Number of service facilities offering a specific reproductive health service per 500,000 people
In a given population of half a million people, the number of health facilities that provide a specific reproductive health (RH) service (e.g., contraceptives, postabortion care, voluntary counseling and testing, micronutrient supplementation)
Information on the total number of facilities offering a specific service and the total population (or relevant subgroup) in the catchment area.
Note: evaluators may limit the denominator to an estimate of the relevant sub-group for the service (e.g., all women of reproductive age for family planning, all pregnant women needing micronutrient supplementation, all adults 15 to 65 for HIV counseling and testing). Because of the difficulties associated with estimating the exact number of persons in need of such a service (e.g., postabortion care), evaluators may opt to use the total population in the denominator.
Program records on the service delivery infrastructure; census data on size of population in the catchment area
This indicator gives a broad sense of the density of service delivery points for specific types of RH interventions. It can be useful for advocacy purposes in creating awareness of the deficiencies in the service delivery environment for particular services.
One potential use of this indicator is to help governments track progress in terms of improving the service delivery environment for the population. However crude this measure is (and how little it reflects the situation of a specific individual in that society), it does represent progress for a government to increase the number of RH facilities per 500,000 in the population (assuming quality remains constant or improves). Moreover, where data on the health service environment are fairly reliable, evaluators may collect this information at relatively little cost to the user.
Caveats for this indicator include the following. First, although this indicator gives a ratio of service delivery points per population, it does not reflect the geographical distribution of such points. In the case where service delivery facilities cluster in urban areas, this indicator may yield a more favorable estimate of access to services than individuals in rural areas actually experience. Second, it is easier to collect information on the availability of some services than of others. For example, many countries have fairly accurate lists of family planning services through government or NGO facilities. However, they may not track the number of pharmacies that carry contraception and other RH products, and thus may underestimate the access of the population to these commodities. In more controversial subject areas, such as postabortion care, facilities may provide services but not publicize them widely, and thus may create undercounts on this indicator for those services. A third caveat is that services may exist “on paper” but not at the actual field site.
access, health system strengthening (HSS), safe motherhood (SM)