Indicator
Definition
3.1.7-38 MCPR: Modern method contraceptive prevalence rate
Percent of reproductive age women in union who are currently using a modern method
of contraception
Numerator: Number of women in union of reproductive age currently using a modern
method of contraception
Denominator: total number of women of reproductive age in union
MCPR is a direct measure of the desired outcome of FP/RH programs. It is directly
Linkage to Longlinked to reductions in unintended pregnancy and is a measure of the functioning of the
Term Outcome or
Health System. When disaggregated by wealth quintile, the measure reflects the
Impact
capacity of the health system to reach all clients in need of health services.
Indicator Type
Unit of Measure
Use of Indicator
Data Source and
Reporting
Frequency
Known Data
Limitations
Baseline
Timeframe
Disaggregate(s)
Outcome
Percentage
At the global level data are aggregated, and a rolling average is computed annually to
report to Congress and to monitor overall progress in achieving USAID FP/RH program
goals. At the country level, data (which are typically available every 5 years) is used for
assessment of longer-term program impact, for assessing regional and rural-urban
differences, for reviewing the reach of various program components and for developing
new strategies and program directions.
Data are collected through national level surveys, typically DHS or CDC surveys
typically every 5 years
Validity – High
Integrity – High
Precision – high
Reliability – High
Timeliness – Data are available annually as global averages to provide an overall trend
in the impact of FP/RH programming. At the country level data are available at
approximately 5-year intervals for review of progress in achieving current strategies
and developing new strategies
Global baseline: 2008
Country baseline: varies by country, generally most recent previous DHS
Numerator
Denominator
Indicator
Definition
Linkage to LongTerm Outcome or
Impact
Indicator Type
Unit of Measure
Use of Indicator
Methodology for
For the
global-level
Aggregation
indicator
Whatreported
countries are
by AID/W,
wein the
included
include
the
aggregate
data point
– please note
changes over time
Is this data reflective
of USG funding only?
Data Source
3.1.7-39 Percent of women aged 18-24 who have first birth before 18
Percent of women aged 18-24 who have first birth before 18, among women aged
their
18-24 at the time of the survey
Delaying the initiation of childbearing helps slow population growth by lengthening
the time between generations. In addition, early childbearing has multiple
detrimental health and non-health consequences. Women who give birth before
the age of 18 are more likely to suffer from obstetric fistula, acquire HIV, and die in
childbirth than women who initiate childbearing at older ages. Their children are
also more likely to experience serious health consequences. Furthermore, early
childbearing is associated with lower levels of education, higher rates of poverty,
and higher incidences of domestic violence and sexual abuse.
Outcome
Proportion of women who had a first birth before age 18 years among women
aged 18-24 at the time of the survey. Numerator: Number of women aged 18-24
at the time of the survey who had a first birth before the age of 18. Denominator:
Number of women aged 18-24 at the time of the survey.
To report to Congress and to monitor overall progress in achieving USAID FP/RH
program goals. At the country level, data (which are typically available every 5
years) is used for assessment of longer-term program impact, for assessing
regional and rural-urban differences, for reviewing the reach of various program
components and for developing new strategies and program directions.
At the global level data are aggregated, and an unweighted rolling average is
computed annually.
26 countries receiving ≥ $2 million in FP/RH in FY 2008 AND with 2 or more DHS
data at the time of the update. Countries receiving less than $2 million in 2008 or
with MCPR over 50% are not included in projections, except Peru where
implementation of graduation plan is in progress. Excludes all E&E countries. Data
from the Uttar Pradesh State used for India. (Benin, Ethiopia, , Ghana, Guinea,
Kenya, Liberia, Madagascar, Malawi, Mali, Mozambique, Nigeria, Rwanda, Senegal,
Tanzania, Uganda, Zambia, Bangladesh, Cambodia, India (UP), Jordan, Nepal,
Pakistan, Philippines, Bolivia, Haiti, Peru)
No
Data are collected through national level surveys, typically DHS .
Typically every 5 years
Reporting Frequency
a. Validity – High
b. Integrity – High
c. Precision – high
d. Reliability – High
Known Data
Limitations
2008 Baseline Data &
Comments
2009 Data &
Comments
2010 Data &
Comments
2011 Data &
Comments
2013 Projection &
Comments
2015 Projection &
Comments
Disaggregate(s)
e. Timeliness – Data are available annually as global averages to provide an overall
trend in the impact of FP/RH programming. At the country level data are available
at approximately 5-year intervals for review of progress in achieving current
strategies and developing new strategies
23.80%
23.90%
24.40%
FY2008 and FY2009 data incorporated a sampling inconsistency that, when
corrected, changes prior year values as follows:
FY08 FY09
Baseline Results
24.7% 24.4%
Thus, rather than an average increase of 0.5% points between FY09 and FY10,
what we see is no change between FY09 and FY10.
24%
23.60%
23%
Numerator: Number of women aged 18-24 who had their first birth before age 18
Denominator: Number of women aged 18-24
Indicator
Definition
3.1.7.1-1 Couple Years Protection in USG supported programs
The estimated protection provided by family planning methods during a one-year
period, based upon the volume of all contraceptive methods provided to clients during
that period.
Linkage to Long- This indicator measures the amount of contraceptive coverage provided to a given
Term Outcome or population in a given year, which is related to contraceptive prevalence and reduction
Impact
in unintended pregnancies. This indicator is an annually-available proxy for MCPR.
Indicator Type
Unit of Measure
Use of Indicator
Data Source and
Reporting
Frequency
Known Data
Limitations
Baseline
Timeframe
Disaggregate(s)
Output
Number, specific to a particular year. The CYP is calculated by multiplying the quantity
of each method distributed to clients by a conversion factor, to yield an estimate of the
duration of contraceptive protection provided per unit of that method. The CYPs for
each method are then summed over all methods to obtain a total CYP figure.
See USAID conversion factors at:
http://www.usaid.gov/our_work/global_health/pop/techareas/cyp.html
N.B. Goals for CYP may be appropriate at the level of the service delivery site or higher
(e.g., district or national program level) for the purposes of planning or budgeting. CYP
targets should not be set for individual service providers.
The information generated by this indicator can be used for program planning and
measurement of trends, budget projections for estimation of costs of needed
contraceptives by Missions, and USAIDW
Data will be collected from USAID-supported projects, and aggregated annually
Validity – high
Integrity –high
Precision – high
Reliability –high
Timeliness – Available on regular basis from USAID-assisted projects
Varies by country, and is set when the program or project is developed.
None
Element 3.7.1 FP/RH
#2 Stock outs
Percent of USG-assisted service delivery points (SDPs) that experience a stock out at
any time during the reporting period of any contraceptive method that the SDP is
expected to provide.
Required
Information
Indicator
Definition
Response
Percent of USG-assisted service delivery points (SDPs) that experience a
stock out at any time during the reporting period of any contraceptive
method that the SDP is expected to provide.
Stock out: The absence, regardless of duration, at an SDP of a
contraceptive product (e.g. oral contraceptive pill or injectable) or related
supplies (e.g. for insertion of IUDs or implants, or male and female
sterilizations) that prevents the SDP from offering that method.
USG-assisted: Any FP assistance that is funded with POP funds from the
GHP account.
Service Delivery Points: Any facility that provides a contraceptive
method to end users. Examples include clinics, hospitals, facilities
(government, private or NGO/FBO), pharmacies, and/or social marketing
sales points. Does not include community health workers (CHWs).
Whether a SDP is expected to offer a particular contraceptive method
may be determined from standard treatment guidelines or other national
policy/program documents.
Both the numerator and denominator should be reported to allow
aggregation across countries.
The numerator is the number of SDPs that experienced a stock out of any
contraceptive method at any time during the year, regardless of duration
or number of methods that were out-of-stock. If an SDP is stocked out of
different methods at the same or different times in the reporting period, or
if an SDP experiences stock outs of a method multiple times in the
reporting period, this should be reported as a single SDP that experienced a
stock out during the period. In other words, an SDP should only be
counted once in the numerator.
The denominator includes the number of monitored SDPs that are
expected to provide one or more contraceptive method(s). SDPs should be
direct or indirect beneficiaries of any kind of USG-funded FP assistance,
regardless of whether it includes contraceptive donations or supply chain
strengthening. There is large variation between countries and programs in
the technical scope, geographic coverage, etc. of USG FP assistance. Below
are some examples:
Where FP assistance includes national-level investments (e.g.,
policy, planning, advocacy, financing, monitoring and evaluation)
meant to strengthen the ability of SDPs nationwide to offer FP
services, all SDPs should be included in the denominator.
If an FP assistance program is by design limited in its intended
impact to specific region(s) within a country, only SDPs in those
regions should be counted in the denominator.
USG-supported social marketing programs vary in how their
Linkage to LongTerm Outcome or
Impact
Indicator Type
Unit of Measure
Use of Indicator
Data Source and
Reporting Frequency
Known Data
Limitations
products are distributed. Some social marketing organizations
manage a dedicated supply chain that supplies retail outlets, in
which case these outlets should be counted in the denominator.
Others may maintain central and/or regional warehouses, but
otherwise leverage existing commercial networks of
pharmaceutical wholesalers and retailers to distribute product, in
which case it may be feasible to monitor only the social marketing
organization's own facilities (warehouses).
Missions are strongly advised to contact PRH (see POC below) for guidance
on how to apply this indicator in their specific circumstances.
The availability of contraceptive products and related supplies is a critical
determinant of the success of any family planning program. This indicator
measures the ability of a supply system to maintain a constant supply of
contraceptives and supplies to the SDP level, where clients obtain their
methods.
Given the critical importance of supply availability to the success of any
USG-assisted FP program, this indicator is required and applies where any
kind of USG-funded FP assistance is provided, and where annual funding is
$2 million or greater.
Output
Percentage, specific to the year.
This indicator may be used by in-country program managers and
stakeholders as a “high level” measure of how well a supply system is
working and direct attention to where further analysis may be needed to
guide program investments for supply chain strengthening. Where USG FP
assistance is not directed at contraceptive donations or supply chain
strengthening, this indicator can serve to flag where lack of supplies to
clients may constrain the success of other program investments and where
assistance for supply availability may be warranted.
This indicator can be used by USAID/W staff to support in-country
managers in allocating resources and program planning. This measure, in
the aggregate, can also inform stakeholders (e.g., Congress) on how well
programs that are supported by USAID are progressing towards reliable
availability of family planning methods for clients.
The recommended “gold standard” methods for collecting data for this
indicator are through routine reporting from SDPs through a logistics
management information system (LMIS).
Alternative methods are available, and in use, that can, through direct
observation, provide point-in-time snapshots of availability at a sample of
SDPs. These include facility-based surveys such as the End-UseVerification tool (EUV) and Logistics Indicator Assessment Tool (LIAT), and
national physical inventories. Supportive supervision checklists can also
be used to check for stock outs at a sample of SDPs, and mHealth methods
such as SMS alerts of stock outs can be used. Missions are advised to
consult with PRH (see POC below) for guidance on how best to adopt any
of these alternative methods to gather data for this indicator.
As defined and reported, the “granularity” of this indicator is limited. A
particular SDP can only be counted once in the numerator. The indicator
Baseline Timeframe
Disaggregate(s)
Point of Contact
will not capture recurring stock outs of a methodat an SDP; stock outs of
different methods at an SDP; or stock out durations. Regardless, it will be
indicative of when there are supply-related issues of likely program
concern.
Data from routine SDP reporting will be more comprehensive, in terms of
frequency of reporting throughout the year and national coverage, than
data collected by the alternative methods listed above. Sample design will
determine how representative is the data that is collected by these
methods. The PRH POC can assist with sample design.
For the purposes of Foreign Assistance reporting, the validity, integrity,
precision, reliability, and timeliness of data collected by any of the methods
listed above can be addressed through known measures.
Varies by country, and is set when the program or project is developed.
No disaggregation needs to be reported to HQ in the PPR. It may be useful
at the country level to collect and analyze data disaggregated by
contraceptive method, rural/urban, sub-national area(s), and/or facility
type.
Alan Bornbusch, GH/PRH/CSL
Indicator
Definition
3.1.7.1-3 Percent of USG-assisted service delivery sites providing family planning
(FP) counseling and/or services
Numerator: Number of USG-assisted service delivery sites providing FP information
and/or services.
Denominator: Number of
SDPs planned to receive USG assistance over life of project.
USG-assisted: Funded with congressionally-earmarked FP funds for any kind of
assistance.
Service Delivery Points: Clinics, hospitals, facilities (government, private or NGO/FBO)
pharmacies, and/or social marketing sales points. Does not include community health
workers (CHWs).
FP counseling: FP information and/or FP counseling provided in the context of a visit
with a FP service provider. ¶
FP Services: Provision of FP methods and or FP referrals.
Linkage to LongTerm Outcome or
Impact
Indicator Type
Unit of Measure
Use of Indicator
Data Source and
Reporting
Frequency
Known Data
Limitations
Baseline
Timeframe
Disaggregate(s)
Increased FP use is related to its physical availability through numerous sites offering
FP counseling and/or services, especially if the counseling and/or services are offered
in a quality, client-friendly, convenient and affordable manner. An increased
contraceptive prevalence rate (CPR) will reduce the unmet need for FP, number of
unintended pregnancies, number of abortions, and neonatal, infant, child and maternal
mortality and morbidity. Initially, the percent of USG-assisted FP SDPs should
approach and reach 100%. However, overtime these FP SDPs should receive less USG
assistance, ultimately graduating from it, as the host government, local NGOs/FBOs,
private for-profit facilities, and social marketing sales points assume increasing and
complete ownership and responsibility.
Output
Percentage, cumulative over time. To aggregate the data, each country would report its
numerator and denominator in order for the global percentage to be computed.
At the country level, data (typically available annually) is used for assessment of longerterm program output and impact and for developing new strategies and program
directions and interventions.
Country level denominators are initially set when country level programs/projects are
designed and typically held constant over the life of the project; although refinement as
implementation progresses is possible. Country level numerators are reported
annually by implementing partners in project/program reporting documents to the
USG COTR/AOTR.
Both
denominators and numerators should be
¶
reported annually for aggregation and global computation.
Validity – high Integrity – high Precision – high Reliability – high Timeliness – high
Varies by country; set when program or projects are designed.
Numerator
Denominator
Indicator
Definition
3.1.7.1-4 Number of additional USG-assisted community health workers (CHWs)
providing family planning (FP) information and/or services during the year
USG-assisted: Funded with congressionally-earmarked FP funds for any kind of
assistance.
Community Health Workers (CHW): Any type of CHW as defined by country programs.
FP Information: FP information and/or FP counseling provided by a CHW
FP Services: FP referrals and/or methods provided by a CHW.
Increased FP use is related to its physical availability through numerous sites, including
door-to-door offering of FP information and/or services, especially if the information
and/or services are offered in a quality, client-friendly, convenient and affordable
Linkage to Longmanner. Increased family planning use reduces the unmet need for FP, number of
Term Outcome or
unintended pregnancies, number of abortions, and neonatal, infant, child and maternal
Impact
mortality and morbidity. Over time, these CHWs may receive less USG assistance,
ultimately graduating from it, as the host government and local NGOs/FBOs assume
increasing and complete ownership and responsibility.
Indicator Type
Unit of Measure
Use of Indicator
Data Source and
Reporting
Frequency
Known Data
Limitations
Baseline
Timeframe
Disaggregate(s)
Output
Number of USG-assisted should represent only new, additional CHWs
At the country level, data (typically available annually) is used for assessment of
progress towards longer-term program output and impact and for developing new
strategies and program directions and interventions.
Country target numbers are initially set when country programs/projects are designed
and typically held constant over the life of the project; although refinement as
implementation progresses is possible. Country numbers are reported annually by
implementing partners in project/program reporting documents submitted to USG
COTR/AOTRs.
Validity – high
Integrity – high
Precision – high
Reliability – high
Timeliness – high
Varies by country, and is set when the program or project is developed.
None