FP2020 is Expanding the Measurement Agenda and Building the Evidence Base for Family Planning
FP2020’s Performance Monitoring & Evidence Working Group (PME WG) is a platform where the world’s leading experts on family planning measurement contribute to the understanding of quantitative and qualitative evidence in key dimensions of family planning and forge a consensus on the metrics for monitoring FP2020’s progress. These metrics are called the FP2020 Core Indicators. FP2020’s Core Indicator estimates are produced annually by Track20, a project of Avenir Health, with technical guidance from the PME WG and in collaboration with a network of country family planning measurement specialists.
This year FP2020 is publishing the FP2020 Measurement Annex 2015, an expanded analysis of the Core Indicator suite prepared by Track20, the PME WG, and the FP2020 Secretariat, as a companion to FP2020 Commitment to Action 2014–2015. The Measurement Annex contains complete tables of the Core Indicator estimates, explores the latest data on youth and contraceptive method mix, and presents a new tool for measuring the enabling environment for family planning.
KEY HIGHLIGHTS 2014–2015
In April 2015, the FP2020 Reference Group approved changes to the Core Indicator suite recommended by the PME WG. Two new indicators measure the range of contraceptive methods available at health facilities and the percentage of facilities stocked-out of contraceptive methods. The new indicators were selected from the suite of harmonized stock-out indicators developed by the Reproductive Health Supplies Coalition’s (RHSC) Systems Strengthening Working Group. They reflect essential elements of quality and choice available to clients, and bring FP2020 into alignment with RHSC’s global Take Stock initiative to establish a common methodology for measuring and addressing stock-outs across agencies. In addition, the Reference Group approved the PME WG’s recommendation to drop an indicator on sterilization counseling due to the lack of available data.
Track20 trains country M&E specialists to use the FP2020 Core Indicators in alignment with country family planning strategies, and supports annual data consensus workshops where government ministries of health and diverse stakeholders conduct reviews of family planning data and evaluate their strategies. In 2015, data consensus workshops were held in 19 FP2020 commitment-making countries: Benin, Burundi, Côte d’Ivoire, the Democratic Republic of Congo (DR Congo), Ethiopia, India, Indonesia, Kenya, Malawi, Mozambique, Myanmar, Nigeria, Pakistan, Senegal, South Africa, Tanzania, Togo, Uganda, and Zambia.
The National Composite Index on Family Planning (NCIFP) is a new index designed to gauge the enabling environment for family planning in each country, taking into account not just the existence of policies and guidelines but also the extent to which family planning programs provide measurable dimensions of quality services and respect for human rights. The NCIFP consists of 35 scores across five such dimensions: family planning strategy, data utilization, quality of services, equity, and accountability. Track20 led the development of the index with technical guidance from the PME WG, and in collaboration with the RE WG and experts from Palladium (formerly Futures Group). Data have been collected from 90 countries, 50 of which are FP2020 focus countries. A full report on the NCIFP was published in September 2015.3
More than a third of women who start using a method of contraception stop using it within the first year. Contraceptive discontinuation is a complex phenomenon with important implications for family planning strategies, but it remains poorly understood. In 2015 FP2020 partnered with the Population Council to develop a report on discontinuation, looking at evidence on when and why women stop using contraception, the interventions that have been shown to be effective, and the means by which discontinuation can be monitored and measured. The report was scheduled for publication in the fall of 2015.
FP2020’s measurement agenda reflects its rights and empowerment principles by, for example, measuring contraceptive use among all women of reproductive age (instead of only married women); identifying markets where a single method of contraception dominates usage among a majority of women (which could indicate insufficient access to a broad range of methods); and analyzing contraceptive prevalence by variables such as age, residence, and wealth (to potentially detect inequities or exclusion). The PME WG, the RE WG, and the Secretariat are continuing to explore ways to measure dimensions of rights and empowerment in family planning programs. In 2015 a landscaping survey was commissioned to evaluate current and soon-to-be-launched initiatives looking at similar areas. Upon completion, FP2020 will launch an effort to develop and test new indicators, working closely with partners in the family planning and measurement spheres.
Performance Monitoring & Accountability (PMA2020) uses an innovative data collection system to conduct routine, low-cost, rapid-turnaround, nationally representative surveys on family planning in nine FP2020 commitment-making countries. PMA2020 supports FP2020’s measurement agenda by producing annual or biannual family planning estimates that can be used to track country progress toward the FP2020 goal. PMA2020 is currently active in Burkina Faso, DR Congo, Ethiopia, Ghana, Kenya, Indonesia, Niger, Nigeria, and Uganda; within the next year it will also launch in India and Pakistan.
