Supply Chain Shortcomings
To date, supply chain efforts have largely focused on the contraceptive commodities themselves—IUDs, implants, injectables—but have often failed to consider the corresponding equipment and consumable supplies. Consumables, for this purpose, refer to expendable materials for one-time use, like:
- Gloves.
- Gauze.
- Anesthetic.
- Iodine.
Equipment includes instruments and reusable materials that are typically used more than once, often for the purpose of infection prevention and control between uses: a towel, forceps, scalpel handle, and kidney dishes, for example. These items are needed for the provision of certain FP methods, like long-acting reversible contraceptives (LARCs), but are not typically packaged with contraceptive commodities. As a result, they need to be planned separately.
The issue of the unavailability of equipment and consumable supplies—and the associated potential outcomes—has been poorly documented to date, both in terms of the extent to which this happens globally as well as the downstream effects that follow. As LARCs continue to gain momentum globally, the necessity to address FP equipment and consumable supplies security will become more urgent, as these methods are more material-intensive (compared to condoms or birth control pills, for example). The COVID-19 pandemic further strained existing supply chains, especially for infection prevention and control supplies (like gloves). As the global family planning community considers how to build resilient health systems and supply chains that provide uninterrupted access to FP services, there is an urgent need to prioritize equipment and consumable supplies security.
Exploring the Issue from Various Perspectives
Through consultations in Uganda, Nepal, and Ghana, as well as with global supply chain experts, we explored potential barriers to equipment and consumable supply availability across different actor groups. Different findings and opportunities for advocacy emerged for each group, though many of the findings transcended groups and were linked across both stakeholders and processes.