Percent of contraceptives available from the private sector
The percent of contraceptive methods available from private sector (PS) outlets relative to all sources of methods in a country or designated area during a specified time period.
The private sector is defined as all the providers, suppliers, and ancillary and support services that lie outside the public sector. These include commercial or for-profit entities, franchises, multinational corporations, non-profit organizations, community groups, informal vendors, and private providers, such as doctors, pharmacies, and hospital staff (Armand et al., 2007).
The basic contraceptives available should include those in the WHO Model List of Essential Medicines – oral hormonal contraceptive pills, injectable hormonal contraceptives, IUDs, barrier methods (condoms and diaphragms), and hormonal implants (WHO, 2011).
This is closely related to the indicators for Improved market segmentation, viability, and sustainability in the expanded Strengthening Health Outcomes though the Private Sector (SHOPS) Project (Abt, 2009) and the indicator for Increased non-public share of the market for condoms, pills, and injectables in the Monitoring and Evaluation Framework of the Reproductive Health Supplies Coalition (RHSC, 2009). For more details on this and related indicators, see Abt (2009) Abt (2011); Abt (2005); and RHSC (2009).
This indicator is calculated as:
(Number of units of contraceptive methods available from PS sources / Total number of units of contraceptive methods available from all sources, including public, private, non-governmental, and community-based) x 100
Data on where contraceptives are available, in what quantities, and what percentage of the market is the PS. The data can be disaggregated by the type of facility or program (public, commercial for-profit, non-profit organization, franchise, community groups, etc.), by the specific types of methods available, and by other relevant factors such as districts, urban/rural location, and target populations.
Public and PS facility and outlet inventory records and surveys; retail sales and pharmacy audits; and information management systems (IMS). In countries where available, DELIVER Project data can be used to assess supplies by sector for the range of modern contraceptive methods (DELIVER, 2006; DELIVER, 2011). Where data have been collected using the WHO Service Readiness Assessment Survey (SARA), the quantities by sector will be available for combined oral contraceptive pills, progestin-only injectable contraceptives, and male condoms (WHO, 2010).
This indicator measures the PS market share of contraceptive method supplies and the PS contribution to increasing access to these methods. As the availability can be quite different for each method, it is important for ministries of health (MOH), donors, and contractors to know what products exist in the commercial market and their market share. Given the importance of the PS in providing contraceptive methods, effective approaches for monitoring PS market segmentation and sustainability of contraceptive supplies and distribution are essential. This indicator can be used for policy and planning purposes to track strengthening and scale-up of contraceptive supplies and services in the PS, in addition to identifying gaps and problems with PS supply chains for the full range or specific contraceptive methods. Strengthening PS involvement and sustainability in providing quality contraceptive methods and services is considered essential to achieving the Millennium Development Goals to #4 reduce child mortality and #5 improve maternal health.
Obtaining full and accurate information on PS entities that provide contraceptive methods can be problematic in settings where PS providers are not required to register with or report to government agencies, such as the MOH. This indicator measures availability of contraceptive methods through the PS, but the overall access to, distribution of, and quality of PS services can best be measured using a range of indicators that provide data on method procurement, storage, affordability, travel time to PS outlets, staffing, delivery of method services and follow-up, and client utilization and satisfaction (WHO, 2010). Information on method affordability is including in the indicator in the section, Number and type of commercial contraceptive products on the market and their prices.
access, family planning, commodity, private sector
Abt Associates, 2005, Performance Monitoring Indicators for the Private Sector Program (PSP), with Explanatory Notes. Bethesda, MD: Abt Associates, Inc. https://www.shopsplusproject.org/sites/default/files/resources/1081_file_PSP_Perfomance_Monitoring_Indicators_April_1_2005.pdf
Abt Associates, 2009, Strengthening Health Outcomes through the Private Sector (SHOPS) Project: Performance Monitoring Plan (PMP), Year 1. Bethesda: MD: ABT Associates, Inc.
Abt Associates, 2011, Updated SHOPS Performance Monitoring Plan (PMP), Bethesda: MD: ABT Associates, Inc.
Armand F., O’Hanlon B., McEuen M., Kolyada L., and Levin L, March 2007, Private Sector Contribution to Family Planning and Contraceptive Security in the Europe and Eurasia Region, Bethesda, MD: Private Sector Partnerships-One project, Abt Associates Inc.
DELIVER, 2006, Contraceptive Security index 2006 a tool for priority Setting and planning, Arlington, VA: John Snow, Inc., USAID DELIVER Project. https://www.who.int/rhem/policy/csinde_2006_book/en/
Reproductive Health Supplies Coalition, 2009, Reproductive Health Supplies Coalition: Monitoring and Evaluation Framework (2007-2015), Brussels: RHSC.
WHO, 2010, Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies, Geneva: WHO. http://www.who.int/healthinfo/systems/WHO_MBHSS_2010_full_web.pdf
WHO, 2011, WHO Model List of Essential Medicines, 17th List (March 2011), Geneva, WHO. http://whqlibdoc.who.int/hq/2011/a95053_eng.pdf