Condoms available for distribution nation-wide
The best distribution system in the world is not much help if there is nothing to distribute. The first challenge for national programmes promoting condom use is to ensure that there are enough condoms in the country to satisfy demand. This indicator measures the number of condoms available for use by those in the most sexually active age group. Where active efforts are made to promote the availability of female condoms, it should include female as well as male condoms, although the indicator should be disaggregated by condom type.
This indicator can be used together with indicators of sexual behaviour to give a powerful picture of the adequacy of condom provision. For example, if a third of all men aged 15-49 say they have had non-regular sex in the past year and 20 percent of married couples say they have used condoms to avoid pregnancy, and yet there are only three condoms available per sexually active adult per year, it can be deduced that the supply of condoms nationally is not sufficient to meet the potential demand.
Number of condoms available for distribution nation-wide during the preceding 12 months
Total population aged 15-49
This indicator sums the condoms in stock nationally at the start of the 12-month period, plus condoms imported during the 12-month period, plus condoms manufactured in country during the same period, minus any exports of condoms over that period. The sum of all condoms available for use in the country during the past 12 months is then divided by the total population aged 15-49.
The indicator is measured by estimating the number of condoms (male and female) available for in-country use during the last 12 months. Key informants are identified and interviewed to uncover all possible sources of condom manufacture, import, distribution and storage. Next, data are collected from all manufacturers and major commercial distributors as well as major donors, condom storage facilities, and government, parastatal and NGO bodies involved in acquiring and distributing condoms.
Geographic location: N/A
Pregnancy status: N/A
Time period: N/A
Type of orphan: N/A
Vulnerability status: N/A
The number of condoms available at the central level helps assess the adequacy of overall condom availability. It is important to note, however, that “availability” is not the same as “accessibility”, which includes dimensions of price, location and access by sub-populations at risk for unprotected sex and HIV. It is often the case that not all available condoms are distributed, or reach the individuals that most need them to protect against the spread of HIV. This indicator by itself cannot give a picture of how many “in-stock” condoms actually get distributed or used. Ironically, efforts at the national level to encourage condom use sometimes complicate the measurement of this indicator. Many countries have deregulated condom imports in the face of AIDS, in order to maximise the number of condoms available. This means that condoms may be imported by a wide variety of companies, NGOs, donors and government departments (the health ministry, the defence ministry, etc.) without necessarily reporting numbers imported to a central body. Traditionally, there is also a distinction between condoms distributed through family planning programmes and those distributed to reduce sexually transmitted infections. It is important to take both sources into account. If possible data need to be presented by programme, as family planning programme condoms are primarily intended for relatively low-risk acts within stable monogamous unions, while AIDS programme condoms aim at higher risk sexual contacts. Where condom promotion activities are centred around marketing condoms at subsidised prices to people likely to be engaging in risky sex (social marketing), sales of particular brands of condoms can also provide a useful indicator of programme success. Organisations responsible for the social marketing of condoms typically keep very good records of condoms distributed down to the retail level. While these data tell only part of the story of condom availability, they provide a very lowcost source of information for the National AIDS Programme, and can be very useful for advocacy purposes. A rise in the number of condoms manufactured or imported into a country, or of condoms sold, can be useful in supporting other indicators measuring rises in self-reported condom use, or falls in selfreported STIs and eventually HIV prevalence.