Stories From the Field

Tracking contraceptives improves health services and choice in Uganda

Uganda family planning services
DrugDash is a digital system that replaced paper records for tracking contraceptive supplies, eliminating stock-outs and waste. © Outbox

KAMPALA, Uganda – When Isirimu Margret got pregnant at 16, her hope to continue her studies vanished. She dropped out of school, married her partner, and had a child. So when the chance to obtain family planning counseling at her local health facility, supported by UNFPA, arose, she took it, choosing a three-year implant. 

That meant time to establish her family in the rural Bukedea District, where she and her husband cultivate crops. When she was ready to have a second child, it was her choice. Soon after removing the implant, she became pregnant.  

“Family planning helps to space children and keep them healthy,” she said. “It also helps in planning better for the children and providing for the family at home.” 

For women like Ms.Isirimu who live in poorer and remote parts of Uganda, getting contraception used to be unpredictable. They would take precious time away from tending their homes and fields to travel a fair distance to health facilities, only to find that their preferred contraceptive method was out of stock.  

Now, things are changing. 

Contraceptive Access and Supply

In Bukedea and four other districts in Uganda, a digital system launched by UNFPA tracks contraceptive supplies to avoid stock-outs and waste. DrugDash is a mobile app and tool that generates and shares information on supplies across health facilities in real-time. The app eliminates frequent errors under the previous, laborious system of record-keeping on paper. With the latest numbers at their fingertips, people can make more accurate and timely decisions about how to redistribute contraceptives. 

“With DrugDash, I can see where there is a need even before [health facilities] communicate it to us. That used to not happen,” explained Bamulikulwaki Ezera, who supervises medicine supplies for Bulambuli District. “It has helped managers in monitoring their stock and taking action based on the data.” 

Innovation to Meet Family Planning Needs

The system was the result of a UNFPA Innovation Fund-sponsored global innovation challenge to ensure rights and choices, part of an organization-wide drive to deliver better services and end unmet need for family planning. The goal: Solve issues that prevent a consistent supply of contraceptives from reaching outlying areas. 

Initially, 56 facilities in five districts rolled out DrugDash. Within a few months, 80% reported improvements in ordering and distributing family planning supplies. Nearly 60% avoided stock-outs or expired supplies. And better supplies of barrier methods like condoms spurred a 37% increase in use in six months. The system will eventually expand to track other reproductive health commodities like maternal health medicines. 

Innovation, too, addressed any challenges at launch. When health workers felt unsure about using smart devices for the first time, WhatsApp groups provided reassurance, increasing uptake. User feedback informed offline functionality to navigate Internet outages and weak cell signals.

Michael Wanduyi, health facility store manager, checks the stock of medicines at Muyembe Health Centre IV in Bulambuli District, one of five districts in Uganda that piloted the tracking technology. © Outbox

Proof of concept 

The timing was fortuitous. Organizations and UNFPA partners such as International Planned Parenthood Federation reported having to close family planning clinics in Uganda due to COVID-19. Closures making the tracking and supply of contraceptives more necessary than ever. And during periods of limited movement due to the pandemic, the system was critical as a virtual way to keep supplies moving. 

Last August, the Constitutional Court of Uganda issued a landmark ruling that maternal health services are essential to the right to life, and indicated that stock-outs, limited supplies and other systemic issues must be urgently addressed. Such a tool can be part of the solution. And now it has the backing of the Government of Uganda, which agreed to host DrugDash on national data servers in a step toward broader replication. 

Because when women can plan their families, they can plan their lives and their futures. originally published a version of this story

Dana Kirkegaard
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