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Providing Real Choice for Women in Developing Countries

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Less than a year ago many of us assembled in London for a groundbreaking family planning summit, where we committed ourselves to mobilizing resources so that an additional 120 million women and girls in the world's poorest countries receive family planning information, services and supplies by 2020. This week, we continued this vital conversation at Women Deliver, where I joined thousands of voices strong, united in our call to bring women better choices for improving their health.

Currently there are more than 200 million women in developing countries who want to avoid pregnancy but lack access to contraceptives -- in part, a problem with the contraceptive supply chain. These women need effective products that allow them to determine how many children they will have, and when. They need real, meaningful choice.

And yet contraceptive choice is not as easy as we once thought it was. Does a woman have true choice when a provider in a rural health clinic offers her one family planning option? What about a woman who wants a non-hormonal method or a long acting method vs. a short term band-aid? Real choice means that a full range of family planning methods is widely available, even in the smallest rural clinic, and that providers are skilled and comfortable offering all the methods in the mix.

Fortunately, donor organizations, R & D companies, and private sector pharmaceutical companies, such as Evofem, are prioritizing the search for new and better methods.

Designing great new products to satisfy unmet family planning needs, however, is only half the battle -- the upstream portion of the supply chain. Moving products out of laboratories and into the hands of women who need them is the next step in broadening the method mix. New products need to clear regulatory authority approvals, be registered in each country of distribution, shipped from a quality-assured manufacturer, and moved out of central warehouses to clinics and providers in both the public and private sector. This middle stretch of the supply chain is often difficult to navigate and far too time consuming, so that new products are not introduced for years.

Farther down the supply chain, family planning providers must be aware of all the products that are available and offer these products in their own practices. It is not enough for a new technology to be approved in a country; the product must also be "pushed " into the supply chain and simultaneous demand must be created and providers be trained in the use of the new product, comfortable offering it to appropriate clients, and committed to offering a wide range of family planning options.

The supply chain for contraceptives is complex and perhaps less glamorous than other interventions to improve women's health. But if we are to meet our promises from the London Summit and at Women Deliver to reduce the unmet need for family planning, we must at a minimum succeed in four areas: We must ensure that the products already available to women in developed markets are also available to every woman regardless of where she lives. We must insist on the same quality standards for every product being introduced into the supply chain as this will ensure faster approvals and continuity of supply. We must adopt sustainable private sector practices and jump off the hamster wheel of solely subsidized activities. And we must focus on supporting medical providers to offer a greater variety of suitable options to their clients by improving medical detailing to include real time interventions which ultimately deliver greater impact for women.

A robust supply chain is critical to offering women more choices for planning their families.