Every year, 289,000 women die from child birth- or pregnancy-related causes, and 5.9 million children die from largely preventable causes, such as pneumonia and malaria. To end preventable child and maternal deaths, medicines and supplies must be available when and where they are needed without causing financial hardship. This requires a strong pharmaceutical system that ensures the availability of both appropriate medicines and service providers at service delivery points. The Millennium Development Goals (MDGs), which included a focus on decreasing maternal and child mortality, were generally successful. Globally, maternal mortality fell below 45%, and child mortality decreased by 53%. However, only 6 of the 75 project countries were on track to meet the goal of reducing maternal mortality; 25 were on track to meet the required child mortality reductions.
As the MDGs concluded in 2015, countries, donors, and partners launched the Sustainable Development Goals. These goals are more ambitious and comprehensive than the MDGs and will require more focused, systems-strengthening efforts. Maternal, newborn, and child health (MNCH) is part of the goal to ensure healthy lives, including “quality essential health care services and medicines and vaccines for all” by 2030.
The SIAPS Approach
Systems for Improved Access to Pharmaceuticals and Services (SIAPS) and its partners have worked to improve women’s and children’s access to and use of life-saving medicines. Through a systems-strengthening approach, SIAPS goes beyond addressing supply chain challenges to incorporate interventions that benefit the whole system, including strengthening pharmaceutical legislation and policies and supporting community case management (CCM) and patient-centered care.
At a global level, SIAPS raises awareness of the barriers to essential maternal and child health commodities by participating on various technical reference teams for the United Nations Commission on Life-Saving Commodities for Women and Children (UNCoLSC), the Reproductive Health Supplies Coalition, and the Community Case Management Task Force, among others. At a country level, SIAPS works to implement customizable tools and job aids, develop standard treatment guidelines, and streamline pharmaceutical management information systems for evidence-based decision-making.
Since 2012, SIAPS has supported UNCoLSC with technical reference teams (TRTs). The supply chain TRT and SIAPS have worked with other partners to develop both quantification guidance on UNCoLSC’s 13 life-saving reproductive, maternal, newborn, and child health commodities and reports on supply chain management best practices. SIAPS has also supported the maternal health TRT to produce an inventory of tools to increase access to and improve the use of maternal health supplies and to develop a case study on integrating oxytocin in the vaccine cold chain in Mali. Through its support of the pneumonia and diarrhea working group, SIAPS has validated job aids and dispensing envelopes in the Democratic Republic of Congo and conducted a landscape analysis for treating newborn sepsis.
In addition, SIAPS has developed innovative tools and resources to assist countries in ensuring access to MNCH commodities. These include methods to estimate the need for maternal health medicines to assist in quantification and procurement, tools to assess the subnational procurement of MNCH medicines, and a district-level guide to developing interventions that will improve the availability and use of medicines for childhood illness.
To assist countries in ending preventable child and maternal deaths, SIAPS has supported a systems-strengthening approach to addressing barriers to access. For example, SIAPS has assisted the Ministries of Health in Guinea and Burundi in improving access to treatment for children under 5 years old through CCM. In Burundi, SIAPS has focused on maintaining the supply chain for community health workers and the quality of care provided; contributed to protocols, job aids, and other tools; and conducted an evaluation of CCM of malaria that included a costing study component.
- Guidance on Elements to Consider When Planning for the Integration of Oxytocin into the EPI Cold Chain
- Guidance for Planning the Introduction of New Reproductive, Maternal, Newborn, and Child Health Medicines and Supplies
- Inventory of Tools for Maternal Health Supplies
- Promising Practices in Supply Chain Management
- Quantification of Health Commodities: RMNCH Supplement (available in English and French)
- Estimation of Unmet Medical Need for Essential Maternal Health Medicines (available in English and French)
- Improving Medicines Access and Use for Child Health: A Guide to Developing Interventions
- SIAPS has showcased the importance of a systems approach in several global forums including: APHA and Mini-U.