Couple-Years of Protection Indicator: New Global Guidance for Updating Existing Methods and Adding New Methods.

BACKGROUND: Couple-years of protection (CYP) is an indicator that allows for monitoring and evaluating of family planning (FP) program performance through simple calculations. The CYP for each contraceptive method is calculated by multiplying the number of contraceptive commodity units distributed to clients over a 1-year period by a conversion factor that quantifies the duration of contraceptive protection provided per unit distributed. CYP calculations across methods were previously updated in 2000 and 2011, resulting in changes in methodology, factor inclusion, and specific methods. Since the 2011 update, changes and additions to the modern contraceptive method mix required new CYP conversion factors for 4 methods of contraception: Levoplant implant, progestin-only pills (POPs), Caya diaphragm, and the hormonal intrauterine device. METHODS: We conducted literature reviews of both published and gray literature and consulted with experts to identify updated data on continuation rates, duration of efficacy, and method effectiveness for the 4 methods. New CYP conversion factors were calculated for the 4 methods either by using the same calculation used previously for the method considering new data or, for new methods, using calculations for similar methods. RESULTS: New CYP conversion factors were assigned to the 4 methods of contraception covered in this update: Levoplant, 2.5 CYP per implant inserted; POPs, 0.0833 CYP per pack (i.e., 12 cycles per CYP); Caya diaphragm, 1 CYP per device, and hormonal intrauterine device, 4.8 CYP per device inserted. CONCLUSIONS: CYP is an important indicator for FP programs. As new methods of contraception are developed and new evidence is generated for current methods, the indicator may need to be updated. A standard process for updating and documenting future CYP updates is recommended.

Routine Family Planning Data in the Low- and Middle-Income Country Context: A Synthesis of Findings From 17 Small Research Grants.

Health information systems rely on high-quality data to measure, track, and inform decision making. Currently, the quality, uptake, and use of family planning data in routine health information systems is limited, presenting an opportunity for improvement on many levels. The current synthesis assessed findings from 17 small grants that MEASURE Evaluation issued to low- and middle-income country research teams between 2015 and 2019. Main findings from that research were collaboratively categorized in 4 major themes: (1) the enabling environment for managing and using family planning information; (2) barriers to integration of family planning in routine health information systems; (3) gaps in the analysis, interpretation, and use of routine family planning data; and (4) family planning data use in management, programmatic, and budgetary decisions. Data quality at the systemic, organizational, technical, and output levels was a crosscutting theme. Collectively, the findings outline barriers to and opportunities for improved integration of family planning data and subsequent strengthening of routine health information systems.