Total Market Approach

 

Welcome to the programmatic area on the Total Market Approach (TMA) to family planning (FP) within MEASURE Evaluation’s Family Planning and Reproductive Health Indicators Database. TMA is one of the subareas found in the family planning section of the database. All indicators for this area include a definition, data requirements, data source(s), purpose, issues and—if relevant—gender implications.  TMA is an approach to coordinating FP services among health planners and facilities, commodity suppliers, and funders from governmental, commercial, and private or nongovernmental sectors. With a TMA, these sectors work together to increase the market for and the availability of FP services and methods. The advantages of a TMA are that it improves market efficiency, increases consumer choice and ranges of affordability so that many socio-economic groups can participate, and has the potential to effectively track trends in the market.

Total number of each type of family planning product and service needed to meet the demand for family planning

Definition:

The total number of each type of family planning (FP) product and service (i.e., contraceptive method) needed to meet the demand for FP. This is also referred to as the universe of need. Universe of need is calculated by multiplying the population at risk, the time at risk, the number of products or services needed to cover the time at risk, and the method mix for the population of interest. For FP, the population at risk is defined as all women of reproductive age (WRA) (ages 15–49) who are currently using FP or who have an unmet need for FP. The time at risk for the calculation is one year. The number of products or services needed to protect a woman from pregnancy for one year is expressed as couple years of protection (CYP). The method mix refers to the distribution of contraceptive users by method.  

The calculation for this indicator is as follows: 

Total number of WRA who are currently using FP or who have an unmet need for FP x One-year x CYP x Method mix

Data Requirements:

This indicator, also know as universe of need, is calculated separately for each method, factoring in current demand for FP, unmet need, and method preference.

Data Sources:

Various.  Third-party expert data science company, such as IQVIA, that collects market value information.

Purpose:

This indicator is necessary for determining market size. A good understanding of market size is essential for making decisions about the types and volume of family planning products that are needed. It is also necessary for understanding the extent to which the current system meets the demand for FP.

References:

Meekers, D., Haynes, S. C., & Kampa, K. (2016). Handbook for research on the family planning market, volume 2: Tool and resources for an in-depth analysis of the family planning market. Chapel Hill, NC, USA: MEASURE Evaluation, University of North Carolina. Retrieved from https://www.measureevaluation.org/resources/publications/tr-16-131b

Total number of each type of family planning product or service sold, distributed, or provided across all sectors

Definition:

The total number of family planning (FP) products or services (i.e., contraceptive methods) sold, distributed, or provided across all sectors—public, NGO (nongovernmental organization), and commercial—also known as the market volume. Market volume should include all products on the market in a reference period (e.g., the past year), regardless of cost. Total market volume will include any free products distributed as well as any products sold. 

The calculation for this indicator is as follows: 

Total number of free products distributed + Total number of products or services sold at a subsidized cost or at cost-recovery levels + Total number of products or services sold for profit 

Data Requirements:

Records of number and types of FP products or services sold, distributed, or provided across sectors

This indicator can be disaggregated by sector, product or service, geographic location, and urban/rural classification.

Data Sources:

Program data, service statistics

Purpose:

This indicator is essential for determining market size. A good understanding of market size is essential for making decisions about the types and volume of FP products that are needed. It is also necessary for understanding the extent to which the current system meets the demand for FP. This indicator, which assesses market volume, refers to the number of products and services currently on the market. Market volume can be compared to universe of need to identify opportunities for market growth.

References:

Meekers, D., Haynes, S. C., & Kampa, K. (2016). Handbook for research on the family planning market, volume 2: Tool and resources for an in-depth analysis of the family planning market. Chapel Hill, NC, USA: MEASURE Evaluation, University of North Carolina. Retrieved from https://www.measureevaluation.org/resources/publications/tr-16-131b

Total market value of all family planning products and services sold

Definition:

The total market value of all family planning (FP) products and services (i.e., contraceptive methods) sold. The total market value of all FP products and services is obtained by summing the market value of each specific product or service. For each type of FP product, each brand (and brand extension, where applicable) should be calculated separately, to account for differences in price. For FP services, data should be separated into the cost of the product (which will be calculated separately) and the cost of the clinical service, where possible. 

For each type of FP product, the calculation is as follows:

Market volume (number of units) x Cost to the consumer per unit

For each type of FP service, the calculation is as follows:

Total number of clinical services provided x Cost to consumer for the service

Data Sources:

Program data; service statistics (for the public sector); third-party expert data science company, such as IQVIA, that collects market value information.

Purpose:

Because total market approach (TMA) seeks to transform the market into a self-sustaining entity, indicators of market sustainability are important for any TMA analysis. 

Market value is an important indicator because it reflects willingness to pay for FP products, and may stimulate commercial interest. Market value is measured as the total value of all products or services sold or distributed to consumers, which is calculated using the average consumer price and product volume. Because the aim is to assess the commercial potential, free products and services do not contribute to market value.

Issue(s):

In theory, it is possible to estimate the value of products and services that are provided free of charge. However, such estimates would not be a useful indicator of the market potential, given that it is unknown how many users would be willing to pay for products or how much they would be willing to pay. Moreover, doing so would create an inconsistency in calculation because value of social marketing products is calculated using their retail price, rather than their actual value.

References:

Meekers, D., Haynes, S. C., & Kampa, K. (2016). Handbook for research on the family planning market, volume 2: Tool and resources for an in-depth analysis of the family planning market. Chapel Hill, NC, USA: MEASURE Evaluation, University of North Carolina. Retrieved from https://www.measureevaluation.org/resources/publications/tr-16-131b

Total number of unsubsidized brands available on the market for each family planning product

Definition:

The number of unsubsidized brands and brand extensions of each family planning (FP) product on the market during a given period (e.g., the past year). This measure should include commercial brands that are sold for profit as well as any brands sold by non-governmental organizations at full cost recovery. 

Data Requirements:

The data can be disaggregated by FP product and brand or brand extension.

Data Sources:

Retail audit/survey; key informants; neutral player that has the experience and reach across the private sector; donor sources (for the public sector)

Purpose:

Because a total market approach (TMA) seeks to transform the market into a self-sustaining entity, indicators of market sustainability are important for any TMA analysis.

The level of subsidization of FP products is important to gauge sustainability. The market share of unsubsidized (commercial) brands and the level of use of unsubsidized brands provides information on the subsidy level for specific products and services. To understand the level of subsidization of FP products (e.g., oral contraceptives, condoms), household surveys such as the DHS can be used to calculate the percentage of users who report using an unsubsidized brand. Such surveys also allow calculation of the percentage of users who use fully subsidized contraceptives, which are typically unbranded, as well as the percentage of users who use a partially subsidized (socially marketed) brand. For users of FP services, such as IUD insertion, household surveys often ask about the type of source where the service was performed. This information can be used to calculate the percentage of service users (e.g. IUD users), who reported using a public sector and non-public sector source.

Issue(s):

Data on the source of where an FP service was performed does not permit distinguishing between commercial FP services and socially-marketed services.

References:

Meekers, D., Haynes, S. C., & Kampa, K. (2016). Handbook for research on the family planning market, volume 2: Tool and resources for an in-depth analysis of the family planning market. Chapel Hill, NC, USA: MEASURE Evaluation, University of North Carolina. Retrieved from https://www.measureevaluation.org/resources/publications/tr-16-131b

Stockout rate at service delivery points

Definition:

The number of service delivery points (SDPs) that experience a stockout of a specific family planning (FP) tracer product that the SDP is expected to provide, at any point, in a defined period (e.g., the past three, six, or twelve months). Occurrence of stockouts can be calculated for a single product or aggregated for all FP tracer products. It can be disaggregated by country, SDP type, and presence or absence of support under the program in question.

This indicator is calculated as:

(Number of SDPs that were stocked out of a specific FP tracer product, according to the ending balance of the most recent logistics report—or on the day of site visit/Total number of SDPs that reported or were visited in supported countries that offer the FP tracer product) x 100

Data Requirements:

Counts of stockouts of specific FP tracer products at SDPs visited or recorded

It can be disaggregated by country, SDP type, and presence or absence of support under the program in question.

Data Sources:

Program service statistics; survey of retail outlets and service providers; for the private sector, a neutral player that has the experience and reach across the private sector

Purpose:

Access to FP can be hampered by product stockouts or gaps in services (e.g. due to a lack of trained personnel) at retail outlets, clinics, or other places where people access FP. This indicator is useful for measuring impeded access to FP because of gaps in supply of FP products.

References:

United States Agency for International Development (USAID) Global Health Supply Chain Program. (2018). USAID global health supply chain program procurement and supply management IDIQ project monitoring and evaluation plan. Washington, DC, USA: Chemonics International Inc. Retrieved from https://www.ghsupplychain.org/sites/default/files/2018-02/2018_02_03%20MandE%20Plan.pdf

Meekers, D., Haynes, S. C., & Kampa, K. (2016). Handbook for research on the family planning market, volume 2: Tool and resources for an in-depth analysis of the family planning market. Chapel Hill, NC, USA: MEASURE Evaluation, University of North Carolina. Retrieved from https://www.measureevaluation.org/resources/publications/tr-16-131b

Percent of service delivery points reporting gaps in availability of each family planning method or service

Definition:

The percent of service delivery points (SDPs) that report experiencing a gap in services for a specific family planning (FP) method or service, owing to unavailability in the past 30 days. Unavailability can be caused by stockouts, provider absence, clinic closure, and so on. This indicator can be calculated for each single method or service of interest or aggregated for all FP methods and services. 

This indicator is calculated as:

(Number of SDPs where a service provider reported a gap in service availability for a specific FP method in the past 30 days/Total number of service providers that offer services for a specific FP method) x 100

Data Requirements:

It can be disaggregated by geographic location, urban or rural classification, type of SDP, and FP method or service.

Data Sources:

Retail audit or survey; for the private sector, a neutral player t hat has the experience and reach across the private sector

Purpose:

Access to FP can be hampered by product stockouts or gaps in services (e.g. due to a lack of trained personnel) at retail outlets, clinics, or other places where people access FP.  This indicator is a useful benchmark for service delivery readiness to provide FP services.

References:

Meekers, D., Haynes, S. C., & Kampa, K. (2016). Handbook for research on the family planning market, volume 2: Tool and resources for an in-depth analysis of the family planning market. Chapel Hill, NC, USA: MEASURE Evaluation, University of North Carolina. Retrieved from https://www.measureevaluation.org/resources/publications/tr-16-131b

Percent of total family planning products or services sold, distributed, or provided by the market leader

Definition:

The percent of each type of family planning (FP) product or service provided by the market leader during a given period (e.g., the past year). The market leader is the entity that accounts for the greatest market volume of that product or service. The market leader’s market share is calculated separately for each type of FP product or service.

This indicator is calculated as:

(Volume of a specific FP product or service that was provided by the market leader/Total market volume for that specific FP product or service) x 100 

Data Sources:

Program data; service statistics; third-party expert data science company, such as IQVIA, that collects market value information.

Purpose:

This is one of the indicators used to assess the extent to which the market is dominated by one brand or player. This measure can indicate whether there is healthy market competition.

References:

Meekers, D., Haynes, S. C., & Kampa, K. (2016). Handbook for research on the family planning market, volume 2: Tool and resources for an in-depth analysis of the family planning market. Chapel Hill, NC, USA: MEASURE Evaluation, University of North Carolina. Retrieved from https://www.measureevaluation.org/resources/publications/tr-16-131b

Percent of current modern family planning users who last obtained their family planning method from each supply sector

Definition:

The percent of current female family planning (FP) users ages 15–49 who last obtained their FP method from each supply sector (i.e., public agency, non-governmental organization [NGO], and commercial enterprise), disaggregated by age group, geographic location, educational attainment level, wealth quintile, urban/rural status, and supply sector. The supply sector includes public, NGO, and commercial sources. Public sources may be government facilities or military, police, or social security clinics; NGO sources may be NGO clinics and faith-based facilities; and commercial sources may be pharmacies, shops, and commercial and private clinics.

To calculate for each FP method:

(Total number of women currently using the FP method who reported last obtaining their FP method by a particular supply sector/Total number of women currently using that FP method) x 100

To calculate for each FP service:

(Total number of women currently using the FP service who report that they obtained this service from a government source or a commercial source/Total number of women currently using an FP service) x 100

Data Sources:

Population-based survey

Purpose:

Information about whether current users use mostly public or private supply sources sheds light on access. For example, public sector facilities may offer mostly short-term FP methods, while private sector facilities may offer both short-term and long-term methods. Because the supply sources are likely to vary by method, it is helpful to examine current supply sources separately for each type of method.

A complimentary indicator is Availability of a specific method at multiple supply sources. 

References:

Meekers, D., Haynes, S. C., & Kampa, K. (2016). Handbook for research on the family planning market, volume 2: Tool and resources for an in-depth analysis of the family planning market. Chapel Hill, NC, USA: MEASURE Evaluation, University of North Carolina. Retrieved from https://www.measureevaluation.org/resources/publications/tr-16-131b

Percent of women of reproductive age who know at least one family planning source

Definition:

The percent of women of reproductive age (WRA) (15-49) who know at least one source to obtain a family planning (FP) product or service, disaggregated by identified source, age group of respondents, geographic location, education attainment levels, wealth quintile, and urban or rural status. This is in response to the question, “Can you please tell me one source to obtain a family planning product or service?”

This indicator is calculated as:

(Total number of WRA who respond that they know of a place where an FP method can be obtained/Total number of WRA) x 100 

Data Sources:

Population-based survey

Purpose:

Increasing product use and expanding the market requires that all potential future users have the ability to access FP products and services. Knowledge of an FP source is a prerequisite for access.

References:

Meekers, D., Haynes, S. C., & Kampa, K. (2016). Handbook for research on the family planning market, volume 2: Tool and resources for an in-depth analysis of the family planning market. Chapel Hill, NC, USA: MEASURE Evaluation, University of North Carolina. Retrieved from https://www.measureevaluation.org/resources/publications/tr-16-131b