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Measuring Contraceptive Security Indicators 2013 – Summary Findings. Introduction to CS Indicators. Why measure contraceptive security (CS)?
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Measuring Contraceptive Security Indicators 2013 – Summary Findings
Introduction to CS Indicators Why measure contraceptive security (CS)? Country stakeholders and advocates recognize the importance of monitoring country-level progress toward contraceptive security (CS) for advocacy, program planning, and monitoring purposes. How were the indicators defined? In 2009, the USAID | DELIVER PROJECT proposed a set of standard CS indicators – some new and some existing – for countries to track changes. These indicators are collected annually and have been refined over time.
Introduction to This Presentation This slide deck presents data from 43 countries, collected through the CS Indicators survey in 2013. In addition to the information on each slide, clarifying comments and more information can be found in the slide notes.Not all indicators are represented in this presentation More information can be found in the complete dataset, found here: http://deliver.jsi.com/dlvr_content/resources/allpubs/factsheets/CSIndiData2013.xlsx You can also find a blank survey in the complete dataset that can be adapted for your country needs.
Contraceptive Security Contraceptive Security (CS) exists when every person is able to choose, obtain, and use quality contraceptives and condoms for family planning and the prevention of sexually transmitted infections.
Reproductive Health Commodity Security Framework The indicators build on the Strategic Pathway to Reproductive Health Commodity Security (SPARHCS) framework of components considered vital to achieve reproductive health commodity security (RHCS).
Contraceptive Security Indicators Survey • Key informant survey • Conducted annually • 40+ countries • USAID | DELIVER PROJECT presence countries • Tier 1 USAID population and reproductive health countries • Topics covered
Survey Audience and Uses Intended Audiences Country governments Policymakers CS committees Advocates–local and global Program managers Donors Global partners Uses Monitor progress toward CS Identify advocacy and programmatic entry points
Survey Limitations Indicator questions are limited in that they are not intended to require extensive background research Precise data may be difficult for respondents to locate– particularly as relates to financing Official policy may vary from actual practice Data are contingent on the knowledge of respondents
Finance for Procurement Sufficient financing is key to ensuring a reliable supply of contraceptives. Government financing indicates a government’s commitment to contraceptive security; it also suggests sustainability. A budget line item can help ensure that contraceptives are a priority in annual budgeting.
Finance for Procurement Indicators include: Dollar value of estimated need for contraceptives to be procured for the public sector* Existence of a government budget line item for contraceptives Amount of government funds allocated for contraceptives Government expenditures for contraceptive procurement Value of in-kind contraceptive donations for the public sector Value of Global Fund grants used for contraceptives (including condoms) Information on the existence of a funding gap
Government Expenditures 63% of respondent countries indicated that their country spent government funds on contraceptive procurement in the most recent complete fiscal year Of these 26countries using government funds: 73% reported using internally generated funds 54% reportedusing other government funds The median amount of government funds spent was: $586,096 from internally generated funds $1,323,526 from other government funds
Government Expenditures Respondent Countries That Did Not Spend Government Funds on Contraceptive Procurement during the Previous Fiscal Year
Finance for Procurement 18 countries indicated there was insufficient funding for contraceptive procurement 13 countries covered more than 100% of the quantified need 12 countries did not know if there was a funding gap
Finance for Procurement A budget line item alone is not enough to ensure that contraceptives will be funded, but it is usually a good indicator 27 out of 42 respondent countries reported having a government budget line item for contraceptive procurement* 77% of countries with a budget line followed up with funding for contraceptive procurement 33% of countries without a budget line funded contraceptive procurement
Policies Policies can reflect the level of government commitment to contraceptive security, as well as significantly impact client access to family planning.
Policies Indicators include: Existence of a national contraceptive security strategy Policies limiting or promoting access to family planning Inclusion of contraceptives on the National Essential Medicines List (NEML) Inclusion of CS concepts and family planning indicators in the Poverty Reduction Strategy Paper (PRSP) Which method is the lowest level provider allowed to dispense (task shifting)?
Policies―National Essential Medicines List On average, countries include7out of the9surveyed methods on the NEML or equivalent
Policies―Government Strategies 38 out of 43countries reported having a contraceptive security strategy (or another strategy that includes a CS component) 92% have been formally approved by the Ministry of Health 34 out of 38 of the strategies are reportedly being implemented A D PPROVE MAR 15 2013 BY: ____________________
Commodities Providing a mix of contraceptive methods is essential to ensure that clients can choose the contraceptive that best fits their needs.
Commodities Indicators include: Range of contraceptives offered through: Public sector facilities Nongovernmental organization (NGO) facilities Social marketing Commercial-sector facilities
Commodities On average, countries offer 8 out of 11 assessed methods in the public sector 8 surveyed countries offer all 11 methods: Benin, Burundi, Ghana, Haiti, Kenya, Malawi, Senegal, and Zimbabwe 86% of countries offer all 5 of the most commonly offered methods: • male condoms • combined oral contraceptives • IUDs • tubal ligations • injectables
Coordination & Leadership For contraceptive security to be realized, stakeholders from various sectors― public, NGO, social marketing and commercial―must work together to promote effective and efficient service delivery and supply chain systems to ensure access to contraceptives for all segments of the population.
Coordination & Leadership Indicators include: Existence of a national committee that works on contraceptive security Organizations represented on the committee Frequency of committee meetings Legal status of the committee Existence of a contraceptive security champion
Coordination & Leadership 91% of countries have a committee that works on contraceptive security 59% of the committees have legal status
Supply Chain An effective supply chain enables the continuous availability of high-quality contraceptives, which is essential to ensuring contraceptive security.
Supply Chain Indicators include: Central-level stockout data Whether stockouts are a major problem at the central level Whether stockouts are a major problem at the service delivery point (SDP) level
Supply Chain 70% (26 of 37) of responding countries reported a central-level stockout of at least one contraceptive method during the last year On average, these countries reported central-level stockouts of approximately 2 products.
Supply Chain 58% of countries identified service delivery point stockouts as a large problem 23% of countries identified central-level stockouts as a large problem
Conclusions The Good News 91% of countrieshave a coordination committee working on CS 88% of countries have strategies for working on CS 63% of countries contribute government funds for contraceptives Room for Improvement • Diversifying membership of CS coordinating committees • Increasing the number of governments contributing funds for contraceptives and the amount of government contributions for contraceptives • Expanding the range of contraceptive methods offered in health centers and included in essential medicines lists
For More Information Visit: http://deliver.jsi.com/dhome/whatwedo/commsecurity/csmeasuring/csindicators