Speaking the same language: Harmonizing how we measure

stockouts and availability of contraceptives

Suzy Sacher, John Snow, Inc.

November 2, 2015

American Public Health Association Annual Meeting

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Presenter Disclosures

The following personal financial relationships with commercial interests relevant to this presentation

existed during the past 12 months:

No relationships to disclose

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Overview of Presentation

- Background and purpose

- Harmonized stockout indicators

- Indicator adoption & snapshot of stockout indicator data

- Next steps

BACKGROUND AND PURPOSE

Harmonizing Stockout Indicators

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Why consider harmonizing stockout indicators? • Inconsistent measurements of stockouts across

organizations, including differences in:

Definitions

Methodology

• Confusion about meaning of collected data

• Challenge to compare data, compile evidence base, & use data for advocacy

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Percentage of Facilities Stocked Out (sample data)

40

30

70

0

10

20

30

40

50

60

70

80

90

100

Pe

rce

nta

ge o

f fa

cilit

ies

Indicator

1) What percentage of all health facilities do not have the product today?

2) What percentage of facilities that offer the product do not have the product today?

3) What percentage of facilities had a stockout of the offered product at any time in the last 3 months?

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Goal and Purpose of Stockout Indicators Activity

Goal: Get people speaking the same language in order to meaningfully mobilize actions to decrease stockouts

Purpose: Propose an approach to measuring stockouts and availability so that results:

more reliably quantify the occurrence and impact of stockouts

can be universally interpreted

can be used to measure progress

can be used for advocacy and accountability

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Overview of Initial Activities

Landscape analysis

Draft suite

of indicators

Field tests

Harmonized Stockout Indicators

Harmonizing Stockout Indicators

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Final Suite of Harmonized Stockout Indicators: Summary

1 primary indicator per category

2 additional indicators per category

Categories

1

2

A. Products or methods offered

B. Point-in-time stockouts

C. Range of methods available

D. Frequency and duration of stockouts over time

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Primary Indicators

A1. Percentage of facilities that offer each product or method, reported by product or method

B1. Percentage of facilities stocked out, by product or method offered, on day of assessment (UNIVERSAL INDICATOR)

C1. Percentage of service delivery points with at least 3 modern methods (primary) and at least 5 modern methods (secondary/tertiary) available on the day of assessment

D1. Percentage of facilities that experienced a stockout according to the ending balances of any of the last three months, reported by product or method offered

A. Products or methods offered

B. Point-in-

time stockouts

C. Range of

methods available

D. Frequency

and duration of stockouts over time

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Indicator Guidance Document

formula definition

purpose

Indicator reference sheets

include

issues

example sentences

data sources &

require-ments

www.rhsupplies.org

Indicator Adoption & Snapshot of Stockout Indicator Data

Harmonizing Stockout Indicators

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Family Planning 2020 (FP2020) Stockout Indicators

B1. Percentage of facilities stocked out,

by product or method offered, on day of assessment

(UNIVERSAL INDICATOR)

C1. Percentage of service delivery points with at least 3 modern methods (primary) and

at least 5 modern methods (secondary/tertiary) available

on the day of assessment

B. Point-in-time

stockouts C. Range of

methods available

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Point-in-time Stockouts in 2014 Percentage of service delivery points stocked out on day of assessment

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Burkina Faso Ethiopia Ghana Kenya

Implants

IUDs

Sterilization (female)

Sterilization (male)

Condoms (male)

Condoms (female)

Injections

Pills

Emergency contraceptives

Source: Performance Monitoring & Accountability 2020 (PMA2020)

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Range of Methods Available in 2014

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Burkina Faso Ethiopia Ghana Kenya

Percentage of primaryservice delivery points thathave at least 3 modernmethods of contraceptionavailable on day ofassessment

Percentage ofsecondary/tertiary servicedelivery points with at least5 modern methods ofcontraception available onday of assessment

Source: Performance Monitoring & Accountability 2020 (PMA2020)

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Advocacy for Further Adoption of Indicators

• .

• PAI developing advocacy plan for adoption of 4 primary indicators - key informants interviewed from:

http://noemptyshelves.org/the-campaign

Next Steps

Harmonizing Stockout Indicators

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Next Steps

• Further disseminate indicator guidance document

• Translate document into French and Spanish

• Begin implementation of advocacy plan

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We cannot overcome together what we cannot see together.

We are forging a common vision of what we must overcome.

--John Skibiak,

Reproductive Health Supplies Coalition

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Thank you! Special thanks to --

Ellen T. Tompsett, Safia Ahsan, & Dana Aronovich

& to all the Stockout Indicators Advisory Group Members:

For more information: ssacher@jsi.com