New Couple Years of Protection (CYP) Conversion Factors Reflect Advances in Family Planning
According to USAID, one Jadelle® implant provides 3.8 “couple years of protection”(CYP). But what exactly does this mean? CYP is an indicator used by USAID and a number of other donors and international agencies to monitor the progress of family planning programs and to estimate family planning coverage. CYP refers to the estimated protection provided by contraceptive methods during a one-year period, based on the volume of all contraceptives sold or dispensed free of charge to clients during that period. In essence, CYP indicates the amount of time a couple will be protected against an unwanted pregnancy based on the contraceptive method used.
CYP is a commonly-used indicator of effectiveness because it can be easily calculated from data that programs routinely collect. CYP is calculated by multiplying the quantity of each contraceptive method distributed to clients by the conversion factor, which yields an estimate of the duration of contraceptive protection provided per unit of that method. This provides programs with an easy way to compare contraceptive coverage provided by different methods, estimate total CYP provided by all methods, monitor program results over time, compare regions within a country, or calculate cost-effectiveness of a method.
Here's an example: Imagine a community-based contraceptive distribution (CBD) program in which community health workers (CHWs) provide contraceptives to patients and clients. Last year, the CHWs distributed 6,000 cycles’ worth of pills, 2,000 doses of DMPA, and 75,000 condoms. This year, they distributed 4,000 cycles of pills, 3,000 doses of DMPA, and 100,000 condoms. Does this mean the program provided more contraceptive coverage, or less?
To answer this question, we can calculate the CYP provided each year using the conversion factors for pills (15 cycles per CYP), DMPA (4 doses per CYP), and condoms (120 units per CYP). The formula looks like this:
CYP for each Contraceptive = # of Contraceptives ÷ Conversion Factor
Total CYP for the CBD = Sum of all Contraceptive CYPs
Year 1: Oral Contraceptives (Pills) (CYP = 6,000÷15 = 400) + DPMA (CYP = 2,000÷4 = 500) + Condoms (CYP = 75,000÷120 = 625); Total Program CYP = 1,525
Year 2: Oral Contraceptive Pills (CYP = 4,000÷15 = 267) + DPMA (CYP = 3,000÷4 = 750) + Condoms (CYP = 100,000÷120 = 833); Total Program CYP = 1,850
The answer? The program provided 1,525 CYP last year and 1,850 CYP this year. Good news! The program’s performance has improved.
In December 2011, USAID collaborated with The RESPOND Project to update the CYP conversion factors to reflect the advances in contraceptive technology—both improvements in existing contraceptive methods and development of new methods such as Jadelle®, Implanon®, and Sino Implant (II)® —that occurred since the factors were last updated in 2000. CYP conversion factors are based on how a method is used, failure rates, wastage, and the number of units of the method typically needed to provide one year of contraceptive protection for a couple. The factors account for incorrect use, as in the case of condoms or oral contraceptives, and early discontinuation, as in the case of IUDs or implants. The new CYP conversion factors are a culmination of an extensive literature review and several expert meetings attended by representatives of donor organizations, multilaterals, and cooperating agencies.
The updated CYP conversion factors are available on USAID’s web site.