Session 5 Data, Indicators, and Performance Management Emily Sonneveldt Track20, Avenir Health Dr. Josephine Kibaru-Mbae Government of Kenya Dr. Zeba Sathar Population Council, Pakistan Dr. S.K. Sikdar Government of India

Session Outline│4 Components Starting with a quiz……. Monitoring FP2020 Progress Producing annual estimates for FP2020 report Using data for decision-making

Two Sided Focus Comparability, Reporting Global Data Focused, Process Oriented Country Data

However, global progress depends on acceleration in country Why Data? Global Level How contraceptive use in progressing in the 69 countries - Including information on quality, equity, and impact However, global progress depends on acceleration in country Country Level Advocating for resources, monitoring progress, improved program focus/efficiency FP2020 provides an opportunity to have progress estimates more frequently Materials available to support monitoring country level progress towards national strategies Ensure that we are not missing opportunities to use data and engage other stakeholders

Monitoring FP2020 Progress Track20 Project 5 years (2013-2018) Funded by Gates Foundation Provides annual estimates for key FP indicators for all FP2020 countries July 2012 London Summit pledges 120 million additional users by 2020 Not collecting new data, using existing data in new, innovative ways

Core Indicators All women Modern contraceptives Not process indicators Indicators Reported Annually for all Track20 Countries Indicator 1. Contraceptive Prevalence Rate, Modern Methods (mCPR), All Women Indicator 1b. % distribution of users by method   Indicator 2. Number of additional users Indicator 3. Percentage of women with an unmet need for modern contraception Indicator 4. Percentage of women whose demand for contraception is satisfied by a modern method Indicator 5. Annual expenditure on family planning from government domestic budget Indicator 6. Couple-Years of Protection (CYP)  Indicator 7: Number of unintended pregnancies Indicator 8: Number of unintended pregnancies averted due to contraceptive use Indicator 9: Number of maternal deaths averted due to contraceptive use Indicator 10: Number of unsafe abortions averted due to contraceptive use Indicators Reported in Years with a DHS Indicator 11: Percent of women who were provided with information on family planning during their last visit with a health service provider Indicator 12: Score on Method Information Index Indicator 13: Percent of women who make family planning decisions alone or jointly with their husband/partner Indicator 14: Adolescent birth rate Indicator 15: Percentage informed of permanence of sterilization All women Modern contraceptives Not process indicators

Annual Monitoring│Main Issues New methodologies to produce annual estimates Family Planning Estimation Tool (FPET) Incorporates all data (survey, HMIS) Introduces confidence intervals around estimates Adoption of methodologies that are flexible to incorporate data from multiple sources that are on different timelines

Annual Estimations

Family Planning Estimation Tool- Country Variations This is the first point you want to make This is the second point you want to make This is additional info you want to share This is also relevant information This is the third point you want to make EMILY

Methodological Issues Related to Measuring Change Rolling Baseline: Annual estimates, starting at 2012, will be recalculated on an ongoing basis as new data become available This is true for mCPR and all indicators that are calculated based on mCPR Why? New mCPR values from surveys (that change trends before and after the new data point) New revisions of population estimates (released every two years) Each time new data are released, estimates for the number of modern method users will be refined, for current and previous years EMILY The methodology we use to estimate the number of additional users of modern methods of contraception has two important components, both of which confer advantages related to data quality and accuracy. The first is the designation of 2012 as the baseline year or starting point for our calculation—the point at which we appropriately set the number of additional users at zero. For each reporting period, we will compare the total number of users in the current year to the total number of users in the baseline year (2012). The difference between the two totals is the number of additional users. The second component is the use of a “rolling” baseline, by which we mean we will recalculate our annual estimates (starting with 2012) on an ongoing basis as new data become available. Continuously incorporating new data improves our ability to monitor progress, so that by 2020 our estimates for all years (2012 to 2020) will represent the most comprehensive and accurate data available. Calculations of the number of additional users depend on mCPR and the population of women of reproductive age (WRA). There is often a lag time of a year, and sometimes longer, before the surveys used to calculate mCPR are released. In addition, updated population estimates (including WRA) often include retrospective modifications of past estimates based on newly released census data and other sources. Consequently, as new data become available, they affect not only current year estimates but those calculated in previous years as well. The advantage of using rolling estimates is seen by comparing the estimate of the number of users of modern contraception that was calculated for the London Summit on Family Planning in 2012 (258 million) to the updated estimate for 2012 that we use now (265 million). Our calculation incorporates new DHS surveys and updated population estimates for 2012 that were not available two years ago, and as a result we now consider the total number of users in 2012 to be 7 million greater than we previously thought. Were we to use the old estimate for 2012, this discrepancy could be misconstrued as an increase of 7 million additional users since 2012. SOURCE NUMBER OF USERS IN 2012 London Summit 258 M 2013 Report (first report) 263 M 2014 Report (second report) 265 M

Producing Annual Estimates

Consensus Meetings│Annual Reviews Countries that have pledged a commitment to FP2020, intent is to have estimates produced in country. Started last year Hope to expand this year Opportunity for governments to pull together partners and review data, analysis, and annual progress

Consensus Meetings│Agenda Discussion of FP data availability and quality Review calculations for all indicators FP2020, country indicators Compare indicator estimates with expected progress Agree on data improvement activities for upcoming year (accessibility, quality, use)

Data for Decision-Making

Using the Data Added effort towards annual estimates needs to be linked to in-country decision making FP2020 report, analysis that contextualizes progress and highlights indicators Track20 supported products Finding and leveraging opportunities to integrate these data into ongoing activities and processes

Data: Disaggregation to Analyze Equity Countries in which users of modern contraception in the poorest wealth quintile account for: Less than 5% of all users of modern contraception 5-10% of all users of modern contraception 10-15% of all users of modern contraception 15-20% of all users of modern contraception Cameroon nigeria Benin Dr Congo Ethiopia Kenya Liberia Mali Mozambique Senegal Sierra leone uganda Bolivia Burkina faso Comoros Cote d’ivoire Ghana Guinea India Lesotho Madagascar Malawi Nepal Niger Pakistan Tanzania Timor-leste Bangladesh Burundi Cambodia Egypt Haiti Honduras Indonesia Philippines Rwanda Sao tome and principe Zambia zimbabwe EMILY

Data: Method Skew Commitment making Countries in which 40-60% OF THE METHOD MIX IS DOMINATED BY ONE CONTRACEPTIVE METHOD Commitment making Countries in which ≥60% of the method mix is dominated by one contraceptive method Bangladesh Indonesia Kenya Liberia Malawi Myanmar Niger Rwanda Sierra leone Dr Congo Ethiopia India Mauritania zimbabwe *Keep on hand* In the Progress Report, we categorize countries according to the number of modern methods that account for 20% or more of their method mix.   In 37 of the FP2020 countries, 20% or more of the method mix is accounted for by either zero or one modern method (“zero” implies traditional method dominance) – DR Congo is the example we use here. India is standing in for the countries where 1 method accounts for 20% or more of the mix. We look in the report at extreme method skew that builds at one method 40-60% they would show high skew. Burkina Faso is one of the twenty-seven countries with method mix profiles in which two modern methods account for 20% or more of the mix. And in four countries, the method mix profile is slightly more diverse, with 20% or more of the method mix being accounted by three methods. Mozambique is one of the four countries.

Country Specific 2020 Objectives Setting country-driven mCPR objectives for 2020 Required modifying strategy in three potential categories: End year- many countries have strategies that end before 2020 Transform from total CPR to modern CPR Transform from married women to all women