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Family Planning

Strategy Overview

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Family planning is a key part of the foundation's broader commitment to empowering women and improving family health.

our goal:

to ensure that women and girls in developing countries have access to quality family planning information, services, and supplies.

The Challenge

At A Glance

Access to family planning information and contraceptives can change lives. Every woman and girl deserves the chance to determine her own future. Read women’s stories here.

More than 220 million women in developing countries who don’t want to get pregnant lack access to effective methods of contraception and voluntary family planning information and services.

Increasing access to contraceptives and family planning information and services will result in fewer women and girls dying in pregnancy and childbirth, fewer unintended pregnancies, fewer abortions, and fewer infant deaths.

We work to increase funding and improve policies for family planning, expand the demand for and use of contraceptives in impoverished urban areas, develop innovative contraceptive technologies, and support further research to close knowledge gaps.

Our family planning strategy, updated in 2008, is led by Gary Darmstadt, director of Family Health, and Monica Kerrigan, team lead for Family Planning, and is part of the foundation’s Global Development Division.

Voluntary family planning is one of the great public health advances of the past century. Enabling women to make informed decisions about whether and when to have children reduces maternal and newborn deaths. It also results in fewer unintended pregnancies and unsafe abortions, increases opportunities for women, and leads to healthier families and communities. Family planning is a smart, sensible, and vital component of global health and development.

However, more than 220 million women in developing countries who don’t want to get pregnant lack access to effective methods of contraception and voluntary family planning information and services. Less than 20 percent of women in Sub-Saharan Africa and barely one-third of women in South Asia use modern contraceptives. In 2012, an estimated 80 million women in developing countries had an unintended pregnancy and at least one in four resorted to an unsafe abortion.

Significant challenges stand in the way of making contraceptives more widely available and accessible, including the high cost of quality mid- to long-acting contraceptives, unpredictable donor funding, cultural and knowledge barriers, and lack of coordination in procurement processes.

The Opportunity

Voluntary family planning is one of the most cost-effective investments a country can make in its future. Every dollar spent on family planning can save governments up to 6 dollars that can be spent on improving health, housing, water, and other public services.

A mother and son at a health center in Dakar, Senegal.

In July 2012, leaders from 150 donor and developing countries, international agencies, civil society organizations, foundations, and the private sector committed to provide contraceptives and family planning information and services to an additional 120 million women and girls in the world’s poorest countries by 2020. This collective effort will result in 200,000 fewer women and girls dying in pregnancy and childbirth, more than 100 million fewer unintended pregnancies, over 50 million fewer abortions, and nearly 3 million fewer babies dying in their first year of life. It will also enable more girls to finish school and earn more income over their lifetime. In Sub-Saharan Africa, up to a quarter of girls drop out of school due to unintended pregnancy.

Our Strategy

Family planning is a key part of the foundation’s broader commitment to empowering women and improving family health, which also includes investments in maternal, newborn, and child health; nutrition; vaccine development and delivery; and preventing and treating HIV/AIDS, pneumonia, malaria, and enteric and diarrheal diseases.

At the global level, our strategy seeks to:

  • Revitalize family planning efforts to help achieve the United Nations Millennium Development Goals (MDGs)
  • Raise awareness of the importance of family planning among donors, national governments, and the private sector
  • Improve the efficiency of contraceptive procurement and distribution
  • Increase access to quality family planning products through reduced prices
  • Engage donors, governments, and civil society organizations to improve coordination, increase funding, and advocate for policies that support access to family planning
  • Develop innovative contraceptive technologies that meet the needs of women and girls

In selected countries in Sub-Saharan Africa and South Asia, our strategy aims to:

  • Increase the use of modern contraceptives
  • Improve family planning services for the growing number of urban poor people
  • Introduce innovative, low-cost solutions that can expand the supply of and demand for family planning products and services
  • Find ways to integrate family planning into HIV and maternal and child health services to gain efficiencies and reduce costs

Areas of Focus

Policy and Advocacy

We work to keep family planning on the global agenda in a number of ways. We advocate for increased funding from governments, donors, and the private sector, as well as better policies at every level that support greater access to and availability of contraceptives. We also work to improve coordination among donors and governments and build a sustainable movement for expanded and improved contraception.

In addition, we conduct economic analyses in priority countries to determine the return on investment of family planning expenditures, and we promote transparency and government accountability by working to increase the availability of national and local budget and policy information.

Contraceptive Use in Urban Areas

Most global population growth is expected to occur in towns and cities in developing countries. In Sub-Saharan Africa and South Asia—the fastest-growing regions in the world—urban populations are projected to double between 2000 and 2030.

A mother and newborn in Uttar Pradesh, India

Currently, the highest birth rates are concentrated among the poorest populations, and a significant number of pregnancies are unintended. We focus on stimulating demand for and providing high-quality, affordable, and voluntary family planning information, services, and supplies in these communities, primarily through the Urban Reproductive Health Initiative in Uttar Pradesh, India, and in Nigeria, Kenya, and Senegal. We focus on birth spacing and family planning counseling and providing supplies and services for post-partum mothers, post-abortion clients, HIV-positive women, and vulnerable adolescent girls.

We work with the private sector and civil society organizations to identify effective approaches, and we help build country-level implementation teams into networks that share practices and strategies. We also support measurement efforts to ensure data-driven implementation, rigorous evaluation, a focus on the poorest and most vulnerable people, and widespread sharing of evidence.

New Contraceptive Technologies

Women forgo the use of contraceptives for a variety of reasons, even when they want to avoid pregnancy. Some women have misconceptions about their risk of becoming pregnant, while others have concerns about the side effects of modern contraceptive methods. In some cases, opposition from family members and a limited choice of methods are key factors.

We support the discovery, development, and distribution of new technologies that address reasons for non-use, with a focus on implants and injectable contraceptives. Implants and 3-month injectables are the most popular reversible contraceptive methods in Sub-Saharan Africa, and new versions of these methods show great potential for increasing access to and use of contraception. We are currently investing in quality assurance, regulatory approval, and introduction of two products in selected countries in Sub-Saharan Africa and South Asia.

Less than 20 percent of women in Sub-Saharan Africa and barely one-third of women in South Asia use modern contraceptives.

The first product is Sino-implant (II), which is produced by Shanghai Dahua Pharmaceuticals in China. Sino-implant (II) is a long-acting, effective, and low-cost implant that is approved for use in more than 20 developing countries. Efforts are under way to ensure prequalification approval by the World Health Organization.

The second product is Sayana Press, a new subcutaneous version of the popular three-month injectable from Pfizer called Depo-Provera. Depo-Provera is delivered through intramuscular injection, which must be administered by a health worker in most countries. Sayana Press can potentially be delivered by nonmedical providers, such as trained community health workers, or even self-administered by women. Efforts are under way to assess the acceptability of the product by women and to implement the training, systems, policies, and infrastructure needed to sustainably deliver it.

Additional contraceptive methods are needed to address the diverse needs of communities around the world. For example, we are investing in the development of an on-demand oral contraceptive pill, contraceptive vaginal rings, a six-month injectable, long-term implants, non-hormonal contraceptive methods, and nonsurgical female sterilization. We also support development of multipurpose solutions, such as those that prevent both pregnancy and HIV infection.

Closing Knowledge Gaps

Improving access to family planning resources requires filling critical gaps in knowledge to inform policy and program implementation. We support research to test ways to integrate family planning services with other health services, including HIV prevention and care, maternal and child healthcare (including postpartum care), and post-abortion services. We also seek better data on the potential interactions between HIV acquisition and the use of hormonal contraceptives.

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