CARE and Family Planning: Let’s accelerate progress and fill key gaps

by 06th Jul 2017
A CARE project in Nepal visits schools and youth clubs to deliver SRH information and conduct pop-up clinics A CARE project in Nepal visits schools and youth clubs to deliver SRH information and conduct pop-up clinics

Just past the halfway point of FP2020 – and looking towards next week’s Family Planning Summit – it’s time to celebrate and showcase progress towards our 2020 commitments but also crucially reflect on what more needs to be done to reach women and girls, especially in emergency settings.

In July 2012, CARE joined other civil society organisations, governments, and donors to commit to reach a shared goal of empowering 120 million additional women and girls with family planning information and services by 2020. FP2020 catalysed a renewed global focus on family planning and great progress has been made since 2012, with 30.2 million more women having access to family planning. However, hundreds of thousands of women and girls still die each year due to pregnancy-related complications and an estimated 214 million women have an unmet need for modern contraception.

Consequently, CARE is reaffirming its own commitments made at the London 2012 Summit, and redoubling our efforts to ensure FP2020’s goals are met.

What did CARE commit to in 2012?

  • Develop approaches for addressing gender and social barriers to family planning use and validating tools to measure the impact of these approaches on health outcomes.
  • Work to strengthen local governance mechanisms and build capacity of women and communities.
  • Focus on reaching the most vulnerable and marginalised populations to reduce inequality and ensure women and girls’ sexual and reproductive health needs are addressed in development, emergency and post-conflict response activities.
  • Build political will and mobilise action at all levels – local to national to global – to ensure implementation of policies and programs that address the needs of communities and are rights-based, effective, and culturally appropriate.

Since 2012, we have been working with our global family planning partners – governments, donors, civil society organisations, community leaders and – most importantly – women and young people themselves to achieve some significant progress. Here are some key highlights of progress against our commitments.

Addressing gender and social barriers to family planning use

CARE facilitates the empowerment of women and girls to ensure they can exercise their rights to access family planning information, services and supplies. For example:

  • CARE’s Social Analysis and Action (SAA) model facilitates dialogue and reflection on norms and behaviours that may undermine reproductive health and helps catalyse a community-led change process to create an environment that supports women and girls’ choices.
  • Through Chat! in Cambodia, which provided garment factory workers with key information and confidence-building to take control of their lives and make healthier choices, the use of modern contraception among sexually active women has doubled from 24% in 2014 to 48% in 2016.

Strengthening local governance mechanisms and building capacity

CARE works to expand spaces for meaningful participation of women and girls in shaping how reproductive health services are provided in their communities, in order to lead to improved responsiveness and acceleration of SRH progress. For example:

  • With help from CARE’s Community Score Card, communities and health providers are identifying and overcoming rights violations like denial of family planning services to adolescents. Results from CARE’s 2017 CSC impact evaluation in Malawi indicated a 57% greater use of modern contraception.

Reaching the most vulnerable and marginalised

CARE has focused on addressing family planning needs in emergency and post-conflict settings, prioritising SRH as an essential, necessary, and feasible part of emergency response. For example:

  • In Syria, CARE has delivered SRH and gender-based violence services, reaching an estimated population of 356,400 Syrians, including 87,501 women of reproductive age.
  • Through CARE’s Supporting Access to Family Planning and Post Abortion Care (SAFPAC) programme, hard to reach women and girls in crisis-affected and fragile settings in Chad, Mali, the Democratic Republic of Congo, and Pakistan are gaining access to contraception and other SRH services. Over the last five years of SAFPAC, results have demonstrated a steady and dramatic increase in new contraceptive users across the countries, with 66% of the new contraceptive users choosing long-acting reversible methods (LARCs).
  • In Chad especially, CARE has seen remarkable uptake in LARCs, with the modern contraceptive prevalence rate rising to more than twice the national average of 5% in two regions where CARE supports the government.

Building political will and mobilising action

  • CARE has worked to build and sustain political will and mobilise investments in family planning from donors and national governments. For example, CARE has been supporting DRC to deliver on its commitments on FP through convening the DRC’s first provincial-level Permanent Technical Multi-sectorial Committee on Family Planning (CTMP/FP).
  • CARE has endeavoured to elevate family planning as a core, life-saving intervention in all humanitarian responses, and mobilise political will to meet the SRH needs and rights of all people affected by crisis and conflict. CARE has advocated this through its active membership of the Interagency Working Group for Reproductive Health in Crises (IAWG) which successfully advocated for the repositioning of family planning as a priority intervention within the Minimum Initial Service Package for Reproductive Health in Crisis Situations (MISP).

Moving forward: the need to accelerate progress and fill key gaps

Great progress has been made by CARE in partnership with countries, partners and women and girls themselves. Yet as a global community we are far from reaching our goal and therefore must accelerate progress and fill key gaps in reaching the hardest to reach. Therefore, CARE is not only reaffirming its commitments made at the London 2012 Summit but also redoubling its efforts to ensure FP2020 commitments are upheld in order to fulfil the goal of reaching 120 million additional women and girls with family planning information and services by 2020.

In order to do this, we will partner with others in the global family planning community and call on governments, partners and civil society to:

1. Ensure access to comprehensive family planning services in all crisis-affected and fragile settings

Delivering family planning services to women and girls in humanitarian settings is critical to achieving FP2020 goals as well as fulfilling their rights. Family planning remains one of the most neglected and underfunded components of humanitarian response. We must ensure that donors, governments and humanitarian actors commit to ensuring universal access to life-saving family planning for all women affected by conflict and crisis. Specifically, the Minimal Initial Service Package – including family planning services – should form a core part of all emergency responses.

2. Invest in participatory governance and social accountability processes to transform health systems and drive FP2020 progress

Social accountability empowers women and young people to directly monitor the healthcare services they receive, and negotiate to receive the services they need and want. Investment in and use of social accountability approaches can build trust and catalyse solutions to improve family planning and SRH outcomes, and help ensure that women and girls’ rights are respected, protected and fulfilled. Evidence shows that investments in social accountability can dramatically increase acceptability, quality and utilisation of family planning.

3. Ensure programming for adolescents is designed and co-created with adolescents themselves

Adolescents urgently need family planning but face powerful barriers to accessing services, such as poverty, stigma, discrimination and lack of knowledge about their health and rights. Unless we partner with young people to design and deliver policies and programs that address their realities and meet their needs, we will not be able to fulfil the family planning needs and rights of the billion young people who live in FP2020’s 69 focus countries.

4. Strengthen health systems by ensuring adequate capacities, compensation, and support to frontline health workers providing family planning and reproductive health services

The global shortage of health workers presents a critical challenge to the accessibility, availability and expansion of contraceptive methods available to women and girls. Innovation in the health workforce is needed to ensure that even the most marginalised and vulnerable have access to high quality family planning information and services.

We have a long way to go

Next week’s summit is a critical opportunity to share and celebrate successes but also remind us that a lot still has to be done to reach our 2020 goals. CARE will continue to deliver progress toward our commitment and we invite you to hold us accountable in this endeavour, and to join us as we build further momentum in the coming years. We believe that the summit should not be a single moment but instead a springboard to sustained long-term progress.

Information for this blog was taken from CARE’s report ‘The Path to 2020: Delivering transformative, rights-based family planning’. The online version of this report can be accessed at www.care.org/work/health/family-planning on 7 July 2017.

Rebecca Gibbons

Currently, I am supporting the Policy and Advocacy team in research and advocacy in themes of Gender in Emergencies: Protecting and Empowering Women in Conflict and Women’s Economic Empowerment and Financial Inclusion. I am particularly working on CARE’s advocacy around the 2017 Family Planning Summit.

I have an MA (Distinction) in War Studies from Kings College, London, having previously studied BA History and Politics at the University of Exeter. I have previously worked at Waging Peace, a human rights organisation which campaigns against genocide in Sudan and, alongside its sister charity, supports Sudanese refugees in the UK. I also currently volunteer in campaigns at Amnesty International UK.

Email: gibbons@careinternational.org
Twitter: @RebeccaJGibbons