Quantities of pills, condoms, and spermicides distributed to clients; numbers of IUDs and implants inserted; number of injections administered; number of sterilization operations performed; number of trained, confirmed clients of SDM; number of LAM clients during the reference period.

If targeting and/or linking to inequity, outlets can be classified by location (poor/not poor) and CYP can be disaggregated by location.

Data Sources:

Purpose:

Issues:

This indicator should not be used as the sole indicator to measure FP program performance. The principal disadvantages of the indicator are that:

• It is not intuitively easy to understand by those outside the field.
• One cannot ascertain the number of individuals represented by CYP. For example, if a program administers 10,000 injections of Depo Provera, this amount is equivalent to 2,500 CYP. Theoretically, this figure represents 2,500 women protected for 12 months each; however, in fact it may refer to 5,000 women covered for 6 months each or 10,000 women covered for 3 months each.
• CYP reflects distribution to clients and is a way to estimate coverage and not actual use or impact.
• The number of years that are included in the estimates impacts the average duration of use. For example, the same curve was used for estimating continuation for all implants by truncating the data at 3 and 5 years. This method probably slightly overestimates continuation for the shorter implants, especially the 3-year implant.
• Effectiveness of the methods is included in the continuation estimates because discontinuations for all reasons, including due to pregnancy, are looked at together.
• It does not provide information on whether the contraceptive methods are accessible and acceptable to all individuals, nor does it provide any indication of the quality of services.

Regarding the calculation of CYP for long-term methods, most programs “credit” the entire amount to the calendar year in which the client accepted the method. For example, if an FP program performed 100 voluntary surgical contraception procedures in a given year, it would credit all 1000 CYP (100 procedures x 10 years/each) to that calendar year, even though the protection from those procedures would in fact be realized over the subsequent nine years. An alternative approach is to “annualize” this projection, allocating it over a 10-year period. The same principle applies to IUDs and implants. Although the first approach (of crediting the full amount of CYP in the calendar year of acceptance) has been harshly criticized, it represents current practice in most programs that report CYP, probably because it is easier to apply.

CYP calculations are based on the volume of contraceptives distributed to clients who will presumably use them, not on those delivered to facilities where they may remain unused in cartons or on shelves. However, in some projects such as social marketing, it may be impossible to monitor the exact numbers reaching the hands of clients. In these cases, a proxy CYP can be calculated based on the volume of contraceptives delivered to the retailers in question. Given that retailers are unlikely to stock products that move slowly, it is assumed that (after an initial shipment) most contraceptives sold to retailers will make their way into consumers’ hands. If a proxy CYP is calculated using data from logistics management information systems, warehouse supply or delivery, stock-on-hand, or similar sources, those preparing the report should state it is a proxy CYP and provide details on the data source to the users of the information.

Illustrative Computation:  Calculations for the number of units of three FP methods that would be required to provide 1,000 CYP¹