Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Institute of Child Health, University College London, London, United Kingdom.
PLoS One. 2020 Aug 3;15(8):e0236659. doi: 10.1371/journal.pone.0236659. eCollection 2020.
Until 2011, stockouts of family planning commodities were common in Senegalese public health facilities. Recognizing the importance of addressing this problem, the Government of Senegal implemented the Informed Push Model (IPM) supply system, which involves logisticians to collect facility-level stock turnover data once a month and provide contraceptive supplies accordingly. The aims of this paper were to evaluate the impact of IPM on contraceptive availability and on stockout duration.
To estimate the impact of the IPM on contraceptive availability, stock card data were obtained from health facilities selected through multistage sampling. A total number of 103 health facilities pertaining to 27 districts and nine regions across the country participated in this project. We compared the odds of contraceptive stockouts within the health facilities on the 23 months after the intervention with the 18 months before. The analysis was performed with a logistic model of the monthly time-series. The odds of stockout for any of the five contraceptive products decreased during the 23 months post-intervention compared to the 18 months pre-intervention (odds ratio, 95%CI: 0.34, 0.22-0.51). To evaluate the impact of the IPM on duration of stockouts, a mixed negative binomial zero-truncated regression analysis was performed. The IPM was not effective in reducing the duration of contraceptive stockouts (incidence rate ratio, 95%CI: 0.81, 0.24-2.7), except for the two long-acting contraceptives (intrauterine devices and implants). Our model predicted a decrease in stockout median duration from 23 pre- to 4 days post-intervention for intrauterine devices; and from 19 to 14 days for implants.
We conclude that the IPM has resulted in greater efficiency in contraceptive stock management, increasing the availability of contraceptive methods in health facilities in Senegal. The IPM also resulted in decreased duration of stockouts for intrauterine devices and implants, but not for any of the short-acting contraception (pills and injectables).
直到 2011 年，塞内加尔公共卫生机构的计划生育药具经常出现缺货现象。为了解决这一问题，塞内加尔政府实施了知情推动模式（IPM）供应系统，该系统要求后勤人员每月收集一次设施层面的库存周转率数据，并相应地提供避孕用品。本文旨在评估 IPM 对避孕用品供应情况和缺货持续时间的影响。
为了评估 IPM 对避孕用品供应情况的影响，我们从通过多阶段抽样选择的卫生机构获取了库存卡数据。全国共有 103 个卫生机构参与了该项目，分布在 27 个区和 9 个地区。我们比较了干预后 23 个月和干预前 18 个月卫生机构内避孕用品缺货的几率。我们使用每月时间序列的逻辑模型进行了分析。与干预前 18 个月相比，干预后 23 个月内，所有五种避孕产品的缺货几率均有所下降（比值比，95%置信区间：0.34，0.22-0.51）。为了评估 IPM 对缺货持续时间的影响，我们进行了混合负二项零截断回归分析。结果表明，IPM 并不能有效缩短避孕用品的缺货持续时间（发病率比，95%置信区间：0.81，0.24-2.7），除了两种长效避孕方法（宫内节育器和植入物）。我们的模型预测，宫内节育器的缺货中位数从干预前的 23 天减少到干预后的 4 天；植入物的缺货中位数从 19 天减少到 14 天。
我们得出结论，IPM 提高了计划生育药具管理的效率，增加了塞内加尔卫生机构内避孕方法的供应情况。IPM 还缩短了宫内节育器和植入物的缺货持续时间，但对任何一种短效避孕方法（药丸和注射剂）都没有影响。
