A Compact kept: Zambia’s unwavering commitment to Reproductive Health

 Seth Broekman

 

OVER thirty years ago, at a revolutionary meeting in Cairo, Zambia stood with 178 other countries and boldly proclaimed ‘NO MORE!’ no more women dying during childbirth, no more women and girls failing to realize their full potential as a result of lack of family planning commodities, no more discrimination, violence and abuse based on gender.

This meeting, which is known as the International Conference on Population and Development or simply ICPD recognized a ground-breaking truth: that population and development, human rights, and sexual and reproductive health and rights (SRHR) are interconnected. This understanding has guided Zambia’s progress, emphasizing that investments in SRHR and human rights are essential for achieving sustainable development.

Working with the United Nations Population Fund (UNFPA), the Government has made notable progress in implementing the ICPD Programme of Action. This is evident in several ground-breaking policies and programmes, such as the Compact of Commitment towards increasing domestic funding for reproductive health commodities, such as family planning methods and maternal health commodities which are critical  in safe childbirth.

In February 2023, the government—through its Minister of Finance and National Planning, Minister of Health, and the Zambia Medicines and Medical Supplies Agency (ZAMMSA)—signed a Memorandum of Understanding in relation to the provision of safe and effective sexual and reproductive health commodities with UNFPA. This agreement was designed to boost local funding for these essential supplies. Since the compact was signed, the government has disbursed over USD 11.4 million from the national treasury, with 4.3 million USD in 2025, to procure these commodities through UNFPA.

Using the UNFPA procurement system has come with several benefits. As a result of its extensive experience in procurement of reproductive health commodities and riding on its long-term agreements with World Health Organisation prequalified manufacturers and suppliers, UNFPA guarantees the provision of quality-assured commodities at relatively lower prices that are delivered within the shortest possible lead times.

Use of local funds to procure reproductive health commodities using the UNFPA procurement system has also seen Zambia qualifying for what is referred to as the Match Fund. The Match Fund simply refers to additional funds released by UNFPA to match government contributions towards the procurement of quality assured commodities. In the current agreement, for every dollar spent by the government over and beyond the agreed threshold, UNFPA releases additional two dollars to the maximum of $2 million. It is applaudable that the Government has for the third consecutive year since 2023 contributed towards procurement of reproductive health commodities beyond the agreed threshold, thereby qualifying for the maximum match fund applicable.

As a result of these procurements, availability of reproductive health commodities has been improving steadily. This has not gone without notice by both service providers as well as beneficiaries of reproductive health services.

“We have seen an increase in availability of family planning commodities from about 30% – 40% at the beginning of 2024 to over 90% in 2025. This improved availability empowers women with a wider variety of family planning options, which is crucial for promoting choice, a core principle of the family planning programme” narrates a pharmacist from Mansa district.

Despite these successes, challenges to ensure full access to vital sexual and reproductive health commodities and other medicines, remain. This includes institutional governance challenges and the last mile distribution due to significant funding constraints, poor road infrastructure and intermittent network connectivity. UNFPA has therefore also stepped up its support by providing third-party logistics support to ZAMMSA to supplement distribution efforts. As of 2025, this support accounts for about 7% of ZAMMSA’s total distributions to regional hubs and selected district health offices, helping to move commodities closer to where they are needed.

“Investing in sexual and reproductive health commodities is not just a health issue; it is a powerful economic one. When women are empowered to make their own choices about their bodies and their families, they can pursue education and careers with greater freedom. This reproductive agency does not just benefit individual women; it builds a more dynamic workforce and ultimately drives the entire nation’s prosperity forward” states the UNFPA Country Representative.

The author is the UNFPA Country Representative