Durban – The findings of the latest survey on medicine stockouts at public health clinics countrywide released by the Stop Stockouts Project (SSP), shows that the sexual and reproductive health of women and girls is in jeopardy.
More than 15 000 public healthcare users and public healthcare providers from over 400 facilities were surveyed over a three-month period beginning in April, 2022 in collaboration with the Ritshidze project.
The research findings demonstrate that medicine stockouts most acutely impact women and girls who cannot access the contraceptives that they need, said a statement on Tuesday.
Key findings show that while there are generally fewer stockouts at facilities, contraceptives now represent the biggest share of medicine stockouts in the public health system.
According to the survey, stockouts of contraceptives represented 40% of all medicine stockouts reported.
“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 to 2015 and 2017, stockouts continue to form a barrier to women’s sexual and reproductive health rights.”
Ritshidze clinic monitors surveyed 15 750 public healthcare users and providers during the period April to June, 2022 and found:
- 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 medicine stockouts include HIV medication (16% of reported stockouts) and pregnancy tests (10% of reported stockouts).
- Facilities monitored were located in seven of the country’s nine provinces (excluding the Northern and Western Cape provinces)
- 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 alternatives. 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.
Dr Indira Govender of the Rural Doctors Association of South Africa (Rudasa), said the impact 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,” she said.
Govender said for some of the most vulnerable women in the country, this lack of access can be “catastrophic”.
Lucy O’Connell, a nurse and adviser at the Southern Africa Medical Unit of Doctors without Borders, said 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,” she said.
SSP urged the government to develop a plan that addresses stockouts at public healthcare facilities so that women and girls are able to access their preferred contraceptive, and develop guidelines for managing the impact of contraceptive stockouts for facilities.
“SSP acknowledges the significant efforts of the National and Provincial Departments of Health 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 contraceptives of choice for women and girls in South Africa,” said the statement.
SSP called on the Department of Health to urgently address these issues to ensure women and girls can always access their preferred contraceptive at any public health facility.
SECTION27 legal researcher, Baone Twala, said failure to prioritise access to contraceptives for all who wish to access them is a failure by the government to prioritise the lives of women and girls across the country.
Twala said the Stop Stockouts Project urges rapid action and response from the government to urgently address this issue.
“Women and girls are bearing the burden of the unavailability of contraceptives in South Africa, despite their clear constitutional right to access public healthcare services, including reproductive healthcare services."