Can Contraceptive Availability Be Improved by Strengthening Organizational Supply Chain Capacity, Data Visibility, and Use?

Reliable, responsive supply chains deliver quality contraceptives when and where they are needed. Through the ‘My Choice’ project, JSI is partnering with Indonesia’s National Population & Family Planning Board (BKKBN) to strengthen the family planning supply chain across four provinces ensuring women have consistent access to a range of contraceptive options.

Over the past decade, contraceptive prevalence rates in Indonesia have remained stagnant in part due to inconsistent access to contraceptives at service delivery points. To address critical gaps in the system, JSI collaborated with stakeholders at each level to design a comprehensive package of data centric interventions to strengthen the supply chain workforce, empowering them with new tools, skills, and information to enable holistic and continuous supply chain improvement.

Our work has been guided by three core themes—strengthen organizational capacity, foster collaboration and accountability, and inculcate a culture of data use for continuous supply chain improvement. After two years, preliminary endline evaluation results have shown improved contraceptive availability with average stockout rates across all methods decreasing by 47 percent, better management of logistic records and reports with stock card use increasing from 24 percent to 80 percent, and stock card accuracy increasing from 34 percent to 64 percent. To achieve these outcomes, we implemented several interventions based on a formative evaluation of supply chain weaknesses in 11 districts, including:

• A new min/max inventory control system using consumption data replaced the previous target-based system. This reduced stock imbalances across facilities with a greater number of these maintaining adequate levels of stock.
• Standardized trigger points for emergency orders and reallocation of overstocks. This resulted in providers becoming more proactive and the system becoming more adaptive to changing consumption patterns.
• Institutionalization of Quality Improvement teams at province and district levels. This improved the capacity of team members to analyze performance indicators, empowering them to develop local solutions and action plans. These forums have been critical in inculcating a culture of data use for decision making and have fostered collaboration among various departments within the family planning office to work towards a common goal of improved supply chain performance.
• Strengthening the supply chain workforce with the support of a routine mentorship and on-the-job training program. This has enabled managers to better understand the needs of health facilities and provide appropriate support. In areas where routine supportive supervision and on-the-job training has been performed regularly, there is improved supply chain performance with every visit.

The last couple of years have elevated the importance of supply chain management within the family planning program and provided the evidence needed to convince the central and local governments to increase investment in and focus on strengthening family planning supply chain systems. Many of the lessons learned in the project districts, especially with regards to the use of data to guide distribution and resupply and the implementation of other supply chain management best practices, is now influencing and changing the policies and procedures at the national level. In addition, provincial and district stakeholders have recognized the value of adopting these interventions and have committed resources to scale up the interventions in 25 additional districts in 2018.

To learn more about the ‘My Choice’ project, download the My Choice Supply Chain Impact Evaluation Report.

Written by Omar Balsara, Sarah Andersson, and Bethany Saad