Trends in and Correlates of Short-Acting Contraceptive Stock-Outs: Multicountry Analysis of Performance Monitoring for Action Agile Platform Data

Alain K. Koffi; Pierre Muhoza; Saifuddin Ahmed; Philip Anglewicz; Funmilola OlaOlorun; Elizabeth Omoluabi; Mary Thiongo; Peter Gichangi; Georges Guiella; Pierre Akilimali; P.R. Sodani; Amy Tsui; Scott Radloff

doi:10.9745/GHSP-D-23-00411

Key Findings

As countries pledge to increase access to contraceptives, there is a need for continuous tracking of stock-outs to ensure continuous contraceptive supply and availability.
The analysis underscores the multifaceted nature of the contraceptive stock-out issue, influenced by both structural supply and demand-side factors that vary across different contexts.

Key Implications

Policymakers should prioritize the development and implementation of targeted strategies that address the unique challenges of each setting to mitigate contraceptive stock-outs.
Program managers are encouraged to monitor contraceptive stock-outs to identify when and where they are not available and take steps to ensure that supplies are replenished.
Donors and international partners have a critical role to play in supporting scalable interventions that address both the structural deficiencies and the demand complexities contributing to contraceptive stock-outs. Funding should also support the expansion of monitoring platforms, such as Performance Monitoring for Action Agile, which are essential for evidence-based decision-making and accountability.

ABSTRACT

Understanding trends in contraceptive stock-outs, as well as their structural and demand-side correlates, is critical for policymakers and program managers to identify strategies to further anticipate, reduce, and prevent stock-outs. We analyzed trends as well as supply- and demand-side correlates of short-acting contraceptive method stock-outs by using data from multiple rounds of Performance Monitoring for Action Agile surveys. These data longitudinally measured contraceptive availability over 2 years (between November 2017 and January 2020) across 2,134 public and private service delivery points (SDPs) from urban areas of 5 countries (Burkina Faso, Democratic Republic of the Congo [DRC], India, Kenya, and Nigeria). For each country, we analyzed the trends and used multilevel mixed-effect logistic regression to model the odds of short-acting contraceptive stock-outs, adjusting for key structural and demand-side factors of the SDPs. Stock-outs in short-acting contraceptive methods were common in health facilities and varied markedly, ranging from as low as 2.9% (95% confidence interval [CI]=1.7%, 5.1%) in India to 51.0% (95% CIs=46.8%, 56.0%) in Kenya. During the observation period, stock-out rates decreased by 28% in the SDP samples in India (aOR=0.72, P<.001) and 8% in Nigeria (aOR=0.92, P<.001) but increased by 15% in DRC (aOR=1.15; P=.036) and 5% in Kenya (aOR=1.05, P=.003) with each round of data collection. Correlates of stock-out rates included the facility managerial authority (private versus public), whether the facility was rated high quality, whether the facility was at an advanced tier, and whether there was high demand for short-acting contraceptives. In conclusion, stock-outs of short-acting contraceptives are still common in many settings. Measuring and monitoring contraceptive stock-outs is crucial for identifying and addressing issues related to the availability and supply of short-acting contraceptives.

Received: September 23, 2023.
Accepted: April 16, 2024.
Published: June 27, 2024.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit https://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-23-00411

View Full Text