Location of service delivery points; information on availability of FP services at those sites; population size of area surveyed

Mapping of service delivery points; health information records of services provided; census data (or other sources to get estimates of population size); population-based survey; local knowledge of common modes of transportation

This indicator measures geographical access to FP services. Use of FP largely depends on access to FP services, which includes physical and time barriers, among other factors.  Research has shown that the more inaccessible an FP service is, the less it is demanded and used.  This indicator will not be useful in the day-to-day monitoring of program implementation (performance). However, it can highlight equity/access issues when accessed occasionally, particularly in instances when a project is working to improve health infrastructure or increase FP access through community-based distribution or other mechanisms.

Alternatively proposed indicators include:

• Number of service delivery points located within a fixed distance or travel time of a given location;
• Proportion of villages or city neighborhoods that have a service delivery point located in the village or neighborhood;
• Average distance to the nearest service delivery point;
• Average travel time to the nearest service delivery point; and
• Average number of hours per month spent obtaining contraceptive services and supplies.

Proximity to a service delivery point that offers an insufficient and/or unreliable range of services and/or methods does not constitute access in the manner intended by this indicator.  Also, “travel time” can be a subjective – and fluctuating – measure.  For instance, a hypothetical service delivery point providing contraceptives may be about a one hour walk away in the dry season, but during the wet season, the travel time may be more than double, thus providing an inaccurate assessment of how far away a population actually is from the service delivery point of interest.

Bertrand, J.T., R. Magnani, and J. Knowles. 1994. Handbook of Indicators for Family Planning Program Evaluation. The Evaluation Project.  University of North Carolina, Chapel Hill: Carolina Population Center.

USAID. 2008. Flexible Fund Guidance for Grantees: Implementation Plan (IP) and Baseline Assessments. Washington DC: USAID.