Eight Practices that Will Maximize Investments in Family Planning Programs

Ruwaida Salem

CCP | Associate Managing Editor, Global Health: Science and Practice

Family planning experts from USAID, UNFPA, WHO, the International Planned Parenthood Federation (IPPF), and 14 nongovernmental and private organizations met on July 9-10, 2012, ahead of the landmark London Summit on Family Planning, to review evidence around high-impact practices in family planning (HIPs).

Mothers in Mozambique take their children for vaccination

Mothers in Nampula, Mozambique take their children for vaccination.

© 2003 Arturo Sanabria, Courtesy of Photosh

Meeting at UNFPA headquarters in New York, the participants discussed evidence on eight specific practices that, when scaled up and institutionalized, will maximize investments in family planning programs:

  • Provide family planning counseling and services at the same time and location where women receive treatment for complications related to abortion. Many postabortion clients have a clear need and demand for family planning, and strong evidence demonstrates that providing family planning services at the same time and location where women receive postabortion treatment is feasible, acceptable, and effective.
  • Train, equip, and support community health workers (CHWs) to provide a wide range of contraceptive methods. CHWs can be an important means of reducing inequities in access to services, especially in areas where individuals face physical and social barriers to health services.
  • Provide a wide range of contraceptive methods through mobile outreach services—services provided by a mobile team of trained providers such as physicians and nurses, sometimes in a vehicle such as a van or bus that is equipped with clinic facilities. Mobile outreach provides services to women and men in the communities where they live and work, as do CHWs. While CHWs provide a limited range of contraceptive methods, such as oral contraceptives, condoms, and sometimes injectables, mobile outreach services have the added benefit of giving people direct access to long-acting and permanent methods (LAPMs).

  • Offer family planning information and services to postpartum women during route child immunization contacts. Child immunization services are well utilized around the world, and thus may be one of the most efficient and effective ways to reach mothers with family planning messages and services during the postpartum period. Many such women want to delay or avoid future pregnancies but may not have ready access to modern contraception.
  • Support distribution of contraceptive methods through social marketing—the use of retail outlets and private providers to market and sell branded contraceptives at subsidized prices. Social marketing is designed to reach a segment of the population that is neither served by free government programs nor by costly commercial programs.
  • Implement a systematic, evidence-based health communication strategy that includes communication through multiple channels to enable voluntary and informed decision-making. Health communication activities are an important part of family planning programming to increase knowledge, shift attitudes and norms, and motivate people to change behavior. 
  • Invest in contraceptive security by developing an effective supply chain. Supply chain management involves moving a product—in this case, contraceptives and related supplies and equipment—from the supplier to the customer. The ultimate objective of supply chain management is matching supply with demand as efficiently as possible.
  • Support financing for family planning services and supplies at national and local levels. To meet people’s family planning needs, programs must mobilize adequate financial resources for contraceptive commodities and to support the broader service delivery environment.

Prior to the meeting in New York, the HIPs project had largely been an initiative led by USAID. Referring to the “power of partnerships,” Sarah Harbison of USAID explained that this meeting was an opportunity to involve new partners and expand participation in order to strengthen dissemination, use, and scale-up of HIPs. Representatives from UNFPA, WHO, and IPPF echoed the commitment to the new partnership and pointed to the need for a more consolidated approach to supporting countries in their efforts to strengthen family planning and other health programs.

Indeed, it was evident to me and others in the room that beyond the primary purpose of the meeting to review evidence and finalize guidance on selected HIPs, a greater accomplishment conceivably was galvanizing the commitment of all these multilateral, bilateral, and nongovernmental organizations to realize results on the ground by working together. At the global level, we work hard to synthesize the knowledge base and distill lessons learned, but a challenge that we often face is translating the research into practice. By bringing together this diverse group of partners, each providing its own unique strengths and capabilities, perhaps we can at least take a step in the right direction.

The evidence on the HIPs reviewed at last week’s meeting, along with tips on how to implement the practices, will be published in short, concise briefs in the coming weeks on the HIPs website. These briefs and the broader HIPs initiative will help inform family planning programming investments at a critical time when global leaders have committed to providing access to contraceptives for an additional 120 million women in the world’s poorest countries by 2020 (beyond the estimated 260 million current users). This sound investment will result in improved maternal and child health, including 200,000 fewer maternal deaths and nearly 3 million fewer infant deaths, more than 110 million fewer unintended pregnancies, and more than 50 million fewer abortions.

Family planning programs can learn from each others’ successes and challenges by adding their programs to the online HIPs map. The map depicts programs that are implementing HIPs and provides information about where the programs are being implemented, what kinds of services are offered, the types of data collected to monitor programming, and contact information to learn more.