December 1, 2011: It is an undeniable fact that Africa has made a significant progress in increasing access to family planning and reproductive health services.  For example, in Senegal and Malawi,  over 40% of the women who require contraceptives are able to access them—a substantial increase over a decade ago, when only 12% of women in Senegal and 28% in Malawi had access to the contraceptives they needed.  Political will has contributed to the decentralization of FP/RH commodity distribution; contraceptives are now more broadly available at the  community level. The President of Senegal, His Excellency Abdoulaye Wade, reiterated Senegal’s commitment to family planning and reproductive health services at the opening ceremony of the 2011 International  Conference on Family Planning (ICFP) this week.

Despite such remarkable progress, it is still disheartening to see the dark side of a lack of the same services as manifested in the young population.

I am 20 years old and for the past 14 years have lived with HIV. I know there are million others in this same situation and these form a significant part of the world population. Family planning can help reverse this trend; it can help prevent unintended pregnancies in those living with HIV, and it can help prevent millions of children getting infected from HIV positive parents. It can save lives. - An ICFP participant

Is the current problem unavailability? Or is it access to information as to where to get the service? Or is it lack of knowledge about “commodities”—the actual products, such as condoms, implants, pills, and injectable contraceptives?

We know over 250 million people require contraceptives but we ought to go beyond that; we ought to reach out with information on family planning to those who do not know about family planning. - Dr. Babatunde Osotimehin, Executive Director, United Nations Population Fund (UNFPA), at the ICFP.

Each of these issues—access to commodities, access to information about the existence of services, and access to information about locations where services are available—is a major challenge in its own right. But ultimately, access to the knowledge about commodities is the biggest challenge. The question is “In all these areas of challenge, what is the right balance for FP/RH investment?”

Across Africa, fewer than four out of every ten people have access to FP commodities; most live in areas with very little or no available family planning information. Ultimately this means six out of ten could have absolutely no access, and do not know anything about it. Even where information is available, much of it is inaccurate, reaching people in inappropriate formats and from ill informed and inadequately trained providers. Misperceptions about contraception are widespread—for example, “I hear that after insertion, contraceptive implants move from the arm down to the uterus where they cause cancer,” or “The pills accumulate in the stomach and cause cancer.”  These pervasive myths are a significant barrier to uptake of effective FP/RH services.

Many organizations focus on individual pieces of this puzzle. The Knowledge for Health (K4Health) Project is working towards bringing the pieces of the puzzle together.  Through its work in many parts of the underserved world, K4Health helps promote sharing and exchange of up-to-date, evidence-based FP/RH and HIV/AIDS knowledge among policy makers, program managers, and healthcare providers, to subsequently provide quality services to all.

K4Health staff people are involved in several presentations, panels, and other activities at the ICFP. If you are here at the conference, come and visit us at the Center for Communication Programs booth. We will also be at the PSI-sponsored Film Festival this evening in the main auditorium, presenting a documentary video about our experience in Malawi.

Thoko Bema, of K4Health partner Management Sciences for Health, works on K4Health’s Malawi country program.