When Covid-19 was declared a global pandemic on March 11, 2020, many feared family planning and reproductive health (FP/RH) programs globally would be decimated, with funds and attention diverted towards the virus and decades of progress in women’s health undermined.
Roughly 18 months later, some fears have been realized. Widespread transportation closures and workforce reductions, rapid changes in freight operations, policy changes and restrictions in China and India as well as consumer price increases have all impacted supply and consumption.
Overall, however, as the United Nations Population Fund (UNFPA) reports, “emerging evidence points to smaller and shorter disruptions in family planning services than initially projected, largely concentrated in April and May 2020”.
In Ethiopia, this trend appears to be playing out, with FP/RH supply and consumption largely stabilized after an initial shock. Contraceptive acceptance has remained steady even if it’s still below the 2020 target of 84%.
This also holds true for DKT Ethiopia, the largest supplier of FP/RH products to the private sector in Ethiopia and the second largest supplier overall after the Government.”
“We experienced two primary outcomes from the pandemic,” says Negussie GebreTsadik, National Operations Director for DKT Ethiopia.
“First, women moved away from clinic-based methods like injectable contraceptives in favor of oral and emergency pills.”
“Second, upstream suppliers were impacted by labor shortages, delays in raw materials and shipping, and price increases across the board.”
“This was particularly felt for injectable contraceptives.”
DKT imports injectable contraceptives from A.N.B. Lab, in Bangkok, Thailand. Long-standing weakness in the supply of injectables dating back to April 2019, was overwhelmed by the pandemic, leading to shortages globally as well as in Ethiopia.
User traffic in DKT’s Partner Clinic Network mimicked some of the changes observed in the organization’s mainstream product distribution. New user traffic was down 13% in 2020 from 2019 while overall user traffic was down just 3% year-over-year.
“We saw some of the same patterns from our regular product supply reflected in our Partner Clinics,” says Dagnachew Alemayehu, National Key Account Manager and Project Lead for DKT’s Partner Clinic Network, which includes more than 100 clinical outlets spread across Ethiopia.
“This was particularly true for first-time and lapsed users.”
“At the start of the pandemic, women and couples stayed away from clinical outlets.”
“After 6-8 months, however, as public health measures kicked in, user traffic largely returned to pre-pandemic levels.”
RECOVERY AND GROWTH
Since the initial shocks of March and April 2020, DKT’s overall product delivery has largely stabilized and even increased for certain product categories. Oral and emergency contraceptive pill distribution are up 17% and 64%, respectively, from 2019, while injectable contraceptives are returning to pre-pandemic levels.
One area of concern is condom distribution, which is down 29% from 2019. According to the Reproductive Health Supplies Coalition, UNFPA and USAID shipped a total of 1.35 billion condoms globally in each of 2018 and 2019 compared to 1.09 billion in 2020. This decrease, suggests that the trend in condom use in Ethiopia is not unique and may reflect a larger systemic problem.
 Reproductive Supplies Coalition. “Building Resilient Sexual and Reproductive Health Supply Chains During Covid-19 and Beyond”. April 2021. https://www.jsi.com/resource/building-resilient-sexual-and-reproductive-health-supply-chains-during-covid-19-and-beyond-community-roadmap-for-action-and-technical-findings/
 UNFPA. “Impact of COVID-19 on Family Planning: What we know one year into the pandemic” [Technical Note],
March 2021. https://www.unfpa.org/resources/impact-covid-19-family-planning-what-we-know-one-year-pandemic