SHOPS is funded by the U.S. Agency for International Development. Abt Associates leads the project in collaboration with: Banyan Global Jhpiego Marie Stopes International Monitor Group O’Hanlon Health Consulting

Global Role of the Private Sector in the Provision of Modern Contraception

Jorge I. Ugaz SHOPS Research, Monitoring, and Evaluation Associate June 16, 2015

2

What has been the global role of the private sector in the provision of modern contraceptives?

3

The private sector is a major source of modern contraception

45%

44%

28%

55%

56%

72%

0% 20% 40% 60% 80% 100%

Asia

LAC

SSA

Modern contraception users who obtained method from private or public sectors (2005 – 2012)

PrivatePublic

Source: Demographic Health Surveys (DHS)

4

Is this global role of the private sector the same across type of methods?

5

In Asia, private sector has played a larger role in provision of short-acting methods than in the provision of LARC and PM

Private 31%

Public 69% Private

59%

Public 41%

Short-acting methods LARC and PM

Source: Demographic Health Surveys (DHS)

6

Short-acting methods LARC and PM

Private 33%

Public 67% Private

54%

Public 46%

We observe the same pattern in the LAC region

Source: Demographic Health Surveys (DHS)

7

Short-acting methods LARC and PM

In sub-Saharan Africa, the private sector plays an important role as well, especially for short-acting methods

Private 29%

Public 71%

Private 21%

Public 79%

Source: Demographic Health Surveys (DHS)

8

In the three regions, the private sector has a strong presence in the provision of short-acting methods

Source: Demographic Health Surveys (DHS)

32% 30% 24%

13% 15%

3%

23% 26% 60%

31% 30%

13%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

ASIA LAC SSA

LARC & PM Public

SAM Public

LARC & PM Private

SAM PrivatePrivate sector

9

The public sector is the main provider of injectables

40% 33%

18%

60% 67%

82%

0%

20%

40%

60%

80%

100%

Asia LAC SSA

Source of injectables, by region (2005 – 2012)

Public

Private

Source: Demographic Health Surveys (DHS)

10

Who is accessing the private sector for modern contraceptives?

11

Short-acting methods: a substantial proportion among poor women

0% 20% 40% 60% 80% 100%

PeruMadagascar

TanzaniaMalawi

PakistanHonduras

BoliviaNepalKenya

BangladeshColombia

PhilippinesIndia

Indonesia

* Lowest two wealth quintiles

% of poor women using short-acting methods who went through the private

sector

Source: Demographic Health Surveys (DHS)

12

LARC and PM: A lower proportion

* Lowest two wealth quintiles

0% 20% 40% 60% 80% 100%

PeruMadagascar

IndiaBangladesh

NepalPhilippines

PakistanColombia

KenyaBolivia

HondurasIndonesia

MalawiTanzania

% of poor women using LARC or PM

who went through the

private sector

Source: Demographic Health Surveys (DHS)

13

Across all regions, young women (15-19 years old) rely more on the private sector for contraceptives

Age group 15-19 years 20-24 years 25+ years Sub-Saharan Africa Private 41% 38% 32% Public 59% 62% 68% Asia Private 56% 53% 43% Public 44% 47% 57% Latin America Private 53% 53% 45% Public 47% 47% 55%

Source of modern contraception by age group

Among users who obtained method from public or private sectors only

14

Working with the private sector to get to FP20/20

• The private sector plays an important role in the provision of modern contraception, especially short-acting methods.

• A substantial proportion of poor women obtain their short-acting methods from the private sector.

• Youth, particularly 15 to 19-year-olds, rely heavily on the private sector for modern contraceptives.

• With its field programs, the SHOPS project focused on increasing full method choice through greater provision of injectables, LARC, and PM.

jorge_ugaz@abtassoc.com www.shopsproject.org