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Global Reproductive Health: Contraceptive Issues |
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Contraceptive Logistics
Contraceptive
Shelf Life and Storage Conditions
Type of Contraceptive |
Required
Storage Conditions |
Shelf
Life |
Oral
Contraceptives |
Store
away from direct sunlight in a cool, dry location. |
5
years (Ovostat, Marvelon, Organon brands – 3 years) |
Condoms |
Below
40°C. No long exposure to high humidity, direct sunlight,
fluorescent light, or ozone. Don’t store near chemicals. |
4 years |
Diaphragms |
Below
40°C. No long exposure to high humidity, extreme temperatures,
ozone, or direct sunlight. Don’t store near chemicals. |
5
years |
Injectable |
Below
40°C. Away from direct sunlight. Store vials upright. |
5 years |
IUDs |
Below
40°C. Protect from direct sunlight and excessive moisture. |
7
years (Multiload brand 3 years) |
Norplant |
Below
30°C. Dry location. |
5
years |
Spermicides |
Between
15 and 30°C. No extreme fluctuations in temperature or humidity.
Cans should be stored in upright position. |
3
to 5 years (5 years for USAID-donated, 3 years for others) |
Vaginal
foaming tablets |
Below
40°C. |
5
years for USAID-donated, 3 years for others |
Problems
with Contraceptive Quality
It is very important to
make sure that the contraceptives are in good condition before they are
distributed or are dispensed to users. Contraceptive quality should be
checked at several points:
- when they arrive at
the storage or service facility;
- immediately before
they are dispensed to a contraceptive user;
- if they have been in
storage for more than six months or if the storage conditions are poor
(for example, high heat or humidity),
- when conducting a
physical inventory,
- when the
contraceptives are close to their expiration date,
- if the
contraceptives show signs of damage.
When you are inspecting
the contraceptives, look for the following warning signs.
CONTRACEPTIVE
QUALITY WARNING SIGNS
Do
Not Use or Distribute If:
Oral Contraceptives
- Pills are
visibly damaged (broken, cracked, crumbled, discolored).
- The aluminum
packaging for any of the pills is broken.
- The packet
is missing any pills.
- There
are signs of deterioration (brown spots, pill crushes easily).
Condoms
- Any condom
packets in the batch are brittle or otherwise damaged.
- Any condom
packets in the batch have yellowed.
- The seal of
the condom packet is not intact.
Intrauterine devices (IUDs)
- The sterile
packaging has been broken or perforated.
- Any of the
product contents are missing from the package.
Note: The
effectiveness of copper-bearing IUDs is not damaged if the copper
darkens or tarnishes.
Injectables
- Solid
material remains on the bottom of the vial even after vigorous
shaking.
- The cap is
no longer on the glass vial.
Note: If
the contents of the vial have separated, shake the vial
immediately before using. The solution must always look milky
white, without solid material, to be used.
Implants
- The implant’s
sterile packaging is broken.
- One or more
of the capsules is missing or discolored (not white).
- One or more
of the capsules is broken or bent.
Spermicidal Jelly
- The jelly
tube is wrinkled or leaking.
- The
applicator cannot easily be screwed onto the top of the
tube.
Foaming Tablets
- The package
has broken or missing tablets.
- The package
is puffy (this indicates a moisture leak).
- The foil
laminate has cracks.
- The tablets
are discolored (they should be white).
- The tablets
are soft, wet, damp, or crumble easily.
Diaphragms
- The package
seal is damaged.
- The
diaphragm looks dirty (only the service provider needs to
check for this).
- The
diaphragm shows holes or cracks when held up to a light (only
the service provider needs to check for this).
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If any products show any of these signs, you will need to examine a
sample of the product for these warning signs, set aside the damaged
products, and report the problem.
Dealing with
Damaged Contraceptives
How big is the problem?
If you have found warning signs in any contraceptive product, you will
need to examine the rest of your supplies of that product for signs of
damage. If the quantity in your supply is very small, you may be able to
examine every contraceptive. If you have a larger supply and this is not
feasible, you will need to examine a sample.
- When contraceptive
supplies arrive or when conducting a routine inspection, take a random
sample from one or two of the cartons. It is important that the sample be
taken from throughout the carton, not from just one section. For example,
take an inner box from the top, bottom, and one or more sides of the
carton. (If you do not have cartons and only have the smaller inner boxes,
begin with the next step.)
- From each of these inner boxes, select one
or two individual product units (e.g., IUDs or pill packets).
- Inspect
their quality and record the findings.
- When the inspection is
complete, make certain to return each unit to the inner box from which it
came.
- Return all inner boxes to the carton.
- Date and initial the
carton and note that it has been inspected.
Contraceptives are
produced in lots, or groups. Each lot has its own unique lot number. If
supplies of a contraceptive have more than one lot number, be sure to take
a sample from each lot. Be sure to record the lot number with your
findings.
If the defective
contraceptive that was found initially seems to be the only one with a
defect, dispense the rest to clients, but be even more alert than usual to
problems or complaints.
If others in the box
have problems, mark the box "Potentially defective" and set it
aside where it will not be used. Report the problem to your supervisor.
Reporting the problem
When reporting problems
with the quality of contraceptive supplies, make sure to include the
following information in your report:
- Product
- Brand
- Lot number(s)
- Manufacturer
- Donor or provider
- Nature of
complaint or problem
- Source(s) of complaint or information
- Number
of complaints
- Transportation history
- Storage history
If it is determined
that the contraceptives are defective, they should be disposed of
according to government and donor regulations, and the donor and
manufacturer should be informed.
Problems with the
quality or condition of contraceptives that were donated by the United
States Agency for International Development should be reported to the
local USAID Mission. If there is no local Mission, then the information
can be reported directly to USAID. Problems with contraceptives provided by other donors or purchased from
the manufacturer should be reported to the donor or manufacturer in
question.
For
more information on contraceptive storage and quality, see the
Contraceptive Fact Sheets, produced by John Snow, Inc.’s Family
Planning Logistics Management project (http://deliver.jsi.com/pdf/factsheets/contrafactsht.pdf*).
Contraceptive Logistics
Every family planning program must have a good supply of contraceptives on
hand at all times. Running out of contraceptives can lead to unwanted, and in
some cases life-threatening, pregnancies and can do serious harm to a family
planning program’s reputation and effectiveness
...more
Lessons Learned from Contraceptive Logistics
Since 1973, CDC/DRH has provided technical assistance in contraceptive
logistics matters to family planning programs in 65 countries in Asia,
Africa, Latin America, and Eastern Europe
...more
Reproductive Health Epidemiology Workshop
Publications on International Surveys, Reports, and Studies
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