Guide

This dashboard gives you access to estimates that contribute to -- but are not published in -- the CGA 2018 report. Use the left tab and dropdown menu to find estimates for individual countries. Use the right tab and dropdown menu to find results for groups of countries, such as the 69 FP2020 focus countries, all LMI countries within a particular region, or the countries participating in the Global Financing Facility.

There are a few noteworthy differences between the array of estimates for individual countries and the results available for country groups. Due to the uneven quality of some data, we do not show individual country estimates of the amount spent on supplies, nor do we show projected funding gaps. Those estimates are available for groups of countries.

The information below provides more detail on the estimates displayed in our dashboard. Additional information can be found in the full CGA 2018 report.

Spending on contraceptive supplies

Total spending on supplies includes expenditures by public sector entities that may have procured volumes above or below user consumption quantities.

The public sector

Public sector spending is the average of three years (2014-2016) of international donor and country government expenditures. We believe using an average allows us to even out the year-to-year fluctuations that occur due to the timing and size of procurement orders. This also allows us to maximize the available data, since not all sources provide estimates for all years.

• International donor spending.  This category captures direct spending on supplies, monetary contributions used to underwrite supply procurement, the value of in–kind contributions of supplies, basket funds provided by donors and used by governments to procure supplies, and World Bank loan funds used to procure supplies across LMI countries.
• Government spending: This category comprises of spending by the governments of LMI countries using non-donor, non-basket fund, and non-World Bank loan revenue to procure contraceptive supplies for domestic use.

Individuals / private sector

This category represents the average annual consumption cost over the three-year period (2014-2016) for all users of contraception who obtained their supplies from a private sector source, as well as a small amount of spending by corporate entities. We assume that supplies obtained from the private sector are paid for out-of-pocket by individuals (mainly women). We recognize, however, in some cases this cost may be borne by an employer or insurer.

In the CGA 2018, the private sector category includes pharmacies and private medical practices offering supplies at the full commercial price as well as social marketing organizations that offer supplies at reduced prices.

Number of users of contraception

The number of users of contraception is the starting point for the CGA report. It contributes to all of our subsequent estimates. The total number of users of modern methods of contraception includes both married and unmarried women, who obtain supplies from both the public and private sectors. The projected number of users in 2020 is calculated from each country’s current growth trajectory.

Our estimate of the total number of users of modern contraception comprises individual estimates for each of the 135 LMI countries. Estimates for the 69 FP2020 countries were calculated using the FPET¹ model, which uses data collected by DHS², MICs³, PMA2020⁴, and national and subnational health, socio-economic, and fertility surveys, as well as high-quality service statistics. Estimates for the 66 non-FP2020 countries were calculated using UN Population Division model-based estimates⁵. Data from DHS, MICs, and similar surveys were used to identify the number of users of each contraceptive method, and where they obtained their supplies (from either the public or private sectors)⁶.

Projections of the total number of users for the years 2018 through 2020 were produced using the FPET model and UN Population Division data. Projected changes in the number of users of each method, including shifts in method mix, were developed for this report based on sub-regional patterns of change seen in recent survey data.

Method mix and number of users of each method

The number of users of each method of contraception is an essential building block of the CGA. It contributes to our estimates of the quantity of supplies consumed by users of each method, which in turn contributes to our calculations of cost.

Users of contraception are disaggregated by the six most prevalent methods and a seventh category representing the least used methods, called other⁷:

Long-term and permanent methods (LAPMs)

• Sterilization (male and female)
• Implant
• IUD

Short-term methods

• Injectable
• Pill
• Condom (male; for contraception only)
• Other 

An increase in the total number of users over time does not translate to equal growth in the number of users each method. Some methods will gain more users than others or may even decrease in use.

The CGA 2018 report analyzes method mix in two ways: by use and by cost. The user method mix shows the percentage of all users of modern contraception that use each method. The cost method mix shows the relative cost of the quantity of supplies consumed by the users of each method.

Quantity of supplies consumed by users (Consumption Quantity)

The consumption quantity is the amount of supplies that a user of contraception must personally consume over the course of a year to avoid becoming pregnant, multiplied by the number of users.

Different approaches were used to estimate consumption quantities for short-term versus long-term and permanent methods. Users of short-term methods must consume multiple products each year to obtain a full year of coverage. By contrast, a subset of users of implants, IUDs, and sterilizations will have no need to consume any supplies in the current year. Consumption quantities were attributed to either the public or private sector using data that indicates whether a user of contraception obtained her supplies from a public or private sector source.

Please note that consumption quantities are different from procurement volumes bought by institutional purchasers, which may be above or below the quantities needed for user consumption.⁸

Cost of supplies consumed (Consumption Cost)

The consumption cost reflects the consumption quantity of supplies multiplied by their price.  This includes both the cost of the contraceptive commodity itself as well as associated clinical supplies. The consumption cost does not include other cost factors like fees paid for necessary medical services or required visits, taxes, freight, or tariffs, nor does it capture the effects of inflation or fluctuations in currency exchange rates.

To produce our public sector consumption cost estimates, we used the country-specific analysis of commodity and associated clinical supply prices produced by the Guttmacher Institute for their annual Adding It Up report⁹. The Guttmacher analysis takes into account variations in the price paid in the public sector for contraceptive commodities and associated clinical supplies in a country, as well as the mix of different products (e.g. types of implants) used, to produce an average cost per method for each country. In addition, for eight LAC countries we used information obtained through an RHSC survey that asked governments to identify the prices of contraceptive commodities they procure.¹⁰

To represent the mix of subsidized and non-subsidized products sold by the private sector, private sector consumption costs were calculated from two sources of price data. We multiplied commercial price data provided by IQVIA for implants, doses of injectables, and pill cycles by the corresponding volumes of each.

We applied public sector prices to volumes of commodities and supplies sold by social marketing organizations (as indicated in data collected by DKT International).¹¹ Where data were insufficient to make volume estimates, we took a conservative approach: IQVIA prices were applied only to implants, doses of injectables, and pill cycles purchased from private sector pharmacies and medical practices.

Supplies funding gap

The CGA 2018 estimates of funding gaps represent the difference between the total amount currently spent on supplies and the cost of the volume of supplies users will require for their own consumption.

In the dashboard table, we use each funding source’s current share of total spending on supplies to estimate their share of the total consumption cost for the years 2018 through 2020. The last row in the table shows the amount by which each source must adjust their level of spending to maintain their current share.

In some cases the current expenditure exceeds the projected consumption cost. In these instances the table shows a negative gap.  Negative gaps can occur when consumption costs are declining; for example, they can occur when less expensive methods claim a growing share of the method mix. They may also occur when procurement spending in prior years exceeded consumption costs (due, for example, to program expansions and the need to provide inventory to additional service delivery points). 

Note that consumption cost only addresses the volume of supplies required by individual users, not the volume needed for public health systems.

1. The Family Planning Estimation Tool (FPET) was designed to produce annual estimates of the contraceptive prevalence rate (CPR) and other indicators using statistical modeling that incorporates survey data and service statistics. For more information, see Technical Brief: Family Planning Estimation Tool at https//goo.gl/OKOim2. 
2. Demographic and Health Surveys (DHS)
3. Multiple Indicator Cluster surveys (MICs)
4. See www.PMA2020.org for more information. 
5. United Nations, Department of Economic and Social Affairs, Population Division (2016). Model-Based Estimates and Projections of Family Planning Indictors 2016. New York: United Nations.
6. For the purpose of this analysis all non-public sources are classified as private.  This includes a small number of sources such as shops and acquaintances that may not otherwise be considered private sector.
7. “Other” methods of contraception include, where data are available, female condom, emergency contraception, Standard Days Method, LAM, spermicide, and other barrier methods.
8. Procurement volume may reflect a number of factors in addition to user consumption, such as the volume necessary to fill supply pipelines and maintain adequate inventory levels from central warehouses to individual service delivery points. Procurement volumes may take into account the volume of supplies already present or on order, inventory holding policies along the supply chain, and wastage or “leakage” of supplies at various levels. 
9. Jacqueline E. Darroch, Singh S., Weissman E. Adding it Up: The Costs and Benefits of Investing in Sexual and Reproductive Health in 2014. Guttmacher Institute, 2016
10. RHSC LAC survey of Honduras, El Salvador, Guatemala, Nicaragua, Mexico, Paraguay, Bolivia, Peru
11. DKT’s compilation of social marketing statistics were used to estimate the volume of private sector commodity consumption that were socially marketed products (https://www.dktinternational.org/contraceptive-social-marketing-statistics/)