Global Health Management and Policy, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St, Suite 1900, New Orleans, LA 70112, USA and.
Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo.
Health Policy Plan. 2018 Mar 1;33(2):155-162. doi: 10.1093/heapol/czx134.
Performance Monitoring and Accountability 2020 (PMA2020) is a population-based and facility-based survey program conducted in 11 countries to track contraceptive use dynamics and the supply environment. Annual data collection provides trend data unavailable from any other source. Two-stage cluster sampling was used to select 58 enumeration areas in Kinshasa; data were collected in 2014, 2015 and 2016 from three to six service delivery points (SDPs) per EA. Of the 228-248 SDPs surveyed each year, only two-thirds reported to offer family planning (FP) services. Of those reporting to offer FP, one-fifth or more did not do so on the day of the survey. As of 2016, only one-half of SDPs offering FP had at least three methods available, a proxy for contraceptive choice; only one in five had at least five methods. Long-acting reversible contraceptives, including implants and IUDs, were less widely offered and more often stocked out than resupply methods, including condoms, pills and injectables. Contraceptive stockouts were rampant: in 2016, over a quarter of the SDPs experienced stockouts of all methods (except condoms) in the previous 3 months, and two of the three most widely used methods-implants and injectables-were also the most likely to be stocked out. The findings documented the inconsistency in pricing of methods across facilities; moreover, less than one quarter of SDPs posted prices. Patterns in the contraceptive supply environment remained relatively unchanged between 2014 and 2016. The PMA2020 SDP module provides timely, actionable information to the DRC government, FP implementing organizations and donors involved in FP service delivery in Kinshasa, DRC. Yet the value of this information will be determined by the ability of the local FP stakeholders to use it in bringing the needed improvements identified by this survey to the contraceptive supply environment.
2020 年绩效监测和问责制（PMA2020）是一个在 11 个国家开展的基于人群和基于机构的调查项目，旨在跟踪避孕方法的使用动态和供应情况。年度数据收集提供了其他任何来源都无法获得的趋势数据。采用两阶段聚类抽样方法选择金沙萨的 58 个普查区；数据于 2014 年、2015 年和 2016 年在每个普查区的三个至六个服务提供点（SDP）收集。每年调查的 228-248 个 SDP 中，只有三分之二报告提供计划生育（FP）服务。在报告提供 FP 的 SDP 中，有五分之一或更多的 SDP 在调查当天没有提供 FP。截至 2016 年，只有一半提供 FP 的 SDP 至少有三种方法可供选择，这是避孕选择的一个代表；只有五分之一有至少五种方法。长效可逆避孕方法，包括植入物和宫内节育器，提供的范围较窄，库存不足的情况更为普遍，而补充供应方法，包括避孕套、药丸和注射剂，供应情况则较为稳定。避孕方法的库存不足情况非常严重：2016 年，超过四分之一的 SDP 在过去 3 个月中经历了所有方法（避孕套除外）的库存不足，而三种最广泛使用的方法——植入物和注射剂——也是最有可能库存不足的方法。调查结果记录了不同机构之间方法定价的不一致性；此外，不到四分之一的 SDP 公布了价格。2014 年至 2016 年期间，避孕供应环境的模式基本保持不变。PMA2020 的 SDP 模块为刚果（金）政府、在金沙萨提供 FP 服务的实施组织和捐助者提供了及时、可行的信息。然而，这些信息的价值将取决于当地 FP 利益相关者是否有能力利用这些信息，为改善调查所确定的避孕供应环境做出必要的改进。
