Problem Statement: Maternal and infant morbidity and mortality remain a global challenge and based on latest reports, mitigation efforts have not been encouraging. Unsustainable fertility rates continue to rise unabated in low and middle-income countries (LMICs). Significant gaps in reproductive health and rights continue unabated. According to a recent United Nations Population Fund (UNFPA) report, 225 million women do not have access to contraceptives. This short fall is universal and only acerbates an already dire situation. Inability to address these challenges has many implications including ubiquitous poor quality of health for both mother and child. Reasons for these dismal performances include limited access to quality services, qualified staff, poor logistics management and lack of commodities. These poor outcomes prompted the author to develop the model: RH Analysis and Planning System (RAPSYS). Methodology: The participatory model is based on pilot-tested results. It is defined by key determinants – utilization, demand, access, supply and procurement; cross cutting components – coordination, supervision, funding, advocacy, capacity building M and E; and all driven by an enabling environment. The systems use expert experience to develop effective strategies including: qualitative assessment, Delphi ranking, action plan, commodity projection and monitoring framework. Findings: There is adequate evidence that the conventional approach in program design and implementation continues to show different levels of understanding of the expected outcomes. This model has helped vulnerable countries in streamlining their interventions, making them more result-based, efficient, effective, sustainable and accountable. It has been successfully implemented in ten Asian countries. Conclusion: There is convincing evidence that the complications involved in designing development interventions have become more convoluted, unstructured, and poorly coordinated. This outlook has resulted in many cases producing inadequate and dismal outcomes. The relevant tasks are daunting with resources becoming more and more limited. This framework is part of an initiative to help refine current processes and procedures.

1. 16-11-04 Prepared by Bongs Lainjo
Reproductive Health Commodity
Security (RHCS) Analysis &
Planning System (RAPSYS): A
Synergistic Model
By!
Bongs Lainjo, MASc Engineering!
Author of “M & E: Data Management Systems”!
Former UN Senior Program Advisor!
Montreal, Canada, Email: bsuiru@bell.net!
!
!
International Conference on Reproductive Health,
San Antonio, Texas
December 01 - 02, 2016!

2. Prepared by:- Bongs Lainjo
Presentation website:
!

3. RAPSYS – Current Gaps
!
…Nearly 40% of all Pregnancies in the
USA are UNINTENDED...( P. Belluck,
NYT, 06/19/2016)
…225 Million Women Globally still need
ACCESS to Contraceptives…( UNFPA,
06/30/2016)
Prepared by:- Bongs Lainjo

4. RAPSYS: OBJECTIVES
General objective:
To Strengthen RHCS Programming Capacity
Specific Objectives:
• Weight RHCS determinants (composite indicator)
• Identifying relevant gaps
• Develop appropriate strategies
• Develop an RHCS Action Plan (RAP)
Prepared by:- Bongs Lainjo

5. RAPSYS: METHODOLOGY !
PANEL SELECTION
PANEL OF EXPERTS (POE)
GROUP COMPOSITION
; GROUP MEMBERS
RAPPORTEURS
; MODERATORS
; GENERAL RAPPORTEUR
PLENARY
v INPUTS
v MODEL
v OUTPUTS
Prepared by:- Bongs Lainjo

6. RAPSYS: METHODOLOGY (cont’d)
PLENARY
v GROUP PRESENTATION
v PEER REVIEW
DRAFT COMMITTEE
v RAPPORTEURS
v GENERAL RAPPORTEURS
v NATIONAL EXPERT Prepared by:- Bongs Lainjo
GROUP WORK
v ASSESSMENT
v STRATEGIES
v ACTION PLAN
v M&E FRAMEWORK

7. DEFINITION: RHCS
Contraceptive Security is defined as the ability to
continuously (enabling environment) provide (Supply,
Procure) high quality commodities to the vulnerable
group and target populations (Use) at the right time and
place (Access) when needed (Demand).
Prepared by:- Bongs Lainjo

8. DEMAND
ACCESS
UTILIZATION
Reproductive Health Commodity Security
SUPPLY
PROCUREMENT
Prepared by:- Bongs Lainjo

9. RAPSYS: HIGHLIGHTS
v Practical
v Simple
v Participatory
v Synergistic
v Inclusive
v Multi-sectoral
v Adaptable
Prepared by:- Bongs Lainjo

10. RAPSYS: RHCS Determinant Matrix
and Corresponding Components
Basic Determinants
DETERMINANT COMPONENTS
Utilization ¬ CPR
¬ Disease Prevention
¬ Strengthened Dual Protection
¬ Promotion of Female condoms
Prepared by:- Bongs Lainjo

11. Basic Determinants (cont’d)
DETERMINANT COMPONENTS
Demand ¬ Vulnerable Groups
¬ Current users
¬ Potential users (Unmet Needs)
¬ Drop Outs – family planning
methods
¬ Unemployed & out of school
youth
Preparedby:-BongsLainjo
RAPSYS

12. Basic Determinants (con’t)
DETERMINANT COMPONENTS
Access ¬ Public Outlets
¬ Private Outlets
¬ Social marketing Outlets
¬ Bars, Hotels, Clubs, Gas
Stations, Toilets, bus/train
station
¬ Dispensers
Prepared by:- Bongs Lainjo
RAPSYS

13. Basic Determinants (cont’d)
DETERMINANT COMPONENTS
Supply ¬ Distribution
¬ Transportation
¬ Storage/Warehousing
¬ LMIS
¬ Quality of Care (QOC)
¬ Commodities
Prepared by:- Bongs Lainjo
RAPSYS

14. Basic Determinants (cont’d)
DETERMINANTS COMPONENTS
Procurement ¬ Projection
¬ Costing/budgeting processes
¬ Tendering process
¬ Ordering
¬ Shipment Schedules
¬ Quality assurance
Prepared by:- Bongs Lainjo
RAPSYS

15. Cross-Cutting Determinants
Environment ¬ Political Will
¬ Appropriate Laws
¬ Appropriate Policies
Prepared by:- Bongs Lainjo
RAPSYS

16. Cross-Cutting Determinants (cont’d)
Advocacy ¬ Political Leaders
¬ Religious Leaders
¬ Community Leaders
¬ Civil Society
¬ Vulnerable groups
¬ Hard to reach Communities
and groups
Prepared by:- Bongs Lainjo
RAPSYS

17. Cross-Cutting Determinants (cont’d)
Coordination ¬ Government leadership
¬ Defining Stakeholder roles
(Private, Civil Society, Social
Marketing, Public sector)
¬ Dissemination Forums
¬ Coordinating Mechanisms
¬ Stakeholder Meetings
¬ Availability of coordinating
committee
Prepared by:- Bongs Lainjo
RAPSYS

18. Cross-Cutting Determinants (cont’d)
Funding ¬ Stakeholders/Partners
¬ Funding gaps
¬ Short, medium and long term
funding strategy
¬ Exit Strategy
¬ Sustainability strategy (phase
in approach)
¬ Grants vs Loans
Prepared by:- Bongs Lainjo
RAPSYS

19. Cross-Cutting Determinants (cont’d)
Capacity Building ¬ Institutionalized (Processes vs
Events)
¬ Medium & long term Plans
¬ Skills transfer
¬ South-south collaboration (PD)
¬ Target Groups
Prepared by:- Bongs Lainjo
RAPSYS

20. Cross-Cutting Determinants (cont’d)
M and E ¬ Institutionalized and
Systematic
¬ Clear and Feasible Objectives
(CAFO)
¬ Established achievable bench
marks and timeframes
¬ Functional instruments
¬ Process approach with built in
feedback Mechanisms
¬ Accountability/Transparency
Prepared by:- Bongs Lainjo
RAPSYS

21. Cross-Cutting Determinants (cont’d)
Supervision ¬ Supportive and constructive
¬ Availability of follow up plans
¬ Availability of feedback
mechanisms
¬ Integrated instead of vertical
¬ Availability of guidelines
¬ Regular and consistent visits
Prepared by:- Bongs Lainjo
RAPSYS

22. RAPSYS:
QUALITATIVE ASSESSMENT MATRIX
(QAM)
!
RHCS
Determinants
Achievement
Level
Low1..5 High
Gaps Strategies Remarks/
Observations
Demand
Supply
Procurement
Utilization
Prepared by:- Bongs Lainjo

23. RHCS
Determinants
(1)
Achievement
(2)
Low1..5 High
Gaps
(3)
Strategies (4) Remarks/
Observations
(5)
Access
Cross Cutting Determinants
Enabling
Environment
Coordination &
Dissemination
Supervision
Prepared by:- Bongs Lainjo
RAPSYS:
QAM (Cont’d)

24. RHCS
Determinants
Achievement
Level
Low1..5 High
Gaps Strategies Remarks/
Observations
Funding
Advocacy
Capacity
Building
M and E
Prepared by:- Bongs Lainjo
RAPSYS:
QAM (Cross-Cutting
Determinants Cont’d)

25. RAPSYS:
Column Description
!
Column 1: List of all RHCS Determinants
Column 2: Scores established by each group based on level of
achievement (1= inadequate, 2 = moderate, 3 = adequate, 4 =
substantial, 5 = Significant;
Column 3: List of potential Gaps;
Column 4: ;Strategies to address gaps identified in column 3;
Column 5: Additional remarks or comments
Prepared by:- Bongs Lainjo

26. RAPSYS
RHCS ACTION PLAN (RAP)
Determinant!
(1)!
Identified
Gaps (2)!
Strategy!
(3)!
Activities!
(4)!
Approximate!
Timing (5)!
Responsible!
Party (6)!
Approximate
Cost (7)!
Column Description!
Column 1: List of All RHCS Determinants;!
Column 2:Appropriate Gaps identified by each group for each determinant!
Column 3: Required relevant strategy to address gaps identified in (2)!
Column 4: Activities required to accomplish the strategy identified in (3)!
Column 5: Approximate completion time of implementation!
Column 6: Stakeholders responsible for implementing activities in (4)!
Column 7: Approximate cost of implementation! Prepared by:- Bongs Lainjo

27. RAPSYS: M and E Summary Matrix
RESULTS: Output, Outcome, Goal
Results
(1)
Strategy
(2)
Activities
(3)
Indicator
(4)
Baseline
(YEAR)
(5)
Q1
(6)
T A
Q2
(7)
T A
Q3
(8)
T A
Q4
(9)
T A
Data
Source
(10)
Column Description:!
!
Column1: Gaps recorded with key words like improved, strengthened, increased
availability, increased accessibility etc.!
Column 2: Strategy from action plan!
Column 3: Activities from action plan!
Column 4: Simple, feasible and measurable indicators!
Column 5: First year benchmark!
Column 6 to 9: (T) Targets and (A) achievements for every quarter of a given year!
Column 10: Source of data! Prepared by:- Bongs Lainjo

28. RAPSYS: FLOW CHART
!
Assessment
!
Strategies
and
activities !
Action Plan
Input! Process! Output!
Prepared by:- Bongs Lainjo

29. Distribution of some
Demographic Indicators
INDICATOR! BANGLADESH! SOURCE! SRI
LANKA!
SOURCE!
Maternal
Mortality Rate
(MMR)
320 per 100,000 Bangladesh maternal
mortality survey,
2001
47 per
100,000
Live Births
Family Health
Bureau 2002
CPR (Modern
Methods)
47.3per cent BDHS, 2004 49.5 per
cent
DHS 2000
TFR 3.0 BDHS, 2004 1.9 DHS 2000
Literacy Rate:
Male
Female
40.3 per cent
33.4 per cent
Population Census,
2001
91.1 per
cent
89 per cent
Dept. of Census and
Statistics, 2000
RHCS MEANS
RHC Level of
Achievement
2.83 RHCS Panel
assessment
2.75 RHCS Panel
Assessment

30. Stake holders Assessment of BCSP by Component
012345
Supervision
Funding
Advocacy
Cap.Building
Demand
Supply
Procurement
Utilization
Access
Enabling Environ
Coord
M&E
Prepared by:- Bongs Lainjo
RAPSYS – CASE STUDY
Country-specific RHCS Rapid
Needs Assessment (Bangladesh)

32. Ad Hoc Committee Assessment of SLRHCS by Determinant
012345
Supervision
Funding
Advocacy
Cap.Building
Demand
Supply
Procurement
Utilization
Access
Enabling Environ
Coord
M&E
RAPSYS – CASE STUDY
Country-specific RHCS Rapid
Needs Assessment (Sri Lanka)
Prepared by:- Bongs Lainjo

34. Stake holders Assessment of BCSP by Component
012345
Supervision
Funding
Advocacy
Cap.Building
Demand
Supply
Procurement
Utilization
Access
Enabling Environ
Coord
M&E
Ad Hoc Committee Assessment of SLRHCS by Determinant
012345
Supervision
Funding
Advocacy
Cap.Building
Demand
Supply
Procurement
Utilization
Access
Enabling Environ
Coord
M&E
RAPSYS – CASE STUDY (Cont’d)

35. RAPSYS: Lessons Learned
1. Panel selection very crucial
2. Role and level of coordinator important
3. Panel composition should be relevant to determinants
4. Level of responsibility of Panel members critical
5. Minimum of 3 days required for meeting
6. Initial group of panelist represents RHCS ad hoc
committee
Prepared by:- Bongs Lainjo

36. 7. Selection process of group moderator and rapporteurs
important
8. Rapporteurs are responsible for first draft report
9. Minimum of one month required for planning
(logistics, mobilization)
10. Media participation important
11. Limit total number of participants to 10 per group
12. Leadership role of National government very
important factor
Prepared by:- Bongs Lainjo
RAPSYS: Lessons Learned (cont’d)
!

37. 13. Panel members come from National & sub national
levels
14. Participatory nature of meeting is a strong
motivating factor.
15. Strong level of ownership among participants also a
motivating factor
16. Peer review session very important
17. Profile of Panelists critical
Prepared by:- Bongs Lainjo
RAPSYS: Lessons Learned(cont’d)

38. 16-11-04 Prepared by Bongs Lainjo
www.bsuiru.wordpress.com

39. Thank You All For Participating!