Update on FP2020 “Core” Indicators for Indonesia, 2017 JAKARTA, 5 OCTOBER 2017

FP2020 Core Indicators Model-based estimates Directly measured 9. Method mix 10. % facilities stocked out 11. % SDP with method choice 12. Annual expenditures 13. Couple-years of protection (CYP) 14. Method information index 15. Information provided 16. Decision making 17. Adolescent birth rate Directly measured Additional modern method users mCPR (all women) Unmet need for a modern method % demand satisfied by modern method Unintended pregnancies Unintended pregnancies averted Unsafe abortions averted Maternal deaths averted

FP2020 Core Indicators for 2017 Annual Report 2017 Value Source 1. Additional modern method users (since 2012) 2,095,000 FPET 2. mCPR (AW) 45.7 3. mCPR (MW) 59.4 4. Unmet need (MW) 14.3 5. % demand satisfied (MW) 80.6 6. Unintended pregnancies 2,605,157 7. Unintended pregnancies averted due to modern contraceptive 9,213,000 8. Unsafe abortions averted 3,203,000 9. Maternal deaths averted 14,400

What is FPET (Family Planning Estimation Tool)? Actually two tools endorsed by FP2020 as the official methodology The first, an adaptation of the UN Pop Division Family Planning Estimation Model (FPEM), was developed for individual country applications Hierarchical, Bayesian model that takes into account virtually every survey that has even been done globally, as well as in specific countries Provides most probable estimates of mCPR and Unmet Need for current and future years, along with uncertainty bounds Useful in countries that have only periodic surveys, as well as in countries like Indonesia that have multiple surveys whose estimates often don’t agree Open access on Avenir Health website

What survey information do we have to inform FPET estimates? Type of Survey Year SUSENAS 2001 IDHS 2003 2005 2007 2008 2009 2010 2012 2013 2014 2015 PMA2020 2016 RPJMN What survey information do we have to inform FPET estimates?

FPET (continued) Second tool calculates “impact” indicators (#s 6-9) Uses as much country-specific are available, and then regional and global averages to fill gaps Algorithms approved by committee of high-level experts at outset of FP2020 Data entered into Excel-based tool – automatic/instant calculations Open access on Avenir Health website

Are we on track to meet our goal?

Is it possible to increase CPR and achieve the RPJMN target in 2019? Yes, but CPR tends to grow slowly once countries reach the 55-60% level

Additional users from 2012 - 2017 are about 2 million

Impacts of contraceptive use Show impacts that did not happen because women were using modern contraceptives (and therefore did not experience unintended pregnancies, and related consequences). The 2012 number represents the impact existing modern contraceptive use had in the country (e.g. if no women in the country were using modern contraceptives, there would have been xxx more unintended pregnancies). Increases from the 2012 number show the additional impacts generated by increasing the number of women using modern contraception and changes in method mix (green on the graphs below).

Turning our attention here FP2020: Core Indicators Turning our attention here Big picture: our progress and its impact Progress from a program perspective Provided by PMA2020 or RPJMN Provided by PMA2020 9. Method Mix 10. % facilities stocked out 11. % SDP with method choice 12. Annual expenditures 13. CYP 14. Method information index 15. Information provided 16. Decision making 17. Adolescent birth rate Additional modern method users mCPR (all women) Unmet need for a modern method % demand satisfied by modern method Unintended pregnancies Unintended pregnancies averted Unsafe abortions averted Maternal deaths averted NIDI F2 BKKBN

Method mix (all women)

Extreme Contraception Methods Mix in Indonesia Provinces Provinces in which the most popular method comprise 60% or more of the provincial method mix Source : Center for Reproductive Health and Center for Health Policy and Management University of Gadja Mada (UGM)

Stock-outs by method and facility type Source: PMA2020 2015

Government expenditures Why is this important? Country 2013 2014 2015 Indonesia NA $189M $210M Source: NIDI 17.7% 16% 24.3% 29.6% Source: DITJALPEM 2015

Source of expenditure (NIDI 2015)

Method Information Index (MII) MII is quality of services indicator  20.8 (PMA) % Informed about other methods   % Informed about side effects % Told what to do if experienced side effects All users Married users 57.1 57.2 48.9 49.1 74.5 74.3

Focus on informed choice – likely to lead to reduced discontinuation Discontinuation rate due to side effect (1st year) Informed choice over time Source: UGM, (Reproductive Health 2016) But we should change the way we analyze informed choice from single information (as above) to whole information (as defined by FP2020 for MII) Source: UGM, (Reproductive Health 2016)

Trend ASFR per 1,000 women aged 15-19 years old in Indonesia

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