evaluation indepth studies. Providers overwhelmingly reported insufficient drugs as the primary barrier to providing adequate RH care. Further, many facilities reported providing RH care yet lacked sufficient equipment and supplies to adequately do so. Action to address commodity security and management is urgently needed.

Reference: Casey et. al, Progress and gaps in reproductive health services in three humanitarian settings: mixed-methodscase studies, Conflict and Health, 2015 9 (Suppl 1):S3. In South Sudan, three facilities reported providing emergency contraception (EC) in the previous three months; scarce supplies and lack of authorization were the primary reasons given for not providing EC.

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Of the health centers that failed to provide adequate neonatal resuscitation in Burkina Faso and DRC, the majority reported lack of supplies as the main reason for not providing the service.

Reference: Casey et. al, Progress and gaps in reproductive health services in three humanitarian settings: mixed-methodscase studies, Conflict and Health, 2015 9 (Suppl 1):S3.

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Only three of 26 facilities assessed in Burkina Faso, South Sudan and DRC had minimum drugs and supplies for clinical management of rape.

Reference: Casey et. al, Progress and gaps in reproductive health services in three humanitarian settings: mixed-methodscase studies, Conflict and Health, 2015 9 (Suppl 1):S3.

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Only one site in the MISP assessment–conducted as part of the IAWG global evaluatin in Zaatri refugee camp and the urban area of Irbid City–had the human resource capacity and supplies to provide clinical care for rape survivors.

Reference: Krause et. al, Reproductive health services for Syrian refugees in Zaatri Camp and Irbid City, Hashemite Kingdom of Jordan: an evaluation of the Minimum Initial Services Package, Conflict and Health, 2015 9 (Suppl 1):S4.