Evaluating the Impact of a Family Planning Supply Chain Intervention on Postpartum Contraceptive Use in Senegal Using Difference in Differences.

内容摘要

Senegal faces high maternal mortality, elevated levels of short‑interval births, and substantial unmet need for postpartum contraception. Supply chain challenges contribute to contraceptive nonuse in the country. Before 2013, Senegal used a pull‑based contraceptive supply chain, in which facility staff estimated demand and procured supplies, leading to frequent stockouts. The informed push model (IPM), launched in 2012, aimed to streamline distribution. We used 2014-2019 DHS data (N = 32,373) and applied an event‑study difference‑in‑differences design with district‑level data to assess changes in the prevalence of modern, long-acting, reversible, and short‑acting contraceptive methods. We further conducted subgroup analyses by wealth and urbanicity. IPM significantly increased contraceptive prevalence. Modern contraceptive use in the postpartum period rose by 7.8 percentage points within 10 quarters post-IPM. Increases were most pronounced for wealthier and more urban districts. Results underscore the value of strong supply chains but show that supply‑side efforts alone may not reach low-income and rural populations. Future work should evaluate the cost-effectiveness and sustainability of alternative financing models and integrated strategies to address persistent supply and access barriers.