Reality :A Planning and Advocacy Tool for Family Planning Programs

Melanie Yahner, MPH

The RESPOND Project

2011 International Conference on

Family Planning, Dakar, SenegalP

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What Is Reality ?

An Excel-based tool for evidence-based planning and advocacy

– Helps users plan/advocate realistically, based on informed estimates of need

– Allows a user to test multiple scenarios in minutes → “What if…”

– Provides a flexible level of analysis: national, regional, district

– Requires only basic Excel skills and is user-friendly

– Requires minimal data entry

What Information Can Reality Generate?

CPRCPR

UsersUsers

AdoptersAdopters

Implant removalsImplant removals

CommoditiesCommodities

Commodity costsCommodity costs

CaseloadCaseload

Couple-years of protection (CYP)Couple-years of protection (CYP)

Generated automatically

Unintended pregnancies averted

Unintended pregnancies averted

Unintended births averted

Unintended births averted

Abortions avertedAbortions averted

Maternal deaths averted

Maternal deaths averted

Child deaths avertedChild deaths averted

Infant deaths avertedInfant deaths averted

Reality Reality

Requires additional data inputs

What Data Input Does Reality Require?

Population projections for WRA or MWRA

Population projections for WRA or MWRA

Contraceptive prevalence by method

Contraceptive prevalence by method

Number of sitesNumber of sites

Discontinuation ratesDiscontinuation rates

Commodity costsCommodity costs

CYP factorsCYP factors

RequiredDefault values provided Optional

Reality Reality

Method-specific failure rates

Method-specific failure rates

Pregnancy ratePregnancy rate

Abortion ratioAbortion ratio

Maternal mortality ratioMaternal mortality ratio

Infant mortality rateInfant mortality rate

Child mortality rateChild mortality rate

Spontaneous abortion (miscarriage) rate

Spontaneous abortion (miscarriage) rate

What Are the Necessary Resources, and Potential Impacts, of Different Prevalence Scenarios for Sino-Implant (II) in Burkina Faso?

How Many Sino-implant (II) Users Would Burkina Faso Have to Serve?

Estimated Number of Sino-implant (II) Users in Burkina Faso

0

50,000

100,000

150,000

200,000

250,000

2012 2013 2014 2015

WRA

1% prevalance 3% prevalence 5% prevalence

Source: Demographic and Health Surveys and Reality

What would be the resources required, and the impact of achieving, by2015, for Sino-implant (II):1. 1% prevalence

2. 3% prevalence

3. 5% prevalence

How Many Sino-Implant (II) Removals Would Be Required?

0

10,000

20,000

30,000

40,000

50,000

2012 2013 2014 2015

Rem

oval

s

1% prevalence 3% prevalence 5% prevalence

By 2015 (cumulative sums):

More than 32,000 removals if 1% prevalence were achieved.

More than 97,000 removals if 3% prevalence were achieved.

More than 162,000 removals if 5% prevalence were achieved.

Estimated Number of Annual Sino-Implant (II) Removals in Burkina Faso

Source: Demographic and Health Surveys and Reality

What Would Be the Commodity and Supply Costs for Each Scenario?

Estimated Annual Sino-Implant (II) Commodity and Supply Costs

0

200,000

400,000

600,000

800,000

1,000,000

2012 2013 2014 2015

Cost

in U

S$

1% prevalence 3% prevalence 5% prevalence

Source: Demographic and Health Surveys and Reality

What Would Be the Impact of Increased Sino-Implant (II) Use?

Adverse Outcomes Averted through Use of Sino-Implant (II) in Burkina Faso

2011-2015

0100,000200,000300,000400,000500,000

1% 3% 5%

Unintended pregnancies Abortions Infant deaths Child deaths Maternal deaths

Source: Demographic and Health Surveys and Reality

Question 2: Could Bangladesh Meet Its Goal?

CPR Trends among Married Women of Reproductive Age in Bangladesh

2035

5065

80

19941996

19982000

20022004

20062008

2010CPR

(mar

ried

wom

en)

CPR trend between 1994 and 2004CPR trend between 2005 and 2010 (projected)

Source: Demographic and Health Surveys and Reality

Trends in Contraceptive Prevalence Rate (CPR) in Bangladesh

How Did Prevalence Remain Stagnant When Service Statistics Indicated Increased Use?

However, the 2007 Demographic and Health Survey showed a slight decline in modern method use in Bangladesh (from 47.6% in 2004 to 47.5% in 2007).

05,000,000

10,000,00015,000,00020,000,00025,000,00030,000,00035,000,00040,000,000

2004 2007

MW

RA

Estimated number of MWRAEstimated number of modern method users

The difference in the number of users of modern methods between 2004 and 2007 is over 850,000.

Source: Demographic and Health Surveys and Reality

What Was the Difference in Impact?

Unintended Pregnancies Averted through Modern Method Use in

Bangladesh, 2004 and 2007

11,000,000

11,500,000

12,000,000

12,500,000

2004 2007Uni

nten

ded

preg

nanc

ies

aver

ted

amon

g M

WRA

The difference between 2004 and 2007 is about 618,000 additional unintended pregnancies averted in 2007.

Source: Demographic and Health Surveys and Reality

Reality Applications

Policymakers and program managers can use Reality to set targets and plan to meet them.

Advocates can use Reality to make the case for investment in FP.

Logistics teams can use Reality to quantify the commodities and supplies needed to meet a goal.

www.respond-project.org