Assessing the contraceptive supply environment in Kinshasa, DRC: trend data from PMA2020

Abstract

Performance Monitoring and Accountability 2020 (PMA2020) is a population-based and facility-based survey program conducted in 11 countries to track contraceptive use dynamics and the supply environment. Annual data collection provides trend data unavailable from any other source. Two-stage cluster sampling was used to select 58 enumeration areas in Kinshasa; data were collected in 2014, 2015 and 2016 from three to six service delivery points (SDPs) per EA. Of the 228-248 SDPs surveyed each year, only two-thirds reported to offer family planning (FP) services. Of those reporting to offer FP, one-fifth or more did not do so on the day of the survey. As of 2016, only one-half of SDPs offering FP had at least three methods available, a proxy for contraceptive choice; only one in five had at least five methods. Long-acting reversible contraceptives, including implants and IUDs, were less widely offered and more often stocked out than resupply methods, including condoms, pills and injectables. Contraceptive stockouts were rampant: in 2016, over a quarter of the SDPs experienced stockouts of all methods (except condoms) in the previous 3 months, and two of the three most widely used methods-implants and injectables-were also the most likely to be stocked out. The findings documented the inconsistency in pricing of methods across facilities; moreover, less than one quarter of SDPs posted prices. Patterns in the contraceptive supply environment remained relatively unchanged between 2014 and 2016. The PMA2020 SDP module provides timely, actionable information to the DRC government, FP implementing organizations and donors involved in FP service delivery in Kinshasa, DRC. Yet the value of this information will be determined by the ability of the local FP stakeholders to use it in bringing the needed improvements identified by this survey to the contraceptive supply environment.

Keywords: Family planning; assessment; contraception; developing countries; evaluation; health services; programmes; survey.

Figure 1.

Availability of specific contraceptive methods at SDPs, PMA2020 Kinshasa, 2014–16. *Chi-squared test of difference with 2014 is significant at P<0.05

Figure 2.

Percentages of SDPs that experienced stockouts in past 3 months, by method, PMA2020 Kinshasa, 2015 and 2016. Notes: *Chi-squared test of difference between 2015 and 2016 is significant at P<0.05; the denominator in these percentages is the number of SDPs that report offering the specific method at the time of the survey