Getting to FP2020: Harnessing the private sector to increase modern contraceptive access and choice in Ethiopia, Nigeria, and DRC

Christina Riley, Danielle Garfinkel, Katherine Thanel, Keith Esch, Endale Workalemahu, Jennifer Anyanti, Godéfroid Mpanya, Arsène Binanga, Jen Pope, Kim Longfield, Jane Bertrand, Bryan Shaw, Andrew Andrada, Eric Auko, Katie Bates, Nirali Chakrabory, Desmond Chavasse, Tarryn Haslam, Catherine Hurley, Tabeth JiriAliza Lailari, Megan Littrell, Julius Ngigi, Kathryn O'Connell, Ricki Orford, P. Prabhu, Stephen Poyer, Justin Rahariniaina, Mac Shoen, Habtamu Tamene, May Me Thet, Chinazo Ujuju, Tadele Kebede, Ephrem Tekle Lemango, Berhane Assefa, Woldemariam Girma, Wapada I. Balami, Kayode Afolabi, Gabriel Ortonga, Thérèse Kyungu, Gaby Kasongo, Veronique Dupont, Janine Hum, Amy Lin, Scott Radloff, Prashant Yadav, Kalamar Amanda Kalamar, Sarah Thurston, Coley Gray

Research output: Contribution to journalArticlepeer-review

Abstract

Background: An estimated 214 million women have unmet need for family planning in developing regions. Improved utilization of the private sector is key to achieving universal access to a range of safe and effective modern contraceptive methods stipulated by FP2020 and SDG commitments. Until now, a lack of market data has limited understanding of the private sector's role in increasing contraceptive coverage and choice. Methods: In 2015, the FPwatch Project conducted representative outlet surveys in Ethiopia, Nigeria, and DRC using a full census approach in selected administrative areas. Every public and private sector outlet with the potential to sell or distribute modern contraceptives was approached. In outlets with modern contraceptives, product audits and provider interviews assessed contraceptive market composition, availability, and price. Findings: Excluding general retailers, 96% of potential outlets in Ethiopia, 55% in Nigeria, and 41% in DRC had modern contraceptive methods available. In Ethiopia, 41% of modern contraceptive stocking outlets were in the private sector compared with approximately 80% in Nigeria and DRC where drug shops were dominant. Ninety-five percent of private sector outlets in Ethiopia had modern contraceptive methods available; 37% had three or more methods. In Nigeria and DRC, only 54% and 42% of private sector outlets stocked modern contraceptives with 5% and 4% stocking three or more methods, respectively. High prices in Nigeria and DRC create barriers to consumer access and choice. Discussion: There is a missed opportunity to provide modern contraception through the private sector, particularly drug shops. Subsidies and interventions, like social marketing and social franchising, could leverage the private sector's role in increasing access to a range of contraceptives. Achieving global FP2020 commitments depends on the expansion of national contraceptive policies that promote greater partnership and cooperation with the private sector and improvement of decisions around funding streams of countries with large populations and high unmet need like Ethiopia, Nigeria, and DRC.

Original languageEnglish (US)
Article numbere0192522
JournalPloS one
Volume13
Issue number2
DOIs
StatePublished - Feb 2018

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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