Elements of Family Planning Success

"Governments play a very critical role [in family planning], in terms of framing policies, planning for adequate programs, making the necessary investments... and also that is seen as integral to development planning."
--Purnima Mane, UNFPA [Watch this interview]
 
Family planning programs need political support to operate successfully. Supportive family planning policies help programs succeed by:
• Establishing favorable laws and regulations,
• Assuring availability of contraceptive supplies,
• Allocating adequate financial resources, and
• Supporting public access to family planning information and services.
 
Q. What types of policies are important to family planning success?
A. Successful FP programs require both supportive national policies and facilitative operational policies, working in tandem. Supportive national policies ensure that family planning has a prominent place on the national agenda and that adequate resources are allocated for services. These policies, which provide the broad vision, framework, and perhaps financial support, are translated into operational policies. Operational policies enable programs to provide services successfully. They include the regulations, codes, guidelines, plans, budgets, and procedures for programs and services.
 
Q. Who are the decision makers in developing family planning policies?
A. Policy represents the outcome of a balancing of interests and power centers. Those in the government with decision-making authority obviously play a large role. Everyone with an interest is a potential player in the policy process—advocacy groups, NGOs, bureaucrats as well as politicians and their staff, the new media, even the public.
 
Q. How can family planning professionals work towards supportive policies?
A. Seek support from key audiences at all levels through advocacy activities informed by evidence. Successful advocacy requires knowing who are the specific decision-makers and stakeholders, what are their specific interests, and how to reach and appeal to them. The following ingredients should be a part of any advocacy effort:
 
• Identify influential leaders who are motivated to be a family planning champion. They can gather others together in support of strong policies. Also, they can lobby persuasively with policy makers to sustain political attention to family planning. Programs can seek out champions at all levels, from local leaders to high-level officials. For example, to address low levels of contraceptive use in Malawi in the early 1990s, a group of highly motivated family planning advocates helped establish family planning coordinators in each district to promote access to services. Family planning is now almost universally available. Having a well-defined policy goal contributed to this success. [USAID/ACQUIRE Malawi Case Study]
 
• Involve all stakeholders in policy and program development. Programs need support not only from clients but also from the general public, health officials, policy-makers, funding agencies, the news media, health care providers, women’s organizations, and religious and community leaders. Identifying supporters in these key audiences and involving them in decision-making and advocacy can help promote ownership of the issue.
 
• Draw upon data and case studies to illustrate the importance of family planning programs. Showing how family planning helps achieve important health, social, and development goals. This helps policy makers justify investments in family planning. There are numerous data sources, such as UNFPA, the Population Reference Bureau , and the Demographic and Health Surveys. Programs can use these data sources to back up key messages, such as “Family planning programs prevent unsafe abortions, and that saves women’s lives.” Having a compelling “story” is also important to convince policy-makers—if possible, the real story of a real individual person. Stories can move people and change minds.
 
Q. What are some examples of supportive government laws and regulations?
A. Examples of supportive government laws and regulations include lowering subsides on imported supplies, putting contraceptives on the essential medicines list, and allowing a range of providers (with appropriate training) to perform procedures.
[USAID Health Policy Initiative]
 
Case Study
Zambia’s Family Planning Policy Framework Improves Service Delivery and Expands Access
 
In Zambia the government gave family planning programs minimal support until the late 1980s. Attitudes towards family planning began to change at that time, following the establishment of a new government and the development of a new national population policy in 1989. This policy recognized the effects of rapid population growth and the need to incorporate population concerns into the national development and planning process. The policy also stated that family planning is good for the welfare of the mother and the child. It also declared that information and access to services are a fundamental human right. This policy shift resulted in a strong focus on family planning during the 1990s, with a number of champions ensuring that it received necessary emphasis.
 
To help service delivery programs operationalize the national family planning policy, the Ministry of Health developed in 1997 the policy framework, “Family Planning in Reproductive Health: Policy Framework, Strategies, and Guidelines.” This document outlined strategies for improving access to and quality of family planning, addressed unnecessary medical barriers to contraceptive use, included guidelines for service provision based on the WHO Medical Eligibility Criteria, and helped to strengthen the logistics system by appointing a champion at the Central Board of Health. With the help of these new supportive policies, use of modern contraception in Zambia increased from 9% of married women of reproductive age in 1992 to 23% in 2002.

[USAID/ACQUIRE Zambia case study]
 

Each of the 10 elements was chosen based on online survey results and was discussed in an online forum hosted by the Implementing Best Practices (IBP) Knowledge Gateway. Read more about the survey, forum and results in the Forum Synopsis. Learn more about IBP Knowledge Gateway, and join their Initiative here.
 
 

Recommended Resources

Comment on this Element