Monitoring Progress Toward Achieving Contraceptive Security:

Monitoring Progress Toward Achieving Contraceptive Security:

APHA Conference, Denver, CONovember, 2010

CS Index 2003–2009

Dana Aronovich, Marie Tien, Nadia OlsonJohn Snow, Inc.

Learning Objectives

• Describe how the CS Index is compiled to help measure progress towards CS

• Describe the changes/trends that have occurred between the 2003 and 2009 CS Index at the national, regional, and global levels?

• Demonstrate how can data from the CS Index can be used to identify priority areas for support and to inform program planning

• Explain how data from the CS Index can be used to advocate for improved resource allocation by country governments and global donors.

A critical component of FP programs:

Contraceptive security exists

when every person is able to

choose, obtain and use

quality contraceptives and condomswhenever she/he needs them.

Reproductive Health Commodity Security Framework

Contraceptive Security Index

• Tool to raise awareness, support advocacy, focus priorities, monitor progress for CS

• Promotes a multisectoral approach to CS at the national, regional, and global levels

• Indicators cover a range of inputs and outputs, and programmatic and macro-level areas

• Over 60 countries from 5 regions

• 3 editions of the Index: 2003, 2006, 2009 – analysis of CS over an extended period of time

Methodology

• Minimize data collection costs and maximize data reliability, validity, and replicability by using only secondary data from regularly updated reliable sources

• Updated approximately every 3 years

• 5 components, 17 indicators– Supply chain (logistics)

– Financing

– Health and social environment

– Access

– Utilization

• Aggregate scores for each component and an overall score

Summary of Findings

Range of CS Index Total Scores (2003, 2009)

0

10

20

30

40

50

60

70

80

90

100

2003 2009

Highest Score

Average Score

Lowest Score

CS Index Total Scores by Region (2003, 2006, 2009)

0

10

20

30

40

50

60

70

80

90

100

Asia & the Pacific(n=7)

Eastern Europe &Central Asia (n=3)

Latin America & theCaribbean (n=13)

Middle East & NorthAfrica (n=4)

sub-Saharan Africa(n=23)

Overall Average (n=50)

2003

2006

2009

N.B. For the 50 countries scored in all 3 indices only.

Average Percentage Change by Region

2003–2006 2006–2009

Entire Period:

2003–2009

Asia & Pacific 3.66% 0.35% 3.87%

E. Europe & C. Asia 0.31% −3.06% −2.76%

L. America & Caribbean 4.35% 2.67% 6.79%

M. East & N. Africa 3.49% −1.66% 1.73%

SS Africa 10.50% 3.34% 13.95%

Average Total Scores 5.8% 1.6% 7.6%

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CS Index Total Scores by Component (2003, 2006, 2009)


0

2

4

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20

Supply Chain Finance Health & SocialEnvironment

Access Utilization

2003

2006

2009

CS Index – Supply Chain (2003, 2006, 2009)

Supply Chain

0

2

4

6

8

10

12

14

16

18

20

Sub-Saharan Africa(n=23)



Latin America &the Caribbean

(n=13)

Middle East &North Africa (n=4)

All countries (n=50)

2003

2006

2009


CS Index – Finance (2003, 2006, 2009)

Finance

0

2

4

6

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18

20







2003

2006

2009


CS Index – Health & Social Environment (2003, 2006, 2009)

Health & Social Environment

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2003

2006

2009


CS Index – Access (2003, 2006, 2009)

Access

0

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2003

2006

2009


CS Index – Utilization (2003, 2006, 2009)

Utilization

0

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2003

2006

2009


Total Weighted Scores: 64 Countries

0 10 20 30 40 50 60 70 80 90 100

MexicoMongoliaP araguay

El SalvadorSouth Africa

NicaraguaViet Nam

J ordanEcuador

IndonesiaHonduras

AlbaniaColombia

P eruGuatemala

EgyptNepal

DominicanKyrgyzstanMorocco

BangladeshBolivia

IndiaTurkey

GuyanaUkraineGeorgiaSenegalNamibiaRwanda

CambodiaTanzania

P hilippinesBurkina Faso

ZimbabweGhana

MadagascarMali

ZambiaKenyaTogo

ArmeniaNigeriaGuinea

CameroonMalawiBenin

EritreaYemen

MozambiqueNigerHaiti

UgandaP akistan

SwazilandChad

LesothoGambia

AzerbaijanLiberia

Congo, Rep. ofEthiopia

Côte d'IvoireCongo, DR

Trends in Total Scores by 2003 Clusters

0

10

20

30

40

50

60

70

80

90

100

2003 2006 2009

CS

Inde

x T

otal

Sco

res,

max

=100

poi

nts

Top

Middle

Bottom


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Regions by Clusters: 2003 - 2009

2003

0%10%20%30%40%50%60%70%80%90%

100%

Asia & thePacific

E. Europe &C.Asia

L. America &Caribbean

M. East & N.Africa

Sub SaharanAfrica

Top

Middle

Bottom

2009

0%10%20%30%40%50%60%70%80%90%

100%

Asia & thePacific

E. Europe &C.Asia

L. America &Caribbean

M. East & N.Africa

Sub SaharanAfrica

Top

Middle

Bottom

N.B. For the 50 countries scored in all 3 indices only

Clusters by Regions: 2003 - 20092003

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Top Middle Bottom

Sub Saharan Africa

M. East & N. Africa

L. America & Caribbean

E. Europe & C.Asia

Asia & the Pacific

2009

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Top Middle Bottom

Sub Saharan Africa

M. East & N. Africa

L. America & Caribbean

E. Europe & C.Asia

Asia & the Pacific


JSI

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Summary of Trends

• Average total scores: statistically significant 2003-09

• Global averages for all components and all but 1 region increased from 2003-09

• Asia & Pacific and LAC had highest scores from 2003-09

• Supply chain: highest or 2nd highest average scores Reflects processes and systems put in place to manage contraceptive

supplies

• Cluster analysis: – Lowest performing countries in 2003 made most progress in total

average scores by 2009– Biggest increases observed in sub-Saharan Africa where significant

donor inputs are made.

Using the CS Index Results

• National and international stakeholders can use results to emphasize importance of CS for better FP program outcomes and to monitor progress toward reaching this goal.

• CS Index can be a powerful tool for raising awareness about CS and interrelationships between different program components.

• Results can be used to set priorities and advocate for more rational resource allocation by country governments and global donors to achieve a secure supply of quality contraceptives.

CS Index 2003, 2006, and 2009

CS Index Technical Manual

and

Trends in Contraceptive Security: 2003-2009

are available online at:

deliver.jsi.com

Documents

Monitoring Progress Toward Achieving Contraceptive Security: