Reproductive health and family planning
Sexual and reproductive health services save lives. Yet millions globally still do not have access to the contraceptive, abortion, STI/HIV prevention and treatment, and other related services that they need and want. Bringing new contraceptive services to markets where women can easily access them increases their use and means women can choose when they have children and how many they have. This choice has significant effect on the health and economic wellbeing of women and their families. Moreover, expanding coverage of effective HIV/AIDS prevention, treatment and care services can reduce the spread of HIV and mitigate the impact of AIDS on the lives of the most vulnerable.
We support better access to reproductive health and family planning services through:
- Research to understand people’s experiences of sexual and reproductive health, particularly for those who struggle to access services due to their age, social class, culture, ethnicity or behaviours.
- Evidence-based solutions to improve service use amongst those who find accessing services difficult or shameful, for example youth, disabled and unmarried women.
- Advocacy and behaviour change communications to change social norms, promote use of family planning services, and to advocate for better provision of sexual and reproductive health services.
- Strengthening delivery and coverage of services to make sure that quality sexual and reproductive health care is accessible to all.
- Improve accountability of service providers, health and government leaders for the ensuring the resources are available to deliver high quality services for all.
For countries’ FP2020 commitments to result in improved family planning uptake, commitments need to translate into increased budgetary allocations and actual expenditure on family planning. Accountability mechanisms are crucial catalysts in making this happen. In Nigeria, our UKAid & Gates-funded Evidence 4 Action programme uses evidence based advocacy to drive accountability at Federal and State level. For example in Lagos State, the 2015 budget scorecard developed by the Lagos State Accountability for maternal and newborn health (LASAM) identified weak participation in the budget process. In the following year’s budget process, LASAM pushed for family planning to be prioritised, based on the findings of the maternal and newborn health scorecard. As a result, the 2017 budget included an allocation for family planning consumables. Scorecards also help monitor services provided and enable civil society to influence decision-making.
We also work in emergency settings, promoting innovative, flexible and responsive approaches that can protect and enhance women’s access to family planning, and trigger broader health system improvements. Throughout Yemen’s conflict, vouchers have ensured access to family planning services. Our KfW-funded voucher programme achieved significant increased uptake of implants and IUDs (134% and 46% respectively in 2014). Reimbursements from vouchers are playing a crucial role enabling facilities to continue providing health services. Success of the scheme led to widespread government support and replication in other governorates.
During and after the earthquakes in Nepal, UKAid-funded technical assistance helped the Ministry of Health introduce ‘Visiting Providers’- qualified nurses and midwives skilled in IUD/implant insertion - providing on-site coaching to village-level facility staff. In eight severely affected districts, users of long-acting reversible contraceptives increased by 36.6% compared with the previous year. This support enabled the Ministry of Health to ‘build back better’ after the earthquake, using peripatetic mentors to effectively reach remote women.
In Pakistan, we worked in partnership with Marie Stopes International to increase women’s access to sexual and reproductive health services. Rapid qualitative research using PEER (Participatory Ethnographic Evaluation and Research) identified barriers to services for women and men. This then informs the development of practical solutions. We led the design of voucher programmes to reach families in more remote areas and provide access to much-needed reliable long-term contraception.
In Nigeria, we have been working to reduce the spread of HIV, to mitigate the impact of AIDS and to improve access to condoms in rural communities. We have supported better coordination and the accountability of national and district level institutions to effectively coordinate and plan the most cost-effective HIV/AIDS interventions in eight states.
In Pakistan, the contraceptive prevalence rate increased in programme areas from 27% to 48% after 1.5 years.
In the same period, the contraceptive prevalence increased in the programme areas by 77% compared to 7% in control areas.
In Yemen uptake of implants and IUDs increased by 134% and 46% respectively in 2014
In earthquake affected districts in Nepal, users of long acting reversible contraceptives increased by 36.6% in 2016 compared to 2015