Towards strengthening logistic support for MCH services and conventional contraceptives in Uttar Pradesh.

This book chapter presents an analysis of the logistics of supply and distribution of contraceptives and maternal and child health (MCH) materials in four states in India. Data were obtained from structured interviews at the state district and primary health care (PHC) center and subcenter levels in the states of Uttar Pradesh Bihar Tamil Nadu and Maharashtra. Field work reveals that one constraint to availability of supplies was the huge cost of transportation from manufacturers or depots to where needs exist. There were shortages of funds for transportation costs that delayed deliveries. MCH materials were particularly in short supply. Manufacturers supplied items based on a fixed rate for the year and apportioned quarterly. The logistics system between levels was very poor and time lags before requests and actual delivery were not accounted for. Supplies to districts and from districts to PHC centers were higher during the last 4 months of the accounting years from December through March. Storage capacity was also inadequate at state district and PHC levels. Huge quantities of contraceptives and MCH materials were kept uncovered in open spaces. Different districts used different means of transportation. Private transportation was very costly compared to use of state vehicles. The accounting system by month and level was poor and could not help to relieve distribution of supply problems. Supplies were pushed from one level down to the lowest level based on delivery and storage issues. The findings suggest a need for regional substores at the divisional headquarters for increasing accessibility to supplies and reducing transportation time and costs. The authors offer a distribution model in five steps for strengthening logistics.