As South Africa faces the scourge of single-mother headed households and teenage pregnancy, the Stop Stockouts Project (SSP) survey highlighted contraceptive shortage in public health facilities.
According to the SSP report titled “Contraceptive Supply Chain: Stockouts and their Causes”, contraceptive shortage and unavailability has become prevalent in the country, in particular in the Eastern Cape, North West and Kwazulu-Natal.
The survey was conducted in intervals of three months between April 2022 and June 2023.
Between April and June 2023, 36% women said contraceptives were not available in 31 medical facilities in KZN. However, this is a positive decline compared to the 60% between April and June 2022.
The Eastern Cape recorded a 7% difference to KZN, because 29% respondents stated contraceptives were unavailable in 30 surveyed medical facilities.
The North West recorded the least with 18% unavailable contraceptives.
Furthermore, the survey sounded the alarm on the 88% that said injectable contraceptives were unavailable in KZN, unlike the 41% was recorded in the Eastern Cape between April and June 2023.
Additionally, 50% of respondents said external condoms were unavailable in Eastern Cape.
The survey evaluated 18 health facilities in the North West, where 78% respondents indicated injectable contraceptives were unavailable. External and internal condoms, and oral contraceptives scored 100% for their unavailability.
Another concern was the discrimination women encountered to access contraceptives. KZN and Eastern Cape reported 7% of sex workers did not receive contraceptives due to their line of work between April and June 2023.
Forty percent said they did not receive contraceptives due to shortage, or stock-out in the North West.
KZN medical facilities rendered 26% of abortions on site, while 87% patients were referred to other facilities, citing unavailable infrastructure to conduct pregnancy terminations between April and June 2023.
Similar to KZN, medical facilities in Eastern Cape conducted 20% pregnancy terminations on site, meanwhile 58% were referrals.
The North West performed few terminations on site totalling to 19%, while 38% were referrals.
In response to alternative solutions to contraceptive stock-out and shortage, KZN and Eastern Cape recorded 100%, having health workers refer patients to other medical facilities, or switched to the available contraceptive on site.
In the North West, 67% of health workers said they referred patients to other facilities, while 33% encouraged women to switch to available contraceptives on site.
According to the report, poor national procurement planning was the leading cause of contraceptive shortages and stock-outs.
“At the provincial level, causes of stock-outs included budgetary limitations, dependence on manual paper-based systems and poor management of stock controls. The report recommends that the national and provincial departments of health urgently address the use of manual data systems for payment and stock management,” said SSP.
The report further stressed poor access to contraceptives was infringing on the constitutional right of women and teenage girls in preventing unwanted pregnancies.
“Access to contraceptives is a crucial component of the enjoyment of the right to sexual and reproductive health rights as well as the right to bodily autonomy. Contraceptives enable women and adolescent girls to exercise their right to decide whether to be pregnant, the number and spacing of their children and to have pleasurable and safe sexual experiences without the risk of unintended pregnancies,” said SSP.
The Star