NATIONAL NEWS - While there are generally fewer medicine stockouts at public health clinics across South Africa, contraceptives now represent the biggest share of medicine stockouts. 

This is one of the key findings of the latest Stop Stockouts Report (SSP) launched today.

The survey, undertaken in April 2022 in collaboration with the Ritshidze project**, indicates that stockouts of contraceptives represented 40% of all medicine stockouts reported, demonstrating that medicines stockouts most acutely impact women and girls.

TheStop Stockouts Project is a consortium of five civil society organisations Doctors Without Borders (MSF), Rural Doctors Association of South Africa (RuDASA), Rural Health Advocacy Project (RHAP), SECTION27, and the Treatment Action Campaign (TAC) that aims to monitor and report on medicine and vaccine shortages and stockouts at primary healthcare facilities.

Adopting a progressive new survey methodology that puts patient experiences alongside data collected from health facility staff and official figures, the survey indicates that while medicine stockouts have declined in comparison to previous SSP surveys conducted in 2013-2015 and 2017, stockouts continue to form a barrier to women's sexual and reproductive health rights.

From April to June 2022, Ritshidze clinic monitors surveyed 15 750 public healthcare users and public healthcare providers of over 400 facilities and found that injectable contraceptives and oral birth control pills were most commonly out of stock at 76.3% and 19.4%, respectively.

The research also indicates that other commonly reported medicines stockouts include HIV medication (16% of reported stockouts) and pregnancy tests (10% of reported stockouts). The monitored facilities were located in seven of the country’s nine provinces (excluding the Northern and Western Cape provinces).*** The impacts of contraceptive stockouts fall exclusively and negatively on women and girls.

“With endemic violence against women in South Africa, failure to meet our reproductive health needs is another stressor as women without access to contraception are forced into a position of negotiating condom use, or risk an unplanned pregnancy. For some of the most vulnerable women in our country, this lack of access can be catastrophic,” says Dr Indira Govender of the Rural Doctors Association of South Africa (RUDASA).

Survey results also indicate that healthcare workers do their best to ensure patients do not leave empty-handed. Of the healthcare workers surveyed who saw contraceptive stockouts for their patients, 58.3% recommended switching to an alternative.

However, this is not a sustainable solution and can have detrimental effects on the lives of women and girls, through side effects like hormonal changes, as well as the inconvenience of making such significant, and sometimes risky changes to their lives.

“Women who take contraception have made a choice not to get pregnant. When supplies are not there, we take away their agency. It’s often risky to change from a long-acting method to a daily method and it can be costly and time consuming to women and girls to ensure future continuous access”, says Lucy O’Connell, a nurse and advisor at the Southern Africa Medical Unit of Doctors without Borders (MSF).

SSP has shared the full survey report findings with the National and Provincial Health Departments. Among other things, we urge the South African government to develop a plan that addresses stockouts at public healthcare facilities so that women and girls can access their preferred contraceptives, and to develop guidelines for managing the impact of contraceptive stockouts for facilities.

Health officials have not responded to our requests for comment on the report, but SSP remains committed to ensuring that recommendations are taken forward by working with health authorities.

SSP acknowledges the significant efforts of the National and Provincial Health Departments in addressing stockouts of all medicines, which is reflected in the data collected in this survey. 

However, it is clear that there are important supply concerns for contraceptives, particularly injectables, which are often the required contraceptive of choice for women and girls in South Africa.

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