Determining How to Supply CycleBeads by tlv10296


									    Determining How to Supply CycleBeads
     The addition of CycleBeads to a reproductive
     health program can provide an important
                                                        Estimating Demand
     option for women and couples—a fertility           After establishing programmatic interest in
     awareness–based method of family planning. To      the SDM and CycleBeads, the next step for
     ensure that this method is affordable, available,   programs is to estimate demand for CycleBeads
     and accessible to the greatest number of users,    in their country or region. Estimating demand
     programs must determine the best manner in         can assist programs in:
     which to supply CycleBeads to their country
     or region. The flowchart on the next page
                                                        1. Assessing the potential contribution and
     provides an overview of the necessary steps for
                                                           impact of CycleBeads introduction on
     program managers to consider when they want
                                                           existing reproductive health programs.
     to add CycleBeads to their reproductive health
     program.                                           2. Determining the required resources for
                                                           introducing and maintaining CycleBeads as
     After the completion of these necessary steps—        part of the family planning program.
     which include assessing programmatic interest,     3. Determining the best method of supplying
     determining the commitments of local groups,          CycleBeads to a country or region.
     and estimating demand—programs can choose
                                                        4. Developing a plan that ensures adequate
     from four options to supply CycleBeads to their
                                                           supply of CycleBeads over time.
     country or region:

                                                        The basic model for estimating demand found
     1. Importation of complete CycleBeads
                                                        in Appendix A is a tool to help program
        product set, including instructional inserts
                                                        managers use generally available statistics
        and calendars.
                                                        and data to define the potential market for
     2. Importation of CycleBeads only, with            CycleBeads in their area. For purposes of this
        instructional inserts and calendars adapted     toolkit, we have assumed that only women
        and produced locally.                           using traditional contraceptive methods or
     3. Importation of CycleBeads components            women not using any contraception (but
        with local assembly, with instructional         who prefer to avoid pregnancy) will adopt
        inserts and calendars adapted and produced      CycleBeads. From this population, the total
        locally                                         number of eligible women who could use
                                                        CycleBeads is calculated. Then, this number
     4. Local production and assembly of
                                                        is reduced by taking into account issues of
        CycleBeads, including instructional inserts
                                                        anticipated awareness of CycleBeads (for
        and calendars.
                                                        example as a result of potential outreach and
                                                        education activities), accessibility, and women’s
     These options are explained in more detail later
                                                        ability to pay.
     in this toolkit.

4       CycleBeads® Procurement and Production Guide
Figure 1. Determining how to supply CycleBeads

                                    Establish programmatic
                                     interest in CylceBeads

                                 Determine MOH/Pharmacy/            Access available?
                                      program interest

                                      Model and estimate            Demand exists?
                                    country/region demand

                                 Model costs and selling price
                                  of different supply options

                                    Determine desired level
                                        of involvement

                                  Determine desired manner
                                   of supplying CycleBeads

Import complete              Import                 Import CycleBeads          Local production
  CycleBeads       or    CycleBeads only      or     components with    or      and assembly of
   product                                            local assembly              Cyclebeads

                                  Sign legal agreements with
                                      Cycle Technologies

                                    CycleBeads® Procurement and Production Guide                  5
    When CycleBeads are initially introduced,            each. Appendix B is a sample case study explaining
    demand will likely be low. But over time, by         how a potential program would evaluate the
    increasing client awareness and provider training    different supply options. Appendix C provides
    and widening distribution, realistic demand will     details for how to use worksheets for each of the
    grow. The experience to date is that in typical      four supply options to determine associated costs
    program introductions, the percentage of new         (worksheets provided separately). It may be that
    family planning users that choose the SDM            a program chooses to make CycleBeads available
    and CycleBeads will range between 2 and 15           at a subsidized cost, or even free of charge. Or
    percent. The exact percentage is difficult to          there may be a charge for counseling, but not for
    predict in advance. It will depend on factors        CycleBeads. Regardless of which option is selected,
    such as the service delivery setting, availability   this toolkit can assist a program to estimate
    and accessibility of other methods, the level of     the budgetary impact of introducing the SDM
    resources made available for behavior change         and CycleBeads on program resources. There
    communication activities and for the training        are two copies of each worksheet—one blank
    of providers, and the speed at which CycleBeads      and one example. The numbers in the example
    are fully integrated into the logistics system.      worksheet are not necessarily appropriate for every
    Programs may decide after having estimated           country, but they are based on data from current
    demand that this information is sufficient             experience.
    to choose which of the four supply options
    is most appropriate. If expected demand is
    low, options 1 or 2 (importation of complete         Option 1
    CycleBeads or importation of CycleBeads only         Importation of complete product
    with instructional inserts and calendars adapted     set with CycleBeads, instructional
    and produced locally, respectively) are likely to
    be the best options. If expected demand is high,     inserts, and calendars
    programs may wish to complete a full analysis by
    making use of this entire toolkit before making        Figure 2. Overview of importation of
    this decision.                                         CycleBeads product set

    The Supply Options                                                Import complete
                                                                     CycleBeads product
    After determining the demand for CycleBeads
    and the level of interest and commitment,
    programs can assess the best approach for
    supplying CycleBeads to their program.                             Management and
    Each option has inherent advantages and                           storage of product
    disadvantages, and each program needs to
    balance these trade-offs with the needs of their
    unique program.
                                                                        Distribution to
    Once potential demand has been determined,                          end customers
    program managers can assess the best option of
    supplying CycleBeads by evaluating the cost of

6        CycleBeads® Procurement and Production Guide
For most programs, importing CycleBeads              these programs may benefit from adapting the
from Cycle Technologies with instructional           instructional insert and calendar to their local
inserts and calendars can provide the greatest       language and culture. This approach integrates
programmatic benefit with the least amount            both a high-quality CycleBeads product
of resource investment. The quality of these         with locally produced materials to deliver a
CycleBeads is guaranteed by the manufacturer,        complete system that is appropriate to the target
and the program can simply incorporate them.         audience.
This is advantageous for programs that do not
have manufacturing experience or cannot justify      Figure 3. Overview of importation of
the investment in time and resources required        Cyclebeads with local production of
for local production or assembly.                    instructions and calender

Under an agreement with Cycle Technologies,
United States Agency for International                    Import CycleBeads
Development (USAID)–supported programs
(including missions, cooperating agencies, and
other local organizations) can obtain CycleBeads                                    • Develop and/or adapt
at a low negotiated price. At the time of                Local adaptation of          instructional inserts
production of this toolkit, the negotiated price         instructional inserts        and calendars.
                                                            and calendars           • Target audience testing
was US$0.99 per set (including instructional                                        • Printing
inserts and calendars). Other programs may
qualify for discounted pricing as well, but should
contact Cycle Technologies for complete pricing           Management and
information at:                                         storage of CycleBeads
Cycle Technologies, Inc.
5505 Connecticut Ave., NW, #237
Washington DC, USA 20015-2601
                                                          Distribution to end
Phone: +1(202) 237-0662                                       customers
Fax: +1(202) 237-0664
Toll Free Phone: +1(877) 292-5399
                                                     The cost of CycleBeads only (not including
                                                     instructions and calendars), utilizing the
Option 2                                             USAID bulk purchase price at the time of
                                                     production of this toolkit, is US$0.87 per unit.
Importation of CycleBeads                            Costs for non-USAID–supported organizations
only, with instructional inserts                     can also be requested from Cycle Technologies.
and calendars adapted and                            Programs that choose this option will need to
                                                     ensure the quality of the instructional inserts,
produced locally                                     the printing, and the completeness of the final
                                                     product package. Note that all CycleBeads must
For many programs, importing CycleBeads              be distributed with an instructional insert and
from Cycle Technologies provides a simple and        a calendar. To ensure the quality of the printed
effective manner to obtain CycleBeads. However,       materials, it is recommended that programs

                                           CycleBeads® Procurement and Production Guide                         7
    work in conjunction with IRH to review the     select this option may also choose to adapt and
    materials as they are being developed.         produce instructional inserts and calendars, based
                                                   on standard prototypes developed by IRH.

    Option 3                                       Figure 4. Overview of importation of CycleBeads
    Importation of components                      components with local assembly
    with local assembly, with
    instructional inserts and                         Identify potential
                                                       local assemblers
    calendars adapted and
    produced locally

    Programs that would like additional              Select assembler(s)
    local involvement in the production of
    CycleBeads, but do not have the necessary
    capacity for local manufacturing of the
    component parts, can consider importing
    CycleBeads components and conducting             Import CycleBeads          Beads, clasps, string,
                                                       components               o-rings, packaging
    assembly locally. Programs are ensured of
    high-quality components that meet product
    requirements and can build on best practices
    learned by IRH and Cycle Technologies            Local adaptation of        • Develop and/or adapt
                                                                                  instructional inserts
    in the field. They can then engage local          instructional inserts
                                                                                  and calendars.
    participation in the assembly of the final           and calendars           • Target audience testing
    product. This option is advantageous for                                    • Printing
    programs that do not have the expertise
    required for local manufacturing but have
    incentives for engaging in local assembly.      Assemble CycleBeads
    Note that this option falls outside the
    agreement with Cycle Technologies for
    special pricing for USAID-funded programs,
    as no economies of scale can be assured.
                                                       Quality control
                                                        of product
    It should be noted that as detailed in the
    Hazard Analysis in Appendix D, the concern
    for meeting specifications and ensuring
    quality is based on the importance of             Management and
    minimizing the risk of pregnancy as a result    storage of CycleBeads
    of product failure. The flowchart at right
    provides an overview of local assembly steps
    and requirements. Costs for the individual
    components can be requested from Cycle
                                                     Distribution to end
    Technologies. Manufacturing partners who             customers

8         CycleBeads® Procurement and Production Guide
                                                 Figure 5. Overview of local production and
Option 4                                         assembly of CycleBeads product
Local production and assembly
of CycleBeads                                                   Obtain license from
                                                                Cycle Technologies
Programs with extensive manufacturing
experience and significant in-country
demand for CycleBeads may find that local
manufacturing and assembly is the most                     Identify and form agreements
attractive supply option. Programs choosing                  with local manufacturers
this option commit to invest the necessary
resources required to identify suppliers and
conduct appropriate due diligence on each,              Produce              Local adaptation of
scale up manufacturing, develop and maintain          CycleBeads             instructional inserts
supplier relationships, and ensure the product        components                 and calendar
quality and ongoing supply in order to have a
successful program. Manufacturing partners                                • Develop and/or adapt
                                                                            instructional inserts
will be sublicensed by Cycle Technologies.             Assemble             and calendars.
The manufacturing partner will work with              CycleBeads          • Target audience testing
local manufacturers and assemblers to meet                                • Printing
the product specifications developed by
Cycle Technologies and will assume the              Obtain approval
responsibilities of product developer.                 from Cycle
                                                    Technologies for
Manufacturing partners will need to be ready           prototypes
to accommodate the lot sizes of CycleBeads
necessary for cost-effective production
                                                             Quality assurance process
(generally greater than 30,000 units). In
addition, local production includes start-up
costs such as creating molds, making and
checking prototypes, and establishing quality
control systems, all of which incur costs and
require careful management of the entire                     Quality control of product
process by the manufacturing partner.

                                                            Management and storage of
                                                               CycleBeads product

                                                            Distribution to end customer

                                         CycleBeads® Procurement and Production Guide                 9
                                                           Depending on the size of the country or
     Supply and Distribution                               region, both ground and air distribution routes
                                                           may need to be established in order to ensure
     No matter which supply option is chosen, the          timely delivery. This toolkit does not provide
     successful delivery of CycleBeads to end users        guidance on this aspect of CycleBeads project
     requires planning up front. Programs need to          management.
     ensure that an adequate supply of CycleBeads is
     available to meet program and client needs and
     that the CycleBeads can be distributed efficiently      Product Order Management
     to vendors and end users. Some of these               Programs and manufacturing partners must
     requirements are outlined below.                      maintain an order tracking system that
                                                           includes order fulfillment; payment status;
     Inventory Control                                     and, if necessary, money transfer, tender,
                                                           or management of local or international
     In order to maintain adequate inventory to            transactions.
     satisfy customer demands but not exceed either
     storage capacity or recommended inventory
     levels (normally sufficient to meet demand for
                                                           Registration of CycleBeads
     one year), programs and manufacturing partners        CycleBeads are not a medical device, and no
     will need to establish and maintain an inventory      country in which they are currently available
     control system. Ideally, inventory control should     has required their registration. In all countries
     be maintained in an electronic format, such as a      where CycleBeads are being used, they are
     Microsoft Excel spreadsheet, in order to facilitate   regarded as an educational tool that does not
     a smooth, timely manufacturing process and            require registration. There is no evidence to
     to permit easily sharing information with other       suggest a need to register CycleBeads, unless the
     manufacturing partners or Cycle Technologies.         particular country requires it.

     Warehousing                                           With the exception of the demand model and
                                                           cost worksheets, the remainder of this toolkit
     Programs and manufacturing partners will need         focuses primarily on the information necessary
     to establish facilities for warehousing of the        for a program considering local production
     CycleBeads product. These facilities will need to     and assembly (option 4). While this toolkit
     be adequately sized, depending on production          does not contain all the information required
     lot size, to maintain a sufficient inventory in a       to successfully manufacture and assemble
     controlled environment (low humidity, moderate        CycleBeads, it provides both an overview of
     temperatures).                                        the requirements as well as specific information
                                                           and advice pertaining to the development
     Distribution Channels                                 of a successful product. These requirements
                                                           ensure the uniform and effective performance
     Distribution channels will need to be established     of CycleBeads. This reduces the chances of
     to service delivery sites—either along with           unplanned pregnancies among couples who
     existing reproductive health products or              choose the SDM and CycleBeads as their
     independently. Distribution may be through a          method of family planning and maintains a
     network of programs or private-sector retailers.      positive product and program image.

10        CycleBeads® Procurement and Production Guide

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