Global Development Support (GDS) conducted an assessment on the availability of contraceptives and essential lifesaving medicines and commodities at service delivery points (SDPs) in Mozambique. This project was funded by the UN Population Fund (UNFPA). UNFPA supplies commodities and technical assistance to the Mozambican Ministry of Health to ensure consistent availability of those commodities in service delivery points. The purpose of the survey was to assess:
- the availability of reproductive health commodities, other supplies, and basic child health equipment;
- functioning of the supply chain, notably its responsiveness;
- the integrity of the cold chain;
- staff skills and training in the provision of contraceptive services;
- the frequency, focus, and effectiveness of supervision;
- the availability of guidelines and protocols for family planning, antenatal care, and disposal of medical waste;
- methods used for safe disposal of medical waste;
- use of information and communication technology;
- client feedback;
- user fees, and
- the perceptions among providers and their use of generic contraceptives.
The assessment team conducted interviews and direct observation in 124 health facilities in ten provinces and the capital city of Maputo. Over 1,100 family planning clients were interviewed regarding their perceptions of the quality and adequacy of the services offered.
Ten teams of data collectors carried out the assessment, which was conducted in September and October 2017. Data were recorded electronically at the point of the interview/ observation and accumulated progressively throughout the fieldwork.
The digital revolution has brought significant advances in the quality and timeliness of research data. The questionnaire was programmed into tablets so that data collectors could record responses and observations for immediate inclusion in the assessment’s database. The program in the tablet detected common errors and denied their entry and would not allow the interview to proceed without an acceptable response. The upshot was that very few questionable entries were detected in the submissions. Incoming data were examined daily at the central level to pick up suspect entries.
In general, there was good cooperation from health facility staff even though there were occasional instances of hesitation.
The survey design and methodology were developed in consultation with UNFPA to ensure comparability across time periods as well as to permit comparisons of results across countries where UNFPA has similar programs. Meetings were held with them and the Ministry of Health regularly throughout the period of data collection. It was an example of excellent cooperation between different stakeholders.
The final report covered the following:
- Policies on provision of contraceptives and maternal/child health services and commodities.
- Availability of contraceptives.
- Availability of maternal and RH medicines and supplies.
- Incidence of full and constant supply of contraceptives over the past three months.
- Availability of “additional medicines.”
Incidence of full and constant supply of maternal/RH medicines, past three months.
- Supply system, including cold chain.
- Staff skills and training in family planning.
- Frequency and focus of supervision.
- Availability of guidelines and checklists.
- Availability and use of information and communication technology (ICT).
- Waste disposal.
- User fees.
- Client feedback on quality of services, organizational, and interpersonal aspects of the service, and the costs of accessing the service.
- Use and perceptions of providers of generic contraceptives.
The survey report will be used by UNFPA and the Ministry of Health of the Government of Mozambique to identify areas of improvement for supply and cold chain management including staff capacity development, improving service delivery, waste management, supervision, as well as client satisfaction.