Percent of facilities offering family planning services that provide referrals for LAPM


In a specified time frame (e.g. one year), percent of facilities offering family planning (FP) services but not providing any particular long-acting or permanent method (LAPM) that provide client referrals to facilities that do provide LAPMs.

This indicator is calculated as:

(Number of FP facilities offering referrals for IUD, implants, male and female sterilization / Total number of surveyed facilities that do not offer these methods) x 100


Responses to a facility survey question asking whether or not a facility offers LAPM services.

The question or questionnaire should specify that this is for facilities that do not provide LAPM services onsite. Data should be collected separately by method. Evaluators may also want to ask follow up questions about the referral system and if there is any follow-up to see if clients acted on the referrals. For female sterilization consider differentiating between minilap and tubal ligation and/or specify responses by type (e.g. interval, postpartum (<7 days) and, transcesarean). For vasectomy services consider differentiating between vasectomy and no-scalpel vasectomy (NSV).

Main questions:

  • Are LAPM services currently provided at this facility?
  • If not, to what facility are clients referred for LAPM services?

Optional follow-up questions:

  • Is there any follow up with referred clients to find out if they used the referral?
  • Is there any follow up with the facilities to which you refer clients to see if they have provided services?

If targeting and/or linking to inequity, classify service delivery points by location (poor/not poor) and disaggregate by location.

Facility survey

This indicator determines the extent to which facilities have referral systems in place and are assisting clients to access a range of FP methods.


It is difficult to track whether clients use referrals.  Also, this indicator does not reveal if the facility being referred to is currently providing LAPM services, thus creating an additional barrier for clients trying to obtain their preferred FP method.

long-acting/permanent methods (LAPM)

Three of the LAPMs are female methods and one is a male method. Method-specific data can offer a perspective on whether a FP program needs to expand its service for men. Low levels of referrals for female LAPM, which may be more expensive and may require extra resources to access services, may indicate a need to assess gender-based constraints to access to clinical services.