Ethiopian women want a steady supply of contraceptives


At Leku Health Center, Nurse Genet Assefa administers an injection of Depo-Provera, a popular
contraceptive given every three months.
 
An average of 20 women per day come for family planning services to the Leku Health Center in Ethiopia’s Southern region; on market days, the average is considerably higher. The women have choices of several contraceptive methods, with most of them preferring the three-month injection of Depo-Provera or the Microgynon pills.

Nurse Genet Assefa reports that there has now been a steady supply of contraceptives for over a year, and women can come with confidence for their favorite method. She points out that “The health center places a contraceptive order every month, our orders are always filled, and we get exactly what we order.” This has made a major difference.

Nurse Genet and other health center staff were trained by the USAID | DELIVER PROJECT, a comprehensive health commodities and logistics initative managed by JSI, to calculate the monthly demand for each method and to avoid stockouts. When more clients come, they have a buffer stock to cover the added demand.

A few years ago at places like Leku Health Center, there were few family planning clients and not many contraceptives were available. Survey data indicate that the change at Leku is in many ways typical of health centers in many locations in Ethiopia. Since 2005, use of contraceptives by women has more than doubled, from less than 14 percent to more than 30 percent.

Since 2005, use of contraceptives by women has more than
doubled, from less than 14 percent to over 30 percent.
 
There are two major challenges to improving family planning services in Ethiopia: distance and increasing demand. Leku is not on a paved road, but it is not a great distance from the regional capital. Many health centers in the region are considerably more remote. As the work of the project continues, more and more staff at remote health centers are trained, and a steady supply of contraceptives is available there. But the clear trend is that the number of family planning clients is increasing.

Even more remote than many rural health centers are small health posts, where community health workers are based.These women go from house to house offering 16 different “health packages.”

One of the most important packages is for family planning, and maintaining contraceptive stocks at health posts is crucial. Some of the health posts are on dirt roads that may be impassable after rains. In mountainous areas, some even get supplies by motorcycle or carried by animals.

Health posts usually get contraceptives and other supplies during their monthly trip to the nearest health center. But because there may be a travel or transport problem, a buffer stock is always needed. Supplying health posts places the responsibility of additional supply calculations on health center staff, but they know that the clients of the community health workers are important, too. The USAID | DELIVER PROJECT training prepares them to calculate needs not only for their own family planning clients but also for all those served out at the health posts.

Ministry of Health officials in Ethiopia are very supportive of family planning, and international donors, such as USAID, have contributed millions of dollars worth of contraceptives. Surveys show, however, that the rate of unmet need for contraceptives is approximately 34 percent. This means that even more women than currently served would use contraceptives if they were available.

The USAID | DELIVER PROJECT is one of the organizations collaborating closely with Ethiopian officials at all levels to make a steady supply of contraceptives available to all women who want them across all the regions of Ethiopia.