Targeting Family Planning Services in Yemen: Let the Data Speak!

The Yemen Partners for Health Reform (YPHR), implemented under the USAID Health Systems 20/20 Project, has been assisting the Yemen Ministry of Public Health and Population (MoPHP) for more than three years with enhancing the health information system to inform better decisions.  Particular focus is now being placed on effective allocation of family planning services given budget constraints, population dynamics, and the pre-existing distribution of adequately equipped and staffed health facilities.  The objective of this analysis was to demonstrate, provide training on, and evaluate MoPHP health planning decisions using novel evidence-based decision support techniques previously unavailable for targeting family planning services with greater precision and likelihood to achieve success.  YPHR synthesized 2004 Census data with quality-assured, comprehensive health facility survey results and analyzed spatial distributions of services in proximity to demand.  A suite of customized geographic information system (GIS) tools were used to initially identify areas of adequate accessibility to family planning services based on 60-minute walking distance influenced by terrain variation, walking speed, and access to roads. The GIS produced population-weighted gaps in services that were prioritized for planning and management according to distribution and accessibility of services in underserved areas.  The GIS revealed specific areas that were previously undetected with conventional analysis using indicators, demographics, and distribution of health resources (see Figure 1).  Adding family planning services to select existing facilities (accessibility coverage in white) are most likely to succeed.  Additionally, evidence-based justification for construction of new health facilities based on greatest needs can be visualized effectively (area encircled in yellow).  As a result, health officials are more efficiently targeting limited resources to provide new family planning services, reducing duplication in coverage of existing services, and realizing cost savings while influencing population dynamics and use of responsible practices.

Figure 1: GIS analysis of family planning services accessibility and gaps