Bill & Melinda Gates Foundation

Family Planning Taking Its Place on the Global Stage

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May 16, 2013

This is the fourth post in the six-part Family Health "Check Up" 2103 series which provides a window into the ways in which we think about our Family Health strategy, at the foundation. Follow @gatesfoundation and @gdarmsta on Twitter to join the conversation. 

The most visible event last year for the Family Planning team here at the Gates Foundation, and for all of our Family Health team was the London Summit on Family Planning. Strong global partnerships are what made the Summit successful. The Summit galvanized the global community to support the rights of women and girls to access family planning information, supplies and services, and included bold commitments by more than 20 countries to address the policy, financing, and delivery barriers to meet the family planning needs of women and families and improve maternal, newborn and child health in the poorest countries in the world.

These partnerships will also move FP2020 forward -  to sustain the momentum from London and ensure all partners are working together to achieve and support the goals and commitments announced at the Summit. At its core, FP2020 will be responsive to country needs and plans. It has been inspiring to see leaders in Nigeria, India, Ethiopia and Senegal, within months after the Summit, organize successful national meetings to galvanize family planning movements, share best practices, and launch new efforts to achieve their family planning goals. These national meetings represent a critical component of the post-Summit momentum and revitalization of family planning at the country level.

 As a global community we must build on a human rights framework to make family planning available, accessible, acceptable and of the highest possible quality.

Since the Summit, civil society and global partners have come together to lay a foundation for FP2020 to respect, protect and fulfill women’s human right to access life-saving contraceptives.  As a global community we must build on a human rights framework to make family planning available, accessible, acceptable and of the highest possible quality. Together we are finding ways to improve the quality of family planning programs and ensure that all women have family planning within their reach. Our partners are looking at innovative ways to measure quality, equity and informed choice in programs, underscoring our accountability to the women and girls FP2020 serves.

Partners also rallied to increase the affordability of contraceptive implants, a method that many women want but often cannot access because of the cost and frequent stockouts. Public and private sector partners helped shape agreements with Bayer HealthCare and with Merck for volume guaranties for the implants Jadelle and Implanon, respectively. These agreements reduced the price of Jadelle and Implanon implants by over 50 percent, and will expand contraceptive options for women in more than 50 of the world’s poorest countries. These agreements will save hundreds of thousands of lives and prevent millions of unintended pregnancies, as well as save an estimated $400-million which can be used to further expand access and improve the quality of programs.

Another exciting event from last year is that the informed push distribution model in Senegal has eliminated stock-outs and dramatically increased average monthly consumption of various contraceptive methods over the 9-month period after the launch of the pilot. The informed push distribution guarantees that contraceptives are available and allows women to decide among a variety of contraceptives to find one that fits her needs.  Because of this, monthly uptake of a wide range of contraceptive methods from injectables to IUDs to CycleBeads has quadrupled. The Senegalese government has made plans for a national expansion of this model during this year and next, with potential to incorporate additional products for distribution and data capture. By making family planning available, accessible and acceptable, the government is helping women achieve their desired fertility and is saving lives along the way.

Contraceptive technology is another major component of the family planning strategy. Women often do not use contraceptives because of concerns about side effects, only needing them periodically, a lack of products suitable for postpartum use, inaccessibility, partner opposition, and price. We invest in the development of technologies that respond to women’s needs and preferences.  

 It is only by working together toward a common goal of increased access, affordability, quality and choice of a range of contraceptive methods that an international family planning movement has been reinvigorated.

One example is Sayana Press, a 3-month injectable hormonal contraceptive that can be used discretely and may be delivered by community health workers and private sector pharmacies. Partners from the Summit are working together to introduce it in a few countries. Through this introduction effort we will evaluate the impact of this technology on our ability to reach new family planning users, improve continuation rates, and reduce service delivery costs. This will inform future decisions on the inclusion of the product in national programs and should further reduce the price.

A priority for the coming year is to develop a monitoring and tracking system to provide real-time data on policy and budgetary processes and program implementation in priority geographies. This will include efforts to monitor how well programs adhere to the core values of voluntary family planning programming and supporting the rights of women and girls. Particularly with so many countries on-board with FP2020, partnerships will help FP2020 monitor efforts and course correct when necessary.

At the foundation we are very excited that a new Director of Family Planning, Dr. Elizabeth Lule, will be joining our team in June to support these efforts and continue to build strong partnerships. She comes with a deep commitment to family planning and has outstanding expertise working with women and girls to address issues in family planning and HIV-AIDS with a focus on sub-Saharan Africa.  

It is only by working together toward a common goal of increased access, affordability, quality and choice of a range of contraceptive methods that an international family planning movement has been reinvigorated. And it is only just beginning. Our collective intention is to cultivate and promote a global movement for family planning. It is through partnership, collaboration, and the participation of diverse stakeholders that we, as a community, can transform family planning. 

How can we scale up these services so that women get the information, supplies and services they need?  What have you learned as you have implemented programs and provided services that can further this movement?  We want to hear from you.

 
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