Table 2

Data extraction – disruption, adaptation and author’s conclusions

Author(s) yearTypes of disruptionAdaptationsAuthors’ conclusions
RHSC 202124Quarantine at ports/border closures; manufacturing stoppage; shortage of freight containers; increased product and freight costs; lack of air cargo/increased demand for sea freight; workforce reduction; reduced demand for MA; uncertainty due to changing restrictions; regulatory approvals; and delay in reauthorisation of products.Diversification of delivery channel; transition to sea freight; mapping and tracking adaptations; dispensing guidelines were changed; funder flexibility and responsiveness. Policy guidance from WHO and UN agencies helped overcome bottlenecks, particularly around the movement of health products and the inclusion of SRH within essential services.Manufacturing, logistics and systems (including policies and procedures) were most affected. Data from six countries showed no unusual changes in stock levels. Higher initial stock levels mitigated delays. Within 2–4 months, most companies and organisations resumed operations with new constraints. Many health supply chains rely on material inputs from China and India, including active pharmaceutical ingredients. Transportation will continue to be challenging.
Otieno et al 202125Limited public procurement; funding shortfall; general stock delayNone related specifically to procurement.MA drugs available in health facilities in 13 (76%) countries. Where not available, reasons included: abortion forbidden, drugs not in health facilities but available in the pharmacies, controlled drugs not available for MA, available but for induction of labour and for postpartum haemorrhage, and abortion drugs not included on the essential medicines list. Madagascar had no abortion care due to lack of trained healthcare workers.
  • MA, medical abortion; SRH, sexual and reproductive health.