TCI Global Toolkit: Service Delivery

Contraceptive Commodity Security
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Evidence from the Urban Reproductive Health Initiative (URHI)

In Kenya, before the Tupange project started, there were frequent stockouts, resulting in missed opportunities and poor procurement, distribution, and supply chain management at both the national and facility level. After Tupange’s contraceptive security intervention:

  • The government and donors committed to increasing funding for commodities, from US$5.97 million in 2011 to $6.2 million in 2013 (government) and from $1.32 million in 2011 to $12.9 million in 2013 (donor).
  • Health facilities were less likely to report stockouts at endline than at baseline.
  • Improved inventory management practices led to minimization of wastage, pilferage, loss and expiries, which in turn led to better commodity availability at the facility level, improved method mix availability and increased family planning uptake.
  • Clear recordkeeping practices facilitated inter-facility redistribution in cases of emergency or sudden stock fluctuations–for example, due to increased client numbers at outreaches or in-reaches–thereby minimizing stock imbalances and interruption of activities within facilities.
  • Reporting rates improved, from less than 40% at baseline to over 80% at endline, resulting in better data for decision making in the Tupange facilities. In comparison, national reporting rates remained below 40%.

In Senegal, when the Informed Push Model was introduced into health centers in Pikine and Kaolack, the average monthly contraceptive stockout rate fell from 83% for implants and 43% for the Depo Provera injectable in 2010-2011 to 0% for both methods in 2012. Overall this approach reduced contraceptive stockouts to less than 2%. Improved product availability at the facility level led to increased uptake in family planning methods.

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