Fertility rates have dramatically declined during the past decade, from six births in the mid-
1980s to 4.5 births per woman during the past five years, according to the Ghana, 1998
Demographic Health Survey. While knowledge of family planning continues to be high among
both men and women, women in rural areas are likely to have twice as many children as those in
the urban areas. Access to basic health service is a major constraints faced by at least 40 percent
of the Ghanaian population. In addition, the Ministry of Health (MOH) continues to struggle
with increasing demand for health services and dwindling resources to manage them.
A joint tripartite team of MOH, USAID/Ghana, and John Snow, Inc.’s Family Planning Logistics
Management (JSI/FPLM) project conducted an assessment of the MOH contraceptive logistics
system from August 29–September 17, 1999, because 48 percent of the women obtain their
contraceptive supplies from the MOH. The team used qualitative and quantitative methods for
data collection to assess the in-country supply chain.
The assessment was conducted to better understand the status of the flow of commodities
(especially to the rural areas), measure the overall performance of the MOH logistics system, and
provide recommendations to make the system more effective.
The assessment results showed that the contraceptive logistics system is operational.
A wide range of modern contraceptives is reaching the clients through the MOH distribution
system, even in the most inaccessible and rural areas. Logistics data is collected throughout the
system and reported to the national level. The family planning program has achieved a 100
percent reporting rate, enabling them to accurately forecast contraceptive requirements for the
coming years. The system currently has an adequate supply of contraceptives; however, a future
shortfall may occur if additional funds are not committed to the procurement of contraceptive
supplies.
Inadequate storage conditions of contraceptive supplies were found at all levels—from the
central level down to the service delivery point (SDP). In addition, the central medical stores was
not always told when to expect deliveries, increasing their operating costs, decreasing their
efficiency, and slowing their response time.
Many of the staff in the system have received basic training in storekeeping; however, the
training did not include management and storage of health commodities, especially drugs. This is
further exacerbated by the fact that there are no established standard operating procedures. A
consequence of this was seen in the stock imbalances found throughout the system and the lack
of an inventory control system.
Several factors may be contributing to the lack of access to family planning programs and they
may need to be monitored nationally. Many of the health workers interviewed reported that the10
recent price increase has had detrimental effects on the demand for contraceptives. The team also
found that a client could not be given a consistent quantity of contraceptive in a given visit, as
none of the health workers was aware of a national dispensing policy.