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On-time delivery: Ensuring reliable reproductive choice in India

Dr. Sudhir Maknikar

PATH has helped leverage the India Post—the world’s largest postal service—into a full-fledged distribution system delivering access to contraceptives for thousands of people in the state of Odisha.

In India, health systems face many obstacles when moving family planning commodities from state warehouses to towns and villages where health care providers and patients need them most. A lack of reliable transportation and other essentials triggers delays in delivery, severely impacting access to contraceptives. Lack of access—often triggered by failures in the supply chain—is a principal barrier to contraceptive use in the country.

PATH’s India office is working with state health systems, governments, and partners to address the gaps that prevent access to family planning commodities such as condoms, oral contraceptive pills, injectable contraceptives, and intrauterine devices (IUDs). With support from the Bill & Melinda Gates Foundation, the family planning supply chain strengthening project provides technical support to eight states in India to improve delivery of contraceptives.

Leveraging the India Post to meet supply chain challenges

A vehicle designated by India Post to transport contraceptives to towns and villages in Odisha, on India’s east coast. Photo: PATH

In Odisha, on India’s east coast, the state’s health system relied for many years on the services of a state-owned vehicle with a government driver to transport family planning commodities to district warehouses. With only one vehicle for a large state, it took at least three months to deliver shipments to all of Odisha. When a given district ran out of supplies—as was frequently the case—there was no chance for replenishment until the next quarter. Especially for women depending on the state-supplied contraceptives, this distribution system jeopardized their access to and choice in family planning.

In response, PATH analyzed several distribution systems that could supplement the existing one. The choice quickly become obvious: India Post, the world’s biggest postal network. With more than 155,000 offices across the country, it has been connecting the subcontinent for 242 years. In January, the state government used India Post to ship its first-ever consignment of family planning supplies from a warehouse in Odisha to depots in five districts.

An illustration of the flow of family planning commodities through India Post. Photo: PATH

The government of Odisha now uses India Post’s express parcel services to transport small quantities of commodities like IUDs, injectable contraceptives, and tubal rings. Larger shipments of condoms, emergency contraceptive pills, and pregnancy testing kits are still supplied through the state-owned transport.

This powerful intervention has strengthened the supply chain and distribution network for contraceptives throughout Odisha. Overall costs are lower, delivery times are faster, and there are no restrictions on the quantities that can be transported. Since the partnership between India Post and the state government began, the state’s health system has been more successful in meeting the urgent demand for contraceptives.

A boon during the COVID-19 crisis

In Odisha, the India Post and state government staff prepare a consignment of family planning commodities for delivery by India Post. Photo: PATH

Until the COVID-19 outbreak in India, the government of Odisha used both its own distribution system and India Post to supply contraceptives to the districts. But the nationwide lockdown closed borders and restricted the movement of vehicles. Soon, districts sounded the alarm: they were running out of contraceptives.

This is when the India Post proved invaluable. Classified as essential, postal services remained functional throughout the lockdown. Since March, the Odisha government has relied on India Post vehicles to dispatch more than 115 consignments of family planning commodities to about 28 districts, charting a 100 percent rate of on-time arrivals.

The project has also demonstrated the huge potential of India Post as a delivery method for other essential medical commodities. PATH is discussing with the governments of other Indian states how to leverage India Post for distribution of family planning commodities and expand it to strengthen the supply chain across the public health spectrum. The success of this intervention has proven, yet again, that innovative approaches can tackle critical health challenges and improve lives.

Dr. Sudhir Maknikar is Director, Family health at PATH’s India Country Program.