Condoms that meet quality control measures
The quality of condoms at their time of use determines their effectiveness in preventing HIV, STIs and pregnancy. Quality (and more particularly poor quality) also affects popular perception of the value of condoms, which can in turn have a major impact on the success of prevention programmes. There are many stages at which the quality of a condom may have deteriorated to the point of being unacceptable. Condoms may be poorly manufactured in the first place, and manufacturers quality control may be inadequate. Condoms may be improperly stored at the central level. Or they may be in perfect condition at the time of distribution but sit in the sunshine for two months on a market stall before being sold. Since it is not practical to sample condoms once they have been acquired by end users, the indicator is based on condoms sampled both from central storage and from retail outlets. The quality indicator will be aggregated into a single figure. However it is vital that the data be reported separately by source of sampled condom for programme purposes. If poor quality is detected at the central level, national tender specifications or quality control procedures will have to be remedied. Poor quality at the retail level may require changes in the distribution system or better advice to retailers on stock handling and storage.
The sampling frame for retail outlets used in Condom Availability Indicator 2, Retail outlets and services with condoms in stock, can be used for the retail portion of this indicator; indeed, condoms may be sampled from retail outlets during the retail survey. Care should be taken in the handling and storage of condoms between sampling and testing, to ensure that no deterioration in quality is attributable to the sampling and testing procedure itself. At the central level, a sampling frame can be constructed from the central level storage facilities identified in the calculation of Condom Availability Indicator 1, Condoms available for distribution nation-wide, and condoms sampled at random from those facilities. A variety of testing procedures are available for condom quality control. Although all measure should give similar results, it is advisable to adopt one methodology and stick with it, to avoid any disruption of trends over time.
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This indicator provides an objective measure of condom quality within a country. It is simple to measure, but does require equipment and trained staff. Since behavioural studies suggest that perceptions of poor condom quality contribute significantly to peoples failure to use condoms, information about adequate quality can be used to good effect in promoting their wider use. It should be noted, however, that this indicator is a double-edged sword. If results are poor and immediate rectifying action is not taken, peoples reservations about condom use are likely to be reinforced, and condom use might suffer further. This indicator will miss deterioration which takes place after the acquisition of a condom by a client, but before its use. Poor storage practices at this point may contribute significantly to condom failure rates.