Challenges in last mile distribution of family planning commodities: Effects on product availability and accessibility in Nigeria

Background Family planning (FP) reduces maternal and child mortality risk. Despite policies and plans to improve FP in Nigeria, access remains poor leading to high unmet need. Contraceptive use is still as low as 4.9% in some regions. Thus, this study assessed challenges in FP commodities distribution and its effect on accessibility. Methods Descriptive survey was used to explore last mile distribution of FP commodities in 287 facilities across various levels of FP service provision. Also, 2528 end users of FP services were assessed to ascertain their attitudes towards FP services. Data were analysed using IBM Statistical Package for the Social Sciences version 25. Results Only 16% of the facilities had all the basic infrastructure requirements assessed with majority of the facilities having inadequate human resource capacity on logistics and supply chain management of health commodities. The study also identified positive attitudes towards FP (80%) and low incidence of stigmatising attitudes (5.4%). Conclusions The study identified challenges in distribution of FP commodities including frequent stock out of commodities and socio‐cultural barriers. Increased positive attitude and limited stigmatising attitudes provides policy directions that are relevant for decision makers to align FP policies and strategies to improve last mile distribution of FP commodities. Highlights Last mile distribution of family planning (FP) commodities remains challenging. Stockouts, human resource shortages and infrastructure deficiencies persist. However, there is increased positive attitudes and less stigma from end users. This new finding offers opportunity to expand FP uptake in northern Nigeria.