Abstract
Background: The " FP2020 Global Partnership" signaled a shift to broader, rights-based approaches to family planning programs, and the National Composite Index for Family Planning was developed as part of related measurement efforts. Methods: In each country 10-15 experts on the family planning program completed a 35-item questionnaire, first in 2014 in 89 countries, and in 2017 in 84 countries. Data were entered in Excel, with checks for consistency and data quality. The total score, and scores for each of 5 dimensions of effort are averages across the 35 indicators. Analytic techniques included cross-tabulations, graphical and correlation approaches. Results: The average total score for all countries in 2017 was 64 of the maximum of 100 of effort. Sub-regions differed: Anglophone and Francophone sub-Saharan Africa (SSA) scored highest in the total score and across all 5 dimensions. Next in order came Latin America and the Caribbean, Asia, the Middle East and North Africa, and Eastern Europe and Central Asia. Despite large differences in scores, the sub-regions followed similar profiles across the 35 indicators. The long term rise in the basic family planning effort scores continued, extending the series from surveys approximately every five years beginning in the 1980s. The highest score reached was for the strategy dimension, but the others were close.Their relative levels remained essentially the same as in the 2014 survey. NCIFP scores correlated positively with modern contraceptive use in both the sub-Saharan Africa (SSA) and non-sub-Saharan Africa (non-SSA) countries, but the relationships were stronger for SSA. Access to long-acting and permanent methods (LAPMs) was accompanied by greater LAPM use and modern method use. Conclusion: Repeated surveys in most developing countries show improvements in family planning effort, though unevenly, by 35 indicators and across regions.
Highlights
For many decades, there has been a sustained interest in measuring the nature and strength of family planning (FP) programs, to understand how efforts change over time and how they relate to key FP outcomes
The intention was not to replace the Family Planning Effort Index (FPE) but to build on the standard FPE questions, adding items to capture areas not fully covered by it, issues related to rights and equity
C For a more detailed description of the modifications made to the 2017 National Composite Index for Family Planning (NCIFP), see the 2014 NCIFP Report on the Track[20] website. http://www. track20.org/pages/data_analysis/policy/NCIFP.php
Summary
There has been a sustained interest in measuring the nature and strength of family planning (FP) programs, to understand how efforts change over time and how they relate to key FP outcomes. Existing studies have used FPE scores to monitor trends in the effort of FP programs over time, compare program strength at the sub-national level, and measure the association between FP program effort and FP indicators, including contraceptive use, contraceptive method mix and fertility. Most of these studies have found a positive relationship between FPE scores and FP indicators: as FP program effort improves, fertility levels tend to be lower[1,6], and contraceptive use tends to increase[9]. Reviewer Status AWAITING PEER REVIEW Any reports and responses or comments on the article can be found at the end of the article
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