Data and Family Planning

Photo by Jane Miller/DFID/Flickr Creative Commons

Family planning is vital to economic development and to maternal and child health. At a summit in July 2012, the global community set the ambitious goal of making modern contraception available to 120 million new users in 69 low-income countries by 2020 — the Family Planning 2020 (FP2020) goal. The summit representatives recognized that high-quality family planning data were essential to monitoring progress toward this goal and to help countries stay on track. In 2013, the Bill & Melinda Gates Foundation launched two programs to support FP2020 data needs, which to date have totaled a $55 million investment. Four years later, in 2017, they wanted to take stock of how these programs were doing.

The Two Family Planning Data Programs

Performance Monitoring and Accountability 2020

The Performance Monitoring and Accountability 2020 (PMA2020) program was designed to generate family planning data through annual, rapid-turnaround, nationally representative surveys of households and health facilities using mobile phone technology for data collection and employing local data collectors. As of 2017, PMA2020 was operating in 11 countries in Africa and Asia, working mainly through university-based partners in those countries.

Track20

The Track20 program was designed to generate estimates of key family planning indicators (such as the proportion of women using modern contraception) and facilitate data use through global standardization and reporting of indicators. It also aimed to strengthen country-level monitoring and evaluation capacity to gather family planning data (including data from PMA2020 surveys), model estimates of family planning indicators, facilitate consensus-building around national estimates, and encourage decisionmakers to use the data for action. As of 2017, Track20 was operating in 37 countries, working mainly through government-based partners, such as ministries of health.

Track20 countries: Tanzania, Zimbabwe, Pakistan, Lao PDR; PMA2020 countries: Ghana; PMA2020 and Track20 countries: Cote d'Ivoire, Burkino Faso, Niger, Nigeria, Uganda, DRC, Uganda, Kenya, Ethiopia, India, Indonesia.

• Track20 only
• PMA2020 only
• PMA2020 and Track20

NOTE: DRC = the Democratic Republic of the Congo; Lao PDR = Lao People’s Democratic Republic.

Key Findings

1. High-quality data are necessary but not sufficient. Having good data does not necessarily mean that they are going to be well understood and used to inform action. Most of these countries have an abundance of family planning data, but many important stakeholders do not understand what the data are telling them and, therefore, do not understand what to do with them.
2. A few highly qualified people are also necessary but not sufficient. It is not enough for these two programs to build the capacity of just a handful of people to generate, manage, analyze, and/or use data. Small numbers of people, however well qualified, cannot meet staffing needs at all levels of government involved in family planning. Stakeholders across the 15 countries called for capacity-building to provide larger numbers of well-qualified data professionals at both the national and subnational levels.
3. Data systems should meet country policymakers’ needs and be sustainable. The right people (at all levels) must be able to get the information they need when they need it for their purposes. The information should be at the right level of detail to inform national-level resource planning and state/provincial and local-level program management—depending on the needs of the decisionmaker.
4. Assessment of data system maturity and sustainability can inform specific improvements. RAND researchers developed and applied two novel frameworks for this evaluation. The data maturity framework included factors in the areas of organizational readiness, data systems, and data use; the sustainability framework included sustainability-enabling factors related to financial, technical, and operational sustainability and data culture. Stakeholder ratings of these factors placed the 15 countries in the middle range for both data system maturity and sustainability. The research team’s findings point to specific strengths and weaknesses in each country. These frameworks could be applied to monitor progress in each country over time.
5. While traditional development support has been top-down, country ownership is a foundation for mature, sustainable data systems. Country stakeholders indicated that they would like greater ownership of family planning data planning, collection, management, analysis, and dissemination processes.
6. Changing data culture requires deliberate planning, effort, and time, and progress should be measured along the way. Explicit attention to this normative change will bring about enduring improvements in data use, data maturity, and sustainability-enabling factors.

1. Quality data: complex, numerical data, in the form of tables and graphs, are generated
2. Understandable information: an interpretation of the data facilitates understanding of the main takeaways
3. Actionable message: the information is used to help focus on what needs to be done.
4. Action: the information is used to help what needs to be done.
5. Data demand: targeted plans are developed, and programs are improved.

Recommendations

1. Promote country-driven agendas. Fostering country ownership increases stakeholder buy-in and the prospects for sustainability.
2. Intensify focus on data use. As depicted in the figure above showing the data-driven accountability cycle, high-quality data must be translated into understandable information for decisionmakers, who then need actionable messages that can inform their decisions, from program planning and management to policy development. Data-driven action then creates more demand for high-quality data, and the cycle continues.
3. Plan for and measure progress toward data system maturity and sustainability. These improvements do not happen on their own. They must be addressed explicitly.
4. Build the ranks—institutionalize the development of data capacity. Train more people at all levels in the generation, analysis, and use of data for action. The RAND team recommended establishment of a permanent country capacity-building program for on-the-job training: Data for Action Training Activity—Family Planning (DATA-FP).