KAMPALA, Uganda – When Isirimu Margret got pregnant at the age of 16, her hope for further education fizzled out. She dropped out of school, married her partner and had their child. So when the opportunity to seek family planning counseling at her local health center, a UNFPA-supported program, arose, she seized it by choosing an implant that would last for three years.
This meant it was time to establish her family in the rural district of Bukedea, where she and her husband cultivate crops. When she was ready to have a second child, it was her choice. Shortly after the implant was removed, she became pregnant.
“Family planning helps keep children apart and keep them healthy,” she said. “It also helps plan better for the kids and support the family at home. ”
For women like Ms. Isirimu who live in the poorest and most remote parts of Uganda, getting contraception when they wanted it was unpredictable. They took precious time tending to their homes and fields, walking a fair distance to health facilities, only to find that their preferred contraceptive method was out of stock.
Now things are changing.
Don’t waste, don’t want
In Bukedea and four other districts in eastern and northern Uganda, a digital system launched by UNFPA tracks contraceptive supplies to prevent stockouts and waste. DrugDash is a mobile application and web-based tool that generates and shares information about supplies in healthcare facilities in real time, eliminating frequent errors in the previous and laborious system of paper-based record keeping. With the latest numbers at their fingertips on a tablet, 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. This never happened before, ”said Bamulikulwaki Ezera, who oversees the drug supply in Bulambuli district. “It helped managers monitor their inventory and take action based on the data. ”
The system is the result of a global innovation challenge sponsored by the UNFPA Innovation Fund to Secure Rights and Choices, as part of an organization-wide campaign to provide better services and ending unmet family planning needs. The goal: To solve the problems that prevent a constant supply of contraceptives from reaching peripheral areas.
Initially, DrugDash was rolled out to 56 facilities in the five districts. Within months, 80 percent had reported improvements in ordering and distributing family planning supplies. Almost 60 percent had avoided stockouts or expired supplies. And better supplies of barrier methods like condoms spurred a 37% increase in use in six months. The system will eventually be expanded to track other reproductive health commodities such as maternal health drugs.
The innovation also met all the challenges at launch. When health workers weren’t sure whether they were using smart devices for the first time, WhatsApp groups reassured, increasing adoption. User feedback informed the offline feature to navigate internet outages and weak cellular signals. When it became apparent that private health facilities were as popular as public facilities for women seeking family planning, six were recruited to implement the new system.
Proof of concept
The moment was fortuitous. UNFPA organizations and partners such as International Planned Parenthood Federation reported having had to close family planning clinics in Uganda due to COVID-19, making monitoring and provision of contraceptives more necessary than ever. And during times of limited movement due to the pandemic, the system has proven essential as a virtual means of keeping supplies moving.
Last August, Uganda’s Constitutional Court issued a landmark ruling that maternal health services are essential to the right to life, and said stockouts, limited supplies and other systemic issues must be urgently resolved. Such a tool can be part of the solution. And now it has the backing of the Ugandan government, which has agreed to host DrugDash on national data servers in a step towards wider replication.
Because when women can plan their families, they can plan their lives and their future.