On a hot afternoon in Bouaflé, central Côte d’Ivoire, Marie Elisabeth Key stands behind the pharmacy counter at a maternal and child health center (PMI). Women enter in steady streams, seeking contraceptives and family planning services. However, unlike before, there are no barriers to access today. The family planning products are free.
Marie Elisabeth Key has been working at this PMI for nearly three years, overseeing the procurement and dispensing of medications, including contraceptives. She has witnessed firsthand how stockouts and financial constraints have prevented women from accessing the products they need.
“Stockouts were frequent at the district pharmacy, which also caused issues at the PMI. There were a lot of times when we didn’t have the necessary medications,” she recalls.
These disruptions not only limited women’s choices but also discouraged them from seeking family planning services. However, this project aims to address this by improving the availability and accessibility of family planning (FP) products and services throughout Côte d’Ivoire.
Marie Elisabeth with midwife Koffi Adjoua outside the Mother and Child Hospital in Bouaflé, Côte d’Ivoire. Photo credit: Ousmane Koné.
A Step Toward Increased Access
Côte d’Ivoire has set an ambitious goal: increasing family planning coverage from 21% to 30% by 2030. Achieving this requires more than just removing financial barriers. It demands a well-functioning supply chain that ensures products are available where and when they are needed.
Recognizing this challenge and opportunity, in November 2024, VillageReach, in collaboration with the Ministry of Health, launched the Family Planning Supply Chain Strengthening Program. It is a four-year initiative aimed at improving the availability and access of family planning (FP) products and services across Côte d’Ivoire. Working across 56 health districts that include 2,072 public health facilities—representing 56% of the country’s total—the program reaches over 5.4 million women of reproductive age and directly supports the government’s “Gratuité” initiative by tackling ongoing supply chain issues.
The initiative is funded by the Gates Foundation and focuses on three key areas:
- Improving the availability of family planning products in last-mile health facilities and communities, particularly in under-reached districts.
- Strengthening health system performance, including data management and analytics for better decision-making.
- Enhancing financing and sustainability to support long-term improvements in family planning services.
Over the long term, the program aims to enhance sustainability to support ongoing supply chain improvements and family planning services. This will involve planning for financial sustainability, exploring long-term solutions and innovations and developing a transition strategy.
Marie Elisabeth Key is hopeful about the impact of this collaboration. “We anticipate a higher number of patients now that the products are free. With the right support, we can prevent stockouts and ensure effective tracking of supplies,” she says.
Marie Elisabeth works closely with Koffi Adjoua, a midwife at the hospital who actively engages with women in their homes to educate them on the importance and types of available family planning services. Adjoua believes that the increased availability of family planning products will save women’s lives.
She points out, “The impact of family planning on the community is positive. It will allow women to space out their births and avoid unwanted pregnancies. For young girls who are in school and lack financial resources, it will enable them to take care of themselves and avoid pregnancies in school settings.”
She further adds that making the products free will greatly increase access to the products for young girls, noting, “The free availability will really have an impact because it will increase the number of people using contraception. Also, from a financial standpoint, for young girls who cannot afford the products, since they were previously paid, this will allow them to better take care of themselves and avoid early pregnancies.”
Participants at the Family Planning Supply Chain Strengthening Workshop, held in conjunction with the Ministry of Health in Yamoussoukro, Côte d’Ivoire. Photo credit: Ousmane Koné.
Planning for Success
To ensure a smooth rollout of the initiative, VillageReach and the Ministry of Health recently co-hosted a workshop to co-create the workplan.
The workshop brought together over a hundred key stakeholders, including Senior Ministry of health officials, pharmacists and supply chain experts, to identify and address gaps in the system. The focus was on:
- Reviewing baseline data to identify supply chain bottlenecks and opportunities for improvement.
- Developing collaborative solutions by leveraging local expertise and innovation.
- Supporting policy implementation to ensure the free family planning program reaches the most vulnerable populations.
Among the attendees was Dr. Koné Blaise, Deputy Director-General of Health in charge of public hygiene, who emphasized the importance of sustainability. “It’s not enough to build access; we must ensure long-term solutions that keep family planning services available, especially in remote areas,” he stated.
Panel discussion at the Family Planning Supply Chain Strengthening Workshop in Côte d’Ivoire. Photo credit: Ousmane Konê.
Next Steps
The success of this expanding free family planning initiative hinges on reliable supply chains, robust data management and unwavering collaboration.
For the women who walk through the doors of Marie Elisabeth Key’s pharmacy, these efforts are not merely about receiving free supplies. They are about reclaiming their autonomy, exercising their fundamental right to choose and finally having the power to shape their destinies.