Impact of family planning logistic management models on uptake of contraceptives in selected states in Nigeria: A comparative retrospective analysis

Abstract

Background: Use of contraceptives improves individual and national health outcomes and indices as it prevents maternal mortality and morbidity, child mortality, incidence of sexually transmitted infections and retains adolescents and young girls in school with improvement in the economic earning power. Contraceptive Logistics is the supply of contraceptives in the right quantity and quality at the right place at the right time for the right cost to the right people. The Contraceptive Logistics Management System in Nigeria stipulates that to ensure uninterrupted product availability and minimal stock out, Family Planning Service Delivery Points (SDPs) are to be re-supplied on a bi-monthly basis to bring their stock level to a maximum of 4 months of stock at any given time. Method: A retrospective analysis of the impacts of the three logistic models operational in six southern states in Nigeria under the auspice of UNFPA funded family planning logistics supply chain. Three outcomes of interest used to assess the impacts were stock out rates, gaps in supply and proportion of new users of contraceptives. The three models of family planning logistics reviewed were direct government last mile distribution with external funding, direct government last mile distribution without external funding and a third party private logistic company last mile distribution Result: The stock out rates for the direct government logistics with external funding was 6-20%, the direct government logistics last mile distribution (LMD) without external funding had a stock out rate of 20-58% and the private logistic company last mile distribution had a stock out rate of 10-30%. In terms of the gap in supply, the supply gap with the direct government LMD with external funding model was 48%, while the direct government LMD with no external funding model had a supply gap of 73% and the private company LMD logistics model had a low supply gap of 28%. The proportion of FP users who were new users was 19% in the direct government LMD with external funding, 8% in direct government LMD without external funding, and 16% in private logistic company LMD. Discussion: Direct government last mile distribution (LMD) with external funding reached the highest number of new FP users followed by private logistic company LMD and therefore contributed the greatest to the reduction of unmet need in family planning and increasing the contraceptive prevalence rates. The highest stock out rate of contraceptives was associated with direct government LMD without external funding and the least stock out rate was associated with same direct government LMD but with external funding. The greatest gap in supply of contraceptives was seen with direct government LMD without external funding followed by direct government LMD with external funding. Private company LMD had the least supply gap in contraceptives.