Madagascar continues to experience periodic stockouts for contraceptives – including DMPA-SC – impacting its ability to attain its FP2020 goals. While in common with many other LMICs, stockouts at the last mile are frequent due to systemic and difficult to resolve factors like poor infrastructure, limited capacity, and weak supply chains. Madagascar faces a more basic problem, which can be fixed over the short term: chronic stockouts at the central level despite adequate funding and support for procurement.
The Madagascar Catalytic Opportunity Fund (COF) II project, funded by the Clinton Health Access Initiative, worked with the existing central level coordination structures, specifically the Family Planning Logistics sub-committee and its members, to strengthen its governance, capacity, and systems to identify and prevent or mitigate central level stockouts before they occur.
For the project, JSI: 1) conducted root cause analysis surrounding reasons for recent stockouts at the central level; 2) conducted “as-is” analysis to map out existing stakeholders, structures, systems, processes, and tools for monitoring, tracking, and quantifying contraceptive needs at the central level; 3) designed new, simple, manageable systems and processes to enable stakeholders to identify and address impending stockouts; and 4) built capacity of the committee through training to identify and mitigate stockouts.