Family planning exemplar country selection methodology: time lag and trends analysis

Introduction While many countries achieved notable gains in contraceptive use levels after the 1994 International Conference on Population and Development which redefined family planning (FP) as a human right, there was a long period of 15 years when contraceptive use levels did not receive due attention. It was only later that its subsequent inclusion in the Sustainable Development Goals and the 2012 London Summit on FP renewed global commitment and a focus towards FP. This paper aims to select countries that identify as ‘exemplar’ low-middle-income countries that have achieved exceptional progress in FP. Examining these outliers can uncover actionable drivers of success to accelerate progress in other countries that have not achieved as much success and are still experiencing stagnation in contraceptive prevalence rates. Methods We selected exemplar countries based on exceptional performance across the outcome indicators of modern contraceptive prevalence and demand satisfied for modern methods, using a recent time frame post 2000 when focus on improving FP returned to the field. A selection approach was applied across various time periods to assess change in modern contraceptive prevalence rates (mCPR) and demand satisfied as the dependent variables. The Human Development Index for 2015 was used as a predictor of contraceptive use on a pooled sample of 130 countries. Results The countries, defined by our criteria of residuals falling much higher than expected levels of predicted mCPR at a high level of significance, fell in the African continent. The countries selected in the first round were Senegal, Malawi, Kenya based on deviation from the predicted pattern at 5% significance level. In the second round, Sierra Leone from the African region, Lao People's Democratic Republic from Asia and Bolivia from Latin America, were added, on relaxing the level of significance, but still using the same approach. This was to have comparators in different regions. Conclusions Our methodology, using a time lag analysis to build in an element of causation, offers a novel approach to selecting exemplar countries in family planning, based on the Human Development Index as a control metric.