Saima Hamid, Shafique Ahmed Qureshi and M Suleman Bajwa
Pakistan ranks in the lowest amongst countries in terms of health indicators including sexual and reproductive health (SRH). “Availability of the contraceptives, a human right” was declared in ICPD and WHO report on SRH in the year 2014. Subsequently, successive governments introduced many programs to improve SRH indicators of Pakistan but have had little success and sustainability. To ensure the availability of contraceptives, the Government of Pakistan, with support of USAID (United States Agency for International Development), introduced the online system of Contraceptive Logistics Management Information System (cLMIS), the competent functioning and effectiveness of which is the focus of this study conducted from October to December of 2015 (cLIMS homepage), (Pakistan Logistics Management Information System). The scope of this study included the two departments of the public sector in the province of Sindh; Department of Health (DOH) and Population Welfare Department (PWD), along with the national-level department Central Warehouse and Supplies (CW and S). The study used both qualitative and quantitative approaches to assess the use of cLIMS. The quantitative component examined the availability of contraceptives, inventory management, warehousing and human resource; it revealed much discrepancy in availability of stock in all departments, with some items in great excess and others out of stock in spite of cLIMS being supported with an auto-generation of demand Contraceptive Logistics Report 6 (CLR6) and the warehouses ‘receiving stock from a common source; the CW and S. The qualitative analysis on the basis of in-depth interviews of the managers dealing with cLMIS at national, provincial and district levels revealed complaints ranging from a lack of training or refresher courses and nonuniformity in methods of data acquisition, to connectivity and communication issues that kept the Service Delivery Points (SDPs) out of the loop, thus inhibiting the effectiveness with which cLMIS could be used for performance evaluation. cLMIS being managed by USAID-deliver project staff (cLIMS homepage) and lack of trained personnel within the public sector was identified as a threat to the project’s sustainability.
