Pierre Muhoza 1, Alain K Koffi 1, Philip Anglewicz 2, Peter Gichangi 3, Georges Guiella 4, Funmilola OlaOlorun 5, Elizabeth Omoluabi 6, P R Sodani 7, Mary Thiongo 3, Pierre Akilimali 8, Amy Tsui 2, Scott Radloff 2
Affiliations
- 1Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
- 2Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
- 3International Centre for Reproductive Health Kenya, Nairobi, Kenya.
- 4Institut Supérieur des Sciences de la Population (ISSP) of the Joseph Ki-Zerbo University, Ouagadougou, Burkina Faso.
- 5Department of Community Medicine, University of Ibadan, Ibadan, Nigeria.
- 6Centre for Research, Evaluation Resources and Development, Ife, Nigeria.
- 7IIHMR University, Jaipur, India.
- 8Ecole de Santé Publique de l’Université de Kinshasa, Kinshasa, Democratic Republic of Congo.
PMID: 33454786 PMCID: PMC8058948 DOI: 10.1093/heapol/czaa197
Abstract
Approximately 214 million women of reproductive age lack adequate access to contraception for their family planning needs, yet patterns of contraceptive availability have seldom been examined. With growing demand for contraceptives in some areas, low contraceptive method availability and stockouts are thought to be major drivers of unmet need among women of reproductive age, though evidence for this is limited. In this research, we examined trends in stockouts, method availability and consumption of specific contraceptive methods in urban areas of four sub-Saharan African countries (Burkina Faso, Democratic Republic of Congo, Kenya and Nigeria) and India. We used representative survey data from the Performance Monitoring for Action Agile Project that were collected in quarterly intervals at service delivery points (SDP) stratified by sector (public vs private), with all countries having five to six quarters of surveys between 2017 and 2019. Among SDPs that offer family planning, we calculated the percentage offering at least one type of modern contraceptive method (MCM) for each country and quarter, and by sector. We examined trends in the percentage of SDPs with stockouts and which currently offer condoms, emergency contraception, oral pills, injectable, intrauterine devices and implants. We also examined trends of client visits for specific methods and the resulting estimated protection from pregnancy by quarter and country. Across all countries, the vast majority of SDPs had at least one type of MCM in-stock during the study period. We find that the frequency of stockouts varies by method and sector and is much more dynamic than previously thought. While the availability and distribution of long-acting reversible contraceptives (LARCs) were limited compared to other methods across countries, LARCs nonetheless consistently accounted for a larger portion of couple years of protection. We discuss findings that show the importance of engaging the private sector towards achieving global and national family planning goals.
Keywords: Family planning; contraception; health services; public/private; reproductive health; surveillance; survey methods.
© The Author(s) 2021. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.
Link
https://pubmed.ncbi.nlm.nih.gov/33454786/
