The human face of contraceptive stockouts: A qualitative study in Uganda

Ensuring access to contraception is one of the most critical and cost-effective means of improving women and children’s health and reducing maternal mortality. All too often, however, contraceptive methods are not on the shelf in the clinics and pharmacies that people depend on. A contraceptive stockout is a time when one or more contraceptive options are unavailable at a health facility that routinely provides that method, or that based on policy should be providing that method. Despite the widespread occurrence of contraceptive stockouts, little is known about the impacts they have—on women and their families, healthcare providers, and the critical services that clinics provide.

Ibis Reproductive Health and researchers from the Mbarara University of Science and Technology conducted a qualitative study to better understand these issues in two districts of Uganda (Kamuli and Mbarara). The objectives were to assess the perceived magnitude, scope, and causes of contraceptive stockouts; identify how women and providers cope with them; and describe the consequences they have. To answer these questions, the study team conducted eight focus groups with a total of 50 women aged 18 to 45; 24 individual in-depth interviews with family planning service providers and health facility managers; and 11 in-depth interviews with district-level policymakers and decision-makers.

Our findings indicate that contraceptive stockouts were common and pervasive in these districts in Uganda, and that women were accustomed to them and developed methods to cope. Stockouts led to numerous negative consequences for women, including unplanned and unwanted pregnancy, stress, domestic conflict, and increased costs for their preferred contraceptive method. Providers also experienced negative consequences such as emotional distress, demoralization, blame for the stockouts, declining skills, and decreased demand for their services. Understanding the human face of stockouts reinforces the critical need to both reduce stockout occurrence, and mitigate the negative consequences that they have.