High-Impact Practices in Family Planning

High-impact practices in family planning (HIPs) are promising or best practices that, when scaled up and institutionalized, will maximize investments in a comprehensive family planning strategy. HIPs help family planning programs focus their resources and efforts to ensure they have the broadest reach and greatest impact. K4Health is working with USAID to collect data on programs which use these practices and to maintain a website devoted to HIPs.

A technical advisory group convened by USAID identified two interrelated categories of HIPs: (1) creating an enabling environment and (2) high-impact practices in service delivery.

Creating an enabling environment, through practices such as developing supportive government policies and strengthening capacity to lead and manage family planning programs, facilitates implementation of high-impact practices in service delivery, for example, to support community health workers in providing a wide range of contraceptive methods and to extend the reach of services through mobile clinical outreach.

Visit the HIP site for the full list of HIPs and to use an interactive online map showing who, what, when, where, and how HIPs are being implemented in the field. The map helps family planning programmers around the world connect with each other and learn from each other’s successes and challenges. If you are implementing HIPs, you can add your program to the map.

  • Blog post

    Bill and Melinda Gates recently released their 2014 Annual Letter (also available in PDF, but I recommend viewing it online to participate in the quizzes and watch the videos). In it, they debunk three myths about global poverty:

    Myth 1: Poor countries are doomed to stay poor

    Myth 2: Foreign aid is a big waste

    Myth 3: Saving lives leads to overpopulation

    Not only does the letter present the data to bust these myths, it is bookended with an appeal for readers to speak up when they hear inaccuracies about these persistent myths by contacting policymakers and speaking up in online forums.

    In that spirit, and as part of K4Health’s continuous effort to share accurate, up-to-date knowledge and tools to strengthen family planning and other public health efforts worldwide, here are some additional resources to help you debunk Myth 3.

    For an easy-to-follow primer on why “ending population growth starts by saving the poorest children,” watch this short video by Hans Rosling from Gapminder:


  • Blog post

    It was January 2009 at Georgetown University’s Institute for Reproductive Health (IRH). We had just put the finishing touches on a concept note, detailing what at the time felt like a harebrained idea: women are increasingly using mobile phones, so why not use them as a family planning tool? Why couldn’t a method of family planning be available, right in the palm of women’s hands?

    A health worker in Goa uses a PDA

    A health worker in Goa, India, uses a PDA sponsored by Sangath Society.

    © 2009 Frederick Noronha, Courtesy of Photoshare

    This idea would later become known as CycleTel™, and we would pioneer offering the Standard Days Method® (SDM) of family planning via text messages. In a matter of a few weeks, we had a script of the intended text messages and a formative research design under Institutional Review Board (IRB) review. We were excited and thought that CycleTel could really be a game changer for expanding access to family planning.

    Since then, we have reached critical milestones: we have validated the concept through rigorous proof-of-concept testing, designed and built a customized software to support the service, integrated a call center to support customer queries, piloted the technology with more than 800 women, and developed a business plan to understand how to reach sustainability and scale in a five-year period. We’ve iterated the innovation, time and time again—adapting the messages too many times to count, tweaking the technology functionality to improve the user experience, and learning many times over that end users need to be involved at each stage of the development cycle to ensure adoption and continued use. We’ve also realized that it takes a community to be disruptive: we’ve participated in countless conferences and meetings, sharing and exchanging hard lessons with many mHealth colleagues, and we’ve benefited from the support of forward thinking investors who have provided the financial resources to introduce and operate CycleTel in India and elsewhere.

    Now it is September 2013. CycleTel is well on its way to reaching its intended social impact—but it’s been a long and winding journey, and we have been creating the pathway as we go. There’s still more work to be done, more partnerships to be brokered, a business model to be validated, and the challenges of scale and sustainability to be met. While I no longer work on CycleTel as a full-time IRH employee, I’ve had the opportunity to be involved from the sidelines and see the innovation make strides this past year. 2014 will be a big year for CycleTel, and I’m looking forward to seeing what’s next. 

    I’m sharing this personal anecdote for two very important reasons:

    1. To underscore that mHealth is not necessarily easy and straightforward, and project timelines are not as overnight as we expect them to be, especially when dealing with technology and innovation; and
    2. If you’re new to mHealth planning and implementation, you’re in luck because you can learn from the mHealth pioneers. In the past five years, the field of mHealth has matured tremendously—and while there is much more to discover, there are also resources and knowledge to build on so you do not have to start with an empty whiteboard.  

    With that, K4Health and FHI 360 are proud to announce the beta launch of what we hope will be your companion as you start your next mHealth journey: The mHealth Planning and Implementation Guide: How to Integrate Mobile Technology into Health Programming. This Guide was designed to help global health practitioners and program planners understand mHealth, its application to health programs, and how to plan to integrate it into programs. 

  • Blog post

    Originally appearing on the Global Health Knowledge Collaborative (GHKC) Blog, this post by Basil Safi describes a pilot eHealth program in Bangladesh that equips community health workers with Netbooks loaded with behavior change communication materials rigorously vetted by the Bangladesh Knowledge Management Initiative (BKMI) and the Bangladesh Ministry of Health and Family Welfare (MOFW). Basil discussed the pilot project at the Global Health Knowledge Management Share Fair last month, and it was recently highlighted on USAID's Impact Blog in a post by Monica Bautista and Peggy D'Adamo.

    A Family Planning Provider in Bangladesh

    BKMI will help providers access the latest resources to better counsel their clients on family planning (FP), maternal, newborn and child health (MNCH) and nutrition. 

    © 2011 Cassandra Mickish/CCP, Courtesy of Photoshare

    Under the Knowledge for Health (K4Health) Project, the Bangladesh Knowledge Management Initiativeworks to build the capacity of the Ministry of Health and Family Welfare (MOHFW) in Bangladesh to improve knowledge management and coordinate behavior change communication (BCC) in the country.  BKMI collaborated with MOHFW to establish the gold standard of BCC for health, population and nutrition and make the best tools and resources available in an offline, digital format to health workers in the field.  BKMI is using a rigorous monitoring and evaluation plan to assess the impact of this pilot project.  

    During the Global Health Knowledge Collaborative's Knowledge Management Share Fair on April 16th in Washington, DC, I explained that as part of the initiative, 300 community-level health workers in the Sylhet and Chittagong districts will receive netbooks pre-loaded with HPN BCC eToolkits and eight eLearning courses to use when counseling clients about family planning (FP), maternal, newborn and child health (MNCH) and nutrition. The digital resources will also be made available on computers in 42 health complexes, 12 clinics and two Agriculture Information Communication Centers.  By the end of the pilot, a robust evaluation will look for changes in field workers’ knowledge and BCC skills, as well as their clients’ intention to adopt healthier behaviors around FP, MNCH and nutrition.

  • Publications & Resources

    From the "Background Information" section: "The key aim of the guide is to pull together, in one place, key resources for Family Planning (FP) programming and advocacy at the country level. The guide provides an array of widely referenced resources in FP. Included are documents that explain the rationale and benefits of investing in FP, as well as more detailed programmatic and policy resources."

  • Blog post

    From the end of 2012 and into the New Year, the global health community looked back on the commitments made at the London Summit on Family Planning and looked ahead to achieving the goals announced at the Summit. While the July event was a highlight in global development for 2012, Family Planning 2020 (FP2020) will to continue to frame our discussions as governments, civil society, and technical institutions move toward the target: deliver contraceptives, information, and services to a total of 380 million women and girls.

    Check out these videos from the Wilson Center's Environmental Change and Security Program on the importance of maintaining the momentum of FP2020:

  • Blog post

    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).

  • Blog post

    A new study by the Guttmacher Institute and the United Nations Population Fund (UNFPA) reveals that the efforts of global family planning programs fall far short of what is needed to effectively address unmet need for family planning in the developing world. The authors of Adding it Up: Costs and Benefits of Contraceptive Services—Estimates for 2012 estimate that the level of unmet need for contraception—defined as the number of fecund, sexually active women who wish to avoid pregnancy but are not using modern contraception—fell only slightly from 226 million in 2008 to 222 million in 2012. Alarmingly, in the world’s 69 poorest countries—home to 73% of all women with unmet need—the number of women with unmet need for contraception has actually increased from 153 million to 162 million since 2008.

    Woman Unmet Need 1

    A smiling woman in Stone Town, Zanzibar, Tanzania.  © 2011 Arturo Sanabria, Courtesy of Photoshare

    While the number of women in the developing world using modern contraceptive methods rose from 603 million to 645 million between 2008 and 2012, a closer look at these numbers reveals that more than half of this increase is due simply to population growth rather than to a higher contraceptive prevalence rate (CPR). CPR increased more noticeably during this time period in Eastern Africa (from 20% to 27%) and Southeast Asia (from 50% to 56%) than in Western Africa and Middle Africa, where little change was observed and fewer than 10% of married women currently use modern contraceptive methods.

  • Publications & Resources

    Booklets providing USAID Missions and their partners with strategies and activities to improve contraceptive security.

    Ready Lessons I (USAID, 2004)

    Complete Series: English (4.7M) español | français

  • Publications & Resources

    This toolkit provides a platform for strengthening the capacity of agencies and organizations to plan, implement, evaluate, promote, and scale up comm

  • Publications & Resources

    Community-based family planning brings family planning information and methods to women and men in the communities where they live rather than require them to visit health facilities. This to