Contraceptive Stock-Outs and Availability

Indicators 10–11

Stock-outs refer to the temporary unavailability of family planning commodities at a health facility or store where they are supposed to be available.

Stock-outs have an impact on contraceptive prevalence and method choice, and reducing contraceptive stock-outs is a critical measure of FP2020’ success. FP2020 stock-out indicators were adopted in 2015 after a consultative process led by the RHSC that resulted in the harmonization of various methods of measuring stock-outs. FP2020 indicators reflect the availability of family planning commodities at the facility level at a point of time (the day of the survey), and measure stock-outs by method (Core Indicator 10) as well as stock-outs for a range of methods (Core Indicators 11a and 11b).21 Data on stock-outs at the facility level are improving but are still not available for the majority of FP2020 countries. The number of countries able to report on stock-outs each year is expected to continue to improve through facility surveys conducted by UNFPA and PMA2020 and well as through routine health information systems.22

What do we know about stock-outs by method?

The number of countries for which we have data for Core Indicator 10 (Estimate Table 10), the percentage of facilities stocked-out of each type of contraceptive method offered on the day of assessment, has more than doubled since last year when we first reported on this indicator, rising from 14 countries last year to 30 countries this year. This improvement is mainly due to the expansion of UNFPA Supplies surveys to more countries.

Despite these increases, many FP2020 countries still lack data, and few countries are able to monitor stock-outs routinely at the facility level. The figure below shows by country the percentage of facilities stocked out by method offered. In general, stock-outs appear to be less frequent for the three most common methods dispensed at the primary level (condoms, pills, and injectables) than other methods. Of particular concern are the stock-outs highlighted in orange that indicate that facilities are stocked out of the most commonly used methods in that country. In Tanzania, for example, where injectables make up almost 40% of the method mix, 28% of surveyed facilities reported that no injectables were available on the day of the assessment. Stock-outs for LARCs, including IUDs and implants, remain high in some countries despite efforts to expand availability. Generally, methods that are less in demand—including female condoms, female and male sterilization, and emergency contraception—have the highest stock-out rates. The continued challenge of stock-outs requires governments and partners to address procurement and health supply chain bottlenecks and strengthen health information systems for timely monitoring, reporting, and action to avert stock-outs at the facility level.

In 2015, eight countries reported data for Core Indicators 11a and b (Estimate Table 11), the percentage of facilities at different levels (primary, secondary, or tertiary) that have a minimum range of modern methods in stock for clients on any given day. This is twice as many countries as reported data last year, with UNFPA Supplies surveys providing information on this for the first time.

The results show that in none of the countries with data were at least three methods in stock at the surveyed primary level facilities at the time of the survey. Kenya (94%) and Côte d'Ivoire (92%) were the two countries with the highest percentage of primary facilities where at least three modern methods were available. Secondary and higher-level facilities show a wide range in method availability, with two countries, Togo and Burkina Faso, reporting 100% of such facilities having five or more modern methods in stock on the day of the survey.

21. Stock-outs of permanent methods, including male and female sterilization, refer to the supplies needed to perform these procedures.

22. UNFPA facility surveys are nationally representative and include both public and private sector. PMA2020 surveys are limited to the facilities monitored in the sampling area for household surveys, which is selected to be nationally representative. Routine systems in Zimbabwe and Bangladesh capture information only on the public sector, while routine systems in Nepal and Kenya also capture part of the private sector.