1. Coordinated Assistance for Reproductive Health Supplies (formerly Countries at Risk) A Workstream of the SSWG Kaitlyn Roche USAID/Commodities Security & Logistics CARhs Co-coordinator The CARhs Group

2. What is CARhs? CARhs is a forum ▫of key global-level partners who fund and procure of contraceptives and condoms ▫who share information ▫to identify countries on the verge of or in supply shortages, to better understand the causes of these shortages, to identify solutions, and to coordinate their implementation. Founded in 2004; first meeting in 2005

3. Who is involved? Core members include UNFPA, USAID, DELIVER, RHSC, RHI. The World Bank and UNF / PGH participate regularly. Marie Stopes and KfW provide additional information on shipments as requested / when available.

4. What do we do? Primary data source: Procurement Planning and Monitoring Report Areas of focus: stockouts, impending stockouts, overstocks Services provided: Primarily provide product and product shipment information, occasionally technical assistance or policy advice Primary means of work: electronic data sharing; monthly conference calls

5. The Procurement Planning & Monitoring Report (PPMR) Currently 23 countries Data submission from JSI, MSH, and Abt Report either monthly or quarterly Report on different levels of the supply chain (central, zones, districts, all) Varying number of programs reporting (public sector, social marketing, NGOs)

6. Actual months of stock and stock status Date of next shipment, and supplier, indicates what shipments may create/resolve problems. “Action Recommended” tells stakeholders how they can help. “Comments” describe the situation.

7. PPMR Database Upgrades USAID has allocated funding for the upgrade of the database in 2011/2012 Move to a web-based platform ▫Increase capacity for additional countries while decreasing manual LOE for PPMR management Online reporting, ability to pull reports from web, quicker data availability Document requirements & specifications to ensure transferability Other features under discussion.

8. What does it take? Over 200 days of effort per year, for CARhs plus PPMR Monthly CARhs process requires about 10 days of effort across all partners including: ▫2 days for Secretariat coordination of meeting, PPMR analysis, and agenda generation ▫1.5 days for USAID to respond to requests; 2 days for UNFPA to respond to requests ▫1 day for DELIVER to log information updates and disseminate information Financial resources are also required - mostly from UNFPA/CSB and USAID Mission funds

9. CARhs Indicators - Process Met monthly without fail An average of 4-8 participating organizations per call 194 distinct commodity issues ▫86 information issues ▫108 action issues FY 2010

10. CARhs Indicators - Countries at Risk FY 2010

11. CARhs Indicators - Products at Risk FY 2010

12. CARhs Indicators - Effectiveness Jan 2010 - Oct 2010 Success rate on information items is 97.5%

13. CARhs Indicators - Effectiveness Jan 2010 - Oct 2010 Success rate on action items is 63.5%

14. How CARhs Actions Added Value Jan 2010 - Oct 2010 Average duration until resolution was 2 months, with a range from 1 - 7 months

15. A CARhs Success Story March - May 2011 Nov 2010: Rwanda reported a massive overstock (67 MOS or 5.5 years) of Jadelle to the PPMR. Feb 2011: Stock at 79 MOS & GoR agreed to a transfer. CARhs identified countries in need & UNFPA confirmed Burkina Faso could absorb a shipment of 100,000 on March 3rd. UNFPA facilitated transfer product, including covering freight costs. May 22nd: Product arrived in Ouagadougou Total commodity cost saved: $2.1m

16. Looking Forward: Opportunities Transition of Secretariat from USAID to UNFPA Executive Committee for high-level policy issues Increased coordination on annual orders Additional countries to the PPMR Recruiting participation from other donors who now support RH commodity procurements outside of basket funding ▫DfID, AusAID, Netherlands, France Support the creation of regional CARhs groups

17. Looking Forward: Challenges Decreased shipment visibility from UNFPA Funding constraints Building in-country coordination among donors, governments, World Bank, etc. Encouraging country-led responses LOE to manage additional countries Addressing chronic RHCS policy challenges

18. More questions? Contact us! USAID CARhs Coordinators Kevin Pilz – kpilz@usaid.govkpilz@usaid.gov Kaitlyn Roche – kroche@usaid.govkroche@usaid.gov UNFPA/CSB CARhs Coordinator Joe Abraham – jabraham@unfpa.orgjabraham@unfpa.org USAID | DELIVER PPMR Coordinator Trisha Long – trisha_long@jsi.comtrisha_long@jsi.com