Cape Town - Women and girls are bearing the brunt of stockouts at public health clinics in South Africa as contraceptives now represent the biggest share of medicine stockouts.
This was one of the key findings of the latest Stop Stockouts Project report (SSP), launched on Tuesday.
The Stop Stockouts Project is a consortium of five civil society organisations: Doctors Without Borders (MSF), Rural Doctors Association of South Africa (RuDASA), Rural Health Advocacy Project (RHAP), SECTION27, and the Treatment Action Campaign (TAC), which aim to monitor and report on medicine and vaccine shortages and stockouts at primary health-care facilities.
From April to June 2022, clinic monitors surveyed 15 750 public health-care users and public health-care providers of over 400 facilities, and found that injectable contraceptives and oral birth control pills were most commonly out of stock, at 76.3% and 19.4% respectively. Facilities monitored were located in seven of the country’s nine provinces, excluding the Northern Cape and Western Cape provinces.
The research also found that other commonly reported medicine stockouts include HIV medication –16% of reported stockouts, and pregnancy tests – 10% of reported stockouts.
The report said most experts agreed that supply chain bottlenecks contributed significantly to persistently high stockout rates, particularly in low- and middle-income countries.
“With endemic violence against women in South Africa, failure to meet our reproductive health needs is another stressor as women without access to contraception are forced into a position of negotiating condom use, or risking an unplanned pregnancy,” said Rudsa’s Dr Indira Govender.
Survey results further indicated that health-care workers did their best to ensure patients did not leave empty handed, as 58.3% recommended switching to an alternative.
However, researchers said it was not a sustainable solution, and could have detrimental effects through side-effects like hormonal changes.
Femconnect founder Asonele Kotu said the government needed to find more innovative ways of distributing contraceptives.
“It’s about providing a basic human right to health care and giving women and girls options to make decisions about their own bodies. What we have tried to do, is build a tele-health platform to digitise family planning.
“You go online instead, have a virtual consultation, then it gets screened and approved by a family planning specialist. Once that is done, we send that information to a pharmacist if you want a self-administered contraceptive.
“We want to digitise the whole process; it cuts down costs and being at risk of facing stockouts, as well as waiting in long queues, and you get advice on what works perfectly for you.”
SECTION27 legal researcher Baone Twala added that a failure to prioritise access to contraceptives for all who wished to access them was a failure by the government to prioritise the lives of women and girls across the country.
The National Health Department acknowledged that while it faced some challenges from time to time, overall medicine availability has improved over the years.
“Currently, the department is not aware of any supply constraints for contraceptives. In the April to June 2022 period, suppliers have reported some supply challenges for some of the contracted contraceptives.
“These challenges included Active Pharmaceutical Ingredient shortages, production delays, and quality control issues. This was reported for both tablets and implants.
“Additionally, the contract for one of the implants was ceded from one supplier to another, which resulted in further interruptions in supply. The department is continuously engaging the suppliers to identify any possible supply challenges, to adjust the demand forecast (where needed) and to work together to mitigate the risks.
“Furthermore, the department has established a decision-making forum, with all provinces represented, to identify interventions aimed at addressing any medicine supply challenges, to improve medicine availability and reduce the potential impact of stockouts.”
FemConnect can be accessed via https://www.femiconnect.com/
Cape Times