Investigations conducted by the Stop Stock Outs Project (SSP) reveal that health facilities across Gauteng, Mpumalanga, North West, Limpopo and the Eastern Cape have reported ongoing stockouts of contraception medications, including Nur-isterate, Ovral, Triphasil and Depo Provera.
To avert further erosion of the right to sexual reproductive health, the SSP is calling on the National Department of Health (NDoH) to review the supply chain management and distribution procedures of contraceptives and produce a comprehensive remediation plan that prioritises contracts with reliable suppliers who can ensure an uninterrupted supply of contraceptives to facilities.
“Health facilities in affected provinces are increasingly reporting stockouts of more than one kind of contraception,” says Dr Indira Govender of Rural Doctors Association of Southern Africa, an SSP consortium member.
“Depo Provera is the most widely used and easy to administer contraceptive in public facilities across South Africa, and the ongoing stockouts leave many women who depend on it at a loss, without alternatives.”
SSP says they raised the alarm over contraceptives stockouts in 2018, yet the problem persists. Despite being well informed about stockouts, the Department of Health is failing to address the issues.
“The impact of a lack of access to contraceptives places women at increased risk of unwanted pregnancy, economic stress and compromises their psychological wellbeing. All of which undermines reproductive and contraceptive health rights,” explains Govender.
Furthermore, there is a shortage of Implanon in Ekurhuleni, Tshwane , in the City of Johannesburg and the Sedibeng District as a result of the gap caused by stockout of injectable contraceptives and pills.
“We have also observed a shortage of Mifegyne in some of the facilities that offer safe termination of pregnancy services,” says SSP Manager, Kopano Klass.
In North West Province, SSP partner organisation Médecins Sans Frontières (Doctors Without Borders) has been supplying the Department of Health with a limited quantity of intra-uterine devices and emergency contraceptives, but this is not a sustainable intervention.
Ultimately, the responsibility to procure medications remains the duty of the provincial and national health departments
In addition to reviewing and improving the current systems of supply chain management and distribution for contraceptives, SSP is calling for the development of a standard referral guideline to be circulated to health facilities, that describes how clinical staff must handle stockouts and appropriately advise women who are unable to access the contraceptive of their choice at the initial point of service.