A Decade of Monitoring Contraceptive Security & Measuring Success around the World International Conference on Family Planning Addis Ababa, November, 2013 CS Index 2003–2012 Dana Aronovich, Ariella Bock, Marie Tien, Emma Stewart, Ellie Bahirai John Snow, Inc.

Learning Objectives Define contraceptive security Describe how the CS Index is compiled to help measure progress towards CS Describe the trends in CS over the past decade at the national, regional, and global levels Discuss achievements since 2003 in reaching contraceptive security and the remaining opportunities and challenges

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 (67 countries in 2012) 4 editions of the Index: 2003, 2006, 2009, 2012 –analysis of CS over a full decade

Methodology Minimize data collection costs and maximize data reliability, validity, and replicability by using only secondary data from regularly updated reliable sources Updated 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

Trends in CS Index Total Scores ( ) 39% increase from 2003 to 2012

CS Index Total Scores by Component ( ) N.B. For the 48 countries scored in all 4 indices only.

CS Index Total Scores by Region ( ) N.B. For the 48 countries scored in all 4 indices only.

Average Component Scores: Sub-Saharan Africa (n=22) N.B. For the countries scored in all 4 indices only.

Average Component Scores: Latin America & the Caribbean (n=12) N.B. For the countries scored in all 4 indices only.

Average Component Scores: Asia & the Pacific (n=7) N.B. For the countries scored in all 4 indices only.

Average Component Scores: Middle East & North Africa (n=4) N.B. For the countries scored in all 4 indices only.

Trends in Average Total Scores by Cluster N.B. For the 48 countries scored in all 4 indices only.

Summary of Trends Average total scores: statistically significant increase Global averages for all components improved from 2003 to 2012, with greatest progress made in Finance component. –Supply chain: highest average scores in every Index  Reflects processes and systems put in place to manage contraceptive supplies

Summary of Trends (cont.) Lowest performing countries in 2003 made most progress in total average scores by 2012 Global averages for all regions improved from 2003 to 2012, with greatest progress made in sub-Saharan Africa. –Latin America & the Caribbean region has highest scores; sub- Saharan Africa region has lowest.

Using the CS Index Results Stakeholders can use results: – to emphasize the importance of CS and its components for better FP program outcomes –to monitor progress toward reaching this goal –for awareness raising and advocacy, to highlight successes and put attention on the lags –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, 2009 and 2012 CS Index Technical Manual and Trends in Contraceptive Security: are available online at: deliver.jsi.com