Couple-Years of Protection (CYP)

The estimated protection provided by family planning services during a one year period, based upon the volume of all contraceptives sold or distributed free of charge to clients during that period. The CYP is calculated by multiplying the quantity of each method distributed to clients by a conversion factor, which yields an estimate of the duration of contraceptive protection provided per unit of that method

Core Indicator 13, couple-years of protection, is the only core indicator to come directly from routine data systems. Countries collect information from the public sector (and in some cases the private sector) about the number of services and products provided to clients. This information is vital for monitoring health system performance, forecasting inventory stocks to ensure adequate supplies are available, and tracking trends and progress over time.

Routine information collected by health providers on their client visits, such as the number of services and products provided to clients, are converted into couple-years of protection (CYPs) to allow for comparison of the pregnancy prevention delivered through the provision of different contraceptive methods. This is needed because providing one IUD and one condom generate very different levels of protection against pregnancy for the clients receiving them. The CYP measure adjusts for these differences and shows the total years of protection that will result from the services provided or products distributed/sold in each year.

The CYP estimates presented in this report are based on data from countries’ routine information systems and were reviewed by countries at their annual data consensus workshops after various quality assessments. Since countries need to have robust health information systems to report on CYPs, the indicator also serves as a proxy for the importance of investing in Health Management Information Systems and using routine data in countries. Each year since 2012, an increasing number of countries have been able to use their service statistics to report on CYPs.

CYP data and particularly trends from year to year should not be interpreted without additional information, as there are often factors that may explain large variations between years. In Ethiopia, for example, CYPs are based on commodities distributed to facilities. In 2012 and 2013 Ethiopia embarked on an effort to improve method choice, particularly for long acting reversible contraceptives in the public sector. The high numbers of CYPs for these years are due to the fact that large volumes of implants - which have a relatively high conversion factor (i.e. number of CYPs per implant) - were distributed to facilities for use in subsequent years.


While there are limitations to what a CYP estimate can tell us about users of family planning, trends in routine service statistics data can be used to inform estimates of current MCPR. In Mozambique, for example, data from routine information systems from 2012 to 2015 suggested an upward trend in services being provided to clients. The last nationally representative survey for Mozambique was conducted in 2011, and without information from routine data systems, estimates of MCPR would have continued on the path of slow growth that Mozambique had been following. The service statistics from Mozambique suggested a more rapid growth in contraceptive services, and these data were used to inform Mozambique’s FP2020 MCPR estimates. Later, a nationally representative survey, the Mozambique AIDS Indicator Survey, confirmed the rapid growth in contraceptive use that had been suggested by service statistics. Without these data Mozambique would have had little information to help explain its progress, and today we know that Mozambique is among the fastest growing countries in terms of expanded contraceptive use.