Voluntary family planning (FP) fosters the right of women to decide freely and for themselves whether, when, and how many children to have. Yet of over 900 million women of reproductive age (15–49 years) in low-and middle-income countries (LMICs) who want to avoid pregnancy, over 200 million lack access to modern contraception. This unmet need is higher among adolescents aged 15 to 19 (43%). Over 111 million unintended pregnancies still occur in LMICs each year, accounting for over 49% of all pregnancies.
In 2012, Family Planning 2020 (FP2020) launched as a partnership for countries and organizations to reignite the global commitment to meet women’s need for modern contraception, through empowering the voluntary use of contraception by an additional 120 million women and girls around the world by 2020. In the last decade, many countries succeeded in increasing access to modern contraception. As 2020 ended, the FP2030 partnership was formed to build on and expand the work of FP2020.
In June 2023, FP2030 East and Southern Hub convened the first Anglophone Africa Focal Point workshop in Kampala, Uganda, with a call to strengthen the countries’ commitments towards achieving their FP2030 goals across the region. The four-day workshop brought together over 120 delegates from 17 countries. Delegates shared experiences of successes, challenges, and learnings in operationalizing their FP commitments. The countries revitalized the focal point structure, promoted mutual accountability amongst focal points, and established the North, West, and Central African (NWCA) and the East and Southern (ESA) hub brands.
In the lively participatory exchanges between countries, delegates discussed a number of key issues including:
- Increasing domestic resource mobilization and reducing the high dependency on donor funding for FP services and commodities to ensure sustainability;
- developing and implementing strategies for ensuring availability, access and uptake of FP services during emergencies; and
- engaging and advancing adolescent and youth partnerships to increase access and voluntary uptake of FP services by young people who need them.
While many challenges still exist, several countries reported promising successes that are improving access and uptake of FP services. These interventions include the following.
- An increased government commitment towards policies, ownership, and financing rights-based approaches to reproductive health (RH) and FP services enables institutionalization of FP into mainstream health services. Some countries mandated FP under their universal health coverage/insurance programs and integrated FP into the essential medicine and supply chain at all levels. This rights-based approach improves general access to FP services and reduces stigma towards use of FP.
- Involving adolescents as advocates combined with stigma-free youth-friendly services promoted FP uptake amongst youth.
- Approaches led by trusted community health structures empowered community members in their own spaces. The use of trusted community role models as advocates increased male involvement and support for FP services, women’s self-care for FP, and access in hard-to-reach areas.
- Engagement of key media representatives in discussions, communications, and joint learning about FP helped demystify and correct misinformation about FP which facilitated appropriate communication about FP to the public.
- Many countries used a multisectoral approach that included key stakeholders such as the education and development sectors, civil society, the private sector, and local communities to provide a synergistic effort to improve availability, access, and uptake of FP services.
Domestic financing of FP services remains well below target and is one of the major areas being addressed in the FP2030 commitments. To successfully implement their commitments, country governments were called to make a minimum domestic financial contribution towards FP commodities. The United Nations Population Fund (UNFPA) will match country contributions for supply chain support through the UNFPA Country Compact Agreement. The compact agreement is made to improve transparency, coordination, partnership, and accountability among committing partners.
At FP2030, members of the youth participated in discussions and had a significant voice in the workshops. Countries that brought the youth on board and gave them the opportunity to champion FP efforts among young people, remarkably increased uptake of services. The region is still grappling with high numbers of teenage pregnancies, therefore, addressing the needs of the youth through friendly and responsive approaches that address misinformation and stigma, will help effectively increase uptake of modern contraception among the young people and reduce the burden of teenage and unintended pregnancies, and missed opportunities in education and employment.
Although Kenya made major strides in expanding FP services, Kenya focal points unanimously agreed on the need to improve financing mechanisms for FP services. To ensure sustainable and timely utilization of available resources and implementation of FP programs, focal points agreed to work as a united body of partners together with the government and ministry of health.
Population Council was an FP2020 organizational commitment maker, and Population Council Nigeria hosts FP2030 North, West and Central Africa (NWCA) regional hub. Over the years, the Population Council developed leading-edge contributions towards the advancement of sexual reproductive health and rights, including family planning. The continued commitment of governments and partners to expand access to FP across the region makes the Council’s work even more relevant moving forward. These developments will further serve to amplify the Council’s work as we continue to generate context-relevant evidence to inform policy and programming for SRHR (sexual and reproductive health and rights) and produce biotechnologies through our Center for Biomedical Research which supports the expansion of modern contraceptive choice not only in ESA, but around the world.
The FP2030 workshop was a melting pot of shared experiences and knowledge about the context-relevant strategies to address FP challenges in the anglophone countries in the NWCA and ESA region. No country stands isolated in the challenges faced, yet blanket approaches will not work everywhere. This calls for developing approaches and expanding high impact practices (HIPs) that are responsive to the needs of different contexts, age groups, and social-economic status. We need to fill gaps in data and information management systems to ensure policies are rooted in evidence. This calls for significant financial and technical investments to support expansion of FP uptake. Community approaches are worthy of further exploration as they could have significant potential in expanding FP services in the region given that most of the population is rural, with some living in hard-to-reach areas.
Family planning is not a women’s issue, it is everyone’s issue; therefore, devising strategies to responsively bring the wider community on board will be an added push to increasing FP access and uptake for women, girls, youth, and all who need it.
Read more about the FP2030 meeting in this full recap.