# Factors That Contribute to Contraceptive Stockout Rates in Nigerian Health Facilities

## TL;DR

This study examines why contraceptive stockouts occur in Nigerian health facilities and finds that delays in resupply and infrequent supervision are key factors.

## Contribution

The study identifies specific supply chain and logistics factors associated with contraceptive stockouts in Nigeria using a large cross-sectional dataset.

## Key findings

- 41.7% of health facilities reported contraceptive stockouts in the three months before the survey.
- Delays exceeding two weeks between ordering and delivery were the strongest predictor of stockouts.
- Monthly supervisory visits were associated with significantly lower stockout rates.

## Abstract

Contraceptive stockouts are a major barrier to effective family planning (FP) service delivery in Nigeria, limiting access to modern methods and contributing to adverse reproductive health outcomes. Despite ongoing efforts to strengthen the supply chain, many health facilities continue to experience stockouts. A cross‐sectional study was conducted in September 2024 across 1,050 service delivery points (SDPs) in Nigeria. Descriptive statistics and univariate mixed‐effects logistic regression were used to explore associations between stockouts and facility characteristics, including location, supervision frequency, resupply methods, and logistics practices. Overall, 41.7 percent of SDPs reported at least one contraceptive stockout in the three months preceding the survey. Stockouts were slightly more common in rural facilities (56.8 percent) compared to urban facilities (43.2 percent), though this difference was not statistically significant (p = 0.53). Monthly supervisory visits were associated with significantly lower stockout rates (p = 0.014). Facilities relying on external agencies for resupply had 1.55 times higher odds of stockouts than those calculating needs internally (p = 0.058). Delays exceeding two weeks between ordering and delivery were the strongest predictor of stockouts (odds ratio: 1.76, 95 percent confidence interval: 1.257–2.474, p < 0.001). Improving supply chain efficiency, supervision frequency, and resupply models is critical to reducing contraceptive stockouts and enhancing FP service delivery in Nigeria.