Total Market Approach to Family Planning

Why consider a total market approach to family planning?

A total market approach to family planning harnesses the resources of the entire range of health care providers—public, private (nonprofit and for-profit commercial), and donor—to ensure that all people who want family planning products and services can access them, regardless of their ability to pay.


  • Family planning market: Clients; providers and outlets of contraceptive products and services; contraceptive manufacturers and distributors; and contraceptive products
  • Private sector: Both not-for-profit and for-profit commercial providers of contraceptives
  • Market segmentation: Division of diverse populations into subgroups with similar characteristics, needs, and likely responses to family planning marketing or service delivery to shed light on the current and potential market
  • Social franchise: Network of private health providers that contractually agree to provide socially beneficial services under a common brand
  • Health vouchers: Tokens distributed by accredited health facilities that entitle clients to services at any contracted facility of their choice, public or private. The provider who accepts the voucher is reimbursed for the cost of services provided, plus a reasonable profit.

Key Messages

  • The total market approach uses a combination of free, subsidized, and commercial delivery methods to ensure access to the full range of high-quality contraceptive methods and services for all segments of a population.
  • Greater efficiency in the market increases sustainability of family planning programs by lessening the burden on donor and government resources and enabling private-sector participation.
  • Equitably meeting the diverse needs of different population segments requires coordination and knowledge-sharing across all market sectors.
  • Healthy family planning markets exist when contraceptive products and services are readily available, affordable, appropriate, quality assured, and in secure supply for all segments of the population, including poor and hard-to-reach segments.


A total market approach to family planning aims to efficiently use all available public, nonprofit, and private commercial sector resources and infrastructure to improve access to family planning products and services for all clients. Ultimately, a total market approach to family planning will grow the market in a sustainable manner, ensuring that those in need of family planning can access it through varied and optimal channels: low-income clients receive free products and services, those with slightly more financial means can access partially subsidized products and services, and those with the most robust ability to pay can purchase products and services from the commercial sector.

A Total Market Approach Requires Cross-Sector Knowledge-Sharing

Each country’s application of a total market approach to family planning will vary depending on the local context. In order to develop and implement a total market approach to family planning, stakeholders must effectively share data and information with each other across sectors to understand the following:

  • What the market looks like from both supply and demand perspectives
  • Who is currently providing products and services (and who could with the right support), where, and at what prices
  • Who is currently accessing services (and who could if the right barriers were removed)

Strategies for a Total Market Approach to Family Planning

With this information, a country can apply a total market approach to ensure that the full range of financial resources—both public and private—are used to access family planning services from the full range of providers. Ideally, governments take a stewardship role of the family planning market, using data for decision making, enabling private sector participation in the family planning market, coordinating market actors, and engaging a range of stakeholders in solutions. Strategies used within a total market approach can include the following:

  • Targeting subsidies so that only those who truly need them can use them.
  • Contracting out family planning services to private providers to expand access to clients who live in areas underserved by public providers.
  • Distributing vouchers to increase access to private facilities by subsidizing the price of health services and products for target populations.
  • Increasing health insurance coverage to include family planning products and services for more people.
  • Social franchising to network quality assured private clinics who can offer contraceptive products and services so that governments can more easily engage in strategic purchasing with private providers instead of contracting with each provider separately. These networks offer private providers and pharmacies training opportunities, access to commodities and advertising, and membership in an organization whose brand signals quality and affordability.
  • Task sharing responsibilities, including delivery of voluntary long-acting and reversible contraceptives and permanent methods, with trained, competent lower-level cadres in order to expand access to contraceptive services.
  • Public-private partnership activities, including joint public-private sector in-service trainings; referral systems so that providers in one sector can send their patients to facilities in another for services that they cannot provide; and collaboration with pharmacists and drug shop owners to increase access through non-facility-based points of care.
  • Demand-creation activities, including public health campaigns to raise awareness about new, effective modern contraceptives and provide information about where they can be accessed, and public, nonprofit, and commercial advertisement of the availability of specific branded services at their facilities.
Topic last updated: June 06, 2018