Percent of service delivery points offering a mixture of short-acting modern contraceptive and long-acting reversible contraceptive methods
In a specified timeframe (e.g., in the past month or in the past three, six, or twelve months), the percent of service delivery points (SDPs) offering at least two modern temporary methods of contraception (male or female condoms, pills, injections, and spermicides) and offering at least one long-acting reversible contraceptives (LARC) method (intrauterine device [IUD] or implant) on site. This indicator can be disaggregated by SDP type and location (i.e., poor/not poor, rural/urban, and geographic region).
This indicator is calculated as:
(Number of SDPs offering at least two temporary contraceptive methods and at least one LARC method/Total number of surveyed SDPs eligible to offer temporary methods and at least one LARC method on site) x 100.
Responses to a facility survey question asking whether or not a facility is eligible to offer the methods/service and if the facility currently provides the methods/service.
The question should specify that the service must be provided onsite rather than as client referrals. Data should be collected for each method provided. Evaluators may also want to ask follow up questions about referrals and the number of days that a method is offered to provide more detail about service provision. Example questions for LARCs are below. For IUD services consider specifying responses by type of IUD service (e.g. interval IUD, postpartum IUD, transcesarean IUD, and IUD after postabortion care) if this is helpful to the design or evaluation of the program.
- Does this facility offer _______ (e.g. all short-acting modern methods and IUD insertion, IUD removal, implant insertion, and implant removal) onsite?
- If yes: In the past ______(e.g. week, month, quarter) has this facility offered these methods or services?
Optional follow-up questions:
- Routinely, how many days in a week does this facility offer XXX?
- Are clients referred elsewhere for XXX?
Because of the differences in the type of services offered at particular levels of facilities, evaluators should also tabulate the indicator by facility type to identify policy and program implications at various service delivery levels.
If targeting and/or linking to inequity, classify service delivery points by location (poor/not poor) and disaggregate by location.
This indicator determines the extent to which facilities are eligible to provide and are currently providing a range of family planning (FP) methods to clients. It is also a long-term indication of whether or not a national FP policy that includes LARCs is being implemented.
This is an overview indicator that does not address the availability of specific methods. It is important to note the distinction between whether a site offers a given service (in other words that the service is defined to be part of the site’s constellation of services) and whether a site has the resources it needs to actually carry out a given service at an adequate level of quality. The latter is explored more fully in other indicators in this section related to availability of infrastructure, supplies, and equipment; provider training; infection prevention systems; and counseling. A relatively large proportion of interviewees may report that LARC services are offered, however a significant proportion of these sites may not be currently offering the services because they do not have a provider who has been trained in the provision of that service in the past three years or the site may not have all the appropriate supplies and instruments.
access, long-acting/permanent methods (LAPM), family planning
Gender-sensitive programming offers a wide range of methods so that all women and men can achieve their reproductive intentions. If a low percentage of facilities, or low percentages at certain levels, are offering a balanced contraceptive mix, that may indicate that a program has not yet considered the full range of gender-based constraints that can impact use of contraceptives (need for confidentiality, limited access to resources, etc.).