Endline Evaluation Report of the Agir 
pour la Planification Familiale Project 
(AgirPF)
September 2018
Endline Evaluation Report of the Agir pour 
la Planification Familiale Project (AgirPF)
September 2018 
By 
Macoumba Thiam 
Reviewed by 
Alioune Diagne 
Andre Koalaga 
About EngenderHealth and AgirPF
EngenderHealth is a leading global women’s health organization committed to working toward a world 
where sexual and reproductive rights are respected as human rights and women and girls have the 
freedom to reach their full potential. In nearly 20 countries around the world, EngenderHealth creates 
lasting change by training health care professionals and partnering with governments and communities 
to make high-quality family planning and sexual and reproductive health services available today and 
for all generations to come. 
In 2013, to support advancement toward both FP2020 and the Ougadougou Partnership, the United 
States Agency for International Development (USAID)/West Africa Regional Health Office awarded 
a five-year, $29 million project, Agir pour la Planification Familiale (AgirPF), to EngenderHealth with 
its core partner, Avenir Health (formerly Futures Institute). The goal of AgirPF is to enable individuals 
and couples to make, and voluntarily act on, informed decisions about FP, in selected urban and peri￾urban areas of Burkina Faso, Côte d’Ivoire, Mauritania, Niger, and Togo. 
The AgirPF Project Endline Evaluation Report i
Contents
Acronyms iii
List of tables iv
List of figures v
Executive summary 1
Performance against PMP indicators 1
AgirPF SBCC campaigns 2
Impact on FP 2
Introduction 3
Overview and methodology 3
Beneficiaries 3
Geographic scope 4
Description of the project intervention 4
Monitoring and evaluation 5
Baseline assessment 7
Mid-term performance evaluation 8
Endline evaluation 9
Overall objectives 9
Specific objectives 9
Methodology 10
Sampling procedures 10
Data collection and entry 11
Data analysis 12
SBCC campaign evaluation overview 15
Results 16
Progress against PMP indicators 16
Output Results 17
Outcome results 22
SBCC custom indicator and outcome indicators 13, 14, and 15. 24
Endline survey and SBCC campaign evaluation 28
Background characteristics of endline survey respondents 28
The AgirPF SBCC campaign: Messaging reach by activity and country 31
Conclusion on the evaluation of the SBCC campaign 39
AgirPF impact on knowledge and use of family planning methods 39
Knowledge of family planning 40
Use of family planning methods 43
Evaluation of the net impact of AgirPF interventions on current use of modern FP 49
Discussion and conclusion 56
The AgirPF Project Endline Evaluation Report ii
Performance against the PMP indicators 56
Strategic objective indicators 56
Intermediate results 1, 2, and 3 57
Results of the AgirPF SBCC campaign 58
AgirPF’s link to FP knowledge and use by population-level indicators 59
FP use 59
Method mix 60
Reason for not using an FP method 60
Bibliography 61
Appendices 63
Appendix A: Questionnaires (Male and Female) 63
Appendix B: Number of intervention and nonintervention health facilities by health district 73
Appendix C: Statistics for population sample calculation 75
Appendix D: AgirPF PMP Indicators’ Results Table 76
Output Indicator Results 76
Outcome Indicator Results 81
The AgirPF Project Endline Evaluation Report iii
Acronyms
AgirPF Agir pour la Planification Familiale
CAPI Computer-assisted personal interviewing
CHWs Community health workers
COPE Client-oriented provider-efficiency
CPR Contraceptive prevalence rate
CSO Civil society organization 
CSPro Census and survey processing system
CYP Couple year of protection
DHIS2 District health information software
DHS Demographic and health survey 
E4D Evidence for Development 
EA Enumeration area
FP Family planning 
FPSD Family planning special days
HF Health facility
HIP/BP High impact practice/best practice
IUD Intrauterine device
IVR Interactive voice response 
KAP Knowledge, attitudes, and practices
LARC/PM Long-acting reversible contraceptives/permanent method 
LOP Life of project
MAP Men as Partners
mCPR Modern contraceptive prevalence rate
MICS Multiple indicator cluster surveys
MNCH Maternal and neonatal child health
MOH Ministry of Health
M&E Monitoring and evaluation
PMP Performance Monitoring Plan 
SDM Standard days method 
SDP Services delivery point 
SBCC Social and behavior change communication 
SRH Sexual and reproductive health
SWT Site walk-through 
UNFPA United Nations Population Fund 
USAID United States Agency for International Development
USG United States Government
WHO World Health Organization 
WRA Women of reproductive age
The AgirPF Project Endline Evaluation Report iv
List of tables 
Table 1. Number of AgirPF intervention and nonintervention sites by country 4
Table 2. AgirPF timeline by country 7
Table 3. Final sample sizes for the household survey 11
Table 4. Main languages spoken in the study areas 12
Table 5. Twenty-five AgirPF PMP indicators, data collection areas, and sources 13
Table 6. List of SBCC campaign activities captured in the endline evaluation by country 15
Table 7. Strategic objective output indicators, regional totals 18
Table 8. IR 1 Output indicators, regional totals 19
Table 9. IR 2 Output indicators, regional totals 20
Table 10. IR 3 Output indicators, regional totals 21
Table 11. AgirPF implemented High-impact Practices (HIPs) by country 24
Table 12. Comparison of the background characteristics of the female respondents living in the 
intervention and nonintervention areas, by country 29
Table 13. Comparison of the background characteristics of the male respondents living in the 
intervention and nonintervention areas, by country 30
Table 14. AgirPF SBCC campaign interactive voice response (IVR) data in Niger, November 1, 2017 
to February 6, 2018 36
Table 15. Percentage of the respondents who heard about specific method, by sex, area, and country 42
Table 16. FP method by zone and country 44
Table 17. Modern FP methods among women by background characteristic, zone, and country 48
Table 18. Modern FP methods among men by background characteristic, zone, and country 49
Table 19. Regression on background characteristics, zone, and country 50
Table 20. Method mix among female users of modern contraceptives, by country 52
Table 21. Method mix among male users of modern contraceptives, by country 53
Table 22. Main reasons cited by women for not using an FP method, by country 54
Table 23. Main reasons cited by men for not using an FP method, by country 54
Table 24. Number of intervention and nonintervention health facilities by health district in the four 
countries 73
Table 25. Statistics for population sample calculation for the four countries 75
The AgirPF Project Endline Evaluation Report v
List of figures
Figure 1. Study design 6
Figure 2. Study hypothesis 7
Figure 3. AgirPF PMP indicator distribution by performance level as of July 2017 16
Figure 4. Contraceptive uptake in AgirPF intervention zones by group age, years 2-5 18
Figure 5. Contraceptive method mix among modern FP users in AgirPF intervention sites 19
Figure 6. Achieved mCPR in AgirPF intervention zone compared to the LOP targets 22
Figure 7. Percentage of supervised providers technically deemed competent in REDI counselling, 
implants and IUD insertion and removal, during PY5Q2, by country 23
Figure 8. Percentage of men who heard or saw a USG-supported FP/RH message by zone and 
country 26
Figure 9. Percentage of women who heard or saw a USG-supported FP/RH message by zone and 
country 25
Figure 10. Percentage of the respondents citing lack of knowledge as a key barrier to FP use (either 
because they do not know about FP at all or they know about FP but lack more information) 27
Figure 11. Percentages of women and men reporting having discussed FP with their partners during 
the past three months, by zone and country 28
Figure 12. Nigeria segmentation example 32
Figure 13. Percentage of women and men reached by different SBCC activities implemented in 
Burkina Faso 33
Figure 14. Percentage of women and men reached by different SBCC activities implemented in Côte 
d’Ivoire 35
Figure 15. Percentage of women and men reached by SBCC activities implemented in Niger 36
Figure 16. Distribution of the calls about basic information for FP methods by method 37
Figure 17. Distribution of the calls to listen to users’ testimonials by method 37
Figure 18. Distribution of the calls inquiring about the methods according to the information 
requested 37
Figure 19. Percentage of women and men reached by different SBCC activities implemented in Togo 39
Figure 20. Percentage of women and men who have heard about FP methods by zone and country40
Figure 21. Comparison between the percentage of women who know an FP method between the 
baseline and the endline, by zone and country 40
Figure 22. Percentage of women and men who have heard about modern FP methods by zone and 
country 41
Figure 23. Percentage of women and men who have heard about LARCs/PM by zone and country41
Figure 24. Contraceptive Prevalence Rate (CPR) among women and men, by zone and country 45
Figure 25. Modern Contraceptive Prevalence Rate (mCPR) among women and men, by zone and 
country 46
Figure 26. Percentage of women and men currently using LARCs/PMs, by zone and country 46
The AgirPF Project Endline Evaluation Report vi
Figure 27. Percentage of the respondents citing lack of knowledge as key barrier to use of FP (either 
because they do not know about FP at all or they know about FP but lack sufficient 
information), by zone and country 55
The AgirPF Project Endline Evaluation Report 1
Executive summary 
Agir pour la Planification Familiale (AgirPF) was a five-year family planning (FP) project funded by 
USAID and implemented by EngenderHealth in five West African francophone countries. The 
objective of AgirPF was to increase access to and use of quality FP services in the selected urban and 
peri-urban areas of Burkina Faso, Côte d’Ivoire, Mauritania, Niger, and Togo. This endline evaluation 
included endline household surveys conducted in each country (except Mauritania), baseline 
assessment data, FP service statistics, and related reports. The evaluators combined descriptive and 
multivariate analytical methods to discern how AgirPF performed against its 25 PMP indicator targets, 
the effectiveness of AgirPF’s strategic behavior change communication campaigns (SBCC), and 
whether the intervention impacted FP knowledge and use. 
Performance against PMP indicators
AgirPF’s performance against PMP indicators was positive. The program met or exceeded targets for 
78% of the 25 PMP indicators for which data are available across the program’s strategic objective 
(SO) and three intermediate result areas, despite challenges related to the broad reach of the project, 
high levels of complexity, and a range of implementation obstacles ranging from office registration 
issues, to political turmoil, to complex differences in culture and demographic characteristics. 
All four of the program’s overall targets for SO indicators were met or exceeded by the program, 
including couple years of protection (CYP), modern contraception prevalence rates (mCPR), total FP 
users, and new modern contraceptive users. The SO output indicators were particularly impressive for 
Burkina Faso and Togo, which exceeded all their targets by significant margins. In the case of Burkina 
Faso, however, this performance masked one of the strangest findings of significance in the 
evaluation—a low mCPR that actually declined from the baseline assessment (47% to 38%) in 
intervention areas despite otherwise high-level performance. While this finding matches other recent 
studies across the country, more research must be done to understand the underlying causes for the 
drop in the mCPR rate despite the strong performance of the program. 
Beyond the SO indicators, the program largely excelled under the intermediate result areas. Of 
particular note under IR 1, the program reached 99% of its training targets, with 5,699 people trained 
in FP and RH. The program was also particularly successful at reaching youth, with over 318,101 
participating in education programs (118% of targets). AgirPF was even more successful at meeting 
targets for evidence-based service delivery as defined under IR 2. Facilities in Burkina Faso, Côte 
d’Ivoire, Niger, and Togo accepted and welcomed innovations in their facilities and implemented 10 
high-impact practices (HIPs), many of which were integrated into national health protocols. The 
program also over doubled the target number of regional technical trainings over the life of the 
program. Targets under IR 3 were all met or exceeded by the program, which highlighted AgirPF’s 
extremely effective approach to removing policy barriers around FP and contraceptives. Advocacy 
conducted under IR 3 led to 19 policies or guidelines changed to improve access to FP and RH services 
The AgirPF Project Endline Evaluation Report 2
(317% of targets), 41 formal agreements signed at the regional level (273% of targets), and over 101 
advocacy activities conducted (289%), among other achievements.
AgirPF SBCC campaigns
In addition to PMP performance, the endline evaluation also had a special focus on evaluating the 
impact of AgirPF’s multi-faceted SBCC campaigns based on an innovative approach of segmenting 
the population according to their attitudes, behaviors, and potential in terms of FP use. The campaign 
reached wide audiences (up to 75% of those living in Niger’s intervention areas were reached with a 
USG-supported FP/RH message, 82% in the nonintervention areas) through a variety of methods, yet 
evaluating the SBCC campaign was virtually impossible given the contamination of the 
nonintervention areas by the activities implemented by AgirPF. Most of the SBCC activities (posters, 
radio spots, Facebook pages, comic books, etc.) could not be confined to a specific area given that 
intervention and nonintervention areas were generally in the same urban/peri-urban districts. Because 
the campaigns began in years 3 and 4 of the program, there was a lack of sufficient baseline data with 
which to track changes in attitudes and behavior post-campaign. The extremely varied techniques, 
themes, and targeted audiences also defied easy analysis. Further research to examine whether the 
SBCC campaigns contribute to increased levels of FP information-seeking, positive attitudes about 
FP, and actual FP use need to be conducted to definitively establish effectiveness. 
Impact on FP
Despite strong performance on many output and outcome indicators in the PMP, it was difficult to 
demonstrate that AgirPF made a difference in terms of FP knowledge and contraceptive prevalence
because of the proximity of intervention and nonintervention areas. For example, an AgirPF 
beneficiary could easily attend health facilities and events in a nearby nonintervention area led by 
another Ministry of Health (MOH) partner. What is more, nonintervention areas were not control 
zones, and were often heavily targeted by other programs related to improving FP methods. 
In large part due to these contamination effects, logistic regression could not show any difference in 
FP outcomes based on living in an AgirPF intervention zone on mCPR after controlling for 
background characteristics, except for a negative finding for women in Burkina Faso. There were some 
small statistically significant variances in mCPR, FP method mix, and use of long-acting reversible 
contraceptives/permanent methods among and between countries based on some background 
characteristics. Analysis by zone does show more opposition to contraceptive use in the 
nonintervention than in the intervention areas in Côte d’Ivoire (16.6% vs 6.8%), Niger (17.6% vs 13%), 
and Togo (11% vs 8.8%), much may be a result of AgirPF educational activities. 
The evaluators recommend further research to determine whether the SBCC campaigns and broader 
education activities contributed to increased levels of FP information-seeking, positive attitudes about 
FP, and actual FP use. It will be critical to take into account evaluation challenges such as baseline data 
collection and potential contamination effects on nonintervention sites (and vice versa) during the 
design stage of future projects to best understand USAID impact. 
The AgirPF Project Endline Evaluation Report 3
Introduction
Despite the dramatic increase in the availability and use of family planning (FP) worldwide over the 
past fifty years, contraceptive use in much of francophone West Africa remains low while unmet need 
remains high. According to the most recent 2013 Demographic and Health Surveys (DHS) and 
Multiple Indicator Cluster Surveys (MICS), which coincided with the launch of the AgirPF project, 
the modern contraceptive prevalence rate (mCPR) was 14% to 34% in the urban areas of Burkina 
Faso, Côte d’Ivoire, Mauritania, Niger, and Togo, while unmet need ranged from 21% to 37%.
On July 5, 2013, the USAID/West Africa Regional Health Office awarded a five-year, $29 million 
cooperative agreement called the Agir Pour la Planification Familiale (AgirPF) project to 
EngenderHealth and its partner, Avenir Health (former Futures Institute). The goal of AgirPF was to 
enable women of reproductive age (15-49 years old) to make and voluntarily act on informed decisions 
about family planning (FP). Zones of intervention included the urban and peri-urban areas of five 
francophone West African countries including Burkina Faso, Côte d’Ivoire, Mauritania, Niger, and 
Togo. The project team worked closely with Ministries of Health (MOHs) and other local partners to 
support the national action plans for strengthening FP that followed the February 2011 Francophone 
West Africa Regional Conference on Population, Development, and Family Planning in 
Ouagadougou, Burkina Faso. 
The current report analyzes data from the endline evaluation study along with other sources of 
information generated by the project to assess AgirPF performance and effectiveness through changes 
over time in key services, enabling environment, and demand indicators. The first part of the report 
gives a detailed overview of the project and presents the objectives and methodology of the evaluation. 
The second part presents the results, conclusions, and lessons learned. 
Overview and methodology
As the objective of the AgirPF project was to increase access to and use of quality FP services in the 
five participating francophone West African countries, the project strengthened public, private, and 
NGO facilities to provide a wide range of FP services, including integrated FP/MNCH services and 
services for youth and men. 
Beneficiaries 
The target beneficiaries of AgirPF interventions were women of reproductive age (WRA) from 15-49
years old living in the urban and peri-urban areas of the 10 largest cities in the 5 countries (see 
Geographic scope below). These beneficiaries included post-partum women, women seeking post￾abortion care services, and first-time parents. Target beneficiaries also included men and youth, 
The AgirPF Project Endline Evaluation Report 4
especially through EngenderHealth’s work with male FP service professionals and through the 
project’s emphasis on “youth-friendly” services.
Geographic scope 
EngenderHealth implemented AgirPF in the 10 largest cities (80,000+ population) of the five 
participating countries, with the exception of Zinder, Niger, which was not selected due to safety 
concerns. Cities included Ouagadougou, Bobo-Dioulasso, and Koudougou in Burkina Faso; Abidjan 
in Côte d’Ivoire; Nouakchott in Mauritania; Niamey and Maradi in Niger; and Lomé, Sokodé, and 
Kara in Togo. 
In consultation with MOH authorities, AgirPF selected 263 intervention and 148 nonintervention 
health facilities (HFs). Table 1 provides the number of cities, health districts, and intervention and 
nonintervention health facilities (HFs) by country. Table 24 in Annex B gives a complete list of the 
intervention and nonintervention HFs. 
Table 1. Number of AgirPF intervention and nonintervention sites by country
Countries # cities # Health Districts
# Intervention 
Health Facilities
# Nonintervention 
Health Facilities
Burkina Faso 3 8 57 31
Côte d’Ivoire 1 10 79 48
Mauritania 1 9 43 13
Niger 2 9 36 32
Togo 3 9 48 24
TOTAL 10 45 263 148
The team determined the intervention zones of the project based on a set of five criteria.1 Similarly, 
the nonintervention zone consisted of the catchment areas of the nonintervention HFs. Apart from 
the intervention HFs, AgirPF also supported 21 private clinics including six in Burkina Faso, 10 in 
Niger, and five in Togo, upon request from USAID. 
Description of the project intervention 
 1 AgirPF’s intervention zones selection criteria: 
- Population size of the district: 5,000 people or more, 
- Level of CPR in the city districts: less than 10%, 
- Activities carried out in the Health Facilities (facilities that do not offer counseling, offering only short acting 
methods (pills, injectable, condoms and spermicides), poor quality of services, and/or poor infection prevention 
practices), and 
- The absence of other international development donors/partners in the zones and their domain of intervention 
to avoid duplication and emphasize complementarity 
The AgirPF Project Endline Evaluation Report 5
To achieve its objectives, AgirPF’s intervention consisted of five broad activities: 
i. Improve FP service quality by establishing Centers of Excellence in each capital city to train 
providers and supervisors in the following areas: 
a. Provision of gender sensitive, male and youth-friendly, rights-based FP services 
b. COPE® quality improvement process 
c. Facilitative supervision
d. Training of nurses, doctors, and midwives to provide implants and IUDs in addition to short-acting 
methods
ii. Bring FP services to underserved communities through: 
a. Mobile outreach services and FP special days, offering a wide range of contraceptives including implants 
and IUDs 
b. Community health workers (CHWs) providing first-offer condoms, pills, and injectables (in Togo and 
Niger) and then immediately transitioning clients to sustainable sources of resupply. CHWs also led 
community discussions on sexual and reproductive health and FP, as well as reflection sessions about 
gender norms as they relate to FP. 
iii. Educate and empower clients and grassroots advocates, by using gender transformative 
social and behavior change communication (SBCC); men as partners (MAP) tools; and 
Avenir Health training for CSO/district advocates to deliver FP information to CHWs and 
clients.
iv. Reduce financial barriers by collaborating with MOHs and other partners to provide 
dedicated FP services at low or no cost (e.g. via FP special days and mobile services) in 
AgirPF countries where services are not free
v. Solve logistics issues and estimate commodity needs in collaboration with the USAID
DELIVER project by training: 
a. Facility staff in the Client-Oriented Provider-Efficiency (COPE) for Contraceptive Security (CS) 
method
b. Contraceptive procurement table (CPT) teams to use Reality Check (√), a tool for assisting FP 
professionals to plan and advocate based on informed estimates of need, by examining the relationship 
of contraceptive prevalence and population to numbers of family planning users, adopters, and 
commodities.2
Monitoring and evaluation 
To measure the performance and effectiveness of activities, AgirPF planned three studies including 
the baseline assessment (2013-2014), mid-term performance evaluation (2016), and endline evaluation 
(2018).3 The monitoring and evaluation (M&E) team used quasi-experimental methods with non￾equivalent control groups to measure changes between the baseline and endline via population-level 
indicators following the AgirPF intervention. The team matched the experimental and control groups 
 
2 https://www.engenderhealth.org/pubs/family-planning/reality-check/ 3 The evaluation team did not conduct a mid-term performance evaluation in Mauritania due to delays in project start￾up. 
The AgirPF Project Endline Evaluation Report 6
by sample age distribution for the household surveys and type of health facility for the facility audits. 
Matching reduced study bias and increased the level of confidence in measuring the final impact of 
the intervention. 
However, the selection of intervention and nonintervention health facilities in the same health district 
resulted in increased spillover effects of the intervention activities on the nonintervention group, as is 
discussed at length in the Results and Discussion and Conclusion chapters. 
The study design (figure 1) depicts the nature and timing of intervention activities introduced by 
AgirPF (X) as well as measurement of dependent variables (0). The team measured 01 and 04 during 
the baseline assessment, and 03 and 06 during the endline evaluation. Due to changes in the mid-term 
evaluation methodology, the team did not measure the 02 and 05 household variables. 
Figure 1. Study design
Time 48 months
 
 Experimental Group 01 Xa 02 Xa 03
 -------------------------------------------
Nonequivalent Control Group 04 05 06
Xa : Intervention activities introduced by AgirPF 
01 & 04 : Baseline measurement of dependent variables, representing the existing situation and 
providing control measures for the experimental group (AgirPF intervention zones) and 
nonequivalent control group (nonintervention zones) 
02 & 05 : Mid-term measurement of dependent variables, representing changes in variables in 
experimental and comparison zones, respectively. 
03 & 06 : Endline measurement of dependent variables, representing changes in variables in 
experimental and comparison zone, respectively.
-------- : Indicates that the two groups were not randomly assigned 
: Intervention duration 
The AgirPF project lasted five years but intervention time varied by country from 24 months in 
Mauritania to 48 months in Togo. Table 2 shows the duration of start-up, intervention, and close-out 
activities in each country. 
The AgirPF Project Endline Evaluation Report 7
Table 2. AgirPF timeline by country
Country
Start Date End Date
Duration 
Start- (months) up
Intervention 
Activities Begin 
/ Reporting in 
DHIS2
Intervention 
Activities End Close-out
Burkina Faso Jul. 2013 Oct. 2014 Mar. 2018 Jul. 2018 42
Côte d’Ivoire Nov. 2014 Mar. 2015 Mar. 2018 Jul. 2018 37
Mauritania Feb. 2014 Mar. 2016 Mar. 2018 Jul. 2018 25
Niger Jul. 2013 Oct. 2014 Mar. 2018 Jul. 2018 42
Togo Jul. 2013 Oct. 2014 Mar. 2018 Jul. 2018 42
Figure 2. Study hypothesis
O1 = O4 ≤ O5 ≤ O6 < O2 < O3
The study hypothesis (figure 2) posits the following: 
a. Women living in urban and peri-urban areas AgirPF intervention areas will have higher levels 
of family planning knowledge and utilization of family planning and other reproductive health 
services after their introduction than before: O1 < O2 < O3. 
b. Knowledge and use of reproductive health services among women will be higher in urban and 
peri-urban areas where AgirPF introduces community-level and clinic-strengthening 
interventions than where there are no AgirPF intervention activities: O5 < O2 andO6 < O3. 
c. Men and women living in urban and peri-urban areas where AgirPF intervenes will have higher 
levels of dialogue with their partner about FP and other reproductive health services after their 
introduction than before: O1 < O2 < O3. 
d. The proportion of men reporting dialogue about FP with their wife/partner will be higher in 
urban and peri-urban areas where AgirPF intervenes than where there are no AgirPF 
intervention activities: O5 < O2 andO6 < O3. 
Baseline assessment 
AgirPF conducted the baseline assessment study in four of its five implementation countries (Burkina 
Faso, Niger, Togo and Côte d’Ivoire)4 in order to inform the development of baseline indicators and 
to guide future AgirPF programming around three identified areas: (1) supply, (2) enabling 
environment, and (3) demand. The baseline assessment identified priority areas and existing strengths 
 
4 Mauritania was not part of this study due to registration challenges in the country that prevented programming from 
starting until later in the project.
The AgirPF Project Endline Evaluation Report 8
and best practices on which to build and comprised (i) a health facility audit; (ii) a key informant 
qualitative survey; (iii) a community health worker qualitative survey; and (iv) a quantitative household 
survey. The household survey participants included women at reproductive age (15-49 years old) and 
men (aged 15-59) and examined their knowledge, attitudes, and practices (KAP) related to FP as well 
as their gender attitudes. Specific indicators included (i) mCPR, (ii) family planning discussion among 
partners, and (iii) exposure to family planning messages. 
The findings formed the basis for a range of program intervention recommendations in each country.
The assessment recommending bringing Côte d’Ivoire, which lagged behind other project countries,
up to expected standards by (1) creating demand for FP through SBCC-related activities for men and 
women; (2) equipping facilities with IEC materials; (3) improving the quality of basic training and 
conducting in-service training of providers in FP; (4) improving availability of supplies; and (5) 
strengthening the waste disposal system and training staff in infection prevention. For Burkina Faso, 
the recommendations included: (1) increasing the availability of IUDs, in particular postpartum IUDs, 
by providing staff training and equipment and supplies and (2) equipping facilities with equipment 
needed for implants and PAC. Focus areas identified for Niger included achieving a higher CPR and 
a more balanced contraceptive method mix. Specific recommended interventions included (1) 
increasing knowledge and demand for condoms; (2) increasing knowledge of and demand for the 
standard days method (SDM) and natural family planning; and (3) investigating and removing demand￾side barriers to use of hormonal methods. Last, for Togo, recommendations included: (1) training/re￾training providers of PAC services; (2) equipping the facilities with PAC equipment; (3) improving 
supplies of cycle beads and female condoms; and (4) increasing demand and awareness for certain FP 
methods such as implants, SDM, and emergency contraceptives. 
Mid-term performance evaluation 
The USAID Evidence for Development (E4D) project carried out the mid-term performance 
evaluation in all countries except Mauritania where the team completed the baseline study a few 
months prior to the midterm evaluation. The purpose of the mid-term evaluation was to determine 
the extent to which the AgirPF portfolio met its overarching objectives. The evaluators sought to
document whether the AgirPF project (i) was on track for achieving its intended results; (ii) advanced 
select high impact practices; (iii) achieved the intermediate results necessary for meeting the final 
expected results; and (iv) had relevant successes, challenges, and lessons learned. 
As such, the mid-term evaluation used a mixed methods approach, which included quantitative data 
from the program record files, AgirPF District Health Information System 2 (DHIS2) database, as 
well as direct data collection on FP service delivery from a representative sample of AgirPF and 
comparison sites. Qualitative data in the form of purposive stakeholder interviews (including AgirPF 
staff, AgirPF trained providers, MOH partners, district and regional health managers, local partners 
and consortium partners) and analysis of quarterly reports were also used to triangulate and verify 
The AgirPF Project Endline Evaluation Report 9
quantitative findings and to answer specific evaluation questions. The evaluation concluded that the 
AgirPF project was on track to meet its pre-set family planning service targets. The evaluation also 
found that AgirPF had contributed important support to the regional advancement of improved 
family planning access and utilization through a combination of regional training, networking and 
exchanges as well as harmonized in-country efforts aimed at training providers, supporting policy 
advocacy, creating or increasing domestic budgets dedicated to FP, improving logistics management, 
and behavior change activities. 
Endline evaluation 
The endline evaluation assessed the project’s effectiveness and changes over time in key services, the 
enabling environment, and demand indicators in four of the five implementation countries of Burkina 
Faso, Cote d’Ivoire, Niger, and Togo. Mauritania was not included as project implementation began 
two years later than the other countries and was limited for policy reasons on some project objectives 
and activities. The study consisted of a light household survey that used the same methodology as the 
baseline assessment but focused on the measurement of the following three PMP indicators as well as 
a USAID demand generation indicator used for reporting to the US Congress:
• Indicator 2: Modern Contraceptive Prevalence Rate (mCPR); 
• Indicator 14: Proportion of women citing lack of information on FP methods as a key barrier 
to use; 
• Indicator 15: Proportion of women and men reporting increased dialogue with their partner 
about FP; and 
• USAID Custom Indicator: Percent of audience who recall hearing or seeing a specific USG￾supported Family Planning/Reproductive Health (FP/RH) message. 
The household survey also included questions regarding respondents’ age, sex, and marital status, 
duration of residence, education, and number of living children. 
Overall objectives
The overall objective of the evaluation was to assess the performance and effectiveness of the project’s 
intervention and changes over time in key services, the enabling environment, and demand indicators
in line with the baseline study and the mid-term evaluation results and recommendations. 
Specific objectives
• Measure AgirPFs progress against Performance Monitoring Plan (PMP) indicators over the 
course of the project 
• Analyze how changes in the population-level indicators are linked to AgirPF’s intervention
• Contribute to the evaluation of the AgirPF SBCC campaign
The AgirPF Project Endline Evaluation Report 10
Methodology
The main data sources for the endline evaluation are household data, facility audit data, and key 
respondent interviews (NGOs managers and DHMTs). Other sources include the following: 
• AgirPF baseline assessment (for the trend analysis of some population-based indicators such 
as the CPR); 
• Server of the toll-free line set up in Niger by AgirPF to provide information on FP; 
• AgirPF DHIS2 database containing FP service statistics collected monthly in AgirPF 
intervention facilities; and 
• AgirPF monthly, quarterly, and annual reports as well as Mid-Term Evaluation Results. 
Sampling procedures
The endline evaluation utilized the same methodology as the household survey of the baseline study, 
thus allowing for similar sampling sizes and methodologies. For example, both surveys included multi￾stage stratified sampling for women whereby each health facility catchment area represented a stratum. 
First, the team selected enumeration areas (EA) in each stratum.5 Second, the evaluators randomly 
selected a minimum of 20 households in the EA. Within the household, the evaluators selected all 
females aged 15-49 years old. The team systematically sampled men by inviting the partner or spouse 
of the woman interviewed to participate in the survey to demonstrate whether the AgirPF intervention 
had a significant impact on men’s dialogue with their partners about FP at the country-level. Appendix 
C provides reporting based on the available estimates of each variable. 
To calculate the minimum sample sizes needed to demonstrate whether AgirPF had a statistically 
significant effect on increasing modern contraceptive use among women of reproductive age, the 
evaluators: 
• Utilized the key indicator, “proportion of women currently using a modern contraceptive 
method”; and 
• Employed the Epi Info Stat-Calc Sample Size and Power program for simple random sampling 
assuming: (i) an average annual women’s CPR increase of 2 percent, (ii) a two-sided confidence 
interval of 95 percent, and (iii) a power of 80 percent. 
Finally, the evaluators adjusted the minimum sample sizes needed for each focus city to account for 
the estimated response rate for sampling a minimum of 20 households at the final stage.
6 Appendix C 
includes sample size calculations as well as estimates of CPR and other parameters.
 
5 The national statistical offices in each country delineate enumeration areas. 6 In a two-stage sampling design, DHS survey data suggest that the optimal sample size is 22-25 households where there 
are 0.90 women of reproductive age per household and 14-16 where there are 1.40 women of reproductive age per 
household. A loss of precision will result where the sample size is less than optimal. See 
http://dhsprogram.com/pubs/pdf/WP30/WP30.pdf, last accessed 26 March 2014.
The AgirPF Project Endline Evaluation Report 11
Table 3 shows the final sample sizes for the household survey in each country. The table gives the 
distribution of facilities concerned by the survey by country and by zone of intervention (intervention 
and nonintervention). It also provides information on the number of men and women entering the 
country by country. 
Table 3. Final sample sizes for the household survey
City/ Health 
Districts
Intervention Nonintervention Total
Number 
of
Facilities
Minimum 
Sample 
Needed*
Actual 
Sample 
Needed**
Number 
of 
Facilities
Minimum 
Sample 
Needed*
Actual 
Sample 
Needed**
Women Men All 
Burkina Faso
Ouagadougou 33 253 660 22 253 440 1,100 550 1,650
Bobo Dioulasso 13 298 298 8 298 298 596 298 894
Koudougou 8 202 202 8 202 202 404 202 606
Total Burkina 
Faso 54 753 1,160 38 753 940 2,100 1,050 3,150
Côte d’Ivoire
Abidjan 8 270 8 270 360 180 540
Total Côte 
d’Ivoire 82 2,802 50 1,688 2,994 1,496 4,490
Niger
Maradi 21 293 420 14 293 294 714 358 1,072
Niamey 15 255 300 15 255 300 600 300 900
Total Niger 36 548 720 29 548 594 1,314 658 1,972
Togo
Lomé 19 202 380 9 202 201 581 291 872
Sokodé 14 176 280 7 176 176 456 228 684
Kara 15 198 300 8 198 198 498 249 747
Total Togo 48 576 960 24 576 575 1,535 768 2,303
TOTAL 110 1,641 3,240 87 1,641 2,409 5,649 2,825 8,475
* Minimum sample is based on sample size calculation by city with proportional distribution by clinic catchment area. 
** Actual needed based on minimum 20 households per clinic catchment area. If (# clinics in district * 20) < than 
minimum sample, then actual sample = minimal sample.
Data collection and entry 
Four private firms (one for each country) collected the household data for the endline survey between 
April and June 2018.7 For security purposes, each company underwent a background check and signed
an agreement not to share any information about the project gathered from the 
surveys. EngenderHealth conducted a rigorous in-house ethical review process of study protocols and 
tools as did the USAID mission and local host country ethics committees. 
The firms worked under the supervision of AgirPF Country Managers, the M&E/Research Advisor, 
and the Regional M&E/Research Officer. AgirPF staff checked data collection process quality and 
supplied predetermined information and survey tools to reduce the potential risk of data reporting 
 
7 Two of the endline household data collection firms also conducted the baseline assessment in Burkina Faso and Togo.
The AgirPF Project Endline Evaluation Report 12
bias. Orientation sessions for the firms included training in mandatory ethics, study protocols, data 
collection guides, and survey tools.8
After household enumeration and the selection of an eligible respondent in each household surveyed, 
trained interviewers conducted private structured interviews with respondents in French or the local 
languages listed in table 4.9 
Table 4. Main languages spoken in the study areas 
Country Local languages
Burkina Faso French, More, and Dioula
Côte d’Ivoire French, Dioula
Niger French, Haoussa, and Zarma (ou Djerma)
Togo French, Ewe, Mina, Cotocoli, and Kabye
The interviewers emphasized that respondent participation was voluntary and obtained the informed 
consent of each participant. The team stored all completed data collection forms and data files without 
the names of respondents to maintain confidentiality. Oversampling compensated for respondents 
that declined to be interviewed. 
AgirPF provided the tablets and CSPro computer-assisted personal interviewing (CAPI) applications 
for the interviewers. The CAPI application integrated quality controls checked in real time during the 
interview. 
Data analysis 
Data were collected at the population level during the baseline assessment and the endline evaluation 
surveys by interviewing women in the reproductive age (15-49 years) and men aged 15-59 years living 
in the project intervention and nonintervention areas. Further, a portion of the data collection 
occurred routinely at the project’s intervention health facilities, while the remaining indicators came 
from activity reports provided by project staff or by its partners. The measurement of the performance 
against the PMP Indicators is described in the Results chapter below. 
Household survey data analysis
The analysis combined descriptive and explicative methods, based on univarate, bivariate, and 
multivariate techniques (chi-2 test, T-test, and logistic regressions). 
The AgirPF M&E/Research Advisor and M&E/Research Officer began the household data analysis
following the data collection and cleaning performed using SPSS software packages. To assess whether 
 
8 AgirPF translated the data collection instruments from English to French and local languages.
9 French and local language fluency was one of the selection criteria for the supervisors and interviewers in each country. 
The AgirPF Project Endline Evaluation Report 13
or not AgirPF reached its objectives, the team (i) entered and analysed the household data, and (ii) 
compared the indicators with their respective life-of-project targets as well as across the intervention 
and nonintervention zones while controlling for confounding factors such as the respondent’s 
background characteristics. 
DHIS2 and report analysis 
The AgirPF M&E team computed the 25 remaining performance monitoring plan (PMP) indicators using 
data retrieved from AgirPF DHIS2 database and activity reports(see table 5). These country- or regional￾level indicators were disaggregated by country and, depending on the indicator, other variables such 
as sex, service delivery type, contraceptive method, and training area. 
The team calculated the level of performance based on the percentage of the LOP targets achieved by 
the last reporting month of the project (June 2018). In a few cases10, the team could not determine 
progress against indicators because of missing indicator targets or unavailable data. For instance, 
without data from the endline evaluation survey (completed in July 2018), the team could not measure 
population-level indicators. Performance was measured as follows:
• Good: 80% or more of the LOP target achieved; 
• Moderate: 70% to 79% of the LOP target achieved; 
• Poor: Less than 70% of the LOP target achieved; and
• Not Measured: Target not set, data missing, or indicator not applicable. 
Table 5. Twenty-five AgirPF PMP indicators, data collection areas, and sources 
# Indicator
Data collection area Data 
Sources Region Burkina 
Faso
Côte 
d’Ivoire
Mauri￾tania
Niger Togo
1 Number of CYP achieved in AgirPF 
supported areas X X X X X X Service 
statistics
2 Modern contraceptive prevalence rate 
(mCPR) n/a X X X X X 
Baseline & 
Endline 
surveys
3 Total number of FP method users X X X X X X Service 
statistics
4 Number of additional users of modern 
methods of contraception X X X X X X Service 
statistics
5 Percentage of FP service providers deemed 
technically competent based on an 
assessment according to national, 
international or other defined standards
X X X X X X 
Supervision 
reports
6 Number of local organizations with improved 
organizational and management capacity as X X X X X X Activity 
reports
 
10 The cases where AgirPF was unable to determine the progress of the indicators include: (i) the number of HIV positive 
women who received comprehensive FP services, (ii) the proportion of men and women with gender-equitable attitudes
and (iii) the number of service delivery points (SDPs) reporting stock-outs of contraceptives per quarter. 
The AgirPF Project Endline Evaluation Report 14
# Indicator
Data collection area Data 
Sources Region Burkina 
Faso
Côte 
d’Ivoire
Mauri￾tania
Niger Togo
measured by a defined organizational 
assessment tool 
7 Number of FP curricula updated to include 
gender sensitivity, couple counseling, youth￾and male-friendly services
X X X X X X 
Activity 
reports
8 Number of people trained in FP and 
reproductive health with USG funds X X X X X X Activity 
reports
9 Number of HIV positive women who received 
comprehensive FP services n/a n/a X n/a n/a n/a
Service 
statistics & 
Activity 
reports
10 Number of FP special days conducted X X X X X X Activity 
reports
11 Number of additional USG-assisted 
community health workers (CHWs) providing 
family planning information and/or services 
during the year
X n/a X n/a X X 
Activity 
reports
12 Proportion of women and men reporting 
increased dialogue with their partner about 
FP
n/a X X X X X 
Baseline & 
Endline 
surveys
13 Proportion of men and women with gender￾equitable attitudes n/a X X X X X 
Baseline & 
Endline 
surveys
14 Percent of women citing lack of information 
on FP methods as a key barrier to use n/a X X X X X 
Baseline & 
Endline 
surveys
15 Percent of women that discussed FP with 
husbands/partners, friends/family within the 
last 15 days
n/a X X X X X 
Baseline & 
Endline 
surveys
16 Number of youth that participate in 
educational program on gender, FP, and 
SRH
X X X X X X 
Activity 
reports
17 Number of site walk-throughs (SWTs) 
conducted X X X X X X Activity 
reports
18 Number of HIPS/BPs for family planning and 
maternal and child health and/or HIV/AIDS 
incorporated into national health protocols or 
standards
X X X X X X 
Activity 
reports
19 Number of HIPs piloted through 
implementation research X X X X X X Activity 
Reports
20 Number of regional technical meetings 
organized and supported by AgirPF and its 
partners
X n/a n/a n/a n/a n/a
Activity 
reports
21 Number of policies or guidelines developed or 
changed with USG assistance to improve 
access to and use of family planning and 
reproductive health services
X X X X X X 
Activity 
reports
22 Number of advocacy presentations created or X X X X X X Activity 
The AgirPF Project Endline Evaluation Report 15
# Indicator
Data collection area Data 
Sources Region Burkina 
Faso
Côte 
d’Ivoire
Mauri￾tania
Niger Togo
updated with support from AgirPF reports
23 Number of advocacy activities conducted X X X X X X Activity 
reports
24 Number of formal agreements (MoU, policy, 
declaration, etc.) signed at the regional level X X X X X X Activity 
reports
25 Number of service delivery points (SDPs) 
reporting stock-outs of contraceptives per 
quarter
X X X X X X 
Service 
statistics
SBCC campaign evaluation overview
One of the objectives of the endline survey was to evaluate the AgirPF SBCC campaign via the
following indicator: “Percent of audience who recall hearing or seeing a specific USG-supported 
family planning/reproductive health (FP/RH) message.” This indicator was not part of the PMP, but 
was discussed with and accepted by USAID specifically for the SBCC activities. As such, the team
prepared survey questions for the target audience in each country, administered the survey by phone, 
and recorded the phone calls on the IVR server. Recorded data included the number of calls, 
completion status, duration, and topics. Table 6 includes the list of SBCC campaign activities captured 
in the endline evaluation by country. Further analysis of the SBCC campaign evaluation can be found 
in the corresponding section of the Results chapter below.
Table 6. List of SBCC campaign activities captured in the endline evaluation by country 
Countries SBCC Activities
Burkina Faso 1. The Nintriga campaign that consisted of radio talk, a song, and a video clip on FP.
2. The “Ali et Ténè” comic book about youth and adolescent sexuality.
3. The “Ali et Ténè” Facebook page containing posts and videos about Nintriga and about FP in 
general.
Côte d’Ivoire 1. Couples discussion and experience sharing about FP using videos about couple interaction 
relating to FP.
2. The “Safi et Leo” comic book about youth and adolescent sexuality.
3. The “Safi et Leo” Facebook page that contains posts and videos about FP.
4. Youth talk (“Causerie avec les jeunes”) about FP.
5. The "Plan My Life" mobile application.
Niger 1. The Inter Voice Reponses system (IVR), a toll-free number one can call to obtain free 
information about FP.
2. Distribution of coupons to obtain FP services free of charge at health centers.
3. Posters and radio spots about the management of side effects of FP methods.
Togo 1. Couples discussion and experience sharing about FP using videos about couple interaction 
relating to FP.
2. The “Assibi et Salifou” comic book about youth and adolescent sexuality.
3. Posters and radio spots about the management of side effects of FP methods.
The AgirPF Project Endline Evaluation Report 16
Results 
Progress against PMP indicators 
The project team developed a Performance Monitoring Plan (PMP) to measure indicators across the 
project based on USAID’s global monitoring guidelines and framework.11 AgirPF’s approach to 
monitoring prioritized data from existing sources, such as service statistics and existing data collection 
tools. As such, AgirPF coordinated with partners to conduct a participatory review of processes, flow, 
and reporting systems for FP data in the Health Management Information System (HMIS) of each 
country and developed monitoring tools and the District Health Information System version 2
database (DHIS2). USAID approved the AgirPF PMP reflecting the USAID/WA Regional 2015 
Cooperation Development Strategy (RCDS), global monitoring guidelines, and accompanying list of 
indicators. 
AgirPF developed 25 output and outcome indicators to evaluate the impact of its technical assistance 
at the intervention site level grouped under the Strategic Objective (SO) of increasing access to and 
use of quality FP services in the selected urban and peri-urban areas of the five countries and three 
Intermediate Results (IRs): (1) delivery of quality FP information, products, and services strengthened 
and expanded, (2) evidence-based service delivery approaches selected, adapted, and implemented, 
and (3) efforts to remove policy barriers and improve contraceptive commodity security coordinated. 
On average, AgirPF performed well on 78% 
of the 25 PMP indicators but moderately and 
poorly on 6% and 17%, respectively.12 Figure 
3 provides details regarding indicator 
performance against targets (see Annex D for 
more detail, including indicators for which 
data were unavailable). There were significant 
variances in meeting targets across the 
countries. For example, Togo performed well 
on 88% of its indicators, followed by Niger at 
76%; and Burkina Faso at 71%. Côte d’Ivoire 
(29%) and Mauritania (57%) had the lowest 
percentages indicators with good 
performance, which is consistent with their later program implementation start dates and more 
 
11 The Performance Monitoring Plan (PMP) outlines the criteria that will be used to assess the outputs and outcomes of 
the AgirPF project in five francophone countries of West Africa between July 5, 2013 and July 4, 2018. It is based on 
USAID’s DQA tools and MEASURE’s Data Demand and Use Toolkit—in particular, the proven Performance of 
Routine Information System Management (PRISM) Framework and tools evaluated by the MEASURE Evaluation. 12 Performance levels include those for which data are available
Figure 3. AgirPF PMP indicator distribution by 
performance level as of July 2017
The AgirPF Project Endline Evaluation Report 17
significant barriers to effective implementation (discussed below). Moderate performance was less 
common in each country, ranging from 0% in Togo to 12% in Côte d’Ivoire and Niger. 
Output Results
Throughout implementation, the project tracked 18 output indicators across the SO and three project 
IRs; AgirPF met or exceeded 15 of the 18 indicators (within a USAID/WA and EngenderHealth 
agreed upon acceptable margin of 20%), reflecting an 83% achievement of its expected results. 
AgirPF’s combined work in capacity building and evidence generation based on the implementation 
of HIPs by health authorities enabled this high performance. The project maintained a results-oriented 
approach throughout implementation and ensured that each activity contributed to the SO. Note that 
the output results are obtained from AgirPF intervention sites only via DHIS2 data and therefore do 
not concern the non-intervention sites. Results from Mauritania are also not taken into account given 
that implementation started much later than at other sites and that there were limitations on 
programming (see Overview above). 
Strategic objective: output results 
Three output indicators were related to AgirPF’s primary SO of increasing the access to and use of 
quality FP methods: the number of CYP achieved (indicator 1), the total number of FP method users 
(indicator 3), and the number of new users of modern methods of contraception/FP (indicator 4). 
Table 7 describes AgirPF performance towards these three indicators. The endline evaluation results 
show that AgirPF performed well across most of the four indicators but with marked variations 
between countries.
The data demonstrates that indicator performance across the three SO output indicators (indicators 
1, 3, and 4) was exceptionally strong in Burkina Faso (152%, 106%, and 123%, respectively) and Togo
(133%, 105%, 129%), mostly successful in Mauritania (35%, 101%, and 78.5%) and Niger (63%, 93%, 
and 90%), and weak in Côte d’Ivoire (34%, 64%, and 41%). The reasons for these discrepancies can 
largely be found in the unique challenges and cultural contexts of each of the countries, and did not 
represent failures of program implementation. 
For example, in Côte d’Ivoire 24% of sites (20 out of 84 sites) had never provided FP services of any 
kind. AgirPF therefore spent considerable time integrating FP service provision in these facilities by 
training facility management teams and providers as well as equipping and supervising the facilities. 
These activities required a minimum of six months to complete, and while critical for laying the 
groundwork to achieve project results, meant that AgirPF did not have time to progress to the range 
of activities implemented in the other three countries, particularly because Côte d’Ivoire joined the 
project one year later than Burkina Faso, Niger, and Togo. Political unrest, including the 2016 terrorist 
attacks, also disrupted programming. 
The AgirPF Project Endline Evaluation Report 18
In Mauritania and Niger, AgirPF interventions had strong performances resulting in 83% and 92% 
average achievement rates for total and additional users, respectively. However, in terms of CYP, the 
project achieved much lower results (35% in Mauritania and 63% in Niger). One of the main reasons 
for low CYP performance in Mauritania and Niger was the preference for short-acting contraceptives
as opposed to LARCs/PMs. CYP is the estimated protection provided by contraceptive methods 
during a one-year period and is based upon the volume of all contraceptives sold or distributed free 
of charge to clients during that period. 13 CYP is calculated by multiplying the quantity of each method 
distributed to clients by a conversion factor which is based on how a method is used, failure rates, 
wastage, and how many units of the method are typically needed to provide one year of contraceptive 
protection for a couple. Therefore, the more the clients use short-acting methods, the lower the CYP.
 
Table 7. Strategic objective output indicators, regional totals 
Indicator
Number
Indicator Target Achieved Rate
1 Number of CYP achieved in AgirPF supported areas 1,683,000 1,367,980 81%
3 Total number of FP method users 1,658,396 1,505372 91%
4 Number of additional users of modern methods of 
contraception
687,193 574,974 84%
 
IR 1: Output results
Results for IR 1 (“Delivery of Quality FP Information, Products, and Services Strengthened and 
Expanded) outputs are largely captured by SO output indicators, as well as indicator 8 which tracks 
the number of people trained in FP and RH with USG funds. Together, these indicators demonstrate 
the reach and expansion of the program along with other indicators in table 8. 
Apart from general expansion, it is 
interesting to note the increase in youth (age 
10 to 24 years old) contraceptive uptake and 
participation in related activities held at 
schools, youth associations, youth clubs, 
among other places. Figure 4 shows that 
from PY2 to PY5, 45% of the new clients in 
the region were young people. New users 
between 10 and 24 years old at the country 
level comprised 50% in Burkina Faso, 44% 
in Côte d’Ivoire, 56% in Niger, and 31% in 
Togo. These results can be clearly seen in 
 
13 https://www.usaid.gov/what-we-do/global-health/family-planning/couple-years-protection-cyp 
Figure 4. Contraceptive uptake in AgirPF intervention 
zones by group age, years 2-5
45% 50% 44%
56%
31%
55% 50% 56%
44%
69%
Region Burkina 
Faso
Cote 
d'Ivoire
Niger Togo
Group Age of 10-24 Years Group Age of 25-50+ years
The AgirPF Project Endline Evaluation Report 19
indicator 16 tracking youth participation; AgirPF reached 318,101 youths in the region which was 
118% of the target. 
The shift towards LARCs in the method mix also suggests a positive change regarding the quality of 
FP information, access to services, and service provision. Figure 5 shows that the contraceptive 
method mix changed significantly between the 2015 baseline and December 2017. The main change 
is the 20% decrease in the share of pills (from 44% to 24%) balanced by a substantial increase in the 
percentage of injectables (from 27% to 40%), implants (from 17% to 28%) and IUDs (from 4% to 
8%). The increased use of LARCs is likely due to expanded availability and affordability. For example, 
LARCs are more widely available now than at the start of project, in terms of both the commodities 
and trained service providers. AgirPF sites also offered LARCs free of charge during FP special days
(indicator 10). 
Table 8. IR 1 Output indicators, regional totals
Indicator
Number
Indicator Target Achieved Rate
6 Number of local organizations with improved 
organizational and management capacity (OCAT)
42 21 50%
7 Number of FP curricula updated to include gender 
sensitivity, couple counseling, youth and male friendly 
services
5 5 100%
8 Number of people trained in family planning and 
reproductive health with USG funds
5,784 5,699 99%
9 Number of HIV positive women who received 
comprehensive FP services
1,300 651 50%
10 Number of special FP days conducted 2,235 1,854 83%
11 Number of additional USG-assisted CHWs providing 
family planning information and/or services during the 
year
505 792 156%
Figure 5. Contraceptive method mix among modern FP users in AgirPF intervention sites
The AgirPF Project Endline Evaluation Report 20
Indicator
Number
Indicator Target Achieved Rate
16 Number of youths who participate in educational 
programs on gender, FP, and SRH
270,000 318,101 118%
17 Number of Site Walk-Throughs (SWT) conducted 329 136 41%
IR 2: Output results 
Under IR 2, AgirPF sought to select, adapt, and implement evidence-based service delivery 
approaches. IR 2 output indicators demonstrate the extent to which the MOH, DHMTs, and facilities 
collaborated with the project. Burkina Faso, Côte d’Ivoire, Niger, and Togo accepted and welcomed 
innovations in their facilities and implemented 10 HIPs. All indicators exceeded the agreed acceptable 
margin of 20 percent. Table 9 shows that AgirPF met both output indicators, and greatly exceeded 
expectations in terms of organizing regional technical meetings (269% over targets). 
Table 9. IR 2 Output indicators, regional totals
Indicator
Number
Indicator Target Achieved Rate
19 Number of HIPs piloted through implementation 
research
10 10 100%
20 Number of regional technical meetings organized and 
supported by AgirPF and its partners
16 43 268.7%
IR 3: Output results
Under IR 3, AgirPF sought to coordinate efforts to remove policy barriers and improve contraceptive 
commodity security. Improving the policy enabling environment for FP programs is part of the 
EngenderHealth SEED model which was incorporated into the program. To address the weak 
political support for FP programs, as well as socio-cultural obstacles for FP access and use, AgirPF, 
in close collaboration with the five implementing country governments, the Ouagadougou Partnership 
(OP), the West Africa Health Organization (WAHO), and other partners achieved or exceeded every 
IR 3 indicator target. Table 9 indicates that AgirPF exceeded the results for the five output indicators 
for IR 3 (see table 10). 
This success in fostering enabling environments was due in part to: 
i. An advocacy strategy focused on the two key determinants of the policy environment of FP—
political support and the socio-cultural climate—so that government officials are less 
fearful of seeing their efforts in favor of FP contradicted by religious leaders; 
ii. The element of “ownership,” which is critical for the credibility of advocacy messages and key 
stakeholder tools and advocacy plan production; 
The AgirPF Project Endline Evaluation Report 21
iii. Pertinent and compelling data presented with RAPID tools that persuaded public administrators 
and officials, as well as religious leaders, that investments in FP would strengthen 
socioeconomic development in their respective countries; 
iv. Institutional strengthening and skills transfer, which assured continuing FP advocacy; and 
v. The methodological approach of AgirPF and the regional partnership with WAHO, which 
increased the legitimacy and credibility of efforts at the country level
EngenderHealth’s vision when developing the AgirPF project was to “achieve the reproductive 
intentions of women and couples in urban/peri-urban areas of Burkina Faso, Côte d’Ivoire, 
Mauritania, Niger, and Togo using FP services.” The project’s success under IR 3 was almost certainly 
due in part to opportune timing for fulfilling this vision, due to global FP coverage intentions. By the 
start of the project, there was broad support for the FP2020 objective of reaching 20 million FP users 
in developing countries, the Ouagadougou Partnership objective of reaching 2.2 million additional FP 
users in Francophone West Africa by 2020, and government willingness to consider FP a national 
priority that would both combat maternal and infant mortality and foster development, which are 
clearly reflected in the over-performance of output indicators under IR 3. 
Table 10. IR 3 Output indicators, regional totals
Indicator
Number Indicator Target Achieved Rate
21. a Number of policies or guidelines developed or changed 
with USG assistance to improve access to and use of FP 
and RH services
6 19 317%
21. b Number of countries with a line item in the national 
budget for FP
5 5 100%
22 Number of advocacy presentations created or updated 
(with Avenir Health and HP+)
6 47 783%
23 Number of advocacy activities conducted 35 101 288.6%
24 Number of formal agreements (MoU, policy, declaration, 
etc.) signed at the regional level
15 41 273%
25 Number of SDP reporting stock-outs of contraceptives 
per quarter14
n/a n/a n/a
Challenges
In sum, AgirPF met 83%, or 15 of 18 of its output result targets over the LOP. The project did not 
reach the remaining targets (indicators 6, 9, and 17) due to delayed project start-up, which took about 
six months in each country due to the need to complete the baseline evaluation prior to 
implementation. In Côte d’Ivoire, government delays in finalizing the National Budgeted FP Action 
Plan meant that implementation activities did not get started until November 2014. In Mauritania, 
AgirPF encountered administrative issues, namely registration, which delayed implementation until 
October 2015. Furthermore, challenges faced in securing government support in Mauritania, iterative 
strikes in Côte d’Ivoire and Togo, political and military unrest in Côte d’Ivoire and Burkina Faso, and 
 
14 The indicator 25 was never defined and target set. USAID/WA was expected to finalize the indicator definition and 
never come back to AgirPF. Therefore, there are no baseline target nor endline results.
The AgirPF Project Endline Evaluation Report 22
the institutional unavailability of FP products in Côte d’Ivoire and Burkina Faso, negatively impacted 
results. While these delays impeded the achievement of LOP indicator targets, AgirPF proactively 
managed shifting constraints and opportunities in each country. 
Outcome results
AgirPF, working in partnership with government officials, achieved outcomes in terms of systems 
improvements, increases in service quality, access and use, and positive changes in health behaviors 
across the targeted states and districts. The following are AgirPF outcome results throughout the 
project life.
Indicator 2 (SO): Modern contraceptive prevalence rate (mCPR) 
AgirPF measured the current use of FP 
methods during the endline survey (see Endline 
survey and SBCC campaign evaluation section 
below for more). Figure 6 compares the 
mCPR, a key outcome indicator for the 
program’s SO, among women aged 15-49 
years living in the project’s intervention zones 
by the end of the project and the LOP target 
by country. The survey revealed that AgirPF 
achieved the target in Togo (48%), surpassed 
targets in Côte d’Ivoire (48% vs. 34%) and 
Niger (62% vs. 47%), but did not meet the 
target in Burkina Faso (38% vs. 47%). 
Not reaching the target in Burkina Faso was surprising given that in Burkina Faso, the project over￾performed against most of the indicators related to mCPR (number of additional users, total users). 
However, this result seems to be consistent with the most recent estimates of the mCPR in Burkina 
Faso. According to the 2017-2018 round of PMA2020, the mCPR is 26.4% among all women age 15-
49 years old and 30.1% among married women. The data is not disaggregated by area of residence, 
but such a national prevalence may correspond to an incidence in urban and peri-urban areas of 38%. 
In addition, a yet unpublished household survey conducted by the USAID E4D project in charge of 
evaluation and research found a similar mCPR in 2018 (40%) in the AgirPF intervention zone. 
Another surprising finding is the high (62%) mCPR in Niger. For example, in Maradi the mCPR in 
the AgirPF intervention zone was 44.2% according to the baseline assessment versus 6.9% found by 
the DHS 2012. Likewise, the mCPR in the AgirPF intervention area in Niamey was 44.3% at baseline 
compared to 31.8% (DHS 2012). According to the most recent 2016 PMA2020 round, mCPR in 
Niamey was 18.8% among all women and 27.8% among married women. Indeed, further research is 
Figure 6. Achieved mCPR in AgirPF intervention zone 
compared to the LOP targets
The AgirPF Project Endline Evaluation Report 23
needed to identify what makes the intervention zones in Niger so different from the rest of the country 
including the developments that occurred before AgirPF started its interventions. 
In conclusion, AgirPF generally performed well for mCPR with marked variations across the 
countries. The evaluation team found unexpected results in Burkina Faso with a mCPR far below the 
target and Niger with a very high mCPR. While external sources corroborate the accuracy of the 
AgirPF results, the evaluators recommend further research to gain a deeper understanding of the 
questions the data present for the FP community. 
Indicator 5 (IR 1): Percent of FP service providers deemed technically competent 
based on an assessment according to national international or other defined 
standards (USAID RDCS). 
As an outcome under IR 1, AgirPF sought to build the capacity of FP service providers. This outcome,
coupled with the provision of equipment and facilitative supervision, contributed to a substantial 
increase in provider competence. AgirPF measured provider competence with the EngenderHealth 
service quality evaluation tool across three dimensions of service quality including counseling based 
on REDI, and implant and IUD insertion and removal. The project defined competent providers as 
those scoring at least 85% for each of the four quality dimensions. AgirPF carried out competence 
evaluations on a quarterly basis during facilitative supervision. Figure 7 indicates the performance 
trends by country in PY5, demonstrating that only facilities in Niger failed to meet the 85% threshold 
(79% across the three components). Facilities in Niger were particularly weak at IUD insertion and 
removal, which dragged down overall scores. 
85% 81% 81%
100%
87%
95%
85%
99%
87%
72% 70%
99%
BURKINA FASO (N= 
251)
COTE D'IVOIRE (N=86) NIGER (N=43) TOGO (N=75)
REDI Counselling Implant Insertion & Removal IUD Insertion & Removal
Figure 7. Percentage of supervised providers technically deemed competent in REDI counselling, 
implants and IUD insertion and removal, during PY5Q2, by country
The AgirPF Project Endline Evaluation Report 24
Indicator 18 (IR 2): Number of HIPs for family planning and maternal and child 
health and/or HIV/AIDS incorporated into national health protocols or standards 
(USAID RDCS). 
As part of IR 2, AgirPF selected and introduced nine FP High-Impact Practices (HIPs) in all of the 
intervention countries (see table 11) in the second year of the program. AgirPF implemented HIPs 
and continued their demonstration through PY5. AgirPF selected the HIPs based on demonstration 
and magnitude of impact on service utilization, including contraceptive use and continuation 
contribution to ensuring informed choice and volunteerism; and potential replication in a wide range 
of settings. The HIPs were instrumental to the main quantitative achievements as well as qualitative 
achievements regarding countries’ acceptance and willingness to continue their implementation and 
replication in other facilities.
Table 11. AgirPF implemented High-impact Practices (HIPs) by country
HIPs Burkina 
Faso
Côte 
d’Ivoire Mauritania Niger Togo 
Service delivery 
• CHW/Task shifting X No n/a X X
• PACFP X X n/a X X
• FP/MCNH services X X X X X
• Outreach services (FPSD, 
mobile services) 
X X X No X
• SWT X X X No X
• COPE for CS X X No X
• Facilitative supervision X X X X X
Enabling environment 
• Advocacy and policy 
development
X X X X X
Enhancement
• Youth-friendly service 
provision 
X No n/a No X
SBCC custom indicator and outcome indicators 13, 14, and 15. 
During the endline survey, the evaluation team measured a custom USAID indicator not found in the 
PMP and outcome indicators 13-15 (all IR 1) to evaluate AgirPF SBCC campaign results. These 
indicators include:
• USAID Custom Indicator: Percent of audience who recall hearing or seeing a specific USG￾supported Family Planning/Reproductive Health (FP/RH) message; 
• Indicator 13: Percent of men and women with gender-equitable attitudes (indicator 13); 
• Indicator 14: Proportion of women citing lack of information on FP methods as a key barrier 
to use; and 
The AgirPF Project Endline Evaluation Report 25
• Indicator 15: Percent of women who discussed FP with husbands/partners, friends/family 
within the last 3 months. 
These indicators were developed in collaboration specifically for the SBCC activities that began half 
way through the project. In many cases, the program therefore lacked baseline data from which to 
measure behavior change. Capturing change was further complicated by the diversity of SBCC 
activities and the audiences they targeted (Endline survey and SBCC campaign evaluation section).
USAID Custom Indicator: Percent of audience who recall hearing or seeing a 
specific USG-supported Family Planning/Reproductive Health (FP/RH) message
Figure 8 and figure 9 show the percentage of women and men, respectively, who reported being 
reached by at least one of the SBCC activities (disaggregated by intervention zone and nonintervention 
zone). Figure 8 shows that the percentage of women reached with a USG-supported FP/RH message 
varied significantly across the four countries with significant differences between the intervention and 
the nonintervention areas. The campaign in Niger reached 75% of women in the intervention area 
and 82% in the nonintervention area, which was far greater than the other countries. However, the 
campaign lasted longer in Niger than in the other countries, especially the radio broadcasts, which is 
consistent with the data. SBCC campaign activities reached fewer than 16% of women in Côte 
d’Ivoire, as well as 14% of the women in the intervention area and 23% in the nonintervention area 
in Burkina Faso. In Togo, 40% of the surveyed women heard or saw a USG-supported FP/RH 
message. The various differences in reach are the result of the highly tailored and varied SBCC 
strategies used across the countries (see the The AgirPF SBCC campaign: messaging reach by activity and 
country section for more). Figure 9 patterns for men are very similar to those for women, except that 
Figure 8. Percentage of women who heard or saw a USG-supported FP/RH message by zone and 
country
The AgirPF Project Endline Evaluation Report 26
the difference between the intervention and nonintervention area is significant only in Burkina Faso, 
where twice as many men were reached in the nonintervention area than in the intervention area. This 
is largely a reflection of one of the most successful SBCC activities in Burkina Faso targeting men 
specifically. 
Indicator 13 (IR 1): Percent of men and women with gender-equitable attitudes (USAID 
RDCS)
This modified gender indicator measures to what extend gender-related issues impeded FP use in 
AgirPF implementing countries. The endline evaluation results revealed that gender-related issues 
(own opposition, husband/partner opposition, others’ opposition, religious prohibition) are still 
relatively frequent reasons for non-use in some countries (17% among women in the nonintervention 
areas of Burkina Faso and 11% among women in the intervention areas of Burkina Faso and the 
nonintervention area of Côte d’Ivoire). Among men, gender-related issues were cited by 10% to 18% 
in nonintervention zone in Côte d’Ivoire, Niger, and Togo and the intervention areas of Burkina Faso 
and Niger. It is notable that there was less opposition to FP in every country among women and men 
in the intervention zones, except for women in Niger, which suggests that program may have had an 
impact at reducing stigma and improving gender-equitable attitudes, at least as they pertain to FP.
Indicator 14 (IR 1): Percent of women citing lack of information on FP methods as a key 
barrier to use
In AgirPF implementing countries, women and men citing lack of information as a key barrier to FP 
use was still high. Figure 10 shows that a high percentage of the population is not using an FP method 
for lack of information, especially in Burkina Faso and Côte d’Ivoire (both sexes) and in Niger (among 
Figure 9. Percentage of men who heard or saw a USG-supported FP/RH message by zone and 
country
The AgirPF Project Endline Evaluation Report 27
men). There is no significant difference between the intervention and the nonintervention areas. In 
particular, the percentage of women not using FP for lack of knowledge varies from 11% to 13% in 
Burkina Faso and Côte d’Ivoire and is under 4% in Niger and Togo. Among men, the percentage is 
higher: from 15% to 17% in Burkina and Côte d’Ivoire, 8 to 10% in Niger and 3% in Togo. The data 
indicates that there is still a long way to go in terms of sensitization about FP and SBC in Burkina, 
Côte d’Ivoire, and Niger. 
 
Figure 10. Percentage of the respondents citing lack of knowledge as a key barrier to FP use (either 
because they do not know about FP at all or they know about FP but lack more information)
 (*) Statistically significant at 5% (-) Not statistically significant at 5%
Indicator 15: Percent of women who discussed FP with husbands/partners, 
friends/family within the past three months
One of the expected results of the SBCC campaign was that couples would discuss FP more frequently 
than before to facilitate joint decision making. The evaluators asked respondents how often they 
discussed FP with their partner over the past three months. Figure 11 gives the percentages of couples 
who reported at least one discussion with the partner over the period. 
The results show that the prevalence of couple’s discussion varies a lot across the countries and, in 
some cases, significantly between the intervention and nonintervention areas. In contrast, there are 
only small gender variations. Discussion about FP is relatively frequent in Niger where half of the 
women reported it (55% in the intervention area and 50% in the nonintervention area). One-third of 
the women in the intervention area of Côte d’Ivoire and Togo reported dialogue about FP with their
partners, compared to 23% in the nonintervention area in Côte d’Ivoire and 30% in Togo. Men in 
Togo report couple’s discussions about FP far more (46% and 41% in the two areas) than women 
(33% and 30%). Burkina Faso stands out with: (i) the lowest percentage of women and men reporting 
The AgirPF Project Endline Evaluation Report 28
discussion with the partner about FP (30% and below); and (ii) being the only country where couple 
discussion is more frequent in the nonintervention area. 
Endline survey and SBCC campaign evaluation 
In order to assess whether or not AgirPF SBCC interventions made a difference, the evaluation team 
compared performance indicator results in the intervention and nonintervention areas. The endline 
survey measured knowledge, attitudes, and FP practices through exposure to FP messages (through 
AgirPF SBCC Campaign), knowledge of FP (knowledge of any method, modern method, 
LARCs/PMs), use of FP methods (past and current use, method mix, reasons not using FP), 
Discussions about FP between partners/spouses 
Background characteristics of endline survey respondents
The endline survey also included women’s and men’s background characteristics linked to FP 
knowledge, attitudes, and practices such as duration of residence in the surveyed area, age group, 
marital status, education, and number of living children. The evaluators controlled for these variables 
when evaluating the differences between the intervention and the nonintervention areas (see table 12). 
The time duration in the intervention area is an important element in explaining the chances of 
exposure to program interventions. As shown in the table above, most women surveyed in different 
countries (from 60% in Togo to 80% in Niger) resided in the intervention area at least five years (or since 
the beginning of the project in 2013). But the duration of residence varied by country. For example, 70% of 
women in Burkina Faso, 72% of women in Côte d’Ivoire, and 76% of women in Niger resided in the area 
of intervention for more than five years. There was no significant difference in the duration of residence 
Figure 11. Percentages of women and men reporting having discussed FP with their partners during the past three 
months, by zone and country
(*) Significant at 5% (-) Not significant at 5%.
The AgirPF Project Endline Evaluation Report 29
between women in the intervention and nonintervention areas, except in Burkina Faso, where 70% of the 
women in the intervention area resided for five years or more compared to 66% in the nonintervention area.
In terms of age distribution, there was no significant difference between age groups in the intervention 
and the nonintervention zones except in Burkina Faso where 4% less women were in the 40-49 years 
old age group (11%) than in the nonintervention area (15%). This difference could be simply due to 
hazard in recruiting respondents. 
Table 12. Comparison of the background characteristics of the female respondents living in the 
intervention and nonintervention areas, by country
Background 
characteristics
Burkina Faso Côte d'Ivoire Niger Togo
Interv. Non￾interv. Interv. Non￾interv. Interv. Non￾interv. Interv. Non￾interv.
N 2,045 813 2,205 922 746 455 1,047 525
Duration of residence (*) (-) (-) (-)
0-1 year 13.1% 12.7% 10.1% 8.9% 6.7% 4.8% 0.0% 0.0%
2-4 years 16.7% 20.9% 18.0% 15.8% 16.6% 15.2% 36.8% 40.3%
5+ years 70.2% 66.4% 72.0% 75.3% 76.7% 80.0% 63.2% 59.7%
Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
Age group (*) (-) (-) (-)
15-19 20.4% 22.1% 18.7% 16.8% 14.6% 10.3% 16.2% 14.1%
20-24 19.6% 18.1% 18.8% 18.9% 23.1% 23.1% 21.3% 19.2%
25-39 48.5% 44.4% 49.6% 51.4% 51.2% 52.5% 46.2% 51.9%
40-49 11.5% 15.4% 12.8% 12.9% 11.1% 14.1% 16.3% 14.8%
Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
Marital status (-) (-) (*) (*)
Currently in union 62.1% 62.9% 54.5% 50.4% 97.6% 93.4% 65.8% 72.8%
Single 34.6% 32.3% 42.6% 47.1% 1.1% 3.1% 29.6% 22.4%
Formerly in union 3.3% 4.8% 2.9% 2.5% 1.3% 3.5% 4.6% 4.8%
Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
Education (*) (*) (-) (*)
No education 31.6% 38.0% 21.1% 23.6% 54.0% 57.6% 13.2% 16.3%
Primary 26.2% 27.1% 25.9% 31.7% 25.6% 22.9% 27.1% 32.0%
Secondary 20.5% 21.2% 22.6% 19.0% 16.0% 13.8% 38.3% 35.4%
High school 15.1% 8.5% 19.2% 16.6% 2.7% 4.0% 12.6% 10.9%
University 6.6% 5.3% 11.2% 9.1% 1.7% 1.8% 8.8% 5.4%
Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
Number of living children (-) (-) (-) (*)
Mean number of living 
children 1.8 1.9 1.8 1.7 3.6 3.6 1.8 2.1
(-) Difference between the zones not significant at the 5% level (*) = Difference significant at the 5% level
The distribution of the surveyed population by marital status varied widely in the selected countries. 
In Niger nearly 98% of the surveyed women lived in a union (either married or in a consensual union), 
which is a reflection of the country’s highly Islamic culture. As such, reproduction and fertility in Niger 
are viewed and discussed almost exclusively though the context of marriage, and entry into unions 
occurs much earlier than in the other study countries. In contrast, the percentage of women living in 
a union in Côte d’Ivoire (50%), Burkina Faso (62%), and Togo (73%), where common-law unions are 
much more permissible, demonstrated a much wider range. The difference in the distribution between 
the intervention and the nonintervention areas was not significant in Burkina Faso and Côte d’Ivoire, 
The AgirPF Project Endline Evaluation Report 30
while there were significant differences in the percentage of women living in a union in Niger (98% 
in the intervention area, 94% in the nonintervention area) and Togo (66% in the intervention area, 
73% in the nonintervention area (94%). 
The level of education of the surveyed women varied significantly between the intervention and the 
nonintervention areas in Burkina Faso, Côte d’Ivoire, and Togo. Education varied from one country 
to another, but also within the same country according to the area of residence. Overall, women living 
in the nonintervention areas were less educated than those living the intervention areas. Taking into 
account the countries of residence, Niger’s education rate is lowest. Indeed, more than the half of 
women (54%-58%) had no education at all. This is in contrast to much lower rates of no education in 
Togo (13%-16%), Côte d’Ivoire (21%-24%), and Burkina Faso (32%-38%). 
The average number of living children per woman varied significantly, ranging from Niger (3.6) to 
Burkina Faso, Côte d’Ivoire, and Togo (between 1.8 and 2.1). The differences between the 
intervention and the nonintervention areas were not significant, except in Togo where women in the 
intervention area have a significantly lower number of children (1.8) than those living in the 
nonintervention area (2.1). The high average number of children per women in Niger may be explained 
by the aforementioned differences in marital status patterns between Niger and the other countries. 
Table 13 compares selected background characteristics of the men living in the intervention and 
nonintervention zone including duration of residence, age, marital status, and education. Differences 
in the background characteristics of men in Burkina Faso and Côte d’Ivoire are not significantly 
different, but they are in Niger and Togo, thus the need to control for the background characteristics 
when analyzing mCPR.
Table 13. Comparison of the background characteristics of the male respondents living in the intervention 
and nonintervention areas, by country
Background 
characteristics
Burkina Faso Côte d'Ivoire Niger Togo
Interv. Non￾interv. Interv. Non￾interv. Interv. Non￾interv. Interv. Non￾interv.
N 886 377 1,184 461 331 240 537 272
Duration of residence (-) (-) (*) (-)
0-1 year 8.7% 7.7% 7.3% 6.1% 6.3% 2.1% 18.2% 15.8%
2-4 years 14.6% 11.7% 17.1% 14.5% 16.0% 12.5% 22.5% 16.5%
5+ years 76.7% 80.6% 75.6% 79.4% 77.6% 85.4% 59.2% 67.6%
Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
Age group (-) (-) (-) (*)
15-19 17.9% 18.8% 15.5% 15.4% .6% 0.0% 13.0% 10.3%
20-24 18.5% 17.8% 14.3% 14.8% 6.0% 4.6% 20.9% 15.4%
25-39 44.9% 42.2% 45.0% 46.2% 49.8% 47.9% 46.6% 47.8%
40-49 18.6% 21.2% 25.3% 23.6% 43.5% 47.5% 19.6% 26.5%
Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
Marital status (-) (-) (*) (*)
The AgirPF Project Endline Evaluation Report 31
Background 
characteristics
Burkina Faso Côte d'Ivoire Niger Togo
Interv. Non￾interv. Interv. Non￾interv. Interv. Non￾interv. Interv. Non￾interv.
Currently in union 48.5% 54.1% 48.1% 48.2% 96.4% 99.2% 51.0% 60.7%
Single 50.7% 45.4% 50.5% 50.1% 3.6% .8% 48.2% 36.4%
Formerly in union .8% .5% 1.4% 1.7% 0.0% 0.0% .7% 2.9%
Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
Education (-) (-) (-) (*)
No education 21.1% 27.9% 10.8% 9.1% 43.2% 47.1% 2.8% 5.5%
Primary 17.6% 20.2% 15.9% 21.0% 20.2% 15.8% 16.6% 21.7%
Secondary 22.0% 25.7% 22.5% 26.7% 16.0% 20.0% 31.3% 36.4%
High school 21.2% 14.9% 28.5% 23.4% 12.1% 8.8% 25.9% 23.2%
University 18.1% 11.4% 22.4% 19.7% 8.5% 8.3% 23.5% 13.2%
Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
 (-) Difference between the two zones not significant at the 5% level (*) = Difference significant at the 5% level
The AgirPF SBCC campaign: Messaging reach by activity and country
The objective of AgirPF’s SBCC component was to provide a unifying strategic framework for social 
and behavior change around FP in the region. In each country, the goal was to define a strategy that 
would excite and inspire stakeholders to adopt new behaviors. During its last two years, AgirPF 
implemented various SBCC activities in four of its five intervention countries (with the exception of
Mauritania) selected based on the findings of an innovative research approach. 
In 2013, the William & Flora Hewlett Foundation commissioned Hope Consulting to study how FP 
programs could improve communication strategies using commercial segmentation: identifying 
segments of women with common FP needs, attitudes, and behaviors, rather than common 
demographic characteristics. The study identified five segments: Modern Elites, Healthy Proactive, 
Traditional Autonomists, Conservative Passives, and Sheltered Skeptics. 
With technical support from Camber Collective, AgirPF used this approach to pilot an SBCC strategy 
for Niger. During the segmentation process, women fell into five groups, each with different FP needs, 
attitudes and behaviors as seen figure 12. AgirPF decided to extend this new approach to the other 
implementation countries with the rationale that similarities in population size and culture would allow 
the approach to be successful. AgirPF then used a series of qualitative research studies, in combination 
with a re-analysis of key components of the project’s baseline results, to validate the segments in 
Burkina Faso, Togo, and Côte d’Ivoire and develop a systematic and evidenced-based SBCC strategy, 
which targeted women, men, youth and other influencers. Applying commercial marketing principles, 
this SBCC strategy continued in Niger, followed by Togo, Burkina Faso and Côte d’Ivoire. A diverse 
set of approaches were used to target these different priority segments and their influencers, including 
printed materials, social media, radio shows, videos, community outreach activities, interpersonal 
communication and an Inter Voice Response system (IVR). 
In each country, the strategy led to an SBCC campaign. AgirPF organized workshops and meetings 
with ministers and other stakeholders to validate strategies, launch SBCC campaigns, and ensure that 
The AgirPF Project Endline Evaluation Report 32
the segmentation approach supported and strengthened existing SBCC campaigns. AgirPF also signed 
sub-grants with local communication agencies and marketing organizations to develop campaign tools 
and implemented the main activities. 
For the ease of data collection, in each country survey participants were asked a limited number of 
questions to capture the exposure to these different activities of the campaign (the list is provided in 
Table 6 in the Overview section). 
Burkina Faso 
In Burkina Faso, SBCC activities consisted of the following: 
• Activities that surrounded promoting the behavior of an “upstanding man” or Nintringa.”15 
These activities included:
o Interactive debate sessions on two local radio and three TV programs promoting 
the desirable behavior of an “upstanding man” planning his family 
 
15 An upstanding man is a man of integrity, caring for his family and already using family planning; a man that everyone in 
his community wants to emulate and called in local language “Nintiriga”.
Figure 12. Nigeria segmentation example
The AgirPF Project Endline Evaluation Report 33
o Recorded 55 reactions (15 of which were on video) during the radio debate 
sessions, to promote the "upstanding man" concept and to share personal 
experiences in SRH including PF 
o Rebroadcasted and continued discussions around the “upstanding man" concept 
on the two radio stations and Facebook TV (@nintiriga ou l’homme modèle) 
o Pre-tested, validated, and used three posters of the "upstanding man" and his 
family to moderate discussions during the TV broadcasts 
o Developed a song and a video clip to promote the “upstanding man” concept on 
TV and radio and during FP special days’ events; created a Facebook page to 
display campaign tools, group discussion reports with couples and youth, photos, 
and other campaign information 
• AgirPF developed a three-episode comic book, “Assibi et Salifou: la première fois” to improve 
youth and adolescent knowledge on SRH information and services in Togo. This comic book 
was adapted to the country context of Burkina Faso as “Tene et Ali; la premiere fois.” The 
Tene et Ali Facebook page was also used to host discussions related to youth SRH. 
Figure 13 shows that the Nintriga activities reached the highest target audience percentage in the 
intervention (12%) and the nonintervention areas (28%), while the two Ali & Tene activities reached 
an average of 3% of all respondents. Finally, the percentage of men and women reached is significantly 
higher in the nonintervention than in the intervention area for the Nintringa activities and for the Ali 
& Tene Facebook page. The rational explanation of this result is contamination given the near 
impossibility of concentrating the campaign on the targeted facilities only in an urban or peri-urban 
area.
 
Figure 13. Percentage of women and men reached by different SBCC activities implemented in Burkina Faso
The AgirPF Project Endline Evaluation Report 34
Côte d’Ivoire 
AgirPF implemented a diverse set of SBCC activities in Côte d’Ivoire (see figure 14 and below):
• Produced, pretested, and used five videos to facilitate couple’s discussion sessions on FP in 
Abidjan; organized group discussion sessions for 600 couples using the videos on FP couple 
interaction
• AgirPF developed a three-episode comic book, “Assibi et Salifou: la première fois” to improve 
youth and adolescent knowledge on SRH information and services in Togo. This comic book 
was adapted to each country context Cote d’Ivoire and became known as “Safi et Léo: la 
premiere fois.”
• Organized young people's group sessions on sexual and reproductive health for 200 young 
people (20 to 25 years old) about how to start an FP conversation with parents and how to 
deal with peer pressure; seventy couples participated in these sessions via the Safi et Léo 
Facebook page (https://www.facebook.com /SAFIetLEO/) and national radio (radio CÔTE 
D’IVOIRE) during three talk shows 
• Developed a free, fun Android application, Plan my Life, for contraceptive decision-making 
and to encourage young people to create open and honest lines of communication about FP; 
promoted the app, which is available on Google Play, with Facebook advertisements 
developed by IROLINE and flyers placed in trendy locations in Abidjan
Youth talks had the highest reach among women (11%) and men (16%) in the intervention and 
nonintervention areas. Couple discussions about FP reached 9% of women and 11% of men. The 
remaining three activities reached less than 6% of the surveyed population. Overall, the activities 
reached a higher percentage of men than women in the intervention and the nonintervention zones. 
All five activities reached more women in the intervention zones than in the nonintervention zones, 
although the difference is not statistically significant for couple talks and the Safi & Leo Facebook 
page. For men, there is no statistically significant difference between the percentages reached in the 
zones except for the “Plan My Life” mobile app. Indeed, significantly more men in the 
nonintervention area reported having heard about the app (5.2%), compared to 4.2% in the 
intervention area. 
In Côte d’Ivoire, AgirPF also supported the diffusion of messages about responsible parenting and 
birth spacing in places of worship such as mosques, churches, and temples. The endline evaluation 
survey reveals that among women, 14.4% of respondents in the intervention area and 21.5% in the 
nonintervention heard about responsible parenting and birth spacing in places of worship, whereas 
the messaging reached 17.8% of men in the intervention area and 23.1% in the nonintervention area. 
However, it difficult to know if these messages were USG-supported. For instance, it is possible that 
The AgirPF Project Endline Evaluation Report 35
an imam talked about responsible parenting, and even FP. As such, the evaluation team did not 
account for its FP messaging in places of worship when computing the percentage of women and 
men that heard or saw a USG-supported FP message. 
Niger
In Niger, AgirPF conducted the following SBCC activities:
• Developed and tested five posters to help the Sheltered Skeptics and Healthy Proactive 
segments to manage the side effects of contraceptives; distributed 400 copies to 36 
intervention sites and five private health facilities. Produced five radio spots in two local 
languages (Haoussa and Djerma) broadcasted by five community radio stations (two in 
Niamey and three in Maradi) to help Sheltered Skeptics discuss FP with their spouses and 
peers
• Organized a word of mouth campaign whereby 140 Healthy Proactives (80 in Niamey and 60 
in Maradi) provided testimonials about their experience with FP and how they handled 
difficulties such as side effects and stigmatization 
• Recorded 12 testimonials and 16 messages on contraceptive methods in Haoussa and Djerma; 
tested and placed them on the IVR platform in collaboration with Voto Mobile, international 
agency for interactive voice response (IVR). 
The interviewers asked respondents in Niger about their exposure to AgirPF SBCC activities; figure 
15 summarizes the responses to these questions. A majority of the respondents reported seeing or 
hearing a message about side effects management including 66% of women and 77% of men in the 
intervention area and 80% of women and men in the nonintervention area. The percentage is 
significantly higher in the nonintervention area; note that this information was aired through radio 
talks and was likely heard in intervention and nonintervention zones alike. The second most popular 
Figure 14. Percentage of women and men reached by different SBCC activities implemented in Côte d’Ivoire
The AgirPF Project Endline Evaluation Report 36
activity, “received a free FP services coupon,” reached 22% of the women in the intervention area. 
Less than 9% of the men received free coupons. In West Africa in general and in Niger in particular, 
men usually do not go to FP facilities. It is therefore not suprising men received fewer coupons. The 
differences between the percentage of respondents reached in the intervention and the 
nonintervention area are not statistically significant for the free FP services coupon and the IVR. 
Twelve percent of women and 16% of men heard about the IVR in the intervention zones. 
In addition to conducting the 
household survey, the evaluation 
team analyzed first-hand data from 
the IVR server related to the calls 
received (see table 14). The system 
connected 94% or 1,027 calls out of 
1,089 trials, resulting in 2,702 
question-answer exchanges between 
the server and the callers over the 98 
day period. Out of 766 calls that 
reached the introductory message, 
62% selected the first choice offered 
by the server, “basic information 
about the FP methods,” compared to 
38% for the second choice, “FP users’ 
testimonials”. This discrepancy in number of subscribers compared to the completed calls is due to 
the frequent trouble in internet connection. The high number of questions on primary FP information 
Table 14. AgirPF SBCC campaign interactive voice response 
(IVR) data in Niger, November 1, 2017 to February 6, 2018 
Indicator Value
Total number of calls received 1,089
Number of calls connected 1,027
Number of calls completed 618
Number of unique subscribers 392
Number of first-time Subscribers 384
Number of question-answers 2,702
Mean duration for all calls 1.4 minutes
Mean duration for completed calls 1.7 minutes
Multiple choice questions
Dial 1 : To receive information about the FP methods
Dial 2 : To listen to FP users’ testimonials 
Answers
1. FP methods 62.3% 477
2. Users’ testimonials 37.7% 289
Total 100% 766
Figure 15. Percentage of women and men reached by SBCC activities implemented in Niger
The AgirPF Project Endline Evaluation Report 37
corroborate recent research findings from the Camber Collective highlighting that women and their 
partners have a critical need for information about RH/FP from reliable sources.16
Figure 16 shows the distribution of the callers inquiring about basic information about FP methods 
by method selected. Out of the 458 callers to receive information about the FP methods offered in 
Niger, 41% asked about pills, followed by injectable contraceptives and male condoms (16% 
respectively). Few callers asked about female condoms (3%) and LARCs/PMs—implants (9%), tubal 
ligation (8%), IUD (6%), and vasectomy (1.5%). This is consistent with the popularity of pills and 
injectable contraceptives among female FP users and weak interest about vasectomy in the country. 
The same pattern is observed for the calls that 
selected the second option related to FP users’ 
testimonials (figure 17). In fact, out of the 271 
calls received, 61% selected user testimonials 
from pill users, 17% from injectable 
contraceptive users, and 14% from implant 
users. 
Noticeably, the callers were more interested in 
how to use the methods rather than on their 
side effects, except for the permanent methods 
(tubal litigation and vasectomy) for which the 
majority wanted to learn more about the side 
effects. Out of 458 calls, 302 selected reversible 
 
16 Planification Familiale, “Vive mobilisation pour le projet d’Analyse de Demande Nationale de la Fondation Hewlett 
“https://partenariatouaga.org/vive-mobilisation-pour-le-projet-danalyse-de-demande-nationale-de-la-fondation￾hewlett/ 
Figure 16. Distribution of the calls about basic 
information for FP methods by method
Figure 17. Distribution of the calls to listen to users’ 
testimonials by method 
Figure 18. Distribution of the calls inquiring about the 
methods according to the information requested
The AgirPF Project Endline Evaluation Report 38
methods and 36 permanent methods. For the reversible methods, between 56% and 77% wanted to 
know about the definitions and the instructions for use of the method. In contrast, for the permanent 
methods, the side effects mattered more: 53% of the callers asked about them for tubal ligation and 
50% for vasectomy.
Togo 
For SBCC activities in Togo, AgirPF carried out the following:
• Developed and tested five posters and five flyers to help Healthy Proactive segments and 
health professionals to manage the side effects of contraceptives; printed 1,100 posters and 
24,000 flyers for 48 AgirPF supported sites and five private health facilities; produced and 
broadcasted 20 radio programs including interactive FP debate sessions in Lomé (10), Sokodé, 
(5) and Kara (5) 
• Recorded five videos of sketches about problematic family planning interactions between 
partners to facilitate 20 couple’s discussion sessions in the three cities. Overall, 300 couples 
participated in the sessions including 150 in Lomé, 75 in Kara and 75 in Sokodé
• With the support of the US Embassy in Lomé, AgirPF developed a three-episode comic book, 
“Assibi et Salifou: la première fois” to improve youth and adolescent knowledge on SRH 
information and services (adapted as above in Burkina Faso and Côte d’Ivoire). 
In Togo, the respondents were asked about their exposure to the AgirPF SBCC campaign: diffusion 
of messages on the management of FP method side effects, couples’ discussions about FP, and the 
“Assibi et Salifou” comic book (see figure 19). As in Niger, the messages on the management of FP 
methods’ side effects reached more women and men in the intervention and the nonintervention areas 
than the other campaign elements. Overall, between 7% and 11% of women and men participated to 
the couples’ discussions in the two areas. Similar percentages read the comic book. 
The differences between the intervention and nonintervention areas are not significant among men 
and women for all activities except for the comic book for which significantly more men in the 
intervention areas have read it (9%) compared to men in the nonintervention area (7%). There are 
slight gender differences in the percentage reached by the SBCC activities in the intervention area. In 
contrast, in the nonintervention area, more men have heard about the messages on the management 
of FP method side effects than women and fewer read the comic book. Men also reported less 
participation to the couples’ discussions.
The AgirPF Project Endline Evaluation Report 39
Figure 19. Percentage of women and men reached by different SBCC activities implemented in Togo
Conclusion on the evaluation of the SBCC campaign 
In Year 3 and 4, AgirPF used an innovative method to design its SBCC activities and target the right 
audience for each activity. Because the campaign started late in the project, the SBCC campaigns 
lacked baseline data from which to track overall patterns of change. The so-called segmentation
approach, originally a marketing approach, yielded activities designed reach each segment with a clear 
idea and a clear objective rather than a one-size-fists-all approach. In doing so, this approach can be a 
powerful tool in a context of limited resources; decision makers and implementers can focus resources 
and programming on the segments most likely to change their behavior. The implementation of this
approach in the AgirPF context helped reach target populations (living in the intervention zone) and 
beyond (living in the nonintervention zone) with messages and experiences that have the potential to 
increase acceptance and use of FP use, including messages countering false rumors related to FP 
methods; experience sharing with users; and education on youth and adolescent sexuality through 
youth friendly channels (social media). 
However, further research to examine whether the SBCC campaigns contributed to increased levels 
of FP information-seeking, positive attitudes about FP, and actual FP use needs to be conducted to 
definitively establish its effectiveness. 
AgirPF impact on knowledge and use of family planning methods 
This section’s analysis goes into deeper findings about the differences in the knowledge and use of FP 
between the intervention and the nonintervention areas and across the respondent’s background 
characteristics in order to evaluate AgirPF’ impact. 
The AgirPF Project Endline Evaluation Report 40
Knowledge of family planning
Knowledge of FP is measured through three indicators: the percentage of respondents who have ever 
heard about FP methods of any kind, the percentage who have heard about a modern FP method(s), 
and the percentage who have heard about long-acting reversible contraceptives and permanent 
methods (LARCs/PMs). 
Knowledge of any type of FP method 
Knowledge of FP was widespread in all four countries. The percentage of men and women who have 
heard about FP varies between 91% and 98% in Niger and Togo and between 84% and 90% in 
Burkina Faso and Côte d’Ivoire. Knowledge is slightly higher among women than among men in all 
countries and in the intervention and nonintervention areas (figure 20). 
Knowledge of FP does not vary significantly across the intervention and nonintervention areas except 
among women in Togo, where the difference is tiny (97% in the intervention area vs. 98% in the 
nonintervention area). 
Knowledge of FP evolved differently over time across the countries (figure 21). In Togo, knowledge 
was already widespread at baseline but increased from 93% to 97% in the intervention area and from 
94% to 98% in the nonintervention area. In Niger, knowledge increased from 96% to 97% in the 
intervention area and 98% in the non-intervention area, respectively. FP knowledge increased 
significantly in the nonintervention area in Côte d’Ivoire from 83% to 90%, yet decreased slightly in 
the intervention zone (90% to 88%). 
Figure 20. Percentage of women and men who have 
heard about FP methods by zone and country
(*) Significant at 5% (-) Not significant at 5%
Figure 21. Comparison between the percentage of 
women who know an FP method between the baseline 
and the endline, by zone and country
The AgirPF Project Endline Evaluation Report 41
In Burkina Faso, there was a slight decline in FP knowledge in both intervention and non-intervention 
areas, which mirrors some of the puzzling findings about mCPR discussed in the Results section. 
Near-universal knowledge of FP in most of the areas surveyed at baseline left little room for 
improvement for new interventions. Therefore, the impact of the project is not captured efficiently 
through this indicator on overall FP knowledge, but rather through knowledge of specific FP 
methods (see Methods known, below). 
Knowledge of modern methods 
Knowledge of modern FP methods is nearly as 
widespread in the intervention and 
nonintervention areas as knowledge of FP 
methods of any type (see figure 22). The 
percentage of men and women who have heard 
about modern FP methods varies from 96% to 
98% in Togo, 90% to 98% in Niger 84% to 89% 
in Côte d’Ivoire and 83% to 88% in Burkina 
Faso. Women know more about modern FP 
than men, but differences are small. Differences 
in knowledge of modern FP do not vary 
significantly across the intervention and 
nonintervention areas except among women in 
Togo, where the difference is tiny (96% in the intervention area vs. 98% in the nonintervention area).
Knowledge of long-acting reversible contraceptives and permanent methods 
(LARCs/PMs) 
Knowledge of long-acting reversible 
contraceptives and permanent methods 
(LARCs/PMs) is less widespread than 
knowledge of any type of methods and of 
modern methods (see figure 23). However, the 
percentage having heard about LARCs/PMs is 
relatively high in Togo (80-87%) and among 
women in Niger (88-92%) and Burkina Faso 
(74-77%). LARCs/PMs are less known in Côte 
d’Ivoire (43-61%) and among men in Burkina 
Faso and Niger (63-70%). Knowledge of 
LARCs/PMs is significantly higher in the 
intervention area than in the nonintervention 
area in Côte d’Ivoire (61% vs. 54% among 
Figure 23. Percentage of women and men who have 
heard about LARCs/PM by zone and country
(*) Significant at 5 (-) Not significant at 5%
Figure 22. Percentage of women and men who have 
heard about modern FP methods by zone and country
(*) Significant at 5 (-) Not significant at 5%
The AgirPF Project Endline Evaluation Report 42
women and 49% vs. 43% among men). It is also higher in Burkina Faso, but the difference is not 
statistically significant. In Niger and Togo, the percentage of women and men that know about
LARCs/PMs is higher in the nonintervention areas, but the difference is not significant. 
 
Methods known 
Table 15. Percentage of the respondents who heard about specific method, by sex, area, and country
Method
Burkina Faso Côte d’Ivoire Niger Togo
Women Men Women Men Women Men Women Men
Interv. Non￾interv. Interv. Non￾interv.
Interv. Non￾interv. Interv. Non￾interv. Interv. Non￾interv. Interv. Non￾interv. Interv. Non￾interv. Interv. Non￾interv.
N 2,073 718 886 377 2,205 922 1,184 461 746 455 331 240 1,047 525 537 272
Female 
sterilization 18% 19% 16% 15% 18% 16% 22% 19% 26% 23% 21% 15% 32% 36% 34% 35%
Male 
sterilization 13% 11% 12% 11% 8% 8% 15% 12% 17% 14% 17% 8% 21% 25% 24% 24%
IUD 45% 47% 30% 23% 23% 21% 20% 20% 63% 55% 25% 24% 53% 55% 39% 42%
Implants 69% 67% 59% 55% 55% 48% 39% 31% 75% 81% 47% 64% 82% 83% 72% 77%
Injectable 73% 73% 59% 61% 74% 70% 65% 59% 89% 93% 65% 80% 86% 90% 81% 85%
Pills 82% 82% 75% 77% 84% 84% 79% 73% 95% 97% 88% 90% 82% 82% 75% 74%
Male 
condoms
58% 56% 73% 72% 74% 80% 83% 81% 39% 40% 53% 55% 91% 93% 96% 96%
Female 
condoms 
34% 30% 34% 26% 52% 54% 55% 54% 25% 23% 21% 15% 75% 79% 80% 78%
Emerg. 
Contr. 18% 13% 22% 11% 28% 29% 24% 21% 3% 3% 2% 2% 21% 18% 26% 17%
Spermicides
/Foam 9% 12% 8% 10% 11% 10% 13% 11% 6% 3% 3% 3% 13% 16% 17% 15%
SDM 22% 25% 17% 16% 20% 25% 20% 24% 6% 5% 4% 4% 34% 30% 29% 30%
LAM 11% 14% 6% 6% 13% 13% 8% 7% 39% 44% 24% 25% 26% 30% 20% 22%
Rhythm 
method 23% 32% 20% 20% 38% 44% 32% 43% 4% 3% 6% 4% 66% 70% 64% 69%
Natural FP 11% 18% 12% 13% 11% 14% 10% 9% 4% 5% 4% 6% 30% 28% 31% 31%
Withdrawal 13% 14% 21% 12% 20% 23% 30% 37% 4% 7% 10% 13% 40% 43% 56% 63%
Percentage for which difference between the intervention and the nonintervention areas is statistically significant at the 5% level (T-test) are 
highlighted in grey
For each FP method, table 15 compares the percentages of respondents in the intervention and 
nonintervention areas who have heard about it by sex and country. The results reveal the following: 
• The most known methods by women are pills (from 82% to 97%), injectable contraceptives 
(70%-93%), and implants (67%-83%, except in Côte d’Ivoire where the percentage is 55% in 
the intervention area and 48% in the nonintervention area). Male condoms are also well known 
The AgirPF Project Endline Evaluation Report 43
by women as a contraceptive method in Côte d’Ivoire (74%-80%), as well as male and female 
condoms in Togo (75%-93%).
• The most known methods by men are pills (73%-90%), injectable contraceptives (65%-80% 
in Niger and Togo, 59%-65% in Burkina Faso and Côte d’Ivoire), male condoms (72%-96%, 
except in Niger), female condoms, and implants in Togo (72%-80%).
• The least known methods (by less than 20% of the respondents) are spermicides/foam, 
emergency contraception (except in Côte d’Ivoire), male sterilization, and natural FP (except 
in Togo). 
• For the majority of the methods, there is no significant difference between the intervention 
and nonintervention areas. 
• By country, Burkina Faso and Côte d’Ivoire have more significant differences between the 
two areas, followed by Niger. In Togo, knowledge of FP does not vary by area.
The comparison between the intervention and nonintervention areas shows that in case of 
significant differences, the percentage is generally higher in AgirPF zone. Some exceptions exist 
however, for instance in Niger where some methods are most known outside AgirPF intervention 
zone (injectables, implants, withdrawal) and in Côte d’Ivoire (male condoms, SDM, rhythm method, 
withdrawal). The fact that injectables are most known outside AgirPF zones may be due to the 
introduction of Sayana press in Niger that was an opportunity of mass sensitization on self￾administrated injectables.
Use of family planning methods
Past use of FP methods
The percentage of women and men having ever used an FP method is slightly higher in the 
nonintervention than in the intervention zones, except in Burkina Faso. The percentage of women 
who reported they have used an FP method in the past is relatively high in Côte d’Ivoire, Niger, and 
Togo (from 72% to 87%) as shown in table 16. Those that have ever used FP methods is less 
widespread in Burkina Faso (61% in the intervention zone and 59% in the nonintervention area). The 
usage of modern contraception is less widespread but follows the same pattern. 
There are significant differences in methods that have been used for FP. In Burkina Faso, male 
condoms and pills were equally popular (around 26% of the women have used them as an FP strategy, 
respectively), followed by implants and injectable contraceptives (between 14% and 18%). In Togo, 
male condoms are by far the most popular method with 58% of women in the intervention area and 
55% in the nonintervention area having used them as an FP strategy. Condoms are followed by 
implants, injectables, and pills, with 14% to 22% of the surveyed women reporting use. In Côte 
d’Ivoire, three methods are the most used: male condoms (45% in the intervention area and 60% in 
the nonintervention area), followed by pills (around 30%), and injectables (19% in the intervention 
area and 11% in the nonintervention area). In Niger, pills (around 49%), injectables (26% in the 
The AgirPF Project Endline Evaluation Report 44
intervention area and 31% in the nonintervention area) and implants (18% in the intervention area 
and 22% in the nonintervention area) are popular, yet male condoms were used at a much lower rate 
than other countries (2% in the intervention area, 5% in non-intervention areas). In all countries, 
permanent methods are not popular, with less than 0.5% of women its use. 
Table 16. FP method by zone and country 
Indicators
Burkina Faso Côte d'Ivoire Niger Togo
Interv. Non￾interv. Interv. Non￾interv. Interv. Non￾interv. Interv. Non￾interv.
N 2,045 813 2,205 922 746 455 1,047 525
% who ever used an FP 
method 61.0% 59.4% 72.2% 75.9% 77.3% 80.0% 86.1% 86.7%
% who ever used a 
modern FP method 59.5% 57.8% 68.5% 73.2% 76.4% 78.0% 77.3% 80.2%
Modern Methods
Female sterilization 0.4% 0.2% 0.3% 0.2% 0.3% 0.2% 0.1% 0.2%
Male sterilization 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.1% 0.2%
IUD 4.2% 4.4% 0.5% 1.0% 4.6% 3.5% 3.8% 3.2%
Implant 17.9% 14.5% 5.9% 5.9% 18.4% 21.8% 16.0% 17.5%
Injectable 17.8% 17.6% 18.9% 10.7% 26.0% 31.2% 17.5% 21.9%
Pill 26.6% 26.7% 30.2% 31.0% 50.0% 48.8% 13.9% 17.1%
Male condom 26.3% 24.4% 44.9% 60.2% 2.0% 5.3% 58.3% 54.5%
Female condom 0.6% 0.5% 2.4% 1.8% 1.2% 1.5% 2.9% 2.5%
Emergency 
contraceptive pill 5.1% 1.7% 8.1% 8.7% 0.1% 0.4% 3.7% 1.3%
Spermicide/vaginal 
foaming tablet 0.2% 0.7% 1.2% 0.8% 0.5% 0.0% 0.9% 0.6%
SDM 4.7% 9.0% 12.7% 21.4% 1.7% 2.0% 18.0% 16.8%
LAM 1.2% 1.4% 5.9% 6.9% 10.6% 14.9% 10.6% 11.4%
Traditional methods
Natural FP 2.0% 3.6% 4.9% 7.0% 0.9% 2.9% 17.0% 13.9%
Rhythm/counting days 8.6% 9.7% 27.0% 36.2% 0.1% 1.5% 50.0% 52.8%
Withdrawal 2.4% 1.8% 7.4% 8.2% 0.9% 4.4% 17.1% 19.4%
Other 
Other/Unspecified 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
Current Use of FP Methods
The current use of FP methods was measured through three indicators: 
i. The percentage of respondents using any type of FP method by the time of the survey, i.e.
the contraceptive prevalence rate (CPR); 
ii. The percentage of respondents using a modern FP method by the time of the survey, that 
i.e modern contraceptive prevalence rate (mCPR); and 
iii. The percentage currently using LARCs/PMs. 
The AgirPF Project Endline Evaluation Report 45
Current use of any type of method 
The CPR among men and among women varied widely across the four countries, but not significantly 
between the intervention and the nonintervention areas within each country (figure 24). The CPR
among women ranges from 39% in the intervention zone in Burkina Faso to 64% in the intervention 
zone in Niger. It is higher in Niger, followed by Togo, then by Côte d’Ivoire. The lowest prevalence 
is recorded in Burkina Faso (39% and 42% for the two zones). 
The patterns of CPR among men differed from CPR among women across the four counties. Men in 
Togo have the highest prevalence (64%), followed closely by Niger (60% in the intervention area and 
63% in the nonintervention area). Côte d’Ivoire follows with a prevalence between 50 and 52%. Again,
Burkina Faso had the lowest prevalence (44% in the intervention area and 39% in the nonintervention 
area) 
Current use of modern FP methods 
The current use of modern contraception follows the same pattern as the use of any method, both 
among women and men (figure 25). Modern methods vary significantly across countries, but not 
significantly by zone. Among women, Niger has the highest mCPR (62% in the intervention area and 
57% in the nonintervention area), followed by Côte d’Ivoire and Togo (48% to 51%). Burkina Faso 
lags behind with 38% in the intervention area and 42% in the nonintervention area. 
Among men, Togo has the highest prevalence, closely followed by Niger with mCPR ranging from 
57% to 61%. Niger has an mCPR around 50% while Burkina records the lowest prevalence (44% in 
the intervention area and 39% in the nonintervention). 
 (-) Significant at 5% (*) Not significant at 5%
Figure 24. Contraceptive Prevalence Rate (CPR) among women and men, by zone and country
The AgirPF Project Endline Evaluation Report 46
Current use of LARCs/PMs 
One of the objectives of AgirPF was to support MOHs to improve the availability of the full range of 
FP methods in its supported facilities, including LARCs and permanent methods. Figure 26 below 
examines the usage of LARCs/PMs among women and men in the intervention zone and compares 
their use by those living in the nonintervention area. 
The results show marked variations in the prevalence of the LARCs/PMs across the four countries 
and no significant disparities by zone except in Togo. The results also reveal that contrary to findings 
related to CPR and mCPR prevalence, Burkina Faso, along with Niger, are leading countries in the 
use of LARCs/PMs. Among women living in the intervention area, 13% in Burkina are currently using 
a LARC/PM and 17% in Niger. These percentages reach 18% in the nonintervention area. The 
 (-) Significant at 5% (*) Not significant at 5%
Figure 25. Modern Contraceptive Prevalence Rate (mCPR) among women and men, by zone and country
 (-) Significant at 5% (*) Not significant at 5%
Figure 26. Percentage of women and men currently using LARCs/PMs, by zone and country
The AgirPF Project Endline Evaluation Report 47
percentage using LARCs/PMs is also high in Togo (11% to 12%), but very low in Côte d’Ivoire (less 
than 6%). The same pattern is observed among men but at lower rates. 
Current use of modern FP methods by background characteristics 
The mCPR varies according to the background characteristics of respondents (tables 17-18). 
Regarding the duration of residence, it is interesting to note that in Burkina Faso, Côte d’Ivoire and 
Niger, the mCPR is higher in the intervention area for those residing in the area since the beginning 
of the project and smaller for those who moved to the area recently (1 year ago or less). Variation in
mCPR by age group depends on the country. In all countries but Niger, the mCPR is higher in the 
age group 20-39 years and lower among adolescents. Niger is the exception with the lowest prevalence 
recorded among the oldest age bracket of WRA (40-49 years). Interestingly, the mCPR among the 
adolescents in the intervention area (66%) is even higher than among those 25-39 years old (62%). 
The use of modern contraception varies substantially by marital status in all countries and in the 
intervention and nonintervention areas as well. In all countries except Togo, the mCPR is higher 
among those living in union and lower among women formerly in union. In Togo, the situation is 
quite different. The highest prevalence is recorded among the single (56% vs. 48 and 49% among the 
other groups). 
The variation of the mCPR by education is consistent with what is already known about the 
relationship between education and contraceptive use: modern contraceptive use is higher among 
better-educated women and less widespread among the less educated. 
The use of modern contraception also depends on the number of living children per woman. In 
general, it is lowest among women with no children (perhaps due to a desire for children) and among 
women with five living children or more. Despite their potential need for contraception, this low 
prevalence may reflect the fact they use traditional methods or they do not use FP methods at all for 
other reasons linked to older age such as lower levels of education and a lack of information about 
modern FP. The prevalence is higher among women with 1-4 living children. The situation in Niger 
varies somewhat from this general pattern, where mCPR is very low among childless women (10% in 
the intervention area and 6% in the nonintervention) but relatively high among women with 5 living 
children or plus (51% in the intervention area and 49% in the nonintervention), albeit still less than 
those with 1-4 living children.
The AgirPF Project Endline Evaluation Report 48
Table 17. Modern FP methods among women by background characteristic, zone, and country
Background 
Characteristic
Burkina Faso Côte d'Ivoire Niger Togo
Interv. Non￾interv. Interv. Non￾interv. Interv. Non￾interv. Interv. Non￾interv.
N 2,045 813 2,205 922 746 455 1,047 525
Total 38.1% 41.5% 48.2% 47.2% 61.7% 57.1% 48.0% 50.5%
Duration of 
residence
0-1 year 32.5% 40.6% 39.6% 43.9% 44.0% 31.8% 50.6% 50.5%
2-4 years 39.2% 38.8% 50.3% 51.4% 69.4% 46.4% 53.2% 54.5%
5+ years 38.9% 42.6% 48.9% 46.7% 61.5% 60.7% 45.7% 49.1%
Age-group
15-19 18.4% 25.7% 32.9% 40.6% 66.1% 44.7% 37.5% 49.3%
20-24 44.4% 44.3% 49.4% 48.3% 68.0% 66.7% 56.5% 63.4%
25-39 46.3% 50.3% 56.2% 52.7% 62.0% 62.3% 51.4% 49.8%
40-49 28.5% 33.6% 37.8% 31.9% 41.0% 31.3% 37.6% 37.2%
Marital status
Currently in union 42.1% 48.0% 49.5% 47.5% 62.6% 60.0% 49.9% 49.1%
Single 32.2% 31.7% 47.4% 48.4% 25.0% 28.6% 48.9% 55.5%
Formerly in union 24.6% 20.0% 35.9% 17.4% 20.0% 6.3% 16.7% 48.0%
Education 
No education 29.0% 33.7% 36.7% 30.7% 48.1% 54.6% 32.4% 37.9%
Primary 42.2% 41.8% 46.0% 43.8% 80.6% 62.5% 44.2% 45.2%
Secondary 38.4% 42.3% 47.0% 52.0% 74.8% 65.1% 49.4% 52.1%
High school 46.0% 63.1% 56.1% 62.7% 65.0% 50.0% 57.3% 64.3%
University 47.4% 52.5% 64.0% 63.1% 76.9% 25.0% 64.5% 82.1%
Number of children 
0 child 24.1% 26.1% 41.0% 44.3% 10.3% 6.3% 42.3% 52.3%
1 child 49.7% 49.2% 54.6% 52.5% 74.0% 65.6% 55.2% 49.5%
2 children 46.1% 52.2% 57.3% 54.8% 77.2% 71.0% 50.5% 47.9%
3 children 48.6% 53.6% 50.4% 51.1% 71.1% 68.4% 45.8% 50.6%
4 children 43.8% 50.0% 50.6% 36.4% 61.1% 64.6% 53.0% 59.1%
5+ children 33.2% 29.2% 41.3% 32.0% 50.6% 48.6% 47.6% 41.8%
Table 18 reveals that current use of modern FP also varies according to men’s background 
characteristics and for each subgroup of men between the intervention and the nonintervention zones.
In Burkina Faso, the mCPR is higher in the intervention area for those residing in the area for 2 years 
or more among adolescents and young adults, the single and formerly married, and men who attained 
secondary school and university. In Côte d’Ivoire, it is only among men with primary level of education 
that the mCPR is higher in the intervention zone (50% vs. 38%) and with secondary education (44% 
vs. 40%). In Niger, mCPR is higher in the intervention area than in the nonintervention among those 
arrived recently in their area, the aged 20-24, the singles and men who attained high school. In Togo, 
mCPR is higher in the intervention area only among those who lived in their area for 5 years or more, 
men aged 40-49 years, and men with no education or with high school level. 
The AgirPF Project Endline Evaluation Report 49
These findings defy easy analysis on the basis of background characteristics. In order to disentangle 
these background characteristics to determine the impact of AgirPF, multivariate analysis is discussed 
in the section below. 
Table 18. Modern FP methods among men by background characteristic, zone, and country
Background 
Characteristic
Burkina Faso Côte d'Ivoire Niger Togo
Interv. Non￾interv. Interv. Non￾interv.
Inter￾vention Interv. Non￾interv. Interv.
N 886 377 1,184 461 331 240 537 272
Total 43.6% 39.0% 48.8% 50.5% 57.1% 60.0% 59.6% 61.4%
Duration of 
residence
0-1 year 42.9% 44.8% 44.2% 42.9% 47.6% 20.0% 52.0% 76.7%
2-4 years 45.7% 34.1% 50.7% 55.2% 62.3% 60.0% 62.0% 62.2%
5+ years 43.2% 39.1% 48.8% 50.3% 56.8% 61.0% 61.0% 57.6%
Age-group
15-19 17.0% 5.6% 33.3% 39.4% 50.0% n/a 38.6% 39.3%
20-24 42.1% 37.3% 53.3% 54.4% 40.0% 36.4% 70.5% 71.4%
25-39 59.0% 56.0% 56.1% 56.8% 61.2% 66.1% 63.6% 69.2%
40-49 33.3% 36.3% 42.8% 43.1% 54.9% 56.1% 52.4% 50.0%
Marital status
Currently in union 47.2% 50.5% 47.8% 50.5% 58.6% 60.5% 58.0% 60.6%
Single 40.3% 25.7% 50.8% 50.2% 16.7% 0.0% 61.8% 64.6%
Formerly in union 28.6% 0.0% 11.8% 62.5% n/a n/a 25.0% 37.5%
Education 
No education 31.6% 39.0% 31.3% 35.7% 49.0% 52.2% 60.0% 46.7%
Primary 39.1% 42.1% 50.0% 38.1% 55.2% 68.4% 44.9% 50.8%
Secondary 30.8% 20.6% 43.6% 39.8% 54.7% 66.7% 56.0% 60.6%
High school 51.6% 55.4% 52.2% 65.7% 72.5% 61.9% 69.1% 58.7%
University 68.1% 53.5% 57.4% 67.0% 85.7% 70.0% 64.3% 91.7%
Evaluation of the net impact of AgirPF interventions on current use of modern FP 
The results presented in the previous sections revealed that use of modern FP does not vary 
significantly between AgirPF intervention and nonintervention areas. However there were significant 
gains in mCPR from baseline to endline in Niger (47% to 62%), Cote d’Ivoire (34% vs 48%); and 
Togo (40% vs 48%). In Burkina Faso, there was a dramatic and inexplicable demobilization (47% vs 
38%) despite the good performance in related indicators such as the number of FP new users, number 
of total FP users, and CYP. However, differences may exist and be hidden by differences in 
background characteristics of the respondents in the two areas. In order to control for these 
confounding variables and measure the net impact of living in the intervention zone versus living in 
the nonintervention area, this section applies multivariate analysis. Evaluators used the logistic 
regression method to estimate the impact of the AgirPF intervention (captured through residency in 
the intervention zone) on the likelihood of using a modern FP method after controlling for 
backgrounding characteristics. Table 19 below presents the results of eight regression models, two per 
country (one for the women and one for the men). All models are statistically significant.
The AgirPF Project Endline Evaluation Report 50
Table 19. Regression on background characteristics, zone, and country
Variables & Modalities Burkina Faso Côte d’Ivoire Niger Togo
Women Men Women Men Women Men Women Men
Significance of the model 
at 5% level (Omnibus 
test)
* * * * * * * * 
Zone * ns Ns ns ns Ns ns ns
Intervention 0.806* 1.060 1.033 0.908 1.061 0.943 0.887 0.827
Nonintervention (Ref.) 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000
Duration of residence ns ns Ns ns * * ns ns
0-1 year 0.949 0.898 0.831 0.714 0.467* 0.347* 0.993 0.779
2-4 years 0.951 0.989 1.075 1.048 0.753 0.753 1.156 0.965
5+ years (Ref.) 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000
Age Group * * * * * Ns * *
15-19 (Ref.) 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000
20-24 2.082* 3.257* 1.654* 1.996* 1.033 0.062 1.666* 3.743*
25-39 1.741* 7.221* 2.024* 2.520* 0.872 0.104 1.061 3.774*
40-49 (W) / 40-59 (M) 0.917 3.029* 1.122 1.621* 0.375* 0.076 0.654 2.573*
Marital Status * ns * ns * Ns * ns
Currently in union (Ref.) 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000
Single 1.570* 0.765 1.269* 1.201 0.565 0.049* 1.649* 1.376
Formerly in union 0.455* 0.475 0.602* 0.452 0.062* n/a 0.418* 0.427
Education * * * * * * * *
No education 0.360* 0.261* 0.311* 0.363* 0.356 0.230* 0.176* 0.540
Primary 0.593* 0.378* 0.471* 0.585* 1.000 0.334* 0.268* 0.463*
Secondary 0.740 0.335* 0.639* 0.585* 0.941 0.385* 0.395* 0.725
High school 1.080 0.843 0.908 0.935 0.821 0.744 0.619 0.985
University (Ref.) 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000
Number of children * * * *
0 child 0.252* 0.724 0.054* 0.221*
1 child 0.859 1.155 1.341 0.502*
2 children 1.019 1.396* 1.877* 0.603*
3 children 1.276 1.231 1.498* 0.666
4 children 1.369 1.125 1.323 1.234
5+ children (Ref.) 1.000 1.000 1.000 1.000
* Significant at 5%
The logistic regression results confirm that living in AgirPF intervention areas has no net impact on 
the use of modern contraception vis-à-vis the non-intervention area after controlling for background 
characteristics, except among women in Burkina Faso. In that case, women living in the intervention 
area were 20% less likely to use a modern FP method than their counterparts living in the 
nonintervention area. We obtain similar findings when we conduct a logistic regression on the 
probability of currently using a LARC/PM. 
In other words, the impact of AgirPF interventions is not perceivable by comparing modern FP use 
in the two area, except among women in Burkina Faso. This does not necessarily mean that AgirPF 
The AgirPF Project Endline Evaluation Report 51
did not make a difference. This finding confirms once again the difficulty of evaluating the net impact
of health interventions in urban and peri-urban settings where intervention and nonintervention areas
are close by or intermingled. There was certainly contamination between the two areas since it is easy 
for an urban dweller to attend a health facility other than the closest one to his/her house, if for 
instance they organize special events like FP special days, are more appreciated by clients, are known 
for better service quality, etc. Moreover, the nonintervention areas are not control zones. They are not 
“sterile” from all interventions since other MoH partners were also implementing activities in the 
nonintervention areas to improve availability, accessibility, and quality of services. This is particularly 
true in Niger.
Finally, the results of the logistic regressions reveal that for women, age, marital status, education and 
number of living children each have an individual and net impact on use of modern FP, independent 
of the other characteristics. Women of middle age (defined as 25-39 years), single, better educated, 
with living children are more likely to use modern contraception than the others. In addition, in Niger, 
women residing in the intervention area since the beginning of the project have greater probability to 
use modern FP than those who moved to the zone more recently. For men, the characteristics that 
matter are age and education, and, in Niger, duration of residence. Marital status has no significant 
effect on men’s use of modern FP. 
Method Mix 
Another way to evaluate whether AgirPF made a difference in terms of modern contraceptive use is 
to compare the method mix among modern FP users between the intervention and the 
nonintervention areas. Table 20 presents the results for female users by country and table 21 the results 
for male users by country. 
The method mix for women is significantly different between the two areas in Côte d’Ivoire (mainly 
with injectable contraceptive used most frequently in the intervention area and condoms used most 
in the nonintervention area) and in Niger (pills in the intervention area and injectable contraceptives 
and implants in the nonintervention area). In each country, the method mix is heavily skewed towards 
short-acting methods, especially in Côte d’Ivoire, Niger and Togo (ranging from 67% in 
nonintervention areas in Niger to 90% in nonintervention areas in Côte d’Ivoire). The situation is 
quite different in Burkina Faso, where only 65% of women in the intervention area and 56% in the 
nonintervention area resort to short-acting methods. 
The AgirPF Project Endline Evaluation Report 52
Table 20. Method mix among female users of modern contraceptives, by country
The method mix varies substantially by country. In Burkina Faso, implants are the most used method 
(26% in the intervention area and 34% in the nonintervention), followed by condoms (27% and 19% 
in the two area), injectable contraceptives (16% and 20%), and pills (17% and 10%). Condoms are the 
most used method in Côte d’Ivoire, (36% in the intervention zone and 48% in the nonintervention 
zone) and Togo (48% and 43% in the two zones respectively), followed by pills and injectable
contraceptives in Côte d’Ivoire and implants and injectable contraceptives in Togo. In Niger, pills and 
injectable contraceptives are the most popular methods (from 28% to 38%), followed by implants 
(22% in the intervention zone and 30% in the nonintervention). Condoms are rarely used (less than 
4%). In all countries, IUDs are not popular (less than 10%), but sterilization and spermicides are the 
most unpopular methods, with a maximum of 1% of the users resorting to those methods. 
The method mixes among men also reveal significant differences between the two zones only in Côte 
d’Ivoire (in pills and injectable contraceptives most used in the intervention zone, and condoms most 
used in the nonintervention zone) and Niger (pills most used in the intervention zone, injectable 
contraceptives and implants most used in the nonintervention zone). Except in Niger, condoms are 
the most used method by men (from 52% in Burkina Faso to 74% in Togo). In Niger, pills are the 
most currently used method by men with their partners (45% in the intervention area and 35% in the 
nonintervention area). Other frequently used methods as reported by men are implants in Burkina 
Faso (19%-24%), pills in Côte d’Ivoire (20%-12%), injectable contraceptives in Niger (21%-27%) and 
implants in Togo (9%). 
Methods
Burkina Faso Côte d'Ivoire Niger Togo
Interv. Non￾interv. Interv. Non￾interv.
Inter￾vention Interv. Non￾interv. Interv.
N 790 298 1,063 435 460 260 503 265
Sig. (-) (*) (*) (-)
Short Acting 
methods
65.4% 56.0% 88.8% 90.1% 72.2% 66.9% 75.0% 77.7%
LAM 0.8% 0.7% 1.6% 0.9% 5.4% 6.5% 2.0% 1.9%
Emerg. contraception 0.1% 0.0% 0.7% 0.7% 0.0% 0.0% 0.6% 0.4%
SDM 4.4% 6.4% 7.0% 6.2% 0.2% 0.0% 8.5% 9.4%
Spermicides/Foam 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.4% 0.0%
Condom 26.8% 19.1% 35.5% 47.6% 3.0% 0.8% 47.5% 42.6%
Pills 17.0% 10.4% 23.2% 25.3% 37.6% 27.7% 5.2% 6.8%
Injectable 16.2% 19.5% 20.9% 9.4% 25.9% 31.9% 10.7% 16.6%
LARCs/PMs 34.6% 44.0% 11.2% 9.9% 27.8% 33.1% 25.0% 22.3%
Implants 27.5% 33.9% 10.1% 8.7% 22.2% 29.6% 19.9% 18.5%
IUD 6.6% 9.1% 0.6% 1.1% 5.2% 3.1% 5.0% 3.4%
Sterilization 0.5% 1.0% 0.6% 0.0% 0.4% 0.4% 0.2% 0.4%
Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
The AgirPF Project Endline Evaluation Report 53
Table 21. Method mix among male users of modern contraceptives, by country
Methods
Burkina Faso Côte d'Ivoire Niger Togo
Interv. Non￾interv. Interv. Non￾interv. Interv. Non￾interv. Interv. Non￾interv.
N 386 147 578 233 189 144 320 167
Sig. (-) (*) (*) (-)
Short Acting 
methods
79.0% 70.1% 95.5% 96.1% 79.4% 77.8% 86.3% 90.4%
LAM 0.0% 0.7% 0.0% 0.0% 3.7% 7.6% 0.3% 0.6%
Emerg. contraception 0.5% 0.0% 0.0% 0.4% 0.0% 0.0% 0.9% 0.0%
SDM 3.1% 1.4% 4.3% 3.0% 0.0% 0.0% 5.6% 3.0%
Spermicides/Foam 0.0% 0.0% 0.2% 0.0% 0.5% 0.0% 0.3% 0.0%
Condom 60.6% 52.4% 59.3% 75.1% 9.0% 7.6% 70.0% 73.7%
Pills 8.8% 8.8% 19.6% 11.6% 45.0% 35.4% 3.4% 4.2%
Injectable 6.0% 6.8% 12.1% 6.0% 21.2% 27.1% 5.6% 9.0%
LARCs/PMs 21.0% 29.9% 4.5% 3.9% 20.6% 22.2% 13.8% 9.6%
Implants 18.7% 25.9% 3.8% 3.4% 15.9% 22.2% 9.1% 9.0%
IUD 1.8% 2.7% 0.5% 0.4% 3.7% 0.0% 3.4% 0.0%
Sterilization 0.5% 1.4% 0.2% 0.0% 1.1% 0.0% 1.3% 0.6%
Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
Main reasons for not using an FP method 
Women and men who know about FP but are not currently using an FP method were asked the main 
reasons of their non-use. The possible answers were grouped in five categories: 
• Fertility-related issues: not having sex, infrequent sex, menopausal/ hysterectomy,
subfecund/infecund, - postpartum amenorrheic, breastfeeding, being fatalistic/having no 
control, desire to get pregnant; 
• Opposition to use: own opposition, husband/partner opposition, others' opposition, religious 
prohibition; 
• Lack of knowledge: know no method, know no source; 
• Method-related reasons: health concerns, fear of side effects, lack of access/too far, costs too 
much, inconvenient to use, interferes with body's normal processes; and 
• Other reasons/don't know/no response. 
Table 22 contains the percentage of women not using an FP method that cited each reason among 
women. Table 23 provides the same information for male non-users. Both tables reveal that fertility￾related concerns are by far the most cited reason (from 70% to 85% among women and from 68% to 
86% among men). In comparison, the second most frequent reasons are cited less than 18%. 
The AgirPF Project Endline Evaluation Report 54
Table 22. Main reasons cited by women for not using an FP method, by country
Background 
characteristics
Burkina Faso Côte d'Ivoire Niger Togo
Interv. Non￾interv. Interv. Non￾interv.
Inter￾vention Interv. Non￾interv. Interv.
N 1,030 327 822 370 250 171 462 222
Fertility-related issues 74.5% 73.1% 78.5% 73.2% 69.6% 82.5% 84.8% 77.5%
Opposition to use 10.6% 16.8% 6.4% 11.4% 9.6% 4.1% 4.5% 5.4%
Lack of knowledge 0.3% 0.3% 2.8% 1.6% 0.8% 0.0% 0.6% 1.8%
Method-related reasons 13.0% 17.1% 8.0% 13.2% 14.8% 9.4% 11.7% 12.6%
Other reasons/Don't 
know/No response 9.0% 11.6% 8.8% 11.9% 8.4% 7.0% 3.7% 3.2%
Table 23. Main reasons cited by men for not using an FP method, by country
Background 
characteristics
Burkina Faso Côte d'Ivoire Niger Togo
Interv. Non￾interv. Interv. Non￾interv.
Inter￾vention Interv. Non￾interv. Interv.
N 361 167 433 151 100 74 181 90
Fertility-related issues 77.0% 80.8% 77.1% 66.9% 76.0% 67.6% 86.2% 81.1%
Opposition 9.1% 6.0% 6.9% 16.6% 13.0% 17.6% 8.8% 11.1%
Lack of knowledge 1.1% 1.8% 5.5% 2.6% 1.0% 4.1% 2.2% 0.0%
Method-related reasons 10.2% 13.2% 5.1% 11.3% 10.0% 9.5% 8.8% 10.0%
Other reasons/Don't 
know/No response 7.8% 9.0% 10.6% 14.6% 9.0% 10.8% 2.2% 0.0%
Opposition to use and method-related issues are relatively frequent reasons for non-use in some 
countries (17% among women in the nonintervention area of Burkina Faso and 11% among women 
in the intervention area of Burkina Faso and the nonintervention area of Côte d’Ivoire). Among men, 
opposition to use is cited by 10% to 18% in nonintervention zone in Côte d’Ivoire, Niger and Togo 
and in the intervention area of Burkina Faso and Niger. Method-related reasons are equally cited 
except in Togo where it was more often cited (12%) than opposition to use (around 5 %). 
Non-use because of lack of knowledge was rarely cited (less than 3% among women and less than 6% 
among men). However, a more accurate measure of lack of knowledge as a key barrier to current use 
of FP should also include those who answered not knowing about FP at all, rather than just focusing 
on those who know but are not currently using as done in the two tables below. The results of this 
more accurate measure is presented in figure 27 below. 
Comparisons by zone reveal more opposition to use in the nonintervention than in the intervention 
areas in Burkia Faso, Côte d’Ivoire and Togo among women and in Côte d’Ivoire, Niger and Togo. 
Women and men in all countries except Niger also more frequently cite method-related reasons in the 
nonintervention area than in the intervention area. 
Figure 27 shows that a high percentage of the population is not using an FP method for lack of 
information, especially in Burkina Faso and Côte d’Ivoire (both sexes) and in Niger (among men). 
There is no significant difference between the intervention and the nonintervention area. 
The AgirPF Project Endline Evaluation Report 55
The percentage of women not using FP for lack of knowledge varies from 11% to 13% in Burkina 
Faso and Côte d’Ivoire and is under 4% in Niger and Togo. Among men, the percentage is higher: 
from 15% to 17% in Burkina and Côte d’Ivoire, 8 to 10% in Niger, and 3% in Togo. These findings
indicate that there is still a long way to go in terms of sensitization about FP and SBC in Burkina, Côte 
d’Ivoire and Niger. 
 
Conclusion on knowledge and use of FP
This evaluation of the impact of AgirPF in terms on FP knowledge and use do not lead to definitive 
conclusions mainly because it was not possible to overcome two major confounding effects. First, 
significant contamination of the nonintervention area by AgirPF’s interventions is highly likely
because nonintervention facilities generally belong to the same district and are situated in urban or 
peri-urban areas where it is easy to reach several health facilities. The second confounding factor is 
the fact that the nonintervention area was actually not a control zone. Other partners of the MoHs 
were implementing activities in the nonintervention area to improve the accessibility and quality of 
health services. 
As the result of this contamination and interference, knowledge of FP does not vary significantly 
across the intervention and nonintervention areas except among women in Togo, where the 
difference is tiny (97% in the intervention area vs. 98% in the nonintervention area). The CPR among 
men and among women varies a lot across the four countries, but not significantly between the 
intervention and the nonintervention areas within each country. Marked variations in the prevalence 
of the LARCs/PMs across the four countries also exist but there is no significant disparity by zone, 
 (-) Significant at 5% (*) Not significant at 5%
Figure 27. Percentage of the respondents citing lack of knowledge as key barrier to use of FP (either because 
they do not know about FP at all or they know about FP but lack sufficient information), by zone and country
The AgirPF Project Endline Evaluation Report 56
except in Togo. The logistic regression results confirm that living in AgirPF intervention has no net 
impact on the use of modern contraception after controlling for the background characteristics, 
except among women in Burkina Faso. In terms of method mix, there is no difference by zone except 
in Côte d’Ivoire. 
The main reason for non-use of FP is the exception to the lack of sensitivity to AgirPF interventions. 
In fact, the comparison by zone reveals more opposition to use in the nonintervention than in the 
intervention areas in Burkina Faso, Côte d’Ivoire, and Togo among women and in Côte d’Ivoire, Niger 
and Togo among men. Women and men in all countries except Niger also more frequently cite 
method-related reasons in the nonintervention area than in the intervention area. 
Discussion and conclusion 
The overall objective of the evaluation was to assess the performance and effectiveness of the project’s 
interventions and changes over time in key services, the enabling environment, and demand indicators
in line with the baseline study and the mid-term evaluation results and recommendations. Specific 
objectives included: 
• Measuring AgirPFs progress against Performance Monitoring Plan (PMP) indicators over the 
course of the project 
• Contributing to the evaluation of the AgirPF SBCC campaign 
• Analyzing how changes in the population-level indicators are linked to AgirPF’s intervention 
Performance against the PMP indicators 
AgirPF’s performance against PMP indicators was highly positive. The program met or exceeded 15 
of the 18 output indicators for the project, despite the broad reach of the project, high levels of 
complexity, and a range of implementation challenges ranging from office registration issues, to 
political turmoil, to complex differences in culture and demographic characteristics. 
Strategic objective indicators
Indicators for the program’s strategic objective show a high level of performance by the program 
through meeting or exceeding overall targets for CYP, mCPR (outcome indicator), total FP users, and 
new modern contraceptive users. The SO output indicators were particularly impressive for Burkina 
Faso and Togo, which exceeded all their targets by significant margins. 
In the case of Burkina Faso, however, this performance masked one of the most confounding findings 
of significance in the evaluation—a mCPR that actually declined from the baseline assessment (47% 
to 34%) in intervention areas. However, other studies have found similar findings. According to the 
2017-2018 round of PMA2020, the mCPR in the country is 26.4% among all women age 15-49 years 
The AgirPF Project Endline Evaluation Report 57
old and 30.1% among married women. The data is not disaggregated by area of residence, but such a 
national prevalence may correspond to an incidence in urban and peri-urban areas of 38%. 
Additionally, a yet unpublished household survey conducted by the USAID E4D project found a 
similar mCPR in 2018 (40%) in the AgirPF intervention zones. Further research is suggested to better 
understand this the underpinnings of this finding. 
Conversely, the program found unexpectedly high mCPR in Niger. In one city, for example, a DHS 
2012 assessment found an mCPR rate of 6.9%, yet the AgirPF baseline found an mCPR of 44.2%. 
Across interventions zones in the country, the mCPR rate rose from 47% at the baseline to 62% at 
the time of the endline survey. Further research is required to understand why intervention zones 
differ so greatly from the rest of the country and/or to understand deviations from the DHS study. 
Judged purely on performance on SO indicators, Côte d’Ivoire had the lowest performance (29%
good) followed by Mauritania (57%). However, the program also had to overcome particularly 
significant challenges in these countries, include 1- and 2- year delays in project start-up outside control 
of the program, respectively. In Côte d’Ivoire, the program also encountered particularly low capacity 
at intervention facilities—24% had never provided FP services of any kind. This low capacity required 
considerable remediation before the program could even begin program activities. 
Intermediate results 1, 2, and 3
Beyond the SO indicators, the program largely excelled under the intermediate result areas. Of 
particular note under IR 1, the program met 99% of its target training target, with 5,699 people trained 
in FP and RH. The program was also particularly successful at reaching youth, with over 318,101 
participating in education programs (118% of targets). This positive engagement of youth could be 
seen in the demographic profile of beneficiaries with 45% falling in the 10-24 year age bracket. The 
program was also mostly successful with ensuring with technical competence of FP service providers,
with providers in every country except Niger reaching EngenderHealth quality standards across 
several components. A range of IR 1 outcome indicators are covered in the AgirPF SBCC campaign 
section below. 
AgirPF was also successful at meeting targets for evidence-based service delivery as defined under IR 
2. Facilities in Burkina Faso, Côte d’Ivoire, Niger, and Togo accepted and welcomed innovations in 
their facilities and implemented 10 HIPs, many of which were integrated into national health 
protocols. The program also over doubled the target number of regional technical trainings over the 
life of the program.
Targets under IR 3 were all met or exceeded by the program, which highlighted AgirPF’s extremely 
effective approach to removing policy barriers around FP and contraceptives. Advocacy conducted 
under IR 3 led to 19 policies or guidelines changed to improve access to FP and RH services (317% 
The AgirPF Project Endline Evaluation Report 58
of targets), 41 formal agreements signed at the regional level (273% of targets), and over 101 advocacy 
activities conducted (289%), among others. 
Results of the AgirPF SBCC campaign 
AgirPF implemented a multi-faceted SBCC campaign based on findings from an innovative approach 
of segmenting the population according to their attitudes, behaviors, and potential in terms of FP use. 
The campaign reached the most people in Niger (75% in the intervention area were reached with a 
USG-supported FP/RH message, 82% in the nonintervention), where the SBCC strategy was first 
piloted and rolled-out. The SBCC campaign reached far fewer people in Côte d’Ivoire (less than 17% 
were reached) and Burkina Faso, where 14% of the women in the intervention area and 23% in the 
nonintervention were reached. Overall, in Togo, two fifths of the female respondents have heard or 
seen a USG-supported FP/RH message. In Côte d’Ivoire and Togo, more women living in the 
intervention areas were reached than in the nonintervention area. In Burkina Faso and Niger, the 
reverse was observed. 
Evaluating the SBCC campaign was not an easy task due to the contamination of the nonintervention 
areas by the activities implemented by AgirPF, on the one hand, and the fact that the nonintervention 
area was not a control area, since they also received many interventions by other partners of the MoH, 
especially in Niger. While this contamination frustrates the ability to attribute change to AgirPF, it 
likely means that the impact of the project was substantially greater than an anticipated as it reached 
many far beyond the narrow intervention zone. Most of the SBCC activities (posters, radio spots, 
Facebook pages, and comic books) could not simply be confined into the specific intervention area, 
since the intervention and the nonintervention areas are generally in the same districts. 
Because the campaigns began in years 3 and 4 of the program, there was likewise not sufficiently 
accurate baseline data with which to track changes in attitudes post-campaign. The extremely varied 
techniques, themes, and targeted audiences also defy easy analysis. Further research to examine 
whether the SBCC campaigns contribute to increased levels of FP information-seeking, positive 
attitudes about FP, and actual FP use need to be conducted to definitively establish its effectiveness. 
The SBCC was an opportunity for testing innovative communication approaches, beyond the overall 
strategic approach. In Niger, the use of IVR led to 1,027 calls successfully connected to the server out 
of 1,089 trials, resulting in 2,702 questions-answers between the server and the callers between 
09/11/2017 and 02/06/2018. Overall 62% selected the first choice offered by the server “Basic 
information about the FP methods”, compared to 38% for the second choice: “FP users’ 
testimonials”. For a first experience, these figures are encouraging and confirmed recent research 
findings from Camber Collective highlighting that women belonging to the different segments and 
theirs partners have critical need for information about RH, including FP from reliable sources. 
The AgirPF Project Endline Evaluation Report 59
AgirPF’s link to FP knowledge and use by population-level indicators 
Knowledge of FP does not vary significantly across the intervention and nonintervention areas except 
among women in Togo, where the difference is tiny (97% in the intervention area vs. 98% in the 
nonintervention area). Near-universal knowledge of FP in most of the areas surveyed at baseline left 
little room for improvement for new interventions. Therefore, the impact of the project is not 
captured efficiently through this indicator of overall knowledge, but through the knowledge of specific 
methods. For the majority of the methods, there is no significant difference between the intervention 
and nonintervention areas. In Burkina Faso and Côte d’Ivoire there are more significant differences 
between the two areas exist. In Togo, knowledge of FP does not vary by area. In case of significant 
differences, knowledge is generally higher in AgirPF zone.
Differences in knowledge of modern FP use does not vary significantly across the intervention and 
nonintervention areas except among women in Togo. Knowledge of LARCs/PMs is significantly 
higher in the intervention area than in the nonintervention area in Côte d’Ivoire (61% vs. 54% among 
women and 49% vs. 43% among men). It is also higher in Burkina Faso, but the difference is not 
statistically significant. In Niger and Togo, the percentage knowing LARCs/PMs is higher in the 
nonintervention areas, but the difference is not significant. 
FP use 
In Burkina Faso, Côte d’Ivoire and Niger, the mCPR is higher in the intervention area for those 
residing in the area since the beginning of the project and lower for those who moved to the area 
recently (1 year ago or less). The results show marked variations in the prevalence of the LARCs/PMs 
across the four countries and no significant disparities by zone except in Togo. Though mCPR is low 
in Burkina Faso, the country, along with Niger, is a leading country in the use of LARCs/PMs. 
The logistic regression results confirm that living in AgirPF intervention has no net impact on the use 
of modern contraception after controlling for the background characteristics, except among women 
in Burkina Faso. In that particular case, women living in the intervention area have 20% less chance 
of using a modern FP method than their counterparts living in the nonintervention area. We obtain 
similar findings when we conduct a logistic regression on the probability of currently using a 
LARC/PM. In other words, the impact of AgirPF interventions is not perceivable by comparing 
modern FP use in the two area, except among women in Burkina Faso. This does not necessarily mean 
that AgirPF did not make a difference, but is a consequence of the contamination of and interference 
in the nonintervention zone. 
The AgirPF Project Endline Evaluation Report 60
Method mix
The women’s method mix is significantly different between the two areas in Côte d’Ivoire (mainly in 
injectable most used in the intervention area and condom most used in the nonintervention area) and 
in Niger. In each country, the method mix is heavily skewed towards short-acting methods, especially 
in Côte d’Ivoire, Niger and Togo (from 67% in nonintervention area in Niger to 90% in 
nonintervention area in Côte d’Ivoire use these methods). The situation is quite different in Burkina 
Faso, where only 65% of women in the intervention area and 56% in the nonintervention area resort 
to short-acting methods. The method mixes among men also reveal significant differences between 
the two zones only in Côte d’Ivoire (in pills and injectable most used in the intervention zone, and 
condom most used in the nonintervention zone) and Niger.
Reason for not using an FP method
Fertility-related concerns is by far the most cited reason (from 70% to 85% among women and from 
68% to 86% among men) for not using FP methods. In comparison, the second most frequent reasons 
are cited less than 18% of the time. Comparisons by zone reveal more opposition to use in the 
nonintervention than in the intervention area in Burkina, Côte d’Ivoire and Togo among women and 
in Côte d’Ivoire, Niger and Togo. Women and men in all countries except Niger also more frequently 
cite method-related reasons in the nonintervention area than in the intervention area. 
A high percentage of the population is not using an FP method for lack of information, especially in 
Burkina Faso and Côte d’Ivoire (both sexes) and in Niger (among men). There is no significant 
difference between the intervention and the nonintervention area. The percentage of women not using 
FP for lack of knowledge varies from 11% to 13% in Burkina Faso and Côte d’Ivoire and is under 4% 
in Niger and Togo. Among men, the percentage is higher: from 15% to 17% in Burkina and Côte 
d’Ivoire, 8 to 10% in Niger and 3% in Togo. This gives indication that there is still a long way to go 
in terms of sensitization about FP and SBC in Burkina, Côte d’Ivoire and Niger. 
 
In sum, AgirPF performed well, but it is difficult to demonstrate that it made a difference in terms of 
FP knowledge and contraceptive prevalence. This does not mean that AgirPF interventions were not 
effective, but rather highlight the difficulty to evaluate the net impact of health interventions in urban 
and peri-urban settings with close intervention and nonintervention areas. There were certainly 
contamination between the two areas since it is easy for an urban dweller to attend a health facilities 
other than the closest one to his/her house, if for instance they organize special events like FP special 
days, are more appreciated by clients, are known for better service quality, etc. Moreover, the 
nonintervention areas are not control zone It is therefore important to pay special attention to the 
evaluation of future project at the time of the design of the project. 
The AgirPF Project Endline Evaluation Report 61
Bibliography 
1. John Caldwell and Pat Caldwell “Fertility Transition in sub-Saharan Africa” (paper 
presented at Conference on Fertility and the Current South African Issues of Poverty, 
HIV/AIDS and Youth, Pretoria, South Africa, Oct. 24, 2002).
2. Donna Clifton, communication with author, 2008 
3. Bongaarts J. Fertility transitions in developing countries: progress or stagnation? Stud Fam
Plann 2008; 39: 105-10 doi: 10.1111/j.1728-4465.2008.00157.x pmid: 18678174. 
4. Ezeh AC, Mberu BU, Emina JO. Stall in fertility decline in Eastern African countries: 
regional analysis of patterns, determinants and implications. Philos Trans R Soc Lond B Biol
Sci 2009; 364: 2991-3007 doi: 10.1098/rstb.2009.0166pmid: 19770151. 
5. Casterline JB. The pace of fertility transition: national patterns in the second half of the
twentieth century. Popul Dev Rev 2001; 27: 17-52.
6. Coale AJ. The demographic transition reconsidered. In: International Union for the
Scientific Study of Population. Proceedings of the international population conference 1973. Liège:
Editions Ordina; 1973.
7. Lesthaeghe R, Vanderhoeft C. Ready, willing, and able: a conceptualization of transitions 
to new behavioral forms. In: Casterline JB, editor. Diffusion processes and fertility transition: 
selected perspectives. Washington: National Academy Press; 2001. pp. 240-64.
8. Bawah AA, Akweongo P, Simmons R, Phillips JF. Women’s fears and men’s anxieties: the
impact of family planning on gender relations in northern Ghana. Stud Fam Plann 1999; 30:
54-66 doi: 10.1111/j.1728-4465.1999.00054.x pmid: 10216896. 
9. Castle S, Konaté MK, Ulin PR, Martin S. A qualitative study of clandestine contraceptive 
use in urban Mali. Stud Fam Plann 1999; 30: 231-48 doi: 10.1111/j.1728-
4465.1999.00231.x pmid: 10546314. 
10. Rutenberg N, Watkins SC. The buzz outside the clinics: conversations and contraception 
in Nyanza Province, Kenya. Stud Fam Plann 1997; 28: 290-307
doi: 10.2307/2137860 pmid: 9431650. 
11. Hulton LA, Cullen R, Khalokho SW. Perceptions of the risks of sexual activity and their
consequences among Ugandan adolescents. Stud Fam Plann 2000; 31: 35-46
doi: 10.1111/j.1728-4465.2000.00035.x pmid: 10765536. 
12. Demographic and Health Surveys [Internet]. Calverton: Measure DHS; 2010. Available
from: http://www.measuredhs.com/accesssurveys/ [accessed 2 November 2010].
13. Tsui AO, Ochoa LH. Service proximity as a determinant of contraceptive behaviour: 
evidence for cross-national studies of survey data. In: Phillips J, Ross JA, editors. Family
planning programmes and fertility. Oxford: Clarendon Press; 1992. pp. 222-56.
The AgirPF Project Endline Evaluation Report 62
14. Cleland J, Ali MM. Sexual abstinence, contraception, and condom use by young African
women: a secondary analysis of survey data. Lancet 2006; 368: 1788-93 doi: 10.1016/S0140-
6736(06)69738-9 pmid: 17113428. 
15. Becker S. Couples and reproductive health: a review of couple studies. Stud Fam Plann 1996;
27: 291-306 doi: 10.2307/2138025 pmid: 8986028. 
16. Becker S, Costenbader E. Husbands’ and wives’ reports of contraceptive use. Stud Fam
Plann 2001; 32: 111-29 doi: 10.1111/j.1728-4465.2001.00111.x pmid: 11449861. 
17. Miller K, Zulu EM, Watkins SC. Husband-wife survey responses in Malawi. Stud Fam
Plann 2001; 32: 161-74 doi: 10.1111/j.1728-4465.2001.00161.x pmid: 11449864. 
18. World population prospects, 2008 revision. New York: United Nations Department of Social and
Economic Affairs; 2009.
19. Shah I, Ahman E. Unsafe abortion: global and regional incidence, trends, consequences,
and challenges. J Obstet Gynaecol Can 2009; 31: 1149-58 pmid: 20085681. 
20. Sedgh G, Henshaw S, Singh S, Ahman E, Shah IH. Induced abortion: estimated rates and
trends worldwide. Lancet 2007; 370: 1338-45 doi: 10.1016/S0140-6736(07)61575-
X pmid: 17933648. 
21. Ross J, Stover J. The family planning program effort index: 1999 cycle. Int Fam Plan
Perspect 2001; 27: 119-29 doi: 10.2307/2673833. 
The AgirPF Project Endline Evaluation Report 63
Appendices
Appendix A: Questionnaires (Male and Female) 
Appendix A1: Women Questionnaire 
ENQUETE MENAGE POUR L’EVALUATION FINALE DU PROJET AgirPF
IDENTIFICATION
Nom Ville : _______________________________
Nom Région Sanitaire : _______________________________
Nom District Sanitaire : _______________________________
Nom Formation Sanitaire : _______________________________
Nom Localité/Quartier : _______________________________
CODE VILLE 
CODE REGION
CODE DISTRICT
CODE FS
CODE LOCALITE/QUARTIER
NUMERO DE ZD |__|__|__|
NUMERO DU MENAGE
NUMERO DE LA REPONDANTE
Nom Enquêteur: _______________________________
Nom Superviseur: _______________________________
Date Interview (jj/mm/aa): /___/___/ /___/___/ /__1_/_8__/ Heure Début interview (hh/mn) :/___/___/ /___/___/ 
SECTION 1: CARACTERISTIQUES SOCIODEMOGRAPHIQUESET SOCIOECONOMIQUES DU REPONDANT
Tout d’abord, je voudrais vous poser des questions sur vous et votre famille
No Questions Modalités de réponses et codes
100 Depuis combien de temps habitez￾vous à [Nom de la localité/Quartier] ?
Nombre d’années ............................................. 
Depuis toujours 66
Pas de réponse/Refus 77
Ne sait pas 99
101 Quel âge aviez-vous lors de votre 
dernier anniversaire ?
ENCERCLEZ LE GROUPE D’AGE 
CORRESPONDANT
15-19ans ............................... 1 
20-24ans ............................... 2 
25-29ans ............................... 3 
30-34ans ............................... 4 
35-39ans................................ 5 
40-44ans................................ 6 
45-49ans................................ 7 
Ne sait pas...........................99
Questionnaire des Femmes en âge de procréer (15-49 ans)
The AgirPF Project Endline Evaluation Report 64
No Questions Modalités de réponses et codes
102 Quel est votre statut matrimonial ?
SI MARIEE, SONDEZ POUR CONNAITRE LE 
NOMBRE DE COEPOUSES
Mariée, monogame............... 1 
Mariée, polygame ................. 2 
Vivons ensemble................... 3 
Célibataire ............................. 4 
Divorcée................................. 5 
Séparée ................................. 6 
Veuve..................................... 7 
Pas de réponse/Refus.........77
103 Avez-vous déjà fait des études ?
SI OUI, quel est votre plus haut niveau 
d’éducation ?
Pas été à l’école.................... 1 
Primaire................................. 2 
Secondaire 1......................... 3 
Secondaire 2.......................... 4 
Universitaire........................... 5 
Pas de réponse/Refus........... 7 
104 En dehors de votre propre ménage, 
faites-vous actuellement un autre 
travail ?(SONDER)
Oui 1 
Non 2 
Pas de réponse/Refus 7 
105 Combien de fils et de fillessurvivants
avez-vous ?
Nombre de garçon(s)...................................... 
Nombre de fille (s)........................................... 
SECTION 2: CONTRACEPTION
Maintenant, je voudrais que nous parlions de la planification familiale, c’est-à-dire les différents moyens ou 
méthodes qu'un couple peut utiliser pour retarder ou éviter une grossesse.
No Questions Modalités de réponses et codes
200 Avez-vous entendu parler de méthodes 
qu’un couple peut utiliser pour retarder ou 
éviter une grossesse ?
Oui ...................................................................... 1 
Non ..................................................................... 2 (Aller à300)
Pas de réponse/Refus ........................................ 7 (Aller à300)
Si « Oui » à 200, de quelle(s) voie(s)/méthode(s) permettant de retarder ou 
éviter les grossesses avez-vous entendu parler ? 
Ecrire le code 1 dans 201 pour chaque méthode mentionnée 
spontanément.Ensuite lisez le nom et la description de chaque méthode qui 
n’est pas mentionnée spontanément. Ecrire le code 1si la méthode est 
reconnue et le code 2 si elle n’est pas reconnue. Ensuite pour chaque 
méthode avec le code 1, posez 202 avant d’aller à la méthode suivante.
PLUSIEURS REPONSES POSSIBLES.SONDER: D’autres méthodes ?
201. Avez￾vous déjà 
entendu 
parler de 
{méthode} ?
1 = Oui
2 = Non 
7 = Refus
202. Avez￾vous déjà 
utilisé 
{méthode} ?
1 = Oui
2 = Non 
7 = Refus
a.
PILULES : Les femmes peuvent prendre une pilule chaque jour pour éviter 
de tomber enceinte.
b. DIU : Les femmes peuvent se faire placer un stérilet par une infirmière ou un 
docteur pour leur éviter les grossesses pendant plusieurs années.
c.
INJECTABLES: Les femmes peuvent avoir des injections qui peuvent leur 
éviter de tomber enceinte pendant plusieurs mois.
d. COMPRIMES MOUSSANTS / GELEE: Les femmes peuvent se placer des 
cachets mousseux dans le vagin avant les rapports sexuels.
The AgirPF Project Endline Evaluation Report 65
Si « Oui » à 200, de quelle(s) voie(s)/méthode(s) permettant de retarder ou 
éviter les grossesses avez-vous entendu parler ? 
Ecrire le code 1 dans 201 pour chaque méthode mentionnée 
spontanément.Ensuite lisez le nom et la description de chaque méthode qui 
n’est pas mentionnée spontanément. Ecrire le code 1si la méthode est 
reconnue et le code 2 si elle n’est pas reconnue. Ensuite pour chaque 
méthode avec le code 1, posez 202 avant d’aller à la méthode suivante.
PLUSIEURS REPONSES POSSIBLES.SONDER: D’autres méthodes ?
201. Avez￾vous déjà 
entendu 
parler de 
{méthode} ?
1 = Oui
2 = Non 
7 = Refus
202. Avez￾vous déjà 
utilisé 
{méthode} ?
1 = Oui
2 = Non 
7 = Refus
e.
PRESERVATIF MASCULIN : Les hommes peuvent mettre une capote en 
caoutchouc sur leur pénis avant les rapports sexuels.
f. PRESERVATIF FEMININ : Les femmespeuvent placer un fourreau dans leur 
vagin avant les rapportssexuels.
g.
Méthodes des Jours Fixes (MJF) : Une femme peut se servir de perles 
pour compter les jours de son cycle et éviter d'avoir des rapports sexuels 
les jours où elle est susceptible de tomber enceinte
h. LA STERILISATION FEMININE: Les femmes peuvent subir une opération 
pour ne plus avoir d’enfants.
i. LA STERILISATION MASCULINE: Les hommes peuvent subir une 
opération pour ne plus avoir d’enfants.
j.
IMPLANT : Les femmes peuvent se faire insérer par un médecin ou une 
infirmière un bâtonnet ou plus sous la peau du haut du bras pour les 
empêcher de tomber enceinte, pendant une annéeou plus.
k.
RYTHME, COMPTAGE DES JOURS: Une femme peut compter les jours de 
son cycle et éviter d’avoir des rapports sexuels les jours où il est probable 
qu’elle tombe enceinte.
l.
PLANIFICATION FAMILIALE NATURELLE:Une femme peut prendre sa 
température tous les jours ou vérifier sa mucosité vaginale pour déterminer 
les jours où il faut éviter des rapports sexuels.
m.
COIT INTERROMPU: L’homme peut faire attention et se retirer de la femme 
avant d’éjaculer.
n.
MAMA: L’allaitement exclusif au sein jusqu’à 6 mois peut constituer une 
protection naturelle contre les grossesses.
o.
CONTRACEPTION D’URGENCE : Une femme peut prendre une forte dose 
de la pilule dans les 24 heures qui suivent les rapports sexuels non protégés.
p.
Avez-vous entendu parler d’autres voies ou méthodes utilisées pour éviter 
les grossesses ? Précisez__________________________________
No Questions Modalités de réponses et codes
203 Vous et votre mari/partenaire faites-vous 
quelque chose ou utilisez-vous actuellement 
une méthode quelconque pour retarder ou 
éviter une grossesse ?
Oui ..................................................1
Non ............................................. 2 (Aller à 205)
Pas de réponse/Refus................ 7 (Aller à 205)
The AgirPF Project Endline Evaluation Report 66
204 Si oui, quelle méthode utilisez-vous ?
METTRE 1=OUI LORSQUE LA METHODE EST 
UTILISEE ET 0=NON DANS LE CAS CONTRAIRE
PLUSIEURS REPONSES POSSIBLES.
PASSER ENSUITE A Q300
Pilules combinées ou à 
progestatif seul…………
DIU ……………………..
Injectables……………...
Implants……………….. 
Préservatif masculin…..
Préservatifféminin……
Spermicides……………
Stérilisationféminine …
Stérilisation masculine …
Méthode des jours 
fixes (MJF)……….
MAMA ……………
Contraception 
d’urgence ………...
Contraception 
naturelle ………….
Refus…………….. 
Ne sait pas……….
205 Vérifiez 203. Si aucune méthode n'est 
utilisée, demandez :
Vous avez dit que vous et votre mari/ 
partenaire n'utilisiez aucune méthode pour 
retarder ou éviter une grossesse. Pouvez￾vous me dire pourquoi vous et votre mari/ 
partenaire n'utilisez pas une méthode ?
SONDEZ: Ya-t-il d’autres raisons ?
METTRE 1=OUI LORSQU'UNE RAISON EST 
EVOQUEE PAR L'ENQUETEE
ET 0=NON SI LA RAISON/MODALITE N'EST PAS 
EVOQUEE
PLUSIEURS RÉPONSES POSSIBLES
PROBLEMES DE FECONDITE
1. N’a pas de rapports sexuels ....................... 
2. Rapports sexuels peu fréquents ................. 
3. Ménopause/hystérectomie.......................... 
4. Peu féconde ................................................ 
5. Aménorrhée postpartum ............................. 
6. Allaitement maternel ................................... 
7. Fataliste/pas de contrôle............................. 
8. Veut tomber enceinte.................................. 
OPPOSITION A L’UTILISATION
9. Répondant est opposé................................ 
10.Mari/Partenaire est opposé .......................... 
11.Autre personne opposée............................. 
12.Interdiction religieuse .................................. 
MANQUE DE CONNAISSANCE 
13.Ne connait pas de méthode ........................ 
14.Ne connait pas de source ........................... 
RAISONS LIEES AUX METHODES
15.Problèmes de santé .................................... 
16.Peur d’effets secondaires............................. 
17.Manque d’accès/trop loin ............................ 
18.Coûtent trop cher ........................................ 
19.Incommode à utiliser................................... 
20.Interfère avec les processus normaux 
du corps....................................................... 
30. Autre (Précisez) : ....................................... 
77. Pas de réponse/Refus ............................... 
99. Aucune idée/Ne sait pas ............................. 
The AgirPF Project Endline Evaluation Report 67
SECTION 3: SBCC / ACTIVITES GENERATRICES DE DEMANDE
No Questions Modalités de réponses et codes
300 Au cours des trois derniers mois, combien de 
fois avez-vous parlé à votre mari/partenaire 
d'une méthode de planification familiale ?
Jamais 1 
Une ou deux fois ......................................................... 2 
Plus de deux fois......................................................... 3 
Pas de réponse/Refus ................................................ 7 
Ne sait pas 9 
301 Au cours des 12 derniers mois, avez-vous vu 
des affiches ou entendu des messages 
radiophoniques sur la gestion des effets 
secondaires des méthodes de planification 
familiale?
Oui ………1
Non 2 
Pas deréponse/Refus ................................................. 7 
302 Au cours des 12 derniers mois, avez-vous 
entendu parler d'un numéro gratuit que l'on peut 
appeler pour obtenir des informations gratuites 
sur la planification familiale?
Oui ………1
Non 2 
Pas de réponse/Refus ................................................7 
303 Au cours des 12 derniers mois, avez-vous été 
contactée par quelqu'un qui vous a donné un 
coupon pour obtenir des services de planification 
familiale gratuitement dans les centres de santé?
Oui ………1
Non 2 
Pas de réponse/Refus 7 
Merci d'avoir repondu à mes questions. Fin de l'interview de temps(hh/mn): 
The AgirPF Project Endline Evaluation Report 68
Appendix A 2 : Men Questionnaire 
ENQUETE MENAGE POUR L’EVALUATION FINALE DU PROJET AgirPF
IDENTIFICATION
Nom Ville : _______________________________
Nom Région Sanitaire : _______________________________
Nom District Sanitaire : _______________________________
Nom Formation Sanitaire : _______________________________
Nom Localité/Quartier : _______________________________
CODE VILLE
CODE REGION
CODE DISTRICT
CODE FS
CODE LOCALITE/QUARTIER
NUMERO DE ZD |__|__|__|
NUMERO DU MENAGE
NUMERO DU REPONDANT
Nom Enquêteur: _______________________________
Nom Superviseur: _______________________________
Date Interview (jj/mm/aa): /___/___/ /___/___/ /___/___/ Heure Déut interview (hh/mn) :/___/___/ /___/___/ 
SECTION 1: CARACTERISTIQUES SOCIODEMOGRAPHIQUES ET SOCIOECONOMIQUES DU REPONDANT
Tout d’abord, je voudrais vous poser des questions sur vous et votre famille
No Questions Modalités de réponses et codes
100 Depuis combien de temps habitez￾vous à [Nom de la localité/Quartier] ?
Nombre d’années ............................................. 
Depuis toujours 66
Pas de réponse/Refus 77
Ne sait pas 99
101 Quel âge aviez-vous lors de votre 
dernier anniversaire ?
ENCERCLEZ LE GROUPE D’AGE 
CORRESPONDANT
15-19ans ............................... 1 
20-24ans ............................... 2 
25-29ans ............................... 3 
30-34ans ............................... 4 
35-39 ans............................... 5 
40-44ans................................6
45-49ans................................ 7 
50-54 ans............................... 8 
55-59 ans............................... 9 
Ne sait pas...........................99
102 Quel est votre statut matrimonial ?
SI MARIE, SONDEZ POUR CONNAITRE LE 
NOMBRE D’EPOUSES
Marié, monogame................. 1 
Marié, polygame.................... 2 
Vivons ensemble................... 3 
Célibataire ............................. 4 
Divorcé................................... 5 
Séparé ................................... 6 
Veuf........................................ 7 
Pas de réponse/Refus.........77
Questionnaire des Hommes âgés de 15 à 59 ans
The AgirPF Project Endline Evaluation Report 69
No Questions Modalités de réponses et codes
103 Avez-vous déjà fait des études ?
SI OUI, quel est votre plus haut niveau 
d’éducation ?
Pas été à l’école.................... 1 
Primaire................................. 2 
Secondaire 1......................... 3 
Secondaire 2.......................... 4 
Universitaire........................... 5 
Pas de réponse/Refus........... 7 
104 En dehors de votre propre ménage, 
faites-vous actuellement un autre 
travail ?(SONDER)
Oui 1 
Non 2 
Pas de réponse/Refus 7 
SECTION 2: CONTRACEPTION
Maintenant, je voudrais que nous parlions de la planification familiale, c’est-à-dire les différents moyens ou 
méthodes qu'un couple peut utiliser pour retarder ou éviter une grossesse.
No Questions Modalités de réponses et codes
200 Avez-vous entendu parler de méthodes 
qu’un couple peut utiliser pour retarder ou 
éviter une grossesse ?
Oui ...................................................................... 1 
Non ..................................................................... 2 (Aller à300)
Pas de réponse/Refus ........................................ 7 (Aller à300)
Si « Oui » à 200, de quelle(s) voie(s)/méthode(s) permettant de retarder ou 
éviter les grossesses avez-vous entendu parler ? 
Ecrire le code 1 dans 201 pour chaque méthode mentionnée 
spontanément.Ensuite lisez le nom et la description de chaque méthode qui 
n’est pas mentionnée spontanément. Ecrire le code 1si la méthode est 
reconnue et le code 2 si elle n’est pas reconnue. Ensuite pour chaque 
méthode avec le code 1, posez 202 avant d’aller à la méthode suivante.
PLUSIEURS REPONSES POSSIBLES.SONDER: D’autres méthodes ?
201. Avez￾vous déjà 
entendu 
parler de 
{méthode} ?
1 = Oui
2 = Non 
7 = Refus
202. Avez￾vous déjà 
utilisé 
{méthode} ?
1 = Oui
2 = Non 
7 = Refus
a.
PILULES : Les femmes peuvent prendre une pilule chaque jour pour éviter 
de tomber enceinte.
b. DIU : Les femmes peuvent se faire placer un stérilet par une infirmière ou un 
docteur pour leur éviter les grossesses pendant plusieurs années.
c.
INJECTABLES: Les femmes peuvent avoir des injections qui peuvent leur 
éviter de tomber enceinte pendant plusieurs mois.
d. COMPRIMES MOUSSANTS / GELEE: Les femmes peuvent se placer des 
cachets mousseux dans le vagin avant les rapports sexuels.
e.
PRESERVATIF MASCULIN : Les hommes peuvent mettre une capote en 
caoutchouc sur leur pénis avant les rapports sexuels.
f. PRESERVATIF FEMININ : Les femmespeuvent placer un fourreau dans leur 
vagin avant les rapportssexuels.
g.
Méthodes des Jours Fixes (MJF) : Une femme peut se servir de perles 
pour compter les jours de son cycle et éviter d'avoir des rapports sexuels 
les jours où elle est susceptible de tomber enceinte
h. LA STERILISATION FEMININE: Les femmes peuvent subir une opération 
pour ne plus avoir d’enfants.
i. LA STERILISATION MASCULINE: Les hommes peuvent subir une 
opération pour ne plus avoir d’enfants.
The AgirPF Project Endline Evaluation Report 70
Si « Oui » à 200, de quelle(s) voie(s)/méthode(s) permettant de retarder ou 
éviter les grossesses avez-vous entendu parler ? 
Ecrire le code 1 dans 201 pour chaque méthode mentionnée 
spontanément.Ensuite lisez le nom et la description de chaque méthode qui 
n’est pas mentionnée spontanément. Ecrire le code 1si la méthode est 
reconnue et le code 2 si elle n’est pas reconnue. Ensuite pour chaque 
méthode avec le code 1, posez 202 avant d’aller à la méthode suivante.
PLUSIEURS REPONSES POSSIBLES.SONDER: D’autres méthodes ?
201. Avez￾vous déjà 
entendu 
parler de 
{méthode} ?
1 = Oui
2 = Non 
7 = Refus
202. Avez￾vous déjà 
utilisé 
{méthode} ?
1 = Oui
2 = Non 
7 = Refus
j.
IMPLANT : Les femmes peuvent se faire insérer par un médecin ou une 
infirmière un bâtonnet ou plus sous la peau du haut du bras pour les 
empêcher de tomber enceinte, pendant une annéeou plus.
k.
RYTHME, COMPTAGE DES JOURS: Une femme peut compter les jours de 
son cycle et éviter d’avoir des rapports sexuels les jours où il est probable 
qu’elle tombe enceinte.
l.
PLANIFICATION FAMILIALE NATURELLE:Une femme peut prendre sa 
température tous les jours ou vérifier sa mucosité vaginale pour déterminer 
les jours où il faut éviter des rapports sexuels.
m.
COIT INTERROMPU: L’homme peut faire attention et se retirer de la femme 
avant d’éjaculer.
n.
MAMA: L’allaitement exclusif au sein jusqu’à 6 mois peut constituer une 
protection naturelle contre les grossesses.
o.
CONTRACEPTION D’URGENCE : Une femme peut prendre une forte dose 
de la pilule dans les 24 heures qui suivent les rapports sexuels non protégés.
p.
Avez-vous entendu parler d’autres voies ou méthodes utilisées pour éviter 
les grossesses ? Précisez__________________________________
No Questions Modalités de réponses et codes
203 Vous et votre femme/partenaire faites-vous 
quelque chose ou utilisez-vous actuellement 
une méthode quelconque pour retarder ou 
éviter une grossesse ?
Oui ..................................................1
Non ................................................. 2 (Aller à 205)
Pas de réponse/Refus.................... 7 (Aller à 205)
204 Si oui, quelle méthode utilisez-vous ?
METTRE 1=OUI LORSQUE LA METHODE EST 
UTILISEE ET 0=NON DANS LE CAS CONTRAIRE
PLUSIEURS REPONSES POSSIBLES.
PASSER ENSUITE A Q300
Pilules combinées ou à 
progestatif seul…………
DIU ……………………..
Injectables……………...
Implants……………….. 
Préservatif masculin…..
Préservatifféminin……
Spermicides…………… 
Stérilisation féminine …
Stérilisation masculine …
Méthode des jours 
fixes (MJF)……….
MAMA ……………
Contraception 
d’urgence ………...
Contraception 
naturelle ………….
Refus…………….. 
Ne sait pas……….
The AgirPF Project Endline Evaluation Report 71
205 Vérifiez 203. Si aucune méthode n'est 
utilisée, demandez :
Vous avez dit que vous et votre femme/ 
partenaire n'utilisiez aucune méthode pour 
retarder ou éviter une grossesse. Pouvez￾vous me dire pourquoi vous et votre femme/ 
partenaire n'utilisez pas une méthode ?
SONDEZ: Ya-t-il d’autres raisons ?
METTRE 1=OUI LORSQU'UNE RAISON EST 
EVOQUEE PAR L'ENQUETEE
ET 0=NON SI LA RAISON/MODALITE N'EST PAS 
EVOQUEE
PLUSIEURS RÉPONSES POSSIBLES
PROBLEMES DE FECONDITE
1. N’a pas de rapports sexuels................. 
2. Rapports sexuels peu fréquents ................. 
3. Ménopause/hystérectomie.......................... 
4. Peu féconde ................................................ 
5. Aménorrhée postpartum ............................. 
6. Allaitement maternel ................................... 
7. Fataliste/pas de contrôle............................. 
8. Veut tomber enceinte.................................. 
OPPOSITION A L’UTILISATION
9. Répondant est opposé................................ 
10.Mari/Partenaire est opposé .......................... 
11.Autre personne opposée............................. 
12.Interdiction religieuse .................................. 
MANQUE DE CONNAISSANCE 
13.Ne connait pas de méthode ........................ 
14.Ne connait pas de source ........................... 
RAISONS LIEES AUX METHODES
15.Problèmes de santé .................................... 
16.Peur d’effets secondaires............................. 
17.Manque d’accès/trop loin ............................ 
18.Coûtent trop cher ........................................ 
19.Incommode à utiliser................................... 
20.Interfère avec les processus normaux 
du corps....................................................... 
30. Autre (Précisez) : ....................................... 
77. Pas de réponse/Refus ............................... 
99. Aucune idée/Ne sait pas ............................. 
SECTION 3: SBCC / ACTIVITES GENERATRICES DE DEMANDE
No Questions Modalités de réponses et codes
300 Au cours des trois derniers mois, combien de 
fois avez-vous parlé à votre femme/partenaire 
d'une méthode de planification familiale ?
Jamais 1 
Une ou deux fois ......................................................... 2 
Plus de deux fois......................................................... 3 
Pas de réponse/Refus ................................................ 7 
Ne sait pas 9 
The AgirPF Project Endline Evaluation Report 72
No Questions Modalités de réponses et codes
301 Au cours des 12 derniers mois, avez-vous vu 
des affiches ou entendu des messages 
radiophoniques sur la gestion des effets 
secondaires des méthodes de planification 
familiale?
Oui ………1
Non 2 
Pas deréponse/Refus ................................................. 7 
302 Au cours des 12 derniers mois, avez-vous 
entendu parler d'un numéro gratuit que l'on peut 
appeler pour obtenir des informations gratuites 
sur la planification familiale?
Oui ………1
Non 2 
Pas de réponse/Refus ................................................7 
303 Au cours des 12 derniers mois, avez-vous été 
contactée par quelqu'un qui vous a donné un 
coupon pour obtenir des services de planification 
familiale gratuitement dans les centres de santé?
Oui ………1 
Non 2 
Pas de réponse/Refus 7 
Merci d'avoir repondu à mes questions. Fin de l'interview de temps(hh/mn): 
The AgirPF Project Endline Evaluation Report 73
Appendix B: Number of intervention and nonintervention health facilities by 
health district 
Table 24. Number of intervention and nonintervention health facilities by health district in the four countries 
City Health Districts Intervention health 
facilities
Control health 
facilities
Total District 
Health Facilities
Number Percent Number Percent Number Percent
Burkina Faso
Ouaga￾dougou
Baskuy 8 80.0 2 20.0 10 100
Bogodogo 10 58.8 5 29.4 17 100
Boulmiougou 9 81.8 2 18.2 11 100
Nongremassom 6 40.0 6 40.0 15 100
Signoghin 0 - 7 87.5 8 100
Sub-total Ouagadougou 33 54.1 22 36.1 61 100
Bobo 
Dioulasso
Do 9 69.2 4 30.8 13 100
Dafra 4 50.0 4 50.0 8 100
Sub-total Bobo Dioulasso 13 61.9 8 38.1 21 100
Koudougou Koudougou 8 42.1 8 42.1 20 100
Sub-total Koudougou 8 42.1 8 42.1 19 100
Total Burkina Faso 54 53.5 38 37.6 101 100
Côte d’Ivoire
Abidjan Abobo-Est 8 50.0 8 50.0 16 100
Abobo-Ouest 7 77.8 2 22.2 9 100
Anyama 9 50.0 9 50.0 18 100
Cocody-Bingerville 7 53.8 6 46.2 13 100
Koumassi-Port-Bouët-Vridi 11 64.7 6 35.3 17 100
Marcory-Treichville 2 33.3 4 66.7 6 100
Adjamé-Plateau-Attécoubé 10 76.9 3 23.1 13 100
Dabou 8 61.5 5 38.5 13 100
Yopougon-Est 10 83.3 2 16.7 12 100
Yopougon-Ouest 10 66.7 5 33.3 15 100
Total Côte d’Ivoire 8217 62.1 50 37.9 132 100
Niger
Maradi District 1 Madarounfa 6 10.5 6 10.5 57 100
District 2 Maradi Commune 9 81.8 2 18.2 11 100
District 3 Aguie 3 4.3 3 4.3 69 100
District 5 Guidan Roumdji 3 2.4 3 2.4 126 100
Sub-total Maradi 21 8.0 14 5.3 263 100
Niamey District 7 Niamey I 1 5.3 1 5.3 19 100
District 6 Niamey II 10 45.5 10 45.5 22 100
District 8 Niamey IV 1 20.0 1 20.0 5 100
District 9 Niamey V 3 30.0 3 30.0 10 100
Sub-total Niamey 15 26.8 15 26.8 56 100
Total Niger 36 11.3 29 9.1 319 100
Togo
Lomé District Sanitaire No 1 1 33.3 1 33.3 3 100
District Sanitaire No 2 3 75.0 1 25.0 4 100
District Sanitaire No 3 2 33.3 2 33.3 6 100
District Sanitaire No 4 1 33.3 0 0.0 3 100
District Sanitaire No 5 6 75.0 2 25.0 8 100
District du Golfe 6 60.0 3 30.0 10 100
Sous-total Lomé 19 55.9 9 26.5 34 100
Sokodé Tchaoudjo 14 46.7 7 23.3 30 100
Sous-total Sokodé 14 46.7 7 23.3 30 100
 
1717 The number felt down to 79 since 3 facilities were no longer part of the project for diverse reasons.
The AgirPF Project Endline Evaluation Report 74
Kara Kozah 14 35.9 7 17.9 39 100
Binah 1 7.1 1 7.1 14 100
Sous total Kara 15 28.3 8 15.1 53 100
Total Togo 48 41.0 24 20.5 117 100
The AgirPF Project Endline Evaluation Report 75
Appendix C: Statistics for population sample calculation 
Table 25. Statistics for population sample calculation for the four countries 
Country City
Response rate
(%) CPR for 
Women
(%)
Proportion of 
men reporting 
dialogue with 
their partner 
about FP (%)
Population 
estimates
(number)
Design 
effect
Women (number)
15-49
Men
15-59
Women
15-49
Men
15-59
Burkina 
Faso
Ouagadougu 95.7 93.3 32.6 46.0 361,601 363,964 1.288
Bobo 98.2 96.3 26.8 46.0 133,276 134,147 1.643
Koudougou 98.2 96.3 09.6 46.0 25,312 25,478 1.643
Côte d’Ivoire Abidjan 90.6 86.2 21.3 49.4 1,065,115 1.148
Niger Niamey 92.4 81.3 31.8 37.9 177,622 177,622 1.449
Maradi 93.2 80.9 23.6 37.9 37,136 37,136 1.399
Togo Lome 90.6 86.3 12.0 51.0 256,451 258,349 1.305
Sokode 93.9 90.6 13.7 51.0 29,091 29,091 1.199
Kara 93.9 90.6 18.6 51.0 29,032 29033 1.199
The AgirPF Project Endline Evaluation Report 76
Appendix D: AgirPF PMP Indicators’ Results Table 
Output Indicator Results
Number
Indicator 
Description and 
Type
Indicator Definition (including 
how measured, disaggregation)
Source of 
information / Data 
collection method 
and frequency
Country Target Achievement Rate
SO: Increase access to and use of quality FP services in select urban and peri-urban areas of five francophone West African countries
1 
Number of CYP 
achieved in AgirPF 
supported areas 
(output indicator)
(USAID RDCS)
The estimated protection by family 
planning (FP) services during a one￾year period, based upon the volume 
of all contraceptives sold or 
distributed free of charge to clients 
during that period. 
MOH supported 
sites data from 
DHIS2, FP special 
days, Sub-grantee 
activity, WAAF, etc.
Monthly Quarterly
Burkina Faso 420,842 640,530 152%
Côte d’Ivoire 643,882 219,512 34%
Mauritania 71,997 25,394 35%
Niger 351,444 221,420 63%
Togo 194,836 258,882 133%
Total 1,683,000 1,367,980 81%
3 
Total number of FP 
method users 
(output indicator)
The number of persons during a 
defined reference period (e.g., one 
year) who use a modern 
contraceptive method. These 
include all users accessing project 
supported sites/services for re￾supply, method changes, and/or 
new users. 
MOH supported 
sites data from 
DHIS2, FP special 
days, sub-grantee 
activity, WAAF, etc.
Collect monthly 
Report quarterly
Burkina Faso 528,454 562,361 106%
Côte d’Ivoire 481,548 309,404 64%
Mauritania 86,690 87,530 101%
Niger 347,833 322,421 93%
Togo 213,871 223,656 105%
Total 1,658,396 1,505,372 91%
4 
Number of additional 
users of modern 
methods of 
contraception 
(USAID RDCS)
Number of new users of a modern 
method of contraception defined as 
someone who was not using a 
modern method of contraception 
when they received their method, 
including people who previously 
used a method, stopped, and are 
now starting a method.
MOH supported 
sites data from 
DHIS2, FP special 
days, sub-grantee
activity, WAAF, etc. 
Collect monthly 
Report quarterly
Burkina Faso 173,824 214,016 123%
Côte d’Ivoire 265,948 107,844 40.5%
Mauritania 21,786 17,116 78.5%
Niger 145,160 130,058 89.5%
Togo 80,475 103,562 129%
Total 687,193 574,974 84%
Result 1: Delivery of quality FP information, products, and services strengthened and expanded
Sub-result 1.1: Partners strengthened to implement evidence-based approaches and deliver quality FP services
6 
Number of local 
organizations with 
improved 
The number of AgirPF local partners 
implementing AgirPF activities which 
are improving organizational and 
Routine 
supervision reports
Burkina Faso 10 6 60%
Côte d’Ivoire 12 3 40%
Mauritania 5 3 60%
The AgirPF Project Endline Evaluation Report 77
Number
Indicator 
Description and 
Type
Indicator Definition (including 
how measured, disaggregation)
Source of 
information / Data 
collection method 
and frequency
Country Target Achievement Rate
organizational and 
management 
capacity (OCAT)
Output indicator 
(USAID RDCS)
managerial capacity. This 
improvement will be measured by 
using the OCAT tool.
 
Annually
Niger 8 3 37.5%
Togo 7 6 86%
Total 42 21 50%
7 
Number of FP 
curricula updated to 
include gender 
sensitivity, couple 
counseling, youth 
and male friendly 
services
Output indicator
FP curriculum integrating gender 
sensitivity, couple counseling, youth 
and male friendly services utilized
Activity reports 
Collect monthly 
report quarterly
Burkina Faso 1 1 100%
Côte d’Ivoire 1 1 100%
Mauritania 1 1 100%
Niger 1 1 100%
Togo 1 1 100%
Total 5 5 100%
8 
Number of people 
trained in family 
planning and 
reproductive health 
with USG funds 
(output indicator)
Number of people (health 
professionals, primary health care 
workers, community health workers, 
volunteers, non-health personnel) 
trained in FP/RH (including training 
in service delivery, communication, 
policy and systems, research, etc.).
Activity reports 
Collect monthly 
report quarterly
Burkina Faso 1296 1525 118%
Côte d’Ivoire 1992 1727 87%
Mauritania 480 424 88%
Niger 864 1250 145%
Togo 1152 1071 93%
Total 5784 5699 98%
9 
Number of HIV 
positive women who 
received 
comprehensive FP 
services
(output indicator)
This indicator informs about level of 
integration of FP services into HIV 
services.
Activity reports, 
WAAF
Collect monthly 
report quarterly
Burkina Faso n/a n/a n/a
Côte d’Ivoire 1200 389 32%
Mauritania n/a n/a n/a
Niger n/a n/a n/a
Togo 100 262 262%
Total 1300 651 50%
10
Number of special 
FP days conducted
(output indicator)
Special FP days are days where the 
range of FP services are offered 
free of charge by dedicated 
providers. 
Activity reports, 
daily consultation 
registers
Burkina Faso 520 668 128%
Côte d’Ivoire 500 282 56%
Mauritania 300 165 55%
Niger 395 223 56%
The AgirPF Project Endline Evaluation Report 78
Number
Indicator 
Description and 
Type
Indicator Definition (including 
how measured, disaggregation)
Source of 
information / Data 
collection method 
and frequency
Country Target Achievement Rate
monthly report 
quarterly
Togo 520 516 99%
Total 2235 1854 83%
Sub-result 1.2: Local leaders, civil society, service providers, municipal government support and promote FP
11
Number of additional 
USG-assisted CHWs 
providing family 
planning information 
and/or services 
during the year
(output indicator)
(USAID RDCS)
CHWs supported (trained, equipped 
with kits) and supervised
Activity reports
Collect monthly 
report quarterly
Burkina Faso 75 127 282%
Côte d’Ivoire 100 100 100%
Mauritania18 N/A N/A N/A
Niger 150 200 133%
Togo 180 365 203%
Total 505 792 156% 
16
Number of youth who 
participate in 
educational program 
on gender, FP, and 
SRH
(output indicator)
Peer educators will lead discussions 
as moderators with enhanced 
knowledge on FP.
This indicator also includes those 
reached by group discussion on FP 
services, WAAF and sub-grantee 
organizations
Sign-in sheets, 
activity reports 
 
Collect monthly 
report quarterly
Burkina Faso 60000 150 579 251%
Côte d’Ivoire 45000 46 403 103%
Mauritania 45000 442 9,8%
Niger 60000 81 352 135%
Togo 60000 39 325 66%
Total 270,000 318,101 118%
17
Number of Site 
Walk-Throughs 
(SWT) conducted 
(output indicator)
Guided tour in facilities by Local 
community leaders aiming at 
contributing to solve health issues
Sign-in sheets, 
activity reports
Collect monthly 
report quarterly
Burkina Faso 84 37 44%
Côte d’Ivoire 100 46 46%
Mauritania 20 0 0
Niger 56 4 7%
Togo 59 49 83%
Total 329 136 41%
Result 2: Evidence-based service delivery approaches selected, adapted, and implemented
Sub-result 2.1: Efficiency and effectiveness enhanced through adaptation and implementation
19
Number of HIPs 
piloted through 
implementation 
research 
Implementation research (IR) have 
been conducted by the project. 
Implementation research focuses on 
understanding how programs are 
Implementation 
research reports
 
Annually
Burkina Faso 2 10 500%
Côte d’Ivoire 2 10 500%
Mauritania 1 3 300%
Niger 3 5 167%
 
18 N/A stands for Not Applicable. It was not previewed to train CHWs in Mauritania
The AgirPF Project Endline Evaluation Report 79
Number
Indicator 
Description and 
Type
Indicator Definition (including 
how measured, disaggregation)
Source of 
information / Data 
collection method 
and frequency
Country Target Achievement Rate
(output indicator)
(USAID RDCS)
implemented, translated, replicated, 
and disseminated in “real-world” 
settings. 
Togo 4 10 250%
Total n/a n/a n/a
Sub-result 2.2: Lessons documented and disseminated from adaptation and implementation
20
Number of regional 
technical meetings 
organized and 
supported by AgirPF 
and its partners
Output indicator
(USAID RDCS)
Use USAID Definition once it 
becomes available
Reports
Annually
Burkina Faso n/a n/a n/a
Côte d’Ivoire n/a n/a n/a
Mauritania n/a n/a n/a
Niger n/a n/a n/a
Togo n/a n/a n/a
Total 17 43 268.7%
Result 3: Efforts to remove policy barriers and improve contraceptive commodity security coordinated
Sub-result 3.1: Policy barriers identified and new/revised policies adopted and implemented
21a
Number of policies or 
guidelines developed 
or changed with USG 
assistance 
(output indicator)
(USAID RDCS)
Number of policies, laws and 
guidelines introduced or updated as 
a result of USG-assistance related 
to improvement in family planning 
and reproductive health services
Policies and 
guidelines 
Annually
Burkina Faso 3 2 67%
Côte d’Ivoire 3 1 33%
Mauritania 3 2 67%
Niger 3 0 0
Togo 3 3 100%
Total 15 19 127%
21b
Number of countries 
with a line item in the 
national budget for 
FP
(USAID RDCS)
Use USAID definition once it 
becomes available.
Indicator activities begin in PY3 and 
are only deemed a success if 
because of AgirPF: (i) A country that 
had no line item adds a line item, or 
(ii) a country that had a line item 
increases the budgeted amount.
Monitoring Report
Collected quarterly 
reported annually
Burkina Faso 1 1 100%
Côte d’Ivoire 1 1 100%
Mauritania 1 1 100%
Niger 1 1 100%
Togo 1 1 100%
Total 5 5 100%
22
Number of advocacy 
presentations created 
AgirPF will support countries to 
develop or update country-specific 
Reports Burkina Faso 1 21 210%
Côte d’Ivoire 1 4 400%
The AgirPF Project Endline Evaluation Report 80
Number
Indicator 
Description and 
Type
Indicator Definition (including 
how measured, disaggregation)
Source of 
information / Data 
collection method 
and frequency
Country Target Achievement Rate
or updated (in 
collaboration with 
Avenir Health and 
HP+)
(output indicator)
advocacy presentations, including 
RAPID models.
Disaggregated by theme of 
advocacy presentation
Quarterly Mauritania 1 4 400%
Niger 1 7 700%
Togo 1 11 1100%
Total 5 47 783%
23
Number of advocacy 
activities conducted
(output indicator)
AgirPF will support the initial launch 
of advocacy activities for the RAPID 
presentation to policy makers at the 
country-level.
Reports
Quarterly
Burkina Faso 6 25 4167%
Côte d’Ivoire 5 17 340%
Mauritania 7 15 214%
Niger 6 12 200%
Togo 7 32 457%
Total 31 101 288.6%
24
Number of formal 
agreements (MoU, 
policy, declaration, 
etc.) that are signed 
at the regional level 
(USAID RDCS)
Use USAID Definition once it 
becomes available
Monitoring Report
Collected quarterly 
reported annually
Burkina Faso n/a n/a n/a
Côte d’Ivoire n/a n/a n/a
Mauritania n/a n/a n/a
Niger n/a n/a n/a
Togo n/a n/a n/a
Total 15 41 273%
Sub-result 3.2: Contraceptive commodity needs identified and coordinated among partners and country commodity security and logistics management
25
Number of SDP 
reporting stock-outs 
of contraceptives per 
quarter
(output indicator)
SDP reporting stock-outs of 
contraceptives per quarter.
Disaggregated by method.
Health facility stock 
reports, inventory 
reports
Collect monthly 
report quarterly
Burkina Faso TBD
Côte d’Ivoire TBD
Mauritania TBD
Niger TBD
Togo TBD
Total TBD19
 
19 The targets failed to be defined due to no existing clear definition of the indicator.
The AgirPF Project Endline Evaluation Report 81
Outcome Indicator Results
Indicator
Number
Indicator 
Description and 
Type
Indicator Definition
Source of 
information / 
Data collection 
method and 
frequency
Country
Annual Target
Notes Y1 Y2 Y3 Y4 Y5 Total 
LOP
SO: Increase access to and use of quality FP services in select urban and peri-urban areas of five francophone West African countries
2 Contraceptive 
Prevalence Rate 
(CPR)
(outcome indicator)
(USAID RDCS)
The proportion of women of 
reproductive age (WRA, age 
15-49) who are using (or 
whose partner is using) a 
contraceptive method at a 
given point in time 
Numerator: number of WRA 
who self-report using FP 
Denominator: number of WRA 
surveyed 
For setting targets, the 
projected growth rate is 2% per 
year 
Baseline and 
end-line 
household 
Surveys
 
Y120 & Y5
Burkina 
Faso
38.5 40.5 42.5 44.5 46.5 38 The results 
of Burkina 
Faso are 
surprising
Côte 
d’Ivoire
n/a 27.9 29.9 31.9 33.9 48
Mauritania n/a n/a 19.3 21.3 23.3 n/a
Niger 39.2 41.2 43.2 45.2 47.2 62
Togo 40.3 42.3 44.3 46.3 48.3 48
Total n/a n/a n/a n/a n/a n/a
Result 1: Delivery of quality FP information, products, and services strengthened and expanded
5 
Percent of FP 
service providers 
deemed 
technically 
competent based 
on an assessment 
according to 
national 
international or 
other defined 
standards
Outcome indicator 
(USAID RDCS)
Health providers will be 
supervised performing the FP 
services and counseling they 
were trained in by AgirPF. 
They will be assessed based 
on international standards for 
competency. “Performing up to 
standards” will be defined as 
receiving a score of at least 
85%.
Facility audits, 
facilitative 
supervision, 
sub-grantees
Quarterly
Burkina 
Faso 80 n/a n/a n/a 97 121%
Côte 
d’Ivoire 80 n/a n/a n/a 79 99%
Mauritania21 80 n/a n/a n/a n/a n/a
Niger 80 n/a n/a n/a 92 115%
Togo 80 n/a n/a n/a 100 125%
Total 80 n/a n/a n/a 92 115% 
 
20 Y1 mCPR are estimates from baseline surveys conducted in the four AgirPF countries (Burkina, Côte d’Ivoire, Niger, and Togo). For Mauritania, data presented is an estimation from the MICS conducted 
in 2011 in this country. AgirPF baseline survey will be conducted in Nouakchott is year 3. 21 n/a stands for not available. Mauritania began supervising providers late in PY4 and closed the project before the other countries in February 2018.
The AgirPF Project Endline Evaluation Report 82
Indicator
Number
Indicator 
Description and 
Type
Indicator Definition
Source of 
information / 
Data collection 
method and 
frequency
Country
Annual Target
Notes Y1 Y2 Y3 Y4 Y5 Total 
LOP
Sub-result 1.2: Local leaders, civil society, service providers, municipal government support and promote FP
12 Proportion of 
women and men 
reporting increased 
dialogue with their 
partner about FP 
(outcome indicator)
A man or a woman is reporting 
dialoguing with their partners if 
during the last three months 
they discussed at least once 
FP issues including the choice 
and/or use of a given FP 
method. 
Pre and post￾Household 
KAPB surveys 
Y1 baseline, Y5 
end-line
Burkina 
Faso
52 n/a n/a n/a 65 20.4 Burkina 
Faso results 
surprisingly 
low
Côte 
d’Ivoire
n/a 40 n/a n/a 55 34.4
Mauritania n/a n/a n/a22 n/a n/a n/a
Niger 39 n/a n/a n/a 50 54.9
Togo 44 n/a n/a n/a 55 32.6
Total n/a n/a n/a n/a n/a n/a
13 Percent of men 
and women with 
gender-equitable 
attitudes
 
(outcome 
indicator) 
(USAID RDCS)
(Modified gender 
indicator)
Attitudes of women and men 
will be assessed to determine 
attitudes in terms of: their 
support for women’s sexual 
and reproductive rights; their 
support for women’s right to 
practice a contraceptive 
method; their support for men’s 
involvement in the promotion of 
women’s sexual and 
reproductive health; their 
support for joint decision￾making about FP; their support 
for consensual sex in a 
relationship; their support for 
women’s involvement in 
decision-making at the 
household level; their support 
for men’s involvement in child 
care; their resistance to all 
forms of violence against
Household 
KAPB survey
 
Y1 baseline, Y5 
end-line
Burkina 
Faso
41 n/a n/a n/a n/a 11
Côte 
d’Ivoire
n/a 45 n/a n/a n/a 10
Mauritania n/a n/a n/a n/a n/a n/a
Niger 22 n/a n/a n/a n/a 10
Togo 43 n/a n/a n/a n/a 10
Total n/a n/a n/a n/a n/a n/a
 
22 Mauritania’s target will be updated when Baseline data will be available.
The AgirPF Project Endline Evaluation Report 83
Indicator
Number
Indicator 
Description and 
Type
Indicator Definition
Source of 
information / 
Data collection 
method and 
frequency
Country
Annual Target
Notes Y1 Y2 Y3 Y4 Y5 Total 
LOP
women; their support for 
women’s human rights. 
14 Percent of women 
citing lack of 
information on FP 
methods as a key 
barrier to use
(outcome indicator)
Numerator: number of women 
citing lack of information on FP 
methods as a key barrier to use
Baseline/Endline 
survey
Y1 & Y5
Burkina 
Faso
n/a n/a n/a n/a n/a 11.2
Côte 
d’Ivoire
n/a n/a n/a n/a n/a 12.6
Mauritania n/a n/a n/a n/a n/a n/a
Niger n/a n/a n/a n/a n/a 2.8
Togo n/a n/a n/a n/a n/a 3.6
Total n/a n/a n/a n/a n/a n/a
15 Percent of women 
who have 
discussed FP with 
husbands/partners, 
friends/family 
within the last 
three months
(outcome indicator)
Numerator: number of women 
who have discussed FP with 
husband/partner, friends/family 
within the last three months
Baseline/Endline 
survey
Y1 & Y5
Burkina 
Faso
n/a n/a n/a n/a n/a 14.3
Côte 
d’Ivoire
n/a n/a n/a n/a n/a 16.4
Mauritania n/a n/a n/a n/a n/a n/a 
Niger n/a n/a n/a n/a n/a 75.1
Togo n/a n/a n/a n/a n/a 41.7
Total n/a n/a n/a n/a n/a
Result 2: Evidence-based service delivery approaches selected, adapted, and implemented
18
Number of HIPs 
for family planning 
and maternal and 
child health and/or 
HIV/AIDS 
incorporated into 
national health 
Evidence of HIPs for family 
planning and maternal and 
child health and/or HIV/AIDS 
incorporated into national 
health protocols or standards 
Step 1: HIP accepted by MOH
Step 2: HIP replicated by MOH
National health 
protocols or 
standards
Collect monthly 
report quarterly 
Burkina 
Faso 5 n/a n/a n/a 10 200%
Côte 
d’Ivoire 4 n/a n/a n/a 10 250%
Mauritania 3 n/a n/a n/a 3 100%
Niger 5 n/a n/a n/a 7 140%
Togo 5 n/a n/a n/a 10 100%
The AgirPF Project Endline Evaluation Report 84
Indicator
Number
Indicator 
Description and 
Type
Indicator Definition
Source of 
information / 
Data collection 
method and 
frequency
Country
Annual Target
Notes Y1 Y2 Y3 Y4 Y5 Total 
LOP
protocols or 
standards23 
(outcome 
indicator)
(USAID RDCS)
Step 3: HIP scaled-up
Step 4: HIP integrated into 
national guidelines Total n/a n/a n/a n/a n/a n/a
 
23 AgirPF counts a target reached once the HIP is integrated into national guidelines, not for any previous steps.