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. 2014 May 13;2(2):245-52.
doi: 10.9745/GHSP-D-13-00171. eCollection 2014 May.

Informed push distribution of contraceptives in Senegal reduces stockouts and improves quality of family planning services

Bocar Mamadou Daff  1 , Cheikh Seck  2 , Hassan Belkhayat  3 , Perri Sutton  4
Affiliations

Informed push distribution of contraceptives in Senegal reduces stockouts and improves quality of family planning services

Bocar Mamadou Daff et al. Glob Health Sci Pract. .

Abstract

Contraceptive use in Senegal is among the lowest in the world and has barely increased over the past 5 years, from 10% of married women in 2005 to 12% in 2011. Contraceptive stockouts in public facilities, where 85% of women access family planning services, are common. In 2011, we conducted a supply chain study of 33 public-sector facilities in Pikine and Guediawaye districts of the Dakar region to understand the magnitude and root causes of stockouts. The study included stock audits, surveys with 156 consumers, and interviews with facility staff, managers, and other stakeholders. At the facility level, stockouts of injectables and implants occurred, on average, 43% and 83% of the year, respectively. At least 60% of stockouts occurred despite stock availability at the national level. Data from interviews revealed that the current "pull-based" distribution system was complex and inefficient. In order to reduce stockout rates to the commercial-sector standard of 2% or less, the Government of Senegal and the Senegal Urban Reproductive Health Initiative developed the informed push distribution model (IPM) and pilot-tested it in Pikine district between February 2012 and July 2012. IPM brings the source of supply (a delivery truck loaded with supplies) closer to the source of demand (clients in health facilities) and streamlines the steps in between. With a professional logistician managing stock and deliveries, the health facilities no longer need to place and pick up orders. Stockouts of contraceptive pills, injectables, implants, and intrauterine devices (IUDs) were completely eliminated at the 14 public health facilities in Pikine over the 6-month pilot phase. The government expanded IPM to all 140 public facilities in the Dakar region, and 6 months later stockout rates throughout the region dropped to less than 2%. National coverage of the IPM is expected by July 2015.

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Conflict of interest statement

Competing Interests: None declared.

Figures

FIGURE 1.
FIGURE 1.
Informed Push Model Streamlines Deliveries and Eliminates Orders Between Service Delivery Points (SDPs) and the Regional Warehouse
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A private logistician delivers contraceptives and collects data at a health post in Pikine, Senegal.
FIGURE 2.
FIGURE 2.
Percentage of Facilities Experiencing a Stockout in 2 Comparison Districts, Dakar, Senegal, January–July 2012 Abbreviation: IUDs, intrauterine devices.
FIGURE 3.
FIGURE 3.
Average Monthly Consumption of Contraceptives in Pikine District, Dakar, Senegal, Before and 1 Year After IPM Implementation Abbreviations: IPM, informed push model; MCPR, modern contraceptive prevalence rate.
FIGURE 4.
FIGURE 4.
Method Mixa Before and 1 Year After IPM Implementation, Pikine District, Dakar, Senegal Abbreviations: IPM, informed push model; IUDs, intrauterine devices. a Excluding condoms.
FIGURE 5.
FIGURE 5.
National IPM Scale-Up Plan, Senegal Abbreviation: IPM, informed push model.
See this image and copyright information in PMC

References

    1. Agence Nationale de la Statistique et de la Démographie (ANSD) [Sénégal]; ICF International. Enquête démographique et de santé à indicateurs multiples au Sénégal (EDS-MICS) 2010–2011. Calverton (MD): ICF International; 2012. Available from: http://dhsprogram.com/pubs/pdf/FR258/FR258.pdf
    1. USAID DELIVER PROJECT, Task Order 1. Delivery team topping up: bringing about reliable distribution in difficult environments. Washington (DC): John Snow, Inc; 2008. Available from: http://pdf.usaid.gov/pdf_docs/PNADO902.pdf
    1. RHInterchange [Internet]. Copenhagen (Denmark): United Nations Population Fund (UNFPA), AccessRH. [2000] -. Senegal: summary of shipments, 2012 Jan 1–2012 Dec 31; [cited 2014 Apr 9]; [about 1 screen] Available from: http://www.myaccessrh.org/rhi-home

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