Percent of primary health care facilities providing family planning services
The percent of primary health care facilities in a designated area that provide basic family planning (FP) services. Ideally, primary health care facilities include all public, private, non-governmental, and community-based facilities.
FP services should be available to men as well as women and to adolescents (with referral as required), and should include counseling, information, education, and method delivery and follow-up (WHO/UNFPA, 2008). The basic package of FP methods available should include modern methods (e.g., hormonal contraceptives, IUDs), condoms, and counseling and/or referrals on fertility awareness methods, postpartum FP, and the lactational amenorrhea method, in addition to referrals for methods requiring higher levels of care, such as implants and sterilization.
This indicator is calculated as:
(Number of primary care facilities providing FP services / Total number of primary care facilities in a designated area) x 100
Data can be used from facility records, health information systems (HIS), and specialized surveys, such as Health Facility Assessments (HFA) and the Service Provision Assessment Survey (SPA).
For an overview of various HFA instruments, see MEASURE Evaluation/USAID/WHO (2008), and for SPA, see MEASURE DHS (2011). The data can be disaggregated by the type of facility or program (public, private, non-governmental, community-based), the types of FP methods and services available, and by other relevant factors such as districts and urban/rural location.
Facility records; HIS; specialized surveys; HFA; SPA
This indicator measures access to FP methods through primary health care facilities and is included among the core access indicators for the achievement of universal access to reproductive health (RH) (WHO/UNFPA. 2008). Primary health care facilities, particularly community-based facilities, often serve low-income and marginalized populations and can be entry points for health care and for FP services. The provision of FP services at the primary care level is considered an essential part of achieving universal access and relates directly to Millennium Development Goals #5. improve maternal health and #4. reduce child mortality.
While this indicator measures availability of FP services in primary health care facilities as a component of access, it does not capture specific aspects of or barriers to access, for example, physical availability, cost, method mix, supply, information, availability of trained providers, and quality of services. For these purposes, data on utilization, travel time, hours of operation, costs of services, types of methods available, stock-outs, youth friendliness, staffing, and perceived quality of care can be beneficial.
The integration of FP services with primary health care can be more costly than providing them in stand-alone RH/FP clinics. However, the benefit of increasing client access and utilization of FP services can outweigh the added costs.
access, health system strengthening (HSS), family planning, integration
MEASURE DHS. 2011, Service Provision Assessments (SPA) Survey Overview, DHS Website
MEASURE Evaluation/USAID/WHO, 2008, Profiles of Health Facility Assessment Methods: Report of the International Health Facility Assessment Network (IHFAN), Chapel Hill, NC: MEASURE Evaluation. http://www.cpc.unc.edu/measure/publications/tr-06-36
WHO/UNFPA, 2008, National-level monitoring of the achievement of universal access to reproductive health: conceptual and practical considerations and related indicators, Geneva: WHO. http://whqlibdoc.who.int/publications/2008/9789241596831_eng.pdf