Access to Medicines Initiative Inc

What it reported doing in 2024

In our first year, Access to Medicines Initiative (AMI) conducted a pilot intervention across 137 primary and secondary public health facilities in Northern Nigeria (in Katsina State and Sokoto State) from September 2024 continuing into 2025. We sought to 1) diagnose supply-chain bottlenecks in contraceptive commodity availability, 2) test how much uptake could increase when supply constraints were removed, and 3) refine a scalable model for state-level rollout. We divided the participating facilities into 3 groups, and each group was assigned a reporting tool to be used to report the consumption and availability of family planning commodities in their facility. The goal was to assess which is most accurate in reporting the stock of commodities available in facilities at any given time. We trained one health worker from each participating facility on how to fill in this survey, either via SMS or WhatsApp, as well as a new paper register we distributed to each facility. The new paper register was meant to capture the number of clients coming in for a family planning consultation, but leaving without taking up a method, as well as the reason for this. Previously, this data was never captured, and we wanted to get a sense of how many women left facilities empty handed due to stockouts. We provided small monthly data stipends to each participating health worker, as well as ongoing support. To measure the impact of these supply chain issues, we provided additional contraceptives and auxiliary commodities such as examination and surgical gloves, syringes, disinfectant and plasters to some of the facilities in each state. By measuring the change in consumption due to this additional stock compared to previous periods and to the facilities not receiving additional commodities, we aimed to gain a better understanding of how stockouts impact contraceptive consumption. After collecting and analyzing facility consumption data, we found that facilities receiving additional contraceptives showed large increases in use compared to baseline levels, while control facilities showed little or no change. In treatment facilities, consumption of oral contraceptives increased by approximately 70 percent, contraceptive injections by 30 percent, condoms by 240 percent, and implants by 90 percent. Based on these results, we estimate the pilot generated more than 1,100 additional Couple Years of Protection, representing the equivalent of providing one year of contraceptive protection to more than 1,100 women. Our paper registers contained data from almost 11,000 visits, showing that almost 80% of these women who came in for a family planning consultation but left empty handed did so because of lack of commodities.

Financial Efficiency

• Mission deployment rate: 17.8%; rating input score 18
• Program expense ratio: 28.6%; rating input score 29

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 52nd percentile among comparable filings
• Major donor itemization: Yes; rating input score 100

Sustainability

• Operating margin: 37.9%; rating input score 88; 88th percentile among comparable filings
• Total-asset coverage ratio: 0.61; rating input score 43; 43rd percentile among comparable filings
• Liabilities to assets ratio: 0; rating input score 76; 76th percentile among comparable filings
• Officer compensation ratio: 50.7%; rating input score 4; 4th percentile among comparable filings

Growth

• Program expense growth: Limited
• Revenue growth: Limited
• Asset growth: Limited