Pharmaceutical stockouts: problems and remedies for faith-based health facilities in Africa

  • Amy M Metzger CCIH
  • Mona Bormet CCIH

Abstract

Background and aims: Faith-based organizations (FBOs) provide a substantial portion of the health care services in many countries but despite this coverage, many health facilities have struggled to maintain adequate stocks of supplies. The purpose of this study was to identify the types of supply chain systems used by African faith-based health facilities to acquire reproductive health commodities, the performance of the different supply chain system types, their associated challenges and possible corrective actions.

Methodology: Through email surveys, phone interviews, and on-site visits, supply chains and challenges of faith-based health facilities in 13 African countries for 16 selected reproductive health (RH) commodities, including contraceptives were studied.

Results: Of the 46 facilities surveyed, 55% faced stockouts of one or more products in the three months prior to the survey. Stockouts were less common for contraceptives than other RH products. Significant strengths of the FBO supply chain included creativity in finding other sources of commodities in the face of stockouts, staff designated to monitor quality of the commodities, high capacity for storage, low incidence of expired products, few instances of poor quality, and strong financial sustainability mechanisms, often including patient fees. Weaknesses included unreliable commodity sources and power supplies, long distances to depots, and problems maintaining the cold chain. Five supply chain types were identified. As a result of this study, FBOs in Cameroon have already taken steps to strengthen their supply chain systems and reduce stockouts by forming the Alliance of Christian Faith-Based Organizations for Family Planning (ACFBOFP) in Cameroon. This coalition is raising the profile and fortifying the voice of FBOs toward strengthening FBO commodity security in Cameroon.

Conclusions: By studying the supply chains of faith-based health facilities, Christian Connections for International Health (CCIH) and its members have created new awareness among FBOs and international agencies of the importance and challenges of these systems and suggested actions toward improvement. This study can serve as a frame of reference as we move forward, anticipating an acceleration in interest to strengthen FBO supply chains to reach as many communities as possible with supplies and services. The alliance formed in Cameroon to strengthen commodity security may be a good model for other FBOs to consider. 

Author Biographies

Amy M Metzger, CCIH
Amy Metzger is a consultant to CCIH, contributing to the organization’s work in family planning and reproductive health.  Amy's global health portfolio includes research on hepatitis and HIV/AIDS at the Centers for Disease Control and Prevention, global health research in the Department of International Health at Rollins School of Public Health at Emory University, malaria and nutrition research and community health work in Uganda, health technical support and advising at FOCAS and Compassion International, as well as global health consulting projects. Amy has a Bachelor of Science degree in Biology from Northern Kentucky University and an MPH from Emory University’s Rollins School of Public Health.   
Mona Bormet, CCIH
Mona Bormet, MPH serves as Program Director for CCIH, currently managing four grants focused on family planning and reproductive health. Mona organizes and implements CCIH’s annual conference and advocacy day, in addition to hill briefings and CCIH’s involvement in global health coalitions. Previously, Mona served as Advocacy Program Specialist for the Asian & Pacific Islander American Health Forum where she focused on national policy efforts to improve data collection and analysis for Asian American, Native Hawaiian and Pacific Islander populations, efforts to collect and share individual’s health care stories in the policy arena, and facilitated advocacy trainings. Mona has an MPH from the University of Minnesota School of Public Health and a BS from Illinois State University.

References

1 Christian Connections for International Health and the FAM Project at Georgetown University. International Family Planning: Christian Actions and Attitudes: A Survey of Christian Connections for International Health Member Organizations [Internet]. McLean, VA. 2008. Available from: http://www.ccih.org/ccih-publications/166-international-family-planning-christian-actions-and-attitudes-a-survey-of-christian-connections-for-international-health-member-organizations-.html

2 USAID, John Snow Inc. Deliver Project and Christian Connections for International Health. Getting Contraceptives to Health Facilities: 10 Questions for Community-Based Groups to Consider [Internet]. McLean, VA 2012 (Updated 2013). Available from: http://www.ccih.org/ccih-publications/411-getting-contraceptives-to-health-facilities-10-questions-for-community-based-groups-.html

3 Christian Connections for International Health and John Snow Inc. Deliver Project. Webinar on Getting Contraceptives to Health Facilities [Internet]. McLean, VA. 2013. Available from: https://www.youtube.com/watch?v=rZgY-Xw_HO8

4 Christian Connections for International Health. Building the Evidence: Unique Stockout Challenges of FBO Health Facilities [Internet]. Washington, DC. 2015. Available from: http://www.ccih.org/CCIH-RHSC-Phase-1-Report.pdf

5 PATH, the World Health Organization, and the United Nations Population Fund. Essential Medicines for Reproductive Health: Guiding Principles for Their Inclusion on National Medicines Lists [Internet]. Seattle. PATH. 2006. Available from: http://www.path.org/publications/files/RH_essential_meds.pdf

6 USAID | DELIVER PROJECT. Guide to Conducting Supply Chain Assessments Using the LSAT and LIAT [Internet]. Arlington, Va. 2011. Available from: http://deliver.jsi.com/dlvr_content/resources/allpubs/guidelines/CondSCAsseLSATLIAT.pdf

7 Survey instruments available upon request: email ccih@ccih.org

8 Advancing Partners and Communities. AFP Smart: A Guide to Quick Wins. [Internet]. 2015. Available from: http://advancefamilyplanning.org/resource/afp-smart-guide-quick-wins-powerpoint
Published
2017-07-12
How to Cite
METZGER, Amy M; BORMET, Mona. Pharmaceutical stockouts: problems and remedies for faith-based health facilities in Africa. Christian Journal for Global Health, [S.l.], v. 4, n. 2, p. 19-29, july 2017. ISSN 2167-2415. Available at: <http://journal.cjgh.org/index.php/cjgh/article/view/130>. Date accessed: 26 sep. 2017. doi: https://doi.org/10.15566/cjgh.v4i2.130.

Keywords

commodity security, family planning, faith-based organizations, Africa, health facilities, stockouts, reproductive health, supply chains