Achieving Equity in Family Planning Disentangling poverty and place of residence for family planning strategic planning Karen G. Fleischman Foreit MEASURE Evaluation PRH

Achieving Equity in Family Planning Equity begins and ends with measurement  Who shows the disparities?  How big are the disparities?  How do we know that our interventions are reaching the people with the disparities?  How do we know if we have made an impact?

Achieving Equity in Family Planning Who is poor?  Relative poverty Wealth quintiles, usually derived from household assets  Absolute poverty Defined against some standard of income and/or expenditures

Achieving Equity in Family Planning Urban-rural differences are common

Achieving Equity in Family Planning …as are differences by wealth quintile

Achieving Equity in Family Planning But residence and wealth go together Kenya 2003

Achieving Equity in Family Planning …making it hard to interpret differences Kenya 2003

Achieving Equity in Family Planning Methods  Secondary analysis DHS standard recode files  Separate urban and rural strata  Rank by wealth score within strata  Create residence-specific wealth quintiles  Analyze outcome indicators by residence- specific quintiles

Achieving Equity in Family Planning Results  Highly variable residence-specific patterns

Achieving Equity in Family Planning Wealth and Residence: Ghana 2008 National

Achieving Equity in Family Planning Wealth and Residence: Senegal 2005 National

Achieving Equity in Family Planning Wealth and Residence: Zambia 2007 National

Achieving Equity in Family Planning Wealth and Residence: Kenya 2003 National

Achieving Equity in Family Planning Wealth and Residence: Kenya 2008 National

Achieving Equity in Family Planning Limitations of assets-based quintiles Track over-all trends in family planning outcomes XDo not match individual consumption measures of poverty

Achieving Equity in Family Planning Match-up between consumption and assets measures of poverty Ecuador 2004 RHS

Achieving Equity in Family Planning Match-up between consumption and assets measures of poverty Ethiopia 2005 DHS 2004/5 HIES

Achieving Equity in Family Planning Conclusions  Disaggregate place of residence and relative poverty to identify pockets of greatest disparities and to assess impact  Use consumption-based measures of poverty to monitor uptake of program interventions by the poor

Achieving Equity in Family Planning Thank you – Merci – Gracias - शुक्रिया © 2007 Felix Masi, Courtesy of Photoshare