Measuring Contraceptive Security Indicators 2014 – Summary Findings

1. Measuring Contraceptive Security Indicators 2014 – Summary Findings

2. 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.

3. Introduction to This Presentation This slide deck presents data from 47 countries, collected through the CS Indicators survey in 2014. 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.

4. Introduction to This Presentation

5. 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.

6. Reproductive Health Commodity Security Framework • The indicators build on the Strategic Pathway to Reproductive Health Commodity Security (SPARHCS) framework • The framework is made up of components considered vital to achieving reproductive health commodity security (RHCS).

7. 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

8. 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

9. 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

10. 2014 Survey 47 countries were surveyed in 2014

11. 2014 Key Findings

12. Finance for Procurement Sufficient financing (from all sources) 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.

13. 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

14. Financing Sources for Public-Sector Contraceptives

15. Finance for Procurement • Was there a government budget line item for procurement of contraceptives? • Were government funds allocated for the procurement of contraceptives? • Were government funds spent for the procurement of contraceptives?

16. Government Expenditures 65% of respondent countries indicated that their country spent government funds on contraceptive procurement in the most recent complete fiscal year Of these 28countries using government funds: 79% reported using internally generated funds 39% reportedusing other government funds The average amount of government funds spent was: $1,182,272 from internally generated funds $2,270,760 from other government funds

17. Government Expenditures Respondent Countries That Did Not Spend Government Funds on Contraceptive Procurement during the Previous Fiscal Year

18. Government Expenditures―Africa

19. Government Expenditures―Europe & Asia

20. Government Expenditures―LAC

21. Finance for Procurement

22. Finance for Procurement 22 countries indicated there was insufficient funding for contraceptive procurement 16 countries covered more than 100% of the quantified need 4countries did not know if there was a funding gap 1154% 125% 214% 159% 270% 121% 121% Africa Europe and Asia LAC

23. 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 29 out of 44 respondent countries reported having a government budget line item for contraceptive procurement* 79% of countries with a budget line followed up with funding for contraceptive procurement 33% of countries without a budget line funded contraceptive procurement

24. Policies Policies can reflect the level of government commitment to contraceptive security, as well as significantly impact client access to family planning.

25. 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)?

26. Policies―National Essential Medicines List On average, countries include7out of the9surveyed methods on the NEML or equivalent

27. Policies―Government Strategies 40out of 47 countries reported having a contraceptive security strategy (or another strategy that includes a CS component) Of those, 92% have been formally approved by the Ministry of Health 92% of the strategies are reportedly being implemented A D PPROVE MAR 15 2013 BY: ____________________

28. Policies―Provision and Access

29. Policies―Charges to Clients *There are exemptions for those who are unable to pay

30. Commodities Providing a mix of contraceptive methods is essential to ensure that clients can choose the contraceptive that best fits their needs.

31. Commodities Indicators include: Range of contraceptives offered through: Public sector facilities Nongovernmental organization (NGO) facilities Social marketing Commercial-sector facilities

32. Commodities

33. Commodities On average, countries offer 8out of 11 assessed methods in the public sector 11 surveyed countries offer all 11 methods: Benin, Burundi, DR Congo, Ghana, Guinea, Haiti, Kenya, Malawi, Senegal, Togo, Zimbabwe 91% of countries offer all 5 of the most commonly offered methods: • male condoms • combined oral contraceptives • IUDs • tubal ligations • injectables

34. 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.

35. 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

36. Coordination & Leadership 89%of countries have a committee that works on contraceptive security 61% of the committees have legal status

37. Supply Chain An effective supply chain enables the continuous availability of high-quality contraceptives, which is essential to ensuring contraceptive security.

38. 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

39. Supply Chain 48% (20 of 42) 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 1-2 products.

40. Supply Chain 53% of countries identified service delivery point stockouts as a large problem 14% of countries identified central-level stockouts as a large problem

41. Supply Chain

42. Where improvements can be made Conclusions

43. For More Information Visit: http://deliver.jsi.com/dhome/whatwedo/commsecurity/csmeasuring/csindicators