SOCIAL MARKETING RESEARCH SERIES

Rwanda (2006): MAP Study Evaluating

Coverage, Quality of Coverage and
Access to Condoms
First Round

MAP: Measuring Access and Performance

Kigali, Rwanda
January 2007

PSIs Core Values

Bottom Line Health Impact * Private Sector Speed and Efficiency * Decentralization, Innovation,
and Entrepreneurship * Long-term Commitment to the People We Serve

Research & Metrics

Population Services International
1120 Nineteenth Street NW, Suite 600
Washington, D.C. 20036

Rwanda (2006): MAP Study Evaluating Coverage, Quality of

Coverage, and Access to Condoms.
First Round

PSI Research & Metrics

2007

Population Services International, 2007

Contact Information:
Bram Piot, Geographer
86 rue du Cercle, Logras, 01630
Pron
France
Phone: +33 (0)4 50 99 09 47
Email: bram.piot@wanadoo.fr

Nicola Hobby, Special Programs Assistant

PSI/Rwanda
BP 3040, Kimihurura
Kigali
Rwanda
Phone: + 250 08 30 79 56
Email: nhobby@psirwanda.org

Acknowledgements
This report represents the work of many individuals. The study was designed by Julia White and
was conducted by the Research Department of PSI/Rwanda under the supervision of Gerard
Karwanga, Eugene Sangano, Teddy Kaberuka and Nicola Hobby.

Data management was

supervised by Eugene Sangano, Teddy Kaberuka and Nicola Hobby. Technical assistance was
provided by Robin Letscher and by Bram Piot, project MAP consultants. Senior Program
Manager Alexis Kamanzi at PSI/Rwanda provided valuable input during the design and
organization of the study. This study was funded KfW and USAID.

Table of Contents

Executive Summary .......................................................................................................... 1

Findings..........................................................................................................................- 4 Coverage of Prudence Plus Condoms .................................................................................- 4 Penetration of Prudence Plus Condoms..............................................................................- 5 Quality of Coverage of Prudence Plus Condoms ...............................................................- 8 Access to Prudence Plus Condoms ....................................................................................- 10 Map 3 Example of an access map with hotspot and Prudence Plus outlet locations .- 11 -

Limitations....................................................................................................................... 13
Conclusions and Programmatic Recommendations .................................................... 14
Appendix 1: Additional Maps
Appendix 2: Audit Sheet

MAP Study Evaluating Coverage, Quality of Coverage and Access to Condoms

Rwanda, 2006

Executive Summary
Background
Population Services International is an international non-profit organization present in over 65
countries, working in the social marketing domain. PSI uses private sector approaches to provide
health products and services with the objective of improving the quality of life for at-risk
populations.
PSI/Rwanda has engaged in condom social marketing in Rwanda since 1993, targeting sexually
active Rwandans among, more specifically, youths and other high risk groups. Following project
MAP (Measuring Access and Performance) studies on the availability of malaria and family
planning products, PSI/Rwanda conducted a second MAP study in order to determine the current
availability of Prudence Plus, its social marketing condom brand.

Research Objectives
Project MAP studies allow programmers assess of product availability and accessibility using
pre-defined criteria for coverage, quality of coverage and access. The goal of project MAP is to
increase the overall efficiency of social marketed products and service delivery systems. The
main objectives of the PSI/Rwanda 2006 MAP survey were to (1) evaluate the coverage and
quality of coverage of Prudence Plus condoms; and (2) monitor access to and market penetration
of Prudence Plus condoms in high-risk areas for HIV/Aids (hotzones) among high risk youth.

Methodology
This project MAP study is based on a census of outlets in three predetermined areas of the
country, namely Kigali, and part of North and West regions. All potential condom outlets were
audited and were geo-referenced in order to integrate the data into a Geographic Information
System (GIS). As a consequence, it was possible to use the outlet census data to determine the
proportion of administrative sectors in which there is a minimum level of availability of Prudence
Plus in outlets. In addition to providing a basic measure of product penetration and coverage for
each region, the assessment also measures a number of quality criteria, such as retail price,
presence of promotional material, mode of supply, stock-outs, etc. A second component of the
study measured the level of access to condoms among high risk groups for HIV/Aids, as well as
penetration and quality indicators in hotspots. Data was collected during August-November 2006
and data analysis was performed during December 2006 and January 2007.

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MAP Study Evaluating Coverage, Quality of Coverage and Access to Condoms

Rwanda, 2006

Main Findings

A total of 6413 outlets were audited, of which 93% were located in Kigali region. In Northern
region, findings are based on 91 outlets and in Western region on 360 outlets. In addition, 291
hotspots were identified by the survey team.

Results show that condoms are available in all sectors that were included in this study,
although overall coverage did not exceed 32.6% because of strict minimum standards of
coverage (Kigali: 26.5%, West: 20%, North: 100% of sectors with at least 30% outlet
penetration). Availability of other condom brands was very low.

Outlet penetration of Prudence Plus is 27.2% on average and is fairly consistent across all
three regions, but there are marked differences from one sector to another (range: 6.7% to
more than 40% of outlets). Penetration in hotspots is very similar (26.1%) and was highest in
Kigali (30%). Prudence Plus was found to be most commonly sold in pharmacies (61.8%),
hotels/motels (40.6%) and kiosks/groceries (30.9%).

About 15% of Prudence Plus outlets displayed promotional items inside the venue, a
proportion which was much higher (30%) in the hotspots. The retail price was found to be 15
francs on average in Kigali, but as high as 49 and 51 francs in Western and Northern regions,
respectively. Wholesalers and boutiques were cited as the most common sources of supply of
Prudence Plus, with PSI agents directly stocking 11% of outlets and 18% of hotspots. Only
about 7% of condom outlets report frequent stock outs the vast majority (71%) reporting
that stock-outs happen rarely or never.

Access to Prudence Plus condoms among clients of hotspot is high, since 83.6% of hotspot
attendants gather in places where condoms are available or in hotspots that are within a 200
meters radius of an outlet selling Prudence Plus.

Programmatic Recommendations
Identify new outlets and hotspots where condoms are currently not available, especially
in sectors where penetration is currently low. Priority outlet types should be hotspots such
as bars/night clubs and hotels/motels.

Focus on making Prudence Plus promotion materials more systematically available in

outlets and hotspots and address other quality issues, such as the price of condoms in
rural areas.

Use information from the current study to set coverage benchmarks for the monitoring of
the condom social marketing program, and conduct similar studies in other regions of the

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MAP Study Evaluating Coverage, Quality of Coverage and Access to Condoms

Rwanda, 2006
country. Multiple rounds of MAP studies will allow researchers to provide regular
information on the distribution system to PSI/Rwanda program managers.

Adjust sampling strategy and simplify audit sheet in order to reduce cost of future rounds.

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MAP Study Evaluating Coverage, Quality of Coverage and Access to Condoms

Rwanda, 2006

Findings
Coverage of Prudence Plus Condoms
Unlike most studies, coverage here is not based on the Lot Quality Assurance Sampling (LQAS)
approach and there were no clearly established geographic units of analysis that were used as
samples. As a result, administrative sector were used as the unit of analysis for coverage. The
minimum standard of availability was defined as a sector having at least 30% of outlets that sell
Prudence Plus condoms. The 30% threshold was chosen because it is close to the overall average
condom penetration as measured in this study. The same standard was used for commercial condom
brands.
Table 1a Condom Coverage by Region in Rwanda, 2006

North
West
Kigali

Nb Sectors
4
5
34

Nb Prudence
>30%
4
1
9

Coverage
Prudence
100.0%
20.0%
26.5%

Nb Others
>30%
0
0
0

Coverage
Others
0.0%
0.0%
0.0%

Nb Any Condom
>30%
4
1
11

Coverage Any
Condom
100.0%
20.0%
32.4%

Total

43

14

32.6%

0.0%

16

37.2%

Region

The average coverage for Prudence condoms in the three study areas was found to be 32.6% (see
Table 1a), which means that one out of three sectors has an adequate level of condom availability, i.e.
at least 30% penetration1. The table shows that all four sectors in the Northern region achieved the
minimum standard, whereas this was the case in only one out of five in the Western region. It should
be stressed however that only a small number of sectors were included in the Northern and Western
regions and as a consequence the findings are relevant to those areas only and does not translate to
regional coverage. For commercial sector condoms, coverage is very low when the same minimum
standard is used: none of the 43 sectors was found to have 30% penetration of commercial condom
brands. Coverage for any condom brand (Prudence Plus or commercial) is 37.2%.
Table 1b below contains the detailed result for each sector that was included in the survey: total
number of outlets audited, number and percentage with Prudence Plus condoms, with other condoms,
and with any type of condom (Prudence Plus or other).

Coverage in hotzones was not measured since many hotspots were isolated and not clustered
together in clearly defined areas.

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MAP Study Evaluating Coverage, Quality of Coverage and Access to Condoms

Rwanda, 2006
Table 1b Condom Coverage by Region in Rwanda, 2006
Region
NORD
NORD
NORD
NORD
OUEST
OUEST
OUEST
OUEST
OUEST
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI
VILLE DE KIGALI

District
GICUMBI
GICUMBI
GICUMBI
GICUMBI
RUBAVU
RUBAVU
RUBAVU
RUBAVU
RUBAVU
GASABO
GASABO
GASABO
GASABO
GASABO
GASABO
GASABO
GASABO
GASABO
GASABO
GASABO
GASABO
GASABO
GISOZI
KICUKIRO
KICUKIRO
KICUKIRO
KICUKIRO
KICUKIRO
KICUKIRO
KICUKIRO
KICUKIRO
KICUKIRO
KICUKIRO
NYARUGENGE
NYARUGENGE
NYARUGENGE
NYARUGENGE
NYARUGENGE
NYARUGENGE
NYARUGENGE
NYARUGENGE
NYARUGENGE
NYARUGENGE

Secteur
NYANKENKE
BYUMBA
KAGEYO
SHANGASHA
RUGERERO
NYUNDO
RUBAVU
KANAMA
GISENYI
JALI
NDERA
GIKOMERO
RUSORORO
JABANA
RUTUNGA
KIMIRONKO
GISOZI
KINYINYA
GATSATA
KACYIRU
REMERA
NDUBA
KIMIHURURA
GAHANGA
MASAKA
GATENGA
KIGARAMA
KAGARAMA
NIBOYE
KANOMBE
KICUKIRO
GIKONDO
NYARUGUNGA
MAGERAGERE
KIGALI
KANYINYA
NYARUGENGE
MUHIMA
NYAKABANDA
NYAMIRAMBO
KIMISAGARA
RWEZAMENYO
GITEGA

Code
Secteur
040514
040503
040506
040521
030312
030310
030311
030305
030304
010206
010211
010203
010214
010205
010215
010209
010204
010210
010202
010207
010213
010212
010208
010301
010308
010302
010307
010304
010309
010305
010306
010303
010310
010105
010103
010102
010109
010106
010107
010108
010104
010110
010101

Nb
Outlets
10
65
7
4
30
36
24
41
229
29
69
22
37
109
11
321
108
67
170
352
235
36
225
43
156
314
269
138
273
390
168
192
270
45
79
37
480
296
120
313
320
123
150

Nb
Prudence
% Prudence
3
30
22
33.8
3
42.9
2
50
7
23.3
9
25
6
25
11
26.8
76
33.2
2
6.9
5
7.2
2
9.1
5
13.5
15
13.8
2
18.2
59
18.4
20
18.5
13
19.4
40
23.5
84
23.9
75
31.9
14
38.9
53
23.6
6
14
29
18.6
70
22.3
69
25.7
37
26.8
75
27.5
109
27.9
49
29.2
57
29.7
89
33
3
6.7
17
21.5
8
21.6
118
24.6
98
33.1
40
33.3
113
36.1
121
37.8
48
39
61
40.7

Nb Other
Condoms
0
3
1
0
0
0
0
0
6
1
1
0
0
1
1
12
0
1
12
17
14
0
9
0
1
10
9
0
12
21
9
15
8
0
4
0
38
28
5
24
17
14
8

% other
0
4.6
14.3
0
0
0
0
0
2.6
3.4
1.4
0
0
0.9
9.1
3.7
0
1.5
7.1
4.8
6
0
4
0
0.6
3.2
3.3
0
4.4
5.4
5.4
7.8
3
0
5.1
0
7.9
9.5
4.2
7.7
5.3
11.4
5.3

Nb Any
% Any
Condom Condom
3
30
23
35.4
4
57.1
2
50
7
23.3
9
25
6
25
11
26.8
77
33.6
3
10.3
6
8.7
2
9.1
5
13.5
15
13.8
2
18.2
63
19.6
20
18.5
13
19.4
42
24.7
87
24.7
79
33.6
14
38.9
58
25.8
6
14
29
18.6
72
22.9
69
25.7
37
26.8
80
29.3
115
29.5
53
31.5
61
31.8
89
33
3
6.7
20
25.3
8
21.6
130
27.1
106
35.8
42
35
116
37.1
125
39.1
50
40.7
62
41.3

Penetration of Prudence Plus Condoms

Penetration of a product is measured as the percentage of outlets where the product is being sold. In
this study it is an important indicator since the coverage results are based on the penetration level of
Prudence Plus condoms. The large sample size (+6400 outlets) allows for an accurate estimate of the
average penetration rates, especially in the Kigali region (see table 2a). Penetration in hotspots, which
are meeting places for youth and for specific high-risk groups (such as bars, night clubs, restaurants,
hotels/motels, etc) was also measured and results are shown in table 2b.

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MAP Study Evaluating Coverage, Quality of Coverage and Access to Condoms

Rwanda, 2006

Table 2a Condom Penetration in Outlets, by Region in Rwanda, 2006

North
West
Kigali

Nb Outlets
91
360
5967

Nb Prudence
33
109
1606

% Prudence
36.3%
30.3%
26.9%

Nb Other
Condoms
4
6
292

% Other
Condoms
4.4%
1.7%
4.9%

Nb Any Condom
35
110
1682

% Any
Condom
38.5%
30.6%
28.2%

Total

6413

1748

27.2%

302

4.7%

1827

28.5%

Region

Table 2b Condom Penetration in Hotspots, by Region in Rwanda, 2006

North
West
Kigali

Nb Hotspots
34
41
216

Nb Prudence
5
6
65

% Prudence
14.7%
14.6%
30.1%

Nb Other
Condoms
0
0
26

% Other
Condoms
0.0%
0.0%
12.0%

Nb Any Condom
5
6
72

% Any
Condom
14.7%
14.6%
33.3%

Total

291

76

26.1%

26

8.9%

83

28.5%

Region

According to the above findings, Prudence Plus is available in roughly a third of all potential condom
outlets and hotspots. Despite marked differences between penetration levels in the administrative
sectors (see map 1), there appear to be only small differences in average penetration from one region
to another for penetration in outlets. In hotspots, Kigali clearly stands out as the penetration rate is
double the rate of hotspot penetration in the two other regions. Commercial sector condoms were
found almost exclusively in the Kigali region, though at very low levels (less than 5% in outlets, 12%
in hotspots).

Table 3a Condom Penetration by Outlet Type, in three Regions of Rwanda, 2006

Outlet Type
Bar/night club
Hotel/motel
Small shop / kiosk
Pharmacy
Street vendor
Health animator
Youth/CBD
health center
Others
Total

Nb Outlets
693
92
4921
110
154
1
3
66
378

Nb Prudence
80
10
1519
68
30
0
0
23
18

% Prudence
11.5%
10.9%
30.9%
61.8%
19.5%
0.0%
0.0%
24.8%
4.8%

Nb Other
Condoms
25
9
218
37
2
0
0
10
1

% Other
Condoms
3.6%
9.8%
4.4%
33.6%
1.3%
0.0%
0.0%
15.2%
0.3%

Nb Any Condom
91
13
1569
77
31
0
0
28
18

% Any
Condom
13.1%
14.1%
31.9%
70.0%
20.1%
0.0%
0.0%
42.4%
4.8%

6413

1748

27.2%

302

4.7%

1827

28.5%

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MAP Study Evaluating Coverage, Quality of Coverage and Access to Condoms

Rwanda, 2006

Table 3b Condom Penetration by Hotspot Type, in three Regions of Rwanda, 2006

OutletTypeName
Bar/night club
Hotel/motel
Restaurant
Church
Market
Bus station
Gaming venue
Others
Total

Nb Hotspots
190
32
18
2
2
3
2
41

Nb Prudence
46
13
2
1
1
1
0
12

% Prudence
24.2%
40.6%
11.1%
50.0%
50.0%
33.3%
0.0%
29.3%

Nb Other
Condoms
14
7
1
0
0
0
0
4

% Other
Condoms
7.4%
21.9%
5.6%
0.0%
0.0%
0.0%
0.0%
9.8%

Nb Any Condom
50
13
2
1
1
1
0
15

% Any
Condom
26.3%
40.6%
11.1%
50.0%
50.0%
33.3%
0.0%
36.6%

291

76

26.1%

26

8.9%

83

28.5%

Tables 3a and 3b show that penetration rates vary greatly by outlet type: highest levels were found
among pharmacies (though 30% of pharmacies do not sell any condoms), groceries/kiosks, health
centers, and among bars/night clubs and hotels/motels that were classified as hotspots. Commercial
condom brands were mostly found in pharmacies, hotels/motels, and in health centers.

Map 1 Condom Penetration by sector, in three Regions of Rwanda, 2006

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MAP Study Evaluating Coverage, Quality of Coverage and Access to Condoms

Rwanda, 2006

Quality of Coverage of Prudence Plus Condoms

The quality of coverage of Prudence Plus was not calculated since no precise minimum quality
standards had been defined; however various quality criteria were evaluated and are reported as % of
outlets with Prudence Plus where quality standard X is present, rather than the proportion of
geographic areas where a minimum standard is met. Tables 4.1 through 4.4 show these findings. The
following quality criteria were used: presence of promotion materials (inside/outside the outlet),
absence of regular stock-outs, mode of supply, and availability of condoms in outlets that are open
during the evening/night at least until 8pm. Price levels were analyzed separately (see Other
Findings).
Table 4.1 Availability of PSI promotional items, in three Regions of Rwanda, 2006

North
West
Kigali

Nb Outlets w/
Prudence
33
109
1606

Nb Promo mat.
15
19
303

% Promo
mat.
45.5%
17.4%
18.9%

Nb Promo
Inside
14
17
229

% Inside
42.4%
15.6%
14.3%

Nb Promo
Outside
5
14
13

% Outside
15.2%
12.8%
0.8%

Total

1748

337

19.3%

260

14.9%

32

1.8%

Region

Promotional items for Prudence Plus are not widely available, since only about one out of five
Prudence Plus outlets display any such materials. This proportion was much higher in the Northern
region, the region in which the fewest total number of outlets were found. Interestingly, 90 hotspots
were said to display any kind of promotional items, although only 76 sites were selling Prudence
Plus. Out of these hotspots, 31.6% displayed promotional items inside the venue and 18.4% outside.

Table 4.2a Mode of supply of Prudence Plus condoms in outlets, 2006

Mode of supply
Agent PSI
Bar/bote
Alimentation/Boutique/
Kiosque
Pharmacie
Commerant ambulant
ONG/Association
Animateur de sant
CBD/Jeune
Grossiste
Autres
Ne sait pas

Nb Outlets w/
Prudence
197
1
515
84
14
5
6
2
804
68
50
1746

%
11.3%
0.1%
29.5%
4.8%
0.8%
0.3%
0.3%
0.1%
46.0%
3.9%
2.9%

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MAP Study Evaluating Coverage, Quality of Coverage and Access to Condoms

Rwanda, 2006

Nearly half of all Prudence Plus outlets stock the product through a wholesaler, followed by other
grocery/kiosk (29.5%) and PSI agents (11.3%) in second and third place, respectively. The other
means of supply are used in very small proportions only. A more detailed analysis of the mode of
supply reveals that PSI agents stock about a third of all pharmacies and roughly 10% of
groceries/kiosks and of bars/night clubs.

Table 4.2b Mode of supply of Prudence Plus condoms in hotspots, 2006

Nb Outlets w/
Prudence
197
1

%
11.3%
0.1%

Small shop / kiosk

Pharmacy

515
84

29.5%
4.8%

Street vendor
NGO/Association
Health animator
CBD/Youth
Wholesaler
Others
Dont know

14
5
6
2
804
68
50

0.8%
0.3%
0.3%
0.1%
46.0%
3.9%
2.9%

Mode of supply
PSI sales agent
Bar / night club

1746

A third of hotspots use wholesalers to stock Prudence Plus although it appears that hotspots are more
likely to stock through PSI sales agents, and slightly less so through wholesalers in comparison with
regular outlets, as shown in the above table. Hotspots stock Prudence Plus condoms through small
groceries/kiosks in similar proportions as regular outlets, but do so in higher proportions through
pharmacies (7.9%). It should be noted however that the sample size here is very small (76 hotspots
with Prudence Plus) and as a result these findings should be interpreted with care.

Table 4.3a Frequency of stock-outs in outlets, 2006

Frequency
Frequently
Sometimes
Rarely
Never
Don't know

Nb Outlets w/
Prudence
129
358
350
892
17

%
7.4%
20.5%
20.0%
51.1%
1.0%

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MAP Study Evaluating Coverage, Quality of Coverage and Access to Condoms

Rwanda, 2006
Table 4.3b Frequency of stock-outs in hotspots, 2006
Frequency
Frequently
Sometimes
Rarely
Never

Nb Hotspots
w/ Prudence
3
13
6
54

%
3.9%
17.1%
7.9%
71.1%

76
Frequently/Sometimes
Rarely/Never

16
60

21.1%
78.9%

Stock-outs do not seem to be a regular problem in the study areas, since in both outlets and hotspots
(tables 4.3a and 4.3b), more than 70% of outlets report stock-outs as occurring rarely or never. Less
than 10% of all Prudence Plus outlets report frequent stock-outs, a response rate which seems fairly
consistent with the stock-out level that was found on the day of survey, when 13.4% of outlets in the
three regions were out of stock (6.1% in Northern region, 14.7% in Western region, and 13.5% in
Kigali). No hotspots were found to be out of stock on the day of survey.

Table 4.4 Availability of Prudence Plus in late-opening outlets, 2006

North
West
Kigali

Nb Outlets
91
360
5967

Nb Outlets w/
Prudence
33
109
1606

Nb Open
>8pm
9
63
1340

% Open
>8pm
9.9%
17.5%
22.5%

Total

6413

1748

1412

22.0%

Region

As shown in the above table, the proportion of outlets that are open until at least 8pm and where
Prudence Plus condoms are available is slightly lower than the overall average, although the
difference is more marked in the two more rural areas than in Kigali.

Access to Prudence Plus Condoms

Access is defined as the proportion of a population segment which is within the catchment area of a
product delivery point. In this study, condom outlets were assumed to have a catchment area of about
200 meters, which implies that all hotspot clients who gather in venues where condoms are either
available inside the hotspot or in outlets that are within 200 meters of the hotspot, have easy access
to Prudence Plus condoms. The access analysis was done in the HealthMapper GIS application.

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The vast majority of hotspot clients have access to Prudence Plus condoms: 83.6% of clients are in
hotspots with condoms or close to existing condom outlets. Although Prudence Plus penetration in
hotspots is not very high (26.1%), it appears that many of these hotspots are located nearby a regular
condom outlet. Two examples of hotspot and access maps are shown below: map 2 shows the hotspot
locations and the average number of clients (on busy days) in Kigali, and map 3 shows all hotspots
and all outlets where Prudence Plus is available, with 200 meter catchment areas in green.

Map 2 Average number of clients in hotspots in the Kigali region, 2006

Map 3 Example of an access map with hotspot and Prudence Plus outlet locations

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Limitations
The methodology that was used in this study was based on PSIs standard project MAP approach,
with one main difference: there was no random sample of geographic areas (such as enumeration
areas) due to a restructuring of administrative boundaries in 2006 and as a result it was not possible to
use the traditional LQAS approach to determine coverage and quality of coverage. Coverage was thus
calculated based on the lowest available administrative unit, which in Rwanda is the sector. Because
this is a baseline study, no clear minimum coverage or quality of coverage standards were
determined; the results of this first round should help researchers and programmers to decide on
realistic minimum standards and benchmarks to be used during the next survey. Another disadvantage
of this approach is that a very large number of outlets were audited, especially in Kigali region. While
the resulting information is very detailed and comprehensive, it is recommended that another strategy
be adopted during subsequent rounds, since it is possible to obtain the same indicators with a much
smaller sample size, at least for large urban areas such as Kigali.
The audit sheet that was used (see annex 2) contained a large number of questions, not all of which
were used in the analysis: during future rounds, the audit sheets should be simplified and only
essential questions should be kept. This will speed up data collection and thus reduce costs of the
study. Questions related to price were eliminated from the analysis due to confusion about how to
collect information related to the retail price. As Prudence Plus is sold in a sachet of 4 condoms, it
was believed that venders may separate these packs and sell individual condoms.

Therefore,

interviewers were asked to divided the given retail price by 4. Because we cannot completely verify
the accuracy of the calculations, the data was not included in the final report. The overall quality of
the dataset was found to be good; only minor corrections (e.g. to the geographic coordinates) needed
to be made during the data cleaning stage.
The census approach raised challenges during data collection as interviewers were pressured to locate
and audit every possible sale point in the determined sectors. The final product resulted in a very
tedious and time consuming process as locating remote sales points was difficult particularly in
terrain that was inaccessible by car. The LQAS sampling approach will help reduce data collection
times as well as large fuel costs and idle interviewers.

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Conclusions and Programmatic Recommendations

A total of 6413 outlets were audited, most of which (93%) were located in Kigali region. In
Northern region, findings are based on 91 outlets and in Western region on 360 outlets. In
addition, 291 hotspots were identified by the survey team.

Condoms are available in all sectors that were included in this study, but the overall coverage did
not exceed 32.6% because of strict minimum standards of coverage (Kigali: 26.5%, Ouest: 20%,
Nord: 100% of sectors with at least 30% outlet penetration). Availability of other condom brands
was very low.

Outlet penetration of Prudence Plus is 27.2% on average and is fairly consistent across all three
regions, but there are marked differences from one sector to another (range: 6.7% to more than
40% of outlets). Penetration in hotspots is very similar (26.1%) and was highest in Kigali (30%).
Prudence Plus was found to be most commonly sold in pharmacies (61.8%), hotels/motels
(40.6%) and kiosks/groceries (30.9%).

About 15% of Prudence Plus outlets displayed promotional items inside the venue, a proportion
which was much higher (30%) in the hotspots. Retail price was found to be 15 francs on average
in Kigali, but as high as 49 and 51 francs in Western and Northern regions, respectively.
Wholesalers and boutiques were cited as the most common sources of supply of Prudence Plus,
with PSI agents directly stocking 11% of outlets and 18% of hotspots. Only about 7% of condom
outlets report frequent stock outs the vast majority (71%) reporting that stock-outs happen
rarely or never.

Access to Prudence Plus condoms among clients of hotspot is high, since 83.6% of hotspot
attendants gather in places where condoms are available or in hotspots that are within a 200
meters radius of an outlet selling Prudence Plus.

Based on the above findings, the following programmatic recommendations should be considered:

Identify new outlets and hotspots where condoms are currently not available, especially in
sectors where penetration is currently low. Priority sectors are defined as less than 30%

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penetration. The following four sectors fall into this category for the Western province:
KANAMA, NYUNDO, RUBAVU, RUGERERO. 25 sectors in Kigali fall into the priority
category: GATSATA, GIKOMERO, GISOZI, JABANA, JALI, KACYIRU, KIMIRONKO,
KINYINYA,

NDERA,

GATENGA,

GIKONDO,

RUSORORO,

RUTUNGA,

KAGARAMA,

KIMIHURURA,

KANOMBE,

KICUKIRO,

GAHANGA,
KIGARAMA,

MASAKA, NIBOYE, KANYINYA, KIGALI, MAGERAGERE, NYARUGENGE.

concentrated effort should be to increase coverage in these districts.

Priority outlet types should be hotspots such as bars/night clubs and hotels/motels.

Focus on making Prudence Plus promotion materials more systematically available in outlets
and hotspots and address other quality issues, such as the price of condoms in rural areas.
Point of sale material need to be clearly visible for potential customers and a concentrated
effort should be made to stock outlets where promotional material is present but condoms are
not.

Use information from the current study to set coverage benchmarks for the monitoring of the
condom social marketing program, and conduct similar studies in other regions of the
country. Recommended benchmark levels should defined as a minimum of 50% coverage
and 85% access. Multiple rounds of MAP studies will allow researchers to provide regular
information on the distribution system to PSI/Rwanda program managers.

Adjust sampling strategy and simplify audit sheet in order to reduce cost of future rounds.
Future round of MAP should employ the LQAS sampling method at the (national or
provincial) level, using the (sector or village) as the unit of analysis.

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Appendix 1: Additional Maps

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Rwanda, 2006

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Rwanda, 2006

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Appendix 2: Audit Sheet

Note: this audit sheet is the version for hotspots; the outlet audit sheet is very similar
N

Questions

101
102
103
104

Date
/__ __ /__ __/__ __ __ __/
Province : _________________
Nom du District : _____________________
Nom du Secteur : ______________________

106

Site ID pour le Point Chaud

107

ENQUETEUR : le Site ID commence avec 2 chiffres

pour le code denquteur, suivi par 3 chiffres pour le
code de PC.
Identifiant

108

Latitude du point chaud

109

Longitude du point chaud

110

111a
111b
111c
111d
111e

Code

/././
/././

/./././././

Type de PC

/./././././////

a) Bar/boite
b) Htel/motel
c) Restaurant
d) Eglise
e) March
f) Gare routire
g) Centre de jeux
i) Autres ( prciser)

A combien estimez-vous en moyenne le nombre de

clients/personnes qui viennent dans cet endroit par jour
avec des heures de grande affluence ?
A combien estimez-vous en moyenne le nombre de
clients/personnes qui viennent dans cet endroit par jour
sans des heures de grande affluence ?
A votre avis, quel est le pourcentage des
clients/personnes parmi les femmes ?
A votre avis, en gnral, quel est le pourcentage des
clients/personnes parmi les jeunes de 15-24 ans ?
A votre avis, en gnral, quel est le pourcentage des
clients/personnes qui sont des filles de 15-24 ans ?

21

|__|__|__|__|
NSP.9999
|__|__|__|__|
NSP9999
|__|__|%
NSP999
|__|__|%
NSP999
|__|__|%

1
2
3
4
5
6
7
8

MAP Study Evaluating Coverage, Quality of Coverage and Access to Condoms

Rwanda, 2006

NSP999
111f

A votre avis, en gnral, quel est le pourcentage des

clients/personnes qui sont des garons de 15-24 ans ?

111g

En gnral, les gens qui frquentent cet endroit sont

entre quelles tranches dges ?

111h

Est-ce que vous vendez le condom de marque

Prudence Plus ?

112

Il y a combien de temps que vous vous tes

approvisionn en Prudence Plus pour la
dernire fois ?

|__|__|%
NSP..999
Moins de 15 ans
15-24 ans
Plus de 24 ans
Non1 123
Oui.2
Heures

|__|__|

Jour(s)

|__|__|

1
2
3

Semaine(s)

UNE SEULE REPONSE POSSIBLE

|__|__|
Mois
Annes

|__|__|

NSP
|__|__|
999
113

La dernire fois que vous vous tes

approvisionn en Prudence Plus , chez qui
est ce que vous vous tes approvisionn ?
UNE SEULE REPONSE POSSIBLE

114

115

Agent PSI
Bar/boite
Alim/Bout/kiosk
Pharmacie
Commerant
ambulant
ONG/association
Animateur de sant
CBD / Jeune
Grossiste
Autres
(A prciser)____
NSP

Combien dunits de Prudence Plus aviez vous achet la dernire

fois ?
ENQUETEUR : une unit est la pice la plus petite. Pour
Prudence Plus = un condom/prservatif
A combien avez-vous achet une unit de Prudence Plus ?

1
2
3
4
5
6
7
8
9
10
99
I___I___I___I___I Units
Ne Sait Pas9999
I___I___I___I___I
FRW/Unit

22

MAP Study Evaluating Coverage, Quality of Coverage and Access to Condoms

Rwanda, 2006

116

Combien dunits Prudence Plus avez-vous en stock maintenant ?

I___I___I___I___I Units

117

Combien dunits de Prudence Plus vendez-vous en moyenne par

mois ?
A combien vous vendez 1 prservatif/condom de Prudence Plus ?

I___I___I___I___I Units

118

I___I___I___I___I
FRW/Unit
119

Y a-t-il frquemment, quelques fois, rarement ou jamais de ruptures de stock

de Prudence Plus ?

120a

Est-ce quil y a des matriaux promotionnels de Prudence Plus bien

visibles sur cet endroit ( lintrieur ou lextrieur) ?
Est-ce quil y a des matriaux promotionnels de Prudence Plus bien
visibles placs lintrieur de cet endroit ?
Est-ce quil y a des matriaux promotionnels de Prudence Plus placs
lextrieur de cet endroit, bien visibles une distance de 5 mtres ?
Quels types de support promotionnels de Prudence
Plus sont visibles, sans effort, sur cet endroit ?
Dangler

120b
121
122

Autocollant
Boite de Prudence
Plus
123

Affiche de marque
Est-ce que vous vendez des condoms autres que Prudence Plus ?

124

Quelles autres marques de condoms vendez-vous ?

NE PAS LIRE DE REPONSES.

a) Lifeguard
b) Durex
c) Protector
d) Trust
e) Rough Rider

125
126
127

ENQUETEUR: EST-CE QUE Q124a=

2?
A combien vendez-vous un prservatif
Lifeguard ?
Combien dunits Lifeguard vendezvous en moyenne par mois ?

x) Autres ( prciser)
___________
Non
Oui
I___I___I___I___I FRW/Unit

Frquemment
Quelques fois
Rarement
Jamais
Non
Oui
Non
Oui
Non
Oui
Non
Oui
Non
Oui
Non
Oui
Non
Oui
Non
Oui
Non..1
Oui...2
Non..1
Oui...2
Non..1
Oui...2
Non..1
Oui...2
Non..1
Oui...2
Non..1
Oui...2
1
2

I___I___I___I___I Units
Ne Sait Pas9999

128

Y a-t-il frquemment, quelques fois,

Frquemment

23

1
2
3
4
1 123
2
1
2
1
2
1
2
1
2
1
2
1
2
1 150
2

1 130

MAP Study Evaluating Coverage, Quality of Coverage and Access to Condoms

Rwanda, 2006

rarement ou jamais de ruptures de stock

de Lifeguard ?
129
130
131
132

Est-ce quil y a des matriels

promotionnels Lifeguard bien visibles
placs lintrieur de cet endroit ?
ENQUETEUR: EST-CE QUE Q124b=
2?
A combien vendez-vous un prservatif
Durex ?
Combien dunits Durex vendez-vous
en moyenne par mois ?

Quelques fois
Rarement
Jamais
Non
Oui

2
3
4
1
2

Non
Oui
I___I___I___I___I FRW/Unit

1
2

1 135

I___I___I___I___I Units
Ne Sait Pas9999

133

Y a-t-il frquemment, quelques fois,

rarement ou jamais de ruptures de stock
de Durex ?

134

Est-ce quil y a des matriels

promotionnels Durex bien visibles
placs lintrieur de cet endroit ?
ENQUETEUR: EST-CE QUE Q124c=
2?
A combien vendez-vous un prservatif
Protector ?
Combien dunits Protector vendezvous en moyenne par mois ?

135
136
137

Frquemment
Quelques fois
Rarement
Jamais
Non
Oui

1
2
3
4
1
2

Non
Oui
I___I___I___I___I FRW/Unit

1
2

1 140

I___I___I___I___I Units
Ne Sait Pas9999

138

Y a-t-il frquemment, quelques fois,

rarement ou jamais de ruptures de stock
de Protector ?

139

Est-ce quil y a des matriels

promotionnels Protector bien visibles
placs lintrieur de cet endroit ?
ENQUETEUR: EST-CE QUE Q124d=
2?
A combien vendez-vous un prservatif
Trust ?
Combien dunits Trust vendez-vous
en moyenne par mois ?

140
141
142

Frquemment
Quelques fois
Rarement
Jamais
Non
Oui

1
2
3
4
1
2

Non
Oui
I___I___I___I___I FRW/Unit

1
2

1 145

I___I___I___I___I Units
Ne Sait Pas9999

143

Y a-t-il frquemment, quelques fois,

rarement ou jamais de ruptures de stock
de Trust ?

144

Est-ce quil y a des matriels

promotionnels Trust bien visibles
placs lintrieur de cet endroit ?
ENQUETEUR: EST-CE QUE Q124e=
2?

145

24

Frquemment
Quelques fois
Rarement
Jamais
Non
Oui

1
2
3
4
1
2

Non
Oui

1
2

1 150

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146
147

A combien vendez-vous un prservatif

Rough Rider ?
Combien dunits Rough Rider
vendez-vous en moyenne par mois ?

I___I___I___I___I FRW/Unit
I___I___I___I___I Units
Ne Sait Pas9999

148

Y a-t-il frquemment, quelques fois,

rarement ou jamais de ruptures de stock
de Rough Rider ?

149

Est-ce quil y a des matriels

promotionnels Rough Rider bien
visibles placs lintrieur de cet endroit
?
Est-ce que cet endroit ouvre tous les
jours de la semaine ?
(Lundi -Dimanche)
UNE SEULE REPONSE POSSIBLE
Quelles sont les heures douverture ?

150

151

UNE SEULE REPONSE POSSIBLE

151b

Quels sont les jours de grande affluence ?

UNE SEULE REPONSE POSSIBLE

151c

Quelles sont les heures de grande

affluence pendant ces jours?
UNE SEULE REPONSE POSSIBLE

152a

A combien de kilomtres dici y a-t-il

un :
Groupement des Travailleuses
de sexe

152b

Est-ce que vous pensez que des membres

de ce groupement de travailleuses de sexe
visitent cet endroit rgulirement?
A combien de kilomtres dici y a-t-il
un :
Groupement des Local Defence
Forces (les forces de dfense
locaux)

153a

Frquemment
Quelques fois
Rarement
Jamais
Non
Oui

1
2
3
4
1
2

Tous les jours

3-4 jours
Moins de 2 jours
Autres ( prciser)
8h00-23h00
8h00-12h00 et 14h00-17h00
8h00-17h00
18h00- 0h00
18h00-aprs minuit
Autre ( prciser)
Tous les jours
Samedi et Dimanche
Vendredi, Samedi, Dimanche
Vendredi et Samedi
Samedi
Vendredi
Dimanche
Lundi Vendredi
Autre ( prciser)
8h00-12h00
8h00-17h00
Aprs 12 H
17H-20H
20H-23H
Aprs 23H
Autre ( prciser)
0-5km
5km-10km
10km-15km
20km-plus
NSP
Non
Oui
NSP
0-5km
5km-10km
10km-15km
20km-plus
NSP

1
2
3
4
1
2
3
4
5
6
1
2
3
4
5
6
7
8
9
1
2
3
4
5
6
7
1
2
3
4
9
1
2
9
1
2
3
4
9

25

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Rwanda, 2006

153b
154a

Est-ce que vous pensez que des membres

de ce groupement des forces de dfense
locaux visitent cet endroit rgulirement?
A combien de Kilomtre dici y a-t-il
une :

154b
155a

Est-ce que vous pensez que des membres

de cette base militaires visitent cet
endroit rgulirement?
A combien de Kilomtre dici y a-t-il
une :

155b
156a

157a

157c

Centre de dtention

Est-ce que vous pensez que des membres

de ce centre de dtention visitent cet
endroit rgulirement?
A combien de Kilomtre dici y a-t-il
un :

157b

Station de police

Est-ce que vous pensez que des membres

de cette Station de police visitent cet
endroit rgulirement?
A combien de Kilomtre dici y a-t-il
un :

156b

Base Militaires

Groupement de jeune

Est-ce que vous pensez que des membres

de ce groupement de jeune visitent cet
endroit rgulirement?
A combien de Kilomtre dici y a-t-il
un :
Organisation des religieux

158

EST-CE QUE Q 111h = 2 ?

159

EST-CE QUE Q 123 = 2 ?

160

Savez-vous faire la dmonstration du port

du condom ?
Pouvez-vous me faire la dmonstration ?

161

162

Que pensez-vous des personnes qui

viennent acheter le condom ici ?

Non
Oui
NSP
0-5km
5km-10km
10km-15km
20km-plus
NSP
Non
Oui
NSP
0-5km
5km-10km
10km-15km
20km-plus
NSP
Non
Oui
NSP
0-5km
5km-10km
10km-15km
20km-plus
NSP
Non
Oui
NSP
0-5km
5km-10km
10km-15km
20km-plus
NSP
Non
Oui
NSP
0-5km
5km-10km
10km-15km
20km-plus
NSP
Non
Oui
Non
Oui
Non
Oui
A russi la dmonstration
Na pas russi
A refus

1
2
9
1
2
3
4
9
1
2
9
1
2
3
4
9
1
2
9
1
2
3
4
9
1
2
9
1
2
3
4
9
1
2
9
1
2
3
4
9
1
2
1
2
1
2
1
2
3

Vagabond sexuel
Personne responsable

1
2

26

2 160
1 FIN
1 162

MAP Study Evaluating Coverage, Quality of Coverage and Access to Condoms

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163
164
165

166

Pensez vous que cest normal quune

femme achte un condom ?
Est-ce que, en gnral, les femmes
viennent souvent acheter les condoms
ici ?
Selon vous, pourquoi certaines femmes
ne viennent pas acheter les condoms ici ?

Comment est-ce que le VIH/SIDA est

transmis ? [Relancer] Est-ce quil y a
dautres manires ?

Prostitues
Fous
Autres
Non
Oui
Non
Oui
Elles ont honte
Elles ont peur quon les traite de
prostitues
Elles nen ont pas besoin
Cest lhomme qui doit lacheter
Autres

Transfusion/contact
sanguinaire (injections des
drogues inclut)
Sexe/Rapports sexuels
Mre lenfant
Par les moustiques
En mangeant avec qqn infecte
En embrasant qqn infecte
En touchant qqn infecte
Autre ( prciser)

27

3
4
5
1
2
1
2
Oui
2
2

Non
1
1

2
2

1
1

2
Oui

1
Non

2
2
2
2

1
1
1
1

2
2
2

1
1
1