Condoms available for distribution nationwide
The total number of condoms available for distribution nationwide during the preceding 12 months, divided by the total population aged 15-49
The indicator estimates the number of condoms (male and female) available for in-country use during the last 12 months. Key informants are identified and interviewed to uncover all possible sources of condom manufacture, import, distribution, and storage. Next, data are collected from all manufacturers and major commercial distributors as well as major donors, condom storage facilities, and government, parastatal, and NGO bodies involved in acquiring and distributing condoms.
This indicator sums the condoms in stock nationally at the start of the 12-month period, plus condoms imported during the 12-month period, plus condoms manufactured in country during the same period, minus any exports of condoms over that period. The sum of all condoms available for use in the country during the past 12 months is then divided by the total population aged 15-49.
This indicator is calculated as:
# of condoms in stock + # of condoms imported + # of condoms manufactured – # of condoms exported during a 12-month period/ Total population aged 15-49
Condom inventories and purchase records for (1) social marketing programs, (2) national condom distribution programs, and (3) commercial wholesalers/distributors; stock records and production records for manufacturers
WHO/Global Program on AIDS protocol for estimating condom availability for distribution at the central and peripheral level
The best distribution system in the world is not much help if it has nothing to distribute. The first challenge for national programs promoting condom use is to ensure that there are enough condoms in the country to satisfy demand. This indicator measures the number of condoms available for use by those in the most sexually active age group. Where programs actively promote the availability of male condoms, they should also include female condoms, although the indicator should be disaggregated by condom type.
Combining this indicator with indicators of sexual behavior gives a powerful picture of the adequacy of condom provision. For example, if a third of all men aged 15-49 say they have had non-regular sex in the past year, and 20 percent of married couples say they have used condoms to avoid pregnancy, and yet only three condoms are available per sexually active adult per year, one can deduce that the national supply of condoms is insufficient to meet the potential demand.
The number of condoms available at the central level helps assess the adequacy of overall condom availability. We must note, however, that “availability” does not equal “accessibility,” which includes dimensions of price, location, and access by sub-populations at risk for unprotected sex and HIV. Frequently, not all available condoms are distributed or reach the individuals who most need them to protect against the spread of HIV. This indicator by itself cannot give a picture of how many “in-stock” condoms actually get distributed or used.
Ironically, efforts at the national level to encourage condom use sometimes complicate the measurement of this indicator. Many countries have deregulated condom imports in the face of AIDS in order to maximize the number of condoms available. Deregulation means that a wide variety of companies, NGOs, donors and government departments (the health ministry, the defense ministry, among others) may import condoms without necessarily reporting numbers imported to a central body. Programs distinguish between condoms distributed through family planning programs and those distributed to reduce sexually transmitted infections. One must take both sources into account. If possible, evaluators need to present data by program, because family planning programs primarily intend condoms for relatively low-risk acts within stable monogamous unions, whereas AIDS program condoms aim at higher risk sexual contacts.
Where condom promotion activities center around marketing condoms at subsidized prices to people likely engaging in risky sex (social marketing), sales of particular brands of condoms can also provide a useful indicator of program success. Organizations responsible for the social marketing of condoms typically keep very good records of condoms distributed down to the retail level. Although these data tell only part of the story of condom availability, they provide a very low-cost source of information for the National AIDS Program and can be very useful for advocacy purposes. A rise in the number of condoms manufactured or imported into a country, or of condoms sold, can be useful in supporting other indicators measuring rises in self-reported condom use or falls in self-reported STIs and, eventually, in HIV prevalence.
family planning, HIV/AIDS, cervical cancer
Community-Based Family Planning Services