Concern over shortage of contraceptives in parts of SA

Rights groups, Stop Stockout Project and Ritsiza, have raised concern over the consistent supply shortage of contraceptives, especially injectables, in three of South Africa’s provinces.

In a recent report released by the two organisations, the North West, Eastern Cape and KwaZulu- Natal are the affected provinces and they have been going through this since 2018.

Principal Investigator at Stop Stockout Project, Dr Jess Rucell, says although between June of 2022 and June of 2023 there was a 39 % and 29 % decrease in patients’ report of unavailability of contraceptive supplies in the KwaZulu-Natal and Eastern Cape provinces, respectively, the North West province has seen the most consistent shortage of stock.

Dr Rucell fingers the Health Department’s poor procurement planning as the key driving factor of this problem.

“This arose from the department not anticipating national stockouts due to the state donating contraceptive methods to the ECHO trial, which was a three-year international randomised clinical trial that took a large portion of participants from SA, as well as not anticipating the market anxiety relating to the outcome of the trial, which was said to have examined the relationship between the use of the three-months-injectable Depo-Provera and a potential increased risk of acquiring HIV,” explains Dr Rucell.

According to the researcher, challenges were already present following the announcement of the trial, as manufactures had discontinued the production of the injectable pathogen, anticipating that the trial would indeed find a link.

Dr Rucell says there was also a lack of supplier competition, which weakened the country’s national position to negotiate affordable contacts. She says they have also witnessed challenges at the provincial level too, citing budgetary limitations and incompatible electronic information systems as reasons for this.

“What’s happening at the provincial level is that we have electronic information systems that allow us to send invoices, report payments, and acknowledge stock receipts, but there are different information systems, including manual paper-based hand-written systems. This makes it difficult to co-ordinate and track payments in a very efficient manner.”

Dr Rucell suggests that adequate human resources, storage, and compatible electronic information systems are needed to address such systemic problems.

“When a stockout occurs in the public health system, women and girls of reproductive age are the most impacted. Girls and women seem to be the ones responsible for preventing unwanted pregnancies” says Dr Rucell.

The stop Stockout movement believes that the Health Department need to ensure accountability for poor procurement planning errors, which are the cause of the contraceptive stockouts.

Dr. Rucell believes that a defined and adequate budget for contraceptives, contraceptive delivery and consequently, for termination of pregnancies also needs to be set out.

“Additionally, there needs to be a move to address incompatible manual data information systems for payment stock and ordering within and between provinces so that the electronic payment systems are compatible. Lastly, the Department of Health needs to appoint an increased adequate Human Resources, including through sharing of information and pharmaceutical training on procurement planning and stock management, focusing on pharmacists” adds the medic. Written by Odirile Rabolao