This document summarizes findings from an email survey and phone interviews with faith-based organization (FBO) health facilities regarding their supply chain challenges and stockouts. The study aimed to identify different types of FBO supply chains and their associated stockout issues. The email survey received 46 responses from 13 countries, and follow up phone interviews were conducted with 16 facilities across 6 countries. The interviews found that ordering, transport, storage, and financing practices varied significantly between facilities. Key challenges included irregular supply and delivery, incomplete orders from the Ministry of Health, long transport times to rural areas, and issues maintaining cold chain storage. Over two-thirds of facilities experienced stockouts of contraceptives in the past 3 months. The document concludes by

1. Building the Evidence:
Unique Stockout Challenges of
FBO Health Facilities:
Email Survey &
Phone Interview Findings
Amy Metzger, MPH
Consultant to CCIH

2. Study Goals
1. To identify distinct typologies of FBO supply chains
2. To identify associated challenges resulting in
stockouts (when products are out of stock)
3. To recommend solutions

3. Objectives
• Identify and describe the basic characteristics and
challenges of FBO supply chains at the service
delivery level.
• Deepen understanding of the types of supply chains
used by FBOs to access vital reproductive health
commodities, including contraceptives.
• Identify potential FBO partners and design strategic
interventions to improve RH supply chain at the
service delivery level.

4. Methodology
• Email survey - baseline data on products carried,
stockouts rates, etc 46 completed in 13 countries
• In-depth follow-up to 6 countries yielded 16
completed phone interviews
Topic covered:
1. Ordering
2. Transport
3. Storage and Product Quality Assurance
4. Cost Recovery and Financing

5. Email Survey Responses by Country (% of FBO facilities who responded)

6. Daily Average of FP Clients by Size and Location

7. Characteristics of Facilities Responding to Email Survey

8. Products Managed By FBO Facilities

9. Sources of Products Managed By Facility

10. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Cycle beads
Combined Pills
Progestin-only Pills
Male Condoms
Implants
Injectables
Magnesium Sulfate
Oxytocin
% of Facilities that Reported Being Stocked Out/Not Stocked Out of the
Product in Last 3 Mos (preceding survey):
Stocked Out Not Stocked Out No Response or DK
Stockout of Products

11. Phone interviews - FBO Facilities’ Logistics Practices,
Strengths & Challenges
Ordering
Facilities generally make ordering decisions for FP/RH products
When dependent on Ministry of Health (occasionally other
donors), MOH decides on quantity and sometimes the product
Most consider safety stocks when determining quantities
Challenges
 69% experienced stockouts of contraceptives in prior 3 months
Ordering practices inconsistent – in large part related to irregular
supply and delivery
MOH orders were not always complete

12. FBO Facilities’ Logistics Practices, Strengths & Challenges
Transport:
Wide spectrum of answers on how products
delivered and if on time and complete
Most common scenario – Facility collects products
with own vehicle (or rents a vehicle, truck,
motorcycle)
Faith Based Supply Organizations typically deliver to
facility on a regular schedule
Challenges:
 Rural facilities are many hours from MOH and FBSO
depots

13. FBO Facilities’ Logistics Practices, Strengths & Challenges
Storage and Product Quality Assurance:
Some use general stores & some keep supplies close to point of use
87% reported at least 1 person designated to deal with QA issues
An equally high percentage had procedure for incidents
Strengths:
Almost all facilities: storage capacity did not affect quantities ordered
Low evidence of expiry or quality issues
Challenges:
A few reported issues regulating temps & maintaining cold chain
Less often mentioned – insufficient space, poor security & lack of
steady electricity
A few had compromised quality of Misoprostol, Oxytocin &
Magnesium Sulfate

14. FBO Facilities’ Logistics Practices, Strengths & Challenges
Cost Recovery and Financing:
Fees charged varied widely
If contraceptives free from MOH, typically can’t charge the patient
In most facilities with single faith-based source – patients pay for
all products including contraceptives
The facility’s main source of financing is through:
Patient fees
External funds or donations
Subsidies from government –salary payments or direct
subsidies
Challenges: A few facilities noted contraceptives from FBSOs are
too expensive

15. Thank you for attending!