Ending Contraceptive Stockouts: A Vision for World Contraception Day
I had no idea what a stockout was—until 2003, when I saw the grave effects of one firsthand. As a Peace Corps volunteer in rural Morocco, I worked with Operation Smile one spring when the organization visited the country to provide free corrective surgery to people born with cleft lips and palates. With my boss and several volunteers, I found a number of people living in the “bled”—the rural area outside my small village—who wanted to undergo the procedure. For nearly every person we accompanied to Marrakech to receive services, this was not only their first time in a hospital—it was their first time seeing a doctor. It didn’t take long to understand why.
For many, the trip began with a hike of several hours to get from their home to a taxi stand. This was followed by a wait that lasted anywhere from an hour to a day for a “grand taxi” to depart to the nearest bus station, which was in my village. (Grand taxis, which transport passengers from one village or city to another, sell six places—two in the front seat and four in the back—and do not depart until all six places are sold, or, in other words, until five other people want to go where you are going.) By the time some of the patients reached my village, they had already been traveling more than a day. We then took an hour-long bus ride to the nearest small city, where we boarded another bus for the five-hour ride to Marrakech. Finally, after a ride in a “petite taxi” (a smaller taxi that transports passengers from place to place within a city), we reached the hospital.
We didn’t learn until after our patients had undergone the corrective procedure that the hospital ran out of pain medicine.
This left us with a handful of patients who had just undergone surgery and now had no access to pain relief. Perhaps in a month, once they had had a chance to heal, these patients would be glad they underwent the procedure. But on this day, they were far from home, scared, angry, and in excruciating pain. “What have we done?” they—and I—wondered miserably.
Contraceptive stockouts put women’s health at risk
Working in family planning now, I wonder how many women have made long or trying journeys to their nearest health clinic for family planning services only to be met with contraceptive stockouts. For many women, balancing everything from childcare needs to transportation issues to work schedules to weather to spousal consent, returning to the clinic in a few days or a week’s time to try again is not a possibility. When faced with a stockout and turned away empty-handed, these women are put at risk of unintended pregnancy and the many accompanying health threats, including anemia, unsafe abortion, and even death.
Avoiding Stockouts: The New Family Planning Logistics Toolkit
This World Contraception Day, I am pleased to announce K4Health’s new Family Planning Logistics Toolkit. This Toolkit provides essential information and tools for achieving greater contraceptive security—that is, ensuring that contraceptives are available to those who want them—with smart logistics system design and supply chain management. Strong logistics systems help ensure access to family planning by delivering the right product, in the right quantity, in the right condition, to the right place, at the right time, for the right cost.
What does the Toolkit offer?
- Essential guidance for effective logistics system design and supply chain management
- Frameworks and other resources for strengthening the supply chain management workforce
- Forecasting tips and tools
- Resources and tools to support optimal procurement strategies.
- Guidelines for proper storage, distribution, and waste disposal.
- Indicators, guides, and tools for assessment, monitoring, and evaluation of logistics systems.
- Videos, infographics, and other advocacy tools for raising awareness and fostering policy change for greater commitment to contraceptive security.
Contraceptive stockouts are a barrier to family planning access for many women and couples in low- and middle-income countries—but they don’t have to be. The tools and knowledge exist to build and improve highly functioning family planning logistics systems and to monitor and strengthen contraceptive security. In the right hands, these tools will save lives.