Staff outside of a clinic in Côte d’Ivoire.

Ensuring access to family planning services is a shared priority for national health systems and local governments. However, in Côte d’Ivoire, maintaining a reliable supply of contraceptives remains a significant challenge, limiting women’s and couples’ ability to make informed reproductive health choices. Frequent stockouts at health facilities threaten progress, undermining the impact of family planning programs.

Thanks to The Challenge Initiative (TCI) in Francophone West Africa, cities are now stepping up to lead efforts in strengthening contraceptive supply chains, ensuring sustainable solutions for long-term impact.

From Dependency to Local Ownership: Cities Take the Lead

TCI empowers local governments to take ownership of their health programs. Through targeted coaching and technical assistance, health districts in Côte d’Ivoire are transitioning from dependence on external support to independently managing their own contraceptive procurement and distribution.

This shift is critical, as stockouts are more than logistical hurdles – they directly impact modern contraceptive use and overall family planning outcomes. By addressing weaknesses in stock estimation, ordering, and distribution, TCI equips health system stakeholders with the skills and systems needed to keep facilities well-stocked and responsive to community needs.

Strengthening Supply Chains Through Local Leadership

A clinic in Côte d’Ivoire organizes its contraceptive stock.

The implementation of TCI’s “Quality Implementation of HII/HIP Checklist” and “Family Planning Supplies Checklist” across seven districts – Anyama, Cocody-Bingerville, Vavoua, Mankono, Daloa, Korhogo, and Séguéla – has been instrumental in identifying critical gaps in the family planning supply chain. This initiative focuses on:

• Training local health stakeholders and pharmacists in best practices for stock management.
• Strengthening coordination between health districts and national supply agencies.
• Enhancing real-time monitoring of contraceptive availability in health facilities.
• Resolving bottlenecks that delay the distribution of family planning commodities.

This hands-on coaching ensures that local government stakeholders not only understand the importance of contraceptive security but also gain the confidence and technical expertise to drive sustainable improvements in supply chain management.

Measurable Progress and Persistent Challenges

Findings from TC’s work in Francophone West Africa highlight both significant progress and areas requiring further investment:

• Strengthened Accountability: 79% of health facilities now produce quarterly stock management reports, enhancing oversight and transparency.
• Reduced Stockouts: Although three districts continue to face supply shortages, local governments are actively improving distribution systems, with early signs of progress.
• Built Capacity: Over half (54%) of health facility managers have received specialized coaching in stock management, boosting local expertise and performance.
• Ongoing Challenges: Some facilities still experience prolonged shortages – such as in Séguéla, where contraceptive stockouts can last up to 300 days annually – highlighting a critical area for continued action.

A Model for Sustainable Health Systems

TCI’s work in Côte d’Ivoire goes beyond short-term supply chain fixes – it is about building a system that cities can sustain long after TCI’s direct support ends. By embedding best practices in health district planning and coaching local teams, TCI ensures that improvements in contraceptive availability are lasting and scalable.

Next steps include:

• Expanding regional supply hubs to improve distribution.
• Integrating private sector partnerships to bolster supply chains.
• Ensuring local governments maintain dedicated budget lines for family planning and conduct periodic stock assessments using the TCI checklist.

As cities take full ownership of their reproductive health programs, they are proving that local leadership is the key to building resilient and self-sustaining health systems.