LaNasa Katherine H, Yalaza Michel, Hitayezu Felix, Roijmans Frank
Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, United States of America.
i+solutions, Kinshasa, DRC.
PLOS Glob Public Health. 2024 Aug 8;4(8):e0003531. doi: 10.1371/journal.pgph.0003531. eCollection 2024.
In the Democratic Republic of Congo (DRC), contraceptive security is one of the largest barriers to improving access to family planning. This article presents findings from a pilot study that adapted an informed push distribution model to the last mile of the contraceptive supply chain, between the health zone pharmacy and health facilities, in the eastern region of DRC. The intervention consisted of three changes in the supply chain: organization of more efficient transportation routes, in-depth involvement of the community in supply chain management and bundling of contraceptives with other essential medications for efficient delivery. The intervention was implemented from October 2017 to October 2018 in the Katana health zone of the South Kivu province. Although there was not a statistically significant difference in availability of contraceptives during the pilot study period, there were sharp declines in the mean length of stockouts at health facilities and the monthly transportation costs of delivering contraceptives. Overall, the pilot study demonstrated it is feasible to adapt the IPM to a new location with complex geographical, political and socioeconomical influences. Future studies will be required to evaluate whether the adapted informed push model is more effective than the existing pull supply chain system for contraceptives in the DRC.
在刚果民主共和国（DRC），避孕药具的供应保障是改善计划生育服务可及性的最大障碍之一。本文介绍了一项试点研究的结果，该研究将知情推动配送模式应用于刚果民主共和国东部地区避孕药具供应链的最后一公里，即从卫生区药房到医疗机构之间。干预措施包括供应链中的三项变革：组织更高效的运输路线、让社区深入参与供应链管理以及将避孕药具与其他基本药物捆绑以便高效配送。该干预措施于2017年10月至2018年10月在南基伍省的卡塔纳卫生区实施。尽管在试点研究期间避孕药具的可获得性没有统计学上的显著差异，但医疗机构缺货的平均时长以及运送避孕药具的每月运输成本均大幅下降。总体而言，试点研究表明，将综合项目管理（IPM）应用于受复杂地理、政治和社会经济影响的新地点是可行的。未来需要开展研究，以评估调整后的知情推动模式是否比刚果民主共和国现有的避孕药具拉动式供应链系统更有效。
