WORK PLAN FOR CONTRACEPTIVE TOTAL

MARKET IN VIETNAM

MPH. Tran Ngoc Sinh Vice Director, Population and Family

planning division, GOPFP - MOH

CONTENTS

WORK PLAN

BACKGROUND

BACKGROUND

RATIONALE In 2010, contraceptive prevalence rate (CPR) has been

increasing to 78.0% and this of modern contraceptive methods has been increased to 67.5%.

However, the provision and use of contraceptives still has some shortcomings:

1. Most contraceptives are provided free of charge with funding source from the State budget → sustainability of the program is not ensured

2. Gaps in terms of income and wealth between the

different social strata is ceaselessly increasing; so is the users’ need toward diversity of choice and quality

RATIONALE

3. The donors discontinued non-refundable aid for contraceptive → shortage of budget for Population and Family Planning (PFP) activities.

To address the above problems, a total market

plan for FP is required to ensure the users’ accessibility to contraceptives through such channels as free of charge, social marketing and commercial market.

LEGAL BASES

1. Decree Nr. 47/NQ/TW dated March 22, 2005 by Politburo on continuous strengthening PFP policies.

Key messages: Meet the contraceptive needs of all users; Promote social marketing and commercial channels for contraceptives.

2. Direction Nr. 23/2008/CT – TTg dated August 4, 2008

by Prime Minister on continuous strengthening PFP activities.

Request ministries, sectors and localities to increase the level of investment from domestic budget to ensure contraceptive commodities security.

LEGAL BASES

3. Decision Nr. 2331/QĐ – TTg dated December 20, 2011 by Prime Minister promulgating the list of National Target Programs in 2011

Stated: PFP program is one of the national target programs, in which the project "Ensuring logistics and providing family planning services" as a important part of the PFP program.

Contraceptive prevalence rate (%)

1988 2006 2010

Percentage of contraceptive use

53.2 78.1 78.0

including: - CPR of modern contraceptives

37.7 67.2 67.5

- CPR of traditional contraceptives

15.5 10.9 10.5

Contraceptive prevalence rate Contraceptive prevalence rate

2000 - 2011

IUD

Sterilization

Vasectomy

Injectable +implant

Oral Pills

Condom

Others

Contraceptive provision in 2010 Market share of contraceptives, 2010 (%)

Free of charge Social marketing

Commercial market

Condom 25.5 64.5 10 Pills 36.1 56.1 7.8 Injectable contraceptives

92.5 7.0 0.5

Implants 99.9 0.1 IUDs 97.5 2.4 0.1 Sterilization 100.0

Contraceptives are managed and provided through 3 channels:

+ Free of charge + Social marketing + Commercial market

Management and organization of contraceptive provision

a) Free of charge PFP network at different levels: Plan on need in terms of

quantity, brands and distribution of contraceptives for the reproductive health (RH)/FP providers at all levels according to the technical decentralization (procurement by GOPFP).

RH/FP service providers: + Commune health centers; obstetric units of inter-

communes polyclinics, district hospitals; district health centers; district PFP centers; obstetric department of provincial hospitals; provincial RH Centers: provide free clinic contraceptives and pills.

+ Commune PFP staff and population collaborators: provide free condoms and pills for the users who register for contraceptives

Management and organization of contraceptive provision

b) Social marketing channel - As of 2011, only 6 agencies involved in social marketing: DKT,

VINAFPA, MSIVN, PSI, CCRD-DHS and the Social Marketing Scheme (GOPFP): Mostly Social marketing for non-clinic contraceptives (condoms, pills).

- DKT and MSIVN are piloting social marketing for clinic contraceptives (IUDs, Injectable contraceptives, Implants).

c) Commercial market channel As regulated, any contraceptives introduced to Viet Nam required

circulation permit by MOH. The licensed companies are entitled to import and sell in the markets.

In fact, many contraceptives sold in the market are not in the list of permited contraceptives in Viet Nam; or some brands sold in the commercial market have the same label of manufacturers that must be provided through free-of-charge or social marketing channels.

Management and organization of contraceptive provision

Constraints

1. Limitation is expressed in managing contraceptive market from the public governance; the free market is not under the government’ management.

2. The free market of contraceptive develops spontaneously, lack of macro coordination: brands, quality and prices are out of control.

3. Overlaps in contraceptive provision: e.g. in a geographic area, contraceptives are provided through all channels, free of charge, social marketing and commercial channels at the same time

Constraints (continued)

4. There is no monitoring mechanism for the free market

5. Coverage of the social marketing program is limited: just concentrates in the urban area

6. Social marketing program only focuses on condoms, pills rather than the clinic contraceptives such as injectables and implants.

7. The users are used to free provision so they are not familiar with purchasing contraceptives through social marketing and commercial market channels.

WORK PLAN

1. Goal: Promote equitable and appropriate access to contraceptives by each category of clients and accommodation of contraceptives in a total multi-element market

2. Specific objectives: a) Strengthen behavior change communication (BCC),

improve the quality of contraceptive provision and FP services, ensure logistics and improve management to meet the clients’ needs and increase CPR:

- CPR increases from 78.0% in 2010 to 82 % by 2015. - CPR of modern contraceptives from 67.5% in 2010 to 73%

by 2015.

Objectives

2. Specific objectives (cont.): b) Promote equitable and suitable access to contraceptives of each category

of clients (preference, affordability and conditions) in order to meet contraceptive needs in terms of quantity, diversity of brands and improved quality by 2015:

- reduce the market share of free condoms to 12.3% and increase that of condoms provided through social marketing and commercial market 87.7%.

- Reduce the market share of free pills to 30.9% and increase that of pills through social marketing and commercial market to 69.1%.

- Reduce the market share of free injectable contraceptives to 75.9% and increase that of injectable contraceptives provided through social marketing and commercial market to 24.1%.

- Reduce the market share of free Implants to 45.1% and increase that of injectable contraceptives provided through social marketing and commercial market to 54.9%.

- Reduce the market share of free IUDs to 70.4% and increase that of injectable contraceptives provided through social marketing and commercial market to 29.6%.

Objectives

2. Specific objectives (cont.): c) Mobilize the funding, experience and participation of

contraceptive provision by the public service providers, private providers and outlets on a basis of encouragement, initiative and equality in market:

- Increase the number of organizations involved in social marketing.

- the public and private providers participate in providing contraceptives in the total market and make sure that each contraceptive has at least three brands and always be available in the commercial market.

Objectives

SCOPE, SITES AND TIMEFRAME

1. Scope: Contraceptives used in PFP program through free of

charge, social marketing and commercial market channels to meet the clients’ need in terms of quantity, diversity of brands and improved qualty for each categories of clients.

2. Timeframe: from June 2011 to the end of 2015. 3. Site: at the central level and 63 provinces/cities

throughout the country.

ACTIVITIES 1. Activities under specific objective 1 a) Identify CPR, quantity and brands of contraceptives - annual CPR for 2011-2015 period is based on the objectives

by 2015: + TFR is reduced to 1.9 + CPR increases from 78% in 2010 to 82%. - CPR in 2015 increases 4% compared to 2010: + On average: each year in 2011-2015 increases 0.8%,

equivalent to 2006-2010 period. + in which, the modern contraceptives increases 5.5%

compared to 2010, higher than 2006-2010 period and traditional contraceptives reduces 1.5% compared to 2010.

ACTIVITIES

1. Activities under specific objective 1 b) Regularly and synchronously implement BCC activities,

advocacy, counseling, etc. for behavior change of individuals, families and community from using the contraceptives in free-of-charge channel to social marketing and commercial market ones.

c) Develop and implement encouraging policies for contraceptives/FP service providers and users.

ACTIVITIES

2. Activities under specific objective 2 a) Segmentation of the total market for Family

Planning in 2011-2015 period - Market segmentation is based on the characteristics of

each type of contraceptives, current situation of product brands provided through the social marketing channel and introduce the new brands for 2011-2015 period.

- Publicize the total market segmentation for contraceptives to provide an enabling environment for the service providers in different channels to be proactive in introducing the manufacturers’ brands without overlaping the products provided in the available channels.

ACTIVITIES

2. Activities under specific objective 2 b) Targeting market-share in the total market for

Family Planning - currently, the free-of-charge FP services accounts high

proportion while the social marketing channel only provide condoms, pills and piloting social marketing for clinic contraceptives.

- Targeting for 2011-2015: expand the market share of the social marketing channel in an equivalent reduction in free-of-charge channel

focus on increasing the market share of the social marketing channel for clinic high-price contraceptives; encourage expanding the market share of commercial market.

Contraceptives market-share objective by 2011

Market share of contraceptives provision, 2011 (%)

Free of charge

Social marketing

Market

Condom 14.2 13.7 72.1

Pills 47.6 34.5 17.9

Injectable contraceptives

88.7 8.6 2.7

Implants 69.7 18.2 12.1

IUDs 78.8 14.4 6.8

Sterilization 100 - -

Market share of contraceptives provision, 2015 (%)

Free of charge

Social marketing

Market

Condom 12,3 7,6 80,1

Pills 30,9 41,4 27,7

Injectable contraceptives

75,9 15,9 8,2

Implants 45,1 31,4 23,5

IUDs 70.4 19.1 10.5

Sterilization 100

- -

Objective for market share by 2015

Segmentation of the total market for Family Planning

Target groups Channel Contraceptives & funding source

By income 1. Poor households (disadvantaged, rural and urban areas)

Free of charge via Public sector + Mass organizations

All modern contraceptives State budget 2. Near-poor households

Disadvantaged areas Rural areas Urban areas Social

Marketing via Public sector + Mass organizations + NGOs

All modern contraceptives State budget & Social marketing product

Segmentation of the total market for Family Planning

Target groups Channel Contraceptives & funding source

By income 3. Middle-income households

Disadvantaged areas Social Marketing via Mass organizations + NGOs

All modern contraceptives State budget & Users payment

Rural areas & Urban areas

Social Marketing via Mass organizations + NGOs

Commercial market

All modern contraceptives State budget & Users payment

Segmentation of the total market for Family Planning

Target groups Channel Contraceptives & funding source

By income 4. High-income households

Disadvantaged areas Social Marketing via Mass organizations + NGOs

All modern contraceptives State budget & Users payment

Rural areas & Urban areas

Social Marketing via NGOs

Commercial market

All modern contraceptives State budget & Users payment

Segmentation of the total market for FP

Target groups Channel Contraceptives & funding source

By hard-to-reach group

1. Handicapped people Free of charge via Public sector + Mass organizations

All modern contraceptives State budget

2. Ethnic minority Free of charge via Public sector + Mass organizations Social Marketing via mass organizations

All modern contraceptives State budget & Users payment

3. Adolescent and youth in rural areas

Social Marketing via Mass organizations + NGOs Commercial market

All modern contraceptives State budget & Users payment 4. Adolescent and youth in

urban areas 5. New users Free of charge via Public sector

+ Mass organizations Social Marketing via Mass organizations + NGOs

All modern contraceptives State budget & Users payment

Segmentation of the total market for FP

Contraceptives Channel Funding source

By contraceptives 1. Condom Free of charge 10% for the

poor group in the disadvantaged areas

State budget & Users payment

2. Pill Free of charge 30% for the poor/near-poor group in disadvantaged areas

3. Injectable Social Marketing via NGOs, Commercial market Plan for promotion of private sector engagement

State budget & Users payment

4. Implants

5. IUD

6. Emergency pills Social Marketing via mass organization,

Users payment

ACTIVITIES 3. Activities under specific objective 3 - Involve the social organizations such as Vietnam

Women Union and private companies in social marketing. - Communicate to encourage all economic components to

involve in production and import different types of contraceptives to Viet Nam in accordance to the technical standards in the National Target Program for Population and Family Planning (Decision Nr. 714/QĐ-BYT dated March 2, 2010).

- Create favorable conditions for the companies in different economic components to involve in production, issue permit for importing and circulation in the country.

- expand international cooperation for investment and technical transference and sharing experience by NGOs in social marketing, development and implementation of total market plan for FP.

4. Estimated budget and funding sources, 2011-2015

Contraceptives Needed budget (VND million)

2011 2012 2013 2014 2015

1. Condoms 109.623 113.945 118.209 122.456 126.715

State budget 30.695 29.626 28.371 26.940 25.343

- Free of charge 15,457 15,497 15,604 15,552 15,586

- Social marketing 15,238 14,129 12,767 11,388 9,757

Commercial market 78,928 84,319 89,839 95,516 101,372 2. Pills 100.794 104.148 107.232 110.394 113.561

State budget 82.752 82.923 82.783 82.464 82.105

- Free of charge 47,978 45,259 42,142 38,748 35,090

- Social marketing 34,774 37,664 40,641 43,716 47,014 Commercial market 18,042 21,225 24,449 27,930 31,456

Contraceptives Needed Budget (VND million)

2011 2012 2013 2014 2015

3. Injectables 22.733 23.381 24.014 24.641 25.267 State budget 22.097 22.446 22.718 22.965 23.196

- Free of charge 20,142 19,991 19,764 19,491 19,178

- Social marketing 1,955 2,455 2,954 3,474 4,018

Commercial market 614 959 1,321 1,676 2,072

4. Implants 614 959 1.321 1.676 2.072

State budget 18.144 20.789 23.456 26.152 28.866

- Free of charge 12,955 13,409 13,534 13,311 12,730

- Social marketing 3,139 4,345 5,747 7,375 9,180 Commercial market 2,068 3,014 4,152 5,466 6,957

4. Estimated budget and funding sources, 2011-2015

Contraceptives Needed budget (VND million)

2011 2012 2013 2014 2015

5. IUDs 14.907 14.740 14.588 14.444 14.297

State budget 13.893 13.590 13.318 13.058 12.810

- Free of charge 11,746 11,306 10,882 10,472 10,079

- Social marketing 2,147 2,285 2,436 2,586 2,731

Commercial market 1,014 1,135 1,255 1,372 1,501

4. Estimated budget and funding sources, 2011-2015

Projection of contraceptive use and number of contraceptives, 2011 - 2015

2011 2012 2013 2014 2015

1. Contraceptive prevalence rate (%)

78.6 79.4 80.2 81.1 82.0

2. Number contraceptive users (1,000)

13,071 13,162 13,245 13,322 13,396

3. Number of new users in in the year (1,000 people)

6,838 6,948 7,062 7,175 7,287

4. Number of contraceptives by year

Condoms (million units) 183 190 197 204 211

Pills (1,000 packets) 27,242 28,120 28,981 29,836 30,692

Injectable contraceptives (1,000 vials)

1,098 1,130 1,160 1,190 1,221

Implants (1,000 doses) 32 37 42 47 51

IUDs (1,000 devices) 1,692 1,673 1,656 1,639 1,623

Solutions

1. Communication, advocacy and capacity building in management

- BCC for contraceptive utility in PFP program, proganda and advertising for each brand of social marketing channel for contraceptives.

- BCC from using contraceptives in free of charge channel to social marketing and commercial market ones to release the burden suffered by the State budget as well as create equity and match the affordability and conditions of each category of users

- Capacity building for the social marketing units

Solutions

2. Develop, issue and implement encouraging policies

Policies for the clients who enjoy free of charge contraceptives (poor, para-poor housholds, social beneficiaries, hard-to-reach people who have need for FP services).

Guidelines for specification of the regulations relating to the contents of social marketing components, retail price, costs for social marketing and subsidy rate for each brand of social marketing products, create favorable conditions for the organizations implementing social marketing in practices

Guidelines for specification of the policies to promote socialization regarding the Decree Nr. 69/2008/NĐ-CP in manufaction, import and provision of contraceptive, RH/FP services, create an enabling environment for the non-public sector to involve in the total market plan for FP.

Solutions

3. Flexible accommodation of the total market plan for Family Planning

Every year, MOH cooperates with MoF, MPI and the relevant ministries and sectors for revision of quantity of contraceptives provided in all channels (free of charge, social marketing and market) to adapt to the reality and funding source for Family Planning

Coordinate the implementation through documents, instructions and cooperation among ministries, sectors, mass organizations, donors, NGOs and manufacturers, distributers of contraceptives to solve any problems risen during the implementation; create favorable conditions for the public and non-public sectors in providing contraceptive and FP services

4. Segment the market for FP service to ensure equity, diversity in terms of types and quality for the different categories of clients;

5. Mobilize funding sources, involve public service providers, NGOs, private companies and outlets in the total market plan for FP.

6. Publicize the total market plan for FP, service prices to improve competition between the public and private providers.

Solutions

THANK YOU FOR YOUR ATTENTION!

Hanoi, March 19, 2012