Planning for Outcomes (P4O) Modeling Tool: Estimating the Impact of Changing the Proportion of Injectable Progestins in the Contraceptive Method Mix

Figures & Tables

TABLE 1.

Sources for Default Assumptions in the P₄O Model

Measure	Source
Contraceptive prevalence	Demographic and Health Surveys¹⁰; Multiple Indicator Cluster Surveys¹¹; Performance Monitoring and Accountability 2020 surveys¹²
Pregnancy rates	Contraceptive Technology¹³; Family Planning Global Handbook¹⁴; Adding It Up: Investing in Contraception and Maternal and Newborn Health¹⁵
Probability of MTCT	Kuznik et al.¹⁶; World Health Organization¹⁷
HIV prevalence and ART coverage	Joint United Nations Programme on HIV and AIDS¹⁸
Maternal mortality	MSI Impact 2 calculator (v.4)¹⁹
Maternal and neonatal health costs; live births and abortions	Adding It Up: Investing in Contraception and Maternal and Newborn Health¹⁵

Abbreviations: ART, antiretroviral therapy; MSI, Marie Stopes International; MTCT, mother-to-child-transmission; P₄O, Planning for Outcomes.

TABLE 2.

Key MCH and HIV outcomes for All sub-Saharan African Countries and for Ethiopia, South Africa, and Zimbabwe^a

Indicator	Ethiopia	South Africa	Zimbabwe	All sub-Saharan Africa^b
Yearly change in unintended pregnancies, No.
Pregnancies	824,933	744,963	51,341	3,565,329
Live births	464,583	374,107	28,914	1,911,731
Abortions	243,121	269,123	15,131	1,155,684
Unsafe abortions	184,976	71,163	11,512	749,343
Yearly change in morbidity and mortality, No.
Women with HIV	−1,227	−22,866	−994	−44,450
Infants with HIV	988	5,560	329	16,068
Maternal deaths	2,750	883	167	12,062
Reallocated DMPA users per method, No.
Pill	149,344	152,698	30,606	742,767
IUD	43,559	27,486	453	179,190
Male condom	26,965	357,313	4,761	823,462
Implant	495,739	97,727	9,182	1,256,796
Other^c	37,336	6,108	340	160,046
Additional maternal and neonatal health care costs per year, US$	35,112,706	118,779,370	2,185,284	249,429,105

Abbreviations: DMPA, depot medroxyprogesterone acetate; HR, hazard ratio; IUD, intrauterine device; MCH, maternal child health.
Note: We are updating the P₄O model as new data become available. Thus, results produced may be different from results displayed in this table.
↵a Assumptions: HR for HIV with DMPA=1.4; 75% of injectable users discontinue; 25% reallocate to other methods according to country-specific method mix after excluding permanent methods (sterilization); other parameters set to default.
↵b Included sub-Saharan African countries: Botswana, Côte d'Ivoire, Ghana, Mozambique, Nigeria, South Sudan, Burundi, Ethiopia, Kenya, Lesotho, Liberia, Malawi, Namibia, Rwanda, South Africa, eSwatini, Tanzania, Uganda, Zambia, and Zimbabwe.
↵c Other methods include emergency contraception, Lactational Amenorrhea Method, Standard Days Method, and other modern methods.