On a humid morning in Treichville–Marcory, a young woman steps into a public health facility that provides free family planning services, clear about what she wants. She has discussed it with her partner, considered the possible side effects, and decided she wants to space her children. She approaches the midwife and asks for a specific contraceptive method.
Not long ago, that request might have ended in disappointment. Today, the answer is: Yes, we have it.
That small exchange captures what supply chains look like when they work.
We spoke with Mrs. Kassi Tanochi Marie Paule, midwife and mother–child health coordinator in the Treichville–Marcory health district, to understand what has changed on the ground since the launch of a family planning supply chain strengthening initiative in Côte d’Ivoire. Her experience shows how stronger supply systems translate into dignity and choice for women.
When Supply Fails, Choice Disappears
Before 2024, stockouts were frequent. Women would arrive requesting a particular method only to be told it was unavailable. Some reluctantly accepted alternatives. Others left. Many did not return.
“Women came with a clear idea of the method they wanted,” Kassi recalls. “Once they arrived, they had to accept something else or leave with nothing.”
She remembers a teenage girl who chose a short-term injectable contraceptive (DMPA). She received the first injection at the clinic. When she returned three months later for the second dose, the product was out of stock.
The clinic offered oral contraceptive pills as an alternative, but the young woman preferred the injectable method and was concerned about remembering a daily pill and possible side effects. So, she declined the alternative and left. Months later, she returned to the clinic pregnant.
“This is one of the concrete consequences of stockouts,” Kassi says.
In reports, stockouts appear as percentages or logistics gaps. In clinics, they interrupt care. Yet, in households, they can change the course of a young woman’s life.
What Changed: Availability Restores Confidence
Since the launch of the family planning supply chain strengthening initiative, availability has improved significantly.
Deliveries are more predictable. Facilities have better visibility into stock levels through digital tools. District pharmacies are receiving more consistent supplies, reducing the risk of gaps.
For providers like Kassi, the difference is immediate.
“Women can finally choose. That is the real change,” she says.
Attendance at clinics has increased. Women who previously discontinued contraception due to side effects or stockouts are returning, reassured that their preferred methods will be available.
Providers also feel more confident. Instead of improvising around shortages, they can focus on counseling women and helping them select the method that best fits their needs.
Treichville–Marcory, Côte d’Ivoire — Mrs. Kassi Tanochi Marie Paule, midwife and maternal and child health coordinator, in the pharmacy store room at the Treichville–Marcory health district. Photo Credit: Aida Bamba
Practical Steps to Keep Products Present
From the perspective of frontline providers, maintaining consistent availability requires practical improvements.
Kassi emphasizes the importance of clear delivery schedules and real-time stock monitoring, which allow facilities to anticipate shortages before they occur.
“If we can see our stock levels early and know when the next delivery is coming, we can plan better and avoid running out,” she explains.
She also stresses the importance of regular refresher training for providers, so staff can manage stock records accurately and ensure timely reporting to district pharmacies.
These operational improvements help ensure that contraceptive products remain available when women need them.
A Message to Partners and to Women
To health authorities and partners who supported the initiative, Kassi expresses appreciation:
“You made the availability of products a reality. Despite doubts about sustainability, today it is effective. This project deserves recognition.”
To women who remain hesitant, she says:
“There is a method for each woman. No one should endure an unplanned pregnancy. Family planning is the power to decide.”
Universal Health Coverage Requires Product Availability
What is happening in Côte d’Ivoire highlights that universal health coverage depends on health systems that function reliably; from forecasting and procurement to last-mile delivery.
When supply chains work, autonomy becomes possible:
A woman walks into a clinic.
She asks for the method she has chosen.
The midwife says yes.
That is public health working as it should.
This initiative is supported by funding from the Gates Foundation.
For more information on the Family Planning Supply Chain Strengthening project in Côte d’Ivoire, contact Alassane Kamagate at alassane.kamagate@villagereach.org