“I started using contraceptives after I gave birth to my second child,” said Birtukan Bezabih, a 25-year-old married mother of three in southern Ethiopia. “I did not know that I was pregnant with my second child until [he] started moving inside my womb.  It was just a few months after I gave birth to my first child…so my first child didn’t get proper care and he was not well breast fed.”

Nurse Haileshet Bekele at Tulla Health Center counsels Birtukan Bezabih, a mother of three. Photo Credit: USAID

Access to family planning empowers couples, like Birtukan and her husband, to plan and maintain healthier families. After the challenge of breastfeeding her first child and carrying her second at the same time, Birtukan turned to family planning methods to choose the right time to bring a third child into her life.

In Ethiopia, the Ministry of Health is committed to improving access to family planning through programs that have benefitted countless women and families to date. During the past six years, Ethiopia has seen a rapid increase in contraceptive use and a decline in the average number of births per woman. From 2005 to 2011, the percent of reproductive-age women using contraceptives in Ethiopia nearly doubled, from 15 to 29 percent. In the same period, the average number of children born to Ethiopian women declined from 5.4 to 4.8. By having fewer children by choice and ensuring children are spaced a healthy distance apart, mothers in Ethiopia are able to care better for the children they have, helping more children reach their fifth birthdays.

Programs that provide a reliable, affordable, accessible supply of contraceptives are essential to empowering women with the ability to plan and space their pregnancies. Without strong, well-managed logistics systems, delivery of contraceptives and other health commodities would be greatly compromised—in some cases, impossible.

Supply chain and logistic activities play an important role in ensuring continuous availability of family planning commodities and providing a diverse mix of options, so each woman can select one that works for her.  If a women arrives at a facility to find that her preferred contraceptive is gone (or “stocked out”), she is less likely to make a return trip for the commodity, which may result in an unintended pregnancy.    When health facilities have a reliable supply of family planning methods, women are more likely to use them as prescribed.

The USAID | DELIVER PROJECT, implemented by John Snow, Inc., supports the Ministry of Health in strengthening supply chain management and reducing stockouts, ensuring the availability of quality contraceptives for those who need them. With improvements in the supply chain, health facility stockouts of the most popular form of birth control (an injectable contraceptive that lasts three months) declined from 30 percent in 2006 to just 4 percent in 2010.

The impact of a stronger supply chain is clear to one of the health workers, Nurse Bekele: “… I can say that in recent years, for example last year, we did not have any major stockout of contraceptives… Because of a regular supply of contraceptive commodities, women are happy to get the service in their nearby health facility. It also improves service quality that clients can choose from different methods.”

Availability of family planning commodities does more than simply support better health for women and their children. As a result of the continued commitment of the Ethiopian government and collaboration with USAID, women like Birtukan are not only able to maintain good health for themselves and their families, but can also secure the family income, send their children to school, and improve the family’s potential for the future.