Assessment of Contraceptive Stock-Out and Its Associated Factors in Public Health Facilities of Hawassa City, Southern Ethiopia: A Cross Sectional Study

Background Family planning services enable individuals to make informed reproductive choices. In Ethiopia, frequent stock-outs persist despite national guidelines and supply chain reforms. This study assessed the impact of these stock-outs on reproductive health outcomes and family planning services in Hawassa City. Objectives The main objective to assess contraceptive stock-outs and its associated factors in public health facilities of Hawassa City, Sidama Ethiopia. Method A facility-based cross-sectional survey was carried out at four health centers and three randomly chosen public hospitals in Hawassa City from May 20 to June 30, 2025. FP records and structured questionnaires were used to gather data. Data were coded, entered into Kobo Toolbox, and SPSS version 26 was used for analysis. Both inferential and descriptive statistics were used. To evaluate relationships between dependent and independent variables, bivariate and multivariate logistic regressions were used. P-values less than 0.05 were regarded as statistically significant. Results 134 (58.5%) of the 229 participants (100% response rate) reported stock-outs lasting two to four weeks, while 83 (36.3%) [95%, CI: (30.1%, 42.5%) reported weekly stock-outs. AOR = 2.44, 95% CI [1.35–4.42], p < 0.003, facilities ≥ 20 km from the district pharmacy (AOR = 2.5, 95% CI [1.3–4.8], p < 0.005), and facilities without trained FP staff (AOR = 3.1, 95% CI [1.4–6.7], p < 0.004) all had higher odds of stock-outs, while updated stock records decreased the likelihood (AOR = 0.4, 95% CI [0.2–0.9], p < 0.02). These structural and organisational factors were significant determinants. The most frequent complaints were from clients (215, 94.1%), service interruptions (38, 16.6%), unmet needs (17, 7.4%), and unplanned pregnancies (15, 6.5%). Conclusion Systemic and organizational problems are the main causes of the frequent contraceptive stock-outs in Hawassa City, which largely result in client discontent and, to a lesser extent, service interruptions, unmet need, and unplanned births. Recommendations: Strengthen supply chains, improve inventory management, enhance staff capacity, prioritize health centers, and address structural barriers to ensure consistent access to all FP methods, particularly LARC, and improve client satisfaction.