List of Indicators for Measurement and Evaluation of CS in LAC

Publication date: 2007

LIST OF INDICATORS FOR MEASUREMENT AND EVALUATION OF CS IN LAC CS FINANCIAL INDICATORS Objective: To ensure adequate and secure funding for family planning contraceptives. SUB-OBJECTIVE / RESULT INDICATOR INDICATOR CALCULATION DATA SOURCE FREQUENCY EXPECTED RESULT NOTES Decrease the gap between required financial needs and actual funding ƒ Percent and absolute difference between current requirements and available funds in current year (year X) ƒ Percent and absolute difference between projected requirements and projected actual funds 5 years from current date (year X+5) ƒ [Available funds for year X (or X+5) / Required funds for year X (or X+5)] * 100 ƒ [Available funds for year X (or X+5)] – [Required funds for year X (or X+5)] DHS, consumption data, PipeLine, SPECTRUM, or other Annually TBD Analysis should be completed by sector Increase efficiency in use of allocated funds ƒ Percent of budget allocated versus funds requested ƒ Percent of actual public sector expenditures versus allocated funds ƒ [Allocated Budget / Funds requested] * 100 ƒ [Actual Public Sector Expenditures / Allocated Funds] * 100 Ministry of Health, Ministry of Finance Annually Government or Ministry of Health Improve processes ƒ Phaseout plan exists ƒ Budget line item exists ƒ Phaseout plan: Y/N ƒ Budget line item: Y/N CS Yes, by date determined by CS Committee Develop checklist Expand financing options ƒ Percent of contraceptive expenditures funded by sources other than donors ƒ Number of new funding sources providing resources to programs formally funded by donors Ministry of Health, Ministry of Finance Annually Specify by source CS PROCUREMENT INDICATORS Objective: Ensure efficient and effective procurement systems. SUB-OBJECTIVE / RESULT INDICATOR INDICATOR CALCULATION DATA SOURCE FREQUENCY EXPECTED RESULT NOTES Ensure the appropriate range of methods are procured to meet country needs ƒ Minimum list of contraceptive products selected ƒ Products included on essential drug list ƒ Minimum list of products selected: Y/N ƒ Products included on EDL: Y/N Ministry of Health Once Ensure efficient procurement ƒ Procurement plan exists ƒ Tracking mechanism exists to monitor status of products during procurement process ƒ Contraceptive costs as a percent of international benchmarks ƒ Contraceptive costs versus lowest local provider ƒ Percent of procurement process costs versus contraceptive cost ƒ Analysis carried out to determine optimal mix of centralized versus decentralized purchases ƒ Percent of purchases made centrally and directly by facility ƒ Procurement plan exists?: Y/N ƒ Tracking mechanism exists?: Y/N ƒ [Price paid for contraceptives / Int’l reference price] * 100 ƒ [Price paid for contraceptives / Lowest price paid for contraceptives from local provider] * 100 ƒ [Procurement process costs / Contraceptive cost] * 100 ƒ Analysis carried out to determine optimal mix?: Y/N ƒ [Amt. of centralized procurement / Total procurement] * 100 ƒ [Amt. of procurement by facility / Total procurement] *100 Program records UNFPA, MSH Previous tenders, current quotes Accounting system, procurement agents bid or cost Program records MOH or NGO finance records Decentralized versus centralized systems; crown agents versus direct government procurement Link to logistics indicators Ensure effective procurement ƒ Supplier fill rate: percent of orders that arrive completely filled within a specified time period ƒ [Number of orders filled in year X / Total number of orders in year X] * 100 Program records Bi-Annually CS LOGISTICS INDICATORS Objective: Improve supply chains capacity for delivering adequate supplies to service delivery points. SUB- OBJECTIVE/RESULT INDICATOR INDICATOR CALCULATION DATA SOURCE FREQUENCY EXPECTED RESULT NOTES Maintain product availability at facility level ƒ Percent of facilities that have contraceptives within reserve level ƒ [Number of facilities with stock levels within the reserve level / Total number of facilities] * 100 Facility registers, spot checks, LMIS At least quarterly Improve forecasting accuracy ƒ Forecasts use consumption data ƒ Forecasts carried out annually ƒ Forecast accuracy: percent discrepancy between forecast and actual use ƒ Forecasts use consumption data: Y/N ƒ Forecasts carried out annually: Y/N ƒ {[Estimated need – actual use of contraceptives] / [Estimated need]} * 100 Forecast and consumption records Annually Ensure timely and accurate data reporting through LMIS ƒ LMIS forms include 4 essential data items: consumption, adjustments/losses, and stock on hand, quantity of contraceptives not dispensed due to stock- outs (unfilled prescriptions) ƒ LMIS reporting rate ƒ LMIS data quality - % discrepancy between inventory stock cards and LMIS reports ƒ LMIS forms include 4 essential data items?: Y/N ƒ [Number of facilities reporting LMIS data / Total number of facilities] * 100 ƒ {[LMIS report count – Stock record count] / [Stock record count]} * 100 Ensure adequate and sustainable human capacity ƒ Warehousing ƒ Distribution ƒ CS POLITICAL COMMITMENT INDICATORS Objective: Strengthen political commitment for sustainable family planning services and contraceptive security SUB- OBJECTIVE/RESULT INDICATOR DATA SOURCE FREQUENCY EXPECTED RESULT NOTES Strengthen advocacy efforts around CS ƒ Number of civil society organizations advocating for FP and CS ƒ Number & type of advocacy events Key informant interviews Annually Distinguish by central and local level Strengthen legal / regulatory framework and policy environment in favor of CS ƒ DAIA Committee institutionalized ƒ Funded national budget line item ƒ Local funding for contraceptives (in decentralized settings) ƒ Contraceptives established as a “strategic commodity” Ministry of Health (central and local) Annually Yes CS MARKET SEGMENTATION INDICATORS Objective: Ensure whole market approach towards contraceptive security SUB-OBJECTIVE / RESULT INDICATOR INDICATOR CALCULATION DATA SOURCE FREQUENCY EXPECTED RESULT NOTES Understand current market structure and address inefficiencies that may exist ƒ Analysis carried out to understand current market structure (based on CPR, source, unment need, method mix, education, age, geographic, socioeconomic status) ƒ CS Committee defines options for future market structure ƒ Action plan developed to move from current to desired market structure ƒ Action plan developed to move from current to desired market structure: Y/N Secondary data analysis of DHS, RHS; CS Committees; Trends Every five years. Rationalize resource use in contraceptive market ƒ Percent of those with means relying on MOH for contraceptives ƒ Source of contraceptives for users ƒ Is there an intentional change in the source(s) of contraceptives for users?: Y/N Secondary analysis of DHS; exit interviews; trends Every five years. Increase access to contraceptives among underserved groups ƒ Unmet need, intenders, and/or traditional method users ƒ Source of contraceptives for users ƒ CPR ƒ [Number of users with unmet need / CPR] * 100 Secondary analysis of DHS; service statistics from facilities Every five years Illustrative Activities for Attaining Contraceptive Security FINANCIAL SUSTAINABILITY ƒ Develop phaseout plans for contraceptive methods, for products, and for years. ƒ Identify financial need based on annual forecasting. o Prepare scenarios based on prices, method mix, and different sources, and identify key assumptions that are used (e.g. consumption versus demography). ƒ Identify and expand the financial mechanisms o Budget line item for the MOH o Social Security o Private Insurance o Commercial Sector / others o User fees / voluntary contributions Determine feasibility (barriers, limits, and opportunities) of financial options and identify specific actions for their implementation. ƒ Achieve a potential cost savings through a change in the method mix. PROCUREMENT ƒ Map out internal procurement processes by source (e.g. UNFPA, local producers, international suppliers) and by sector (MOH, Social Security, NGO) ƒ Identify different options/variables for procurement: o Compare different internal procurement procedures between various sectors and discuss viable options for effective and efficient procurement. o Discuss advantages/disadvantages of public sector procurement versus other mechanisms. o Advantages/disadvantages of local suppliers versus international ones. ƒ Evaluate the benefits, costs, legal and regulatory issues, and prices associated with different procurement options ƒ Select a minimum range of contraceptive methods to offer and include them on the essential drugs list (public sector) o Consider the availability of different contraceptives among suppliers when the decision is to be made about what to include on the essential drugs list. ƒ Develop standard operating procedures for procurement (MOH) o Product specification, supply processes, etc. LOGISTICS ƒ Analyze the effectiveness of the logistics system o Distribution - Potential cost savings for different distribution systems • Effectiveness of the transport system for ensuring product availability • Reach of the supply chain - Warehouse conditions (space, ventilation, etc.) o Inventory management - Automation - Analysis of the minimum storage requirements for the inventory o Logistics Management Information System - Automated system o Needs Estimates - Make sure they are based on consumption data ƒ Analyze the impact of integrating logistics functions to ensure the availability of contraceptives. o Protect the ground that has been gained in contraceptive logistics systems - Estimate need based on consumption data - Ensure that the information system for contraceptives is maintained throughout the integration process ƒ Analyze the impact of decentralization on all aspects of the logistics functions o Maintain centralized procurement (include price negotiations) o Evaluate the financing and administration of the distribution system, based on the procurement options available. MARKET SEGMENTATION ƒ Understand the current market structure with respect to prioritizing scarce resources and maintaining or increasing CPR ƒ Discuss options for future market structures, if it is deemed necessary. ƒ If a change is necessary, develop action plans to move from the current market structure to the desired one. POLITICAL COMMITMENT ƒ Develop a political commitment through evidence-based advocacy o Strengthen the civil society’s advocacy capacity to include issues related to CS o Tie advocacy to reducing poverty, maternal mortality, infant mortality, and HIV/AIDS o Quantify the costs of FP (such as the percentage of the budget for essential drugs and health expenditures) ƒ Establish a line item in the national budget for FP ƒ Establish contraceptives as a strategic commodity ƒ Budget for family planning at the local level in decentralized settings ƒ Institutionalize the CS Committee LIST OF CS RESOURCES ƒ CS Index http://www.deliver.jsi.com/pdf/factsheets/csindex_booklet.pdf • Reproductive Health Supply Initiative http://www.rhsupplies.org/ • UNFPA http://www.unfpa.org/supplies/essentials/index.htm • JSI – DELIVER Policy Briefs and Guidelines/Manuals/Software http://deliver.jsi.com/2002/Pubs/Pubs_Policy/index.cfm http://deliver.jsi.com/2002/Pubs/Pubs_Guidelines/index.cfm http://deliver.jsi.com/2002/Pubs/Pubs_Software/index.cfm ƒ SPECTRUM www.policyproject.com/software.cfm ƒ PipeLine www.deliver.jsi.com/2002/Software/index.cfm ƒ Macros DHS www.measuredhs.com ƒ CDC RHS ‘International Reproductive Health Surveys and Survey Reports’ http://www.cdc.gov/reproductivehealth/gp_surveys.htm ƒ MSH Drugs Index International Drug Price Indicator Guide http://erc.msh.org/mainpage.cfm?file=1.0.htm&module=DMP&language=English ƒ UNFPA contraceptive prices and CS materials RH commodities price list http://www.unfpa.org/procurement/prices.htm ƒ Maternal mortality strategy – PAHO ‘Regional Strategy for Maternal Mortality and Morbidity Reduction’ 2002 www.paho.org/english/gov/ce/spp/spp36-08-e.pdf ƒ SPARHCS – ‘Strategic Pathway to Reproductive Health Commodity Security’ http://www.policyproject.com/pubs/monographs/SPARHCS.pdf http://www.maqweb.org/sparhcs/index.shtml ƒ Market segmentation analyses, various countries (not available online) – available upon request ƒ LAC CS Regional Initiative http://www.policyproject.com/pubs/CS_Lac.cfm • MEASURE Chapter on commodities and logistics http://www.cpc.unc.edu/measure/publications/pdf/ms-02-06-vol_1_part_2_e.pdf ƒ Logistics indicator handbooks (forthcoming) ƒ CS Advocacy manual (forthcoming) ƒ Repositioning FP advocacy manual (forthcoming)

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