Monitoring Progress Toward Achieving Contraceptive Security: APHA Conference, Denver, CO November, 2010 CS Index 2003–2009 Dana Aronovich, Marie Tien, Nadia Olson John Snow, Inc.

Learning Objectives Describe how the CS Index is compiled to help measure progress towards CS Describe the changes/trends that have occurred between the 2003 and 2009 CS Index at the national, regional, and global levels? Demonstrate how can data from the CS Index can be used to identify priority areas for support and to inform program planning Explain how data from the CS Index can be used to advocate for improved resource allocation by country governments and global donors.

A critical component of FP programs: Contraceptive security exists when every person is able to choose, obtain and use quality contraceptives and condoms whenever she/he needs them.

Reproductive Health Commodity Security Framework

Contraceptive Security Index Tool to raise awareness, support advocacy, focus priorities, monitor progress for CS Promotes a multisectoral approach to CS at the national, regional, and global levels Indicators cover a range of inputs and outputs, and programmatic and macro-level areas Over 60 countries from 5 regions 3 editions of the Index: 2003, 2006, 2009 –analysis of CS over an extended period of time

Methodology Minimize data collection costs and maximize data reliability, validity, and replicability by using only secondary data from regularly updated reliable sources Updated approximately every 3 years 5 components, 17 indicators –Supply chain (logistics) –Financing –Health and social environment –Access –Utilization Aggregate scores for each component and an overall score

Summary of Findings

Range of CS Index Total Scores (2003, 2009)

CS Index Total Scores by Region (2003, 2006, 2009) N.B. For the 50 countries scored in all 3 indices only.

Average Percentage Change by Region 2003– –2009 Entire Period: 2003–2009 Asia & Pacific3.66%0.35%3.87% E. Europe & C. Asia0.31%−3.06%−2.76% L. America & Caribbean4.35%2.67%6.79% M. East & N. Africa3.49%−1.66%1.73% SS Africa10.50%3.34%13.95% Average Total Scores5.8%1.6%7.6%

CS Index Total Scores by Component (2003, 2006, 2009) N.B. For the 50 countries scored in all 3 indices only.

CS Index – Supply Chain (2003, 2006, 2009) N.B. For the 50 countries scored in all 3 indices only.

CS Index – Finance (2003, 2006, 2009) N.B. For the 50 countries scored in all 3 indices only.

CS Index – Health & Social Environment (2003, 2006, 2009) N.B. For the 50 countries scored in all 3 indices only.

CS Index – Access (2003, 2006, 2009) N.B. For the 50 countries scored in all 3 indices only.

CS Index – Utilization (2003, 2006, 2009) N.B. For the 50 countries scored in all 3 indices only.

Trends in Total Scores by 2003 Clusters N.B. For the 50 countries scored in all 3 indices only.

Regions by Clusters: N.B. For the 50 countries scored in all 3 indices only

Clusters by Regions: N.B. For the 50 countries scored in all 3 indices only.

Summary of Trends Average total scores: statistically significant Global averages for all components and all but 1 region increased from Asia & Pacific and LAC had highest scores from Supply chain: highest or 2 nd highest average scores  Reflects processes and systems put in place to manage contraceptive supplies Cluster analysis: –Lowest performing countries in 2003 made most progress in total average scores by 2009 –Biggest increases observed in sub-Saharan Africa where significant donor inputs are made.

Using the CS Index Results National and international stakeholders can use results to emphasize importance of CS for better FP program outcomes and to monitor progress toward reaching this goal. CS Index can be a powerful tool for raising awareness about CS and interrelationships between different program components. Results can be used to set priorities and advocate for more rational resource allocation by country governments and global donors to achieve a secure supply of quality contraceptives.

CS Index 2003, 2006, and 2009 CS Index Technical Manual and Trends in Contraceptive Security: are available online at: deliver.jsi.com