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Full Access, Full Choice: Tackling barriers to family planning


Mothers and babies at Ramada Health Post, Ethiopia. (Photo: Anne-Sofie Helms/Save the Children)

Family planning is moving up the global agenda. Last year’s Family Planning Summit in London led to pledges of US$2.6 billion to enable 120 million more women and girls to access contraceptives by 2020. In Ethiopia last week, the turnout for the Third International Conference on Family Planning – over 3,500 participants, crucially including many young people – was huge. This is not an issue that is going away.

Tackling health system barriers

At last year’s summit, Save the Children launched a report, Every Woman’s Right, which called on the international community to put health workers at the heart of family planning, invest in education, and promote women’s rights and empowerment. These are still our recommendations.

Efforts to promote full access and full choice to family planning services must not be undertaken in a bunker. It is important to recognise how these issues relate to the broader health system: we must address barriers to equitable access, so that all women can get the health services they need, including family planning. It was great to see high-level panellists raise this vital point. Anuradha Gupta from India’s Ministry of Health spoke about the importance of strong health systems, investing in health workers and making treatment free at the point of use. HE Roman Tesfaye, Ethiopia’s First Lady, talked of the need to expand health infrastructure to improve access.

Addressing wider challenges

There are also challenges to improving access to family planning outside the health sector: education, youth, women’s empowerment, and linked social and cultural barriers, and many of these issues were high on last week’s agenda. The President of Malawi pointed out that family planning is alsoabout development and human rights; Dr Zuma, AU Commission Chairperson, talked about the importance of education. Speaking on cultural barriers, Tewodros Melesse from IPPF said it was a crime that girls were being “given away” for marriage; and as Kate Gilmore from UNFPA very poignantly put it, no culture is dependent on girls being married at 12.

Celebrating progress and successes

The conference was also a great opportunity to highlight progress and celebrate successes. For instance, mHealth in Tanzania is helping improve the efficiency of commodity supply chains (including family planning commodities) and reducing stock outs, in which health centres run out of medicines or other supplies. Participants from Uganda and Senegal shared stories of successful policy change that led to community health workers being able to reach remote communities with services.

Ethiopia’s progress on improving coverage of family planning and other health services was widely celebrated. They have recently achieved MDG 4, demonstrating their commitment to improving the health of citizens. Their health extension workers programme, a cornerstone of their health system which ensures broad reach for health services, has been critical to this success.

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