Behavioral change communication is critical for the success of voluntary and choice-based family planning programs

Guest post by Banchiamlack Dessalegn, Ph.D., Senior Technical Advisor for Monitoring, Evaluation and Research, Family Health International 360 (FHI 360), Addis Ababa Ethiopia

Knowledge and awareness of available family planning (FP) methods, as well as of their benefits and side effects, is a prerequisite for informed decision making (Bongaarts et al., 2012). Behavior change communication (BCC) is a tool for increasing knowledge and awareness. In this way, BCC can be seen as critical to facilitating successful voluntary, choice-based FP.

FP options

The Government of Ethiopia aims to increase the modern contraceptive prevalence rate (mCPR) to 55% by 2020, as stated in Ethiopia’s new Health Sector Transformation Plan. To achieve this, the Federal Ministry of Health (FMOH) is putting emphasis on improving the FP method mix, including by increasing demand for and access to long-acting and permanent methods of FP (LA/PMs) without compromising informed and free choice. While target-setting at the national and subnational levels might lead to the erosion of choice-based FP services, the FMOH has given clear direction that services must be based on proper counseling and free choice. As a result of the concerted efforts and results-oriented policies of the FMOH, impressive achievements have been made in recent years, with the mCPR increasing from 28.6% in 2011 to 41.8% in 2014 and the total fertility rate dropping from 4.8 to 4.1 lifetime births per woman during the same period (CSA [Ethiopia] & ICF International, 2012; CSA [Ethiopia], 2014).

Continue reading

Meeting the Reproductive Needs and Rights of Women and Girls: The Legacy of ICPD is in the Details

Guest post by Mary Beth Hastings, Vice President of Center for Health and Gender Equity (CHANGE)

The task of translating the International Conference on Population and Development’s (ICPD) Programme of Action (PoA) into meaningful change for women and girls globally includes some important detail work. Several years ago, my organization – the Center for Health and Gender Equity (CHANGE) – set out to better define the meaning of key PoA terms. Our guiding question was: “What constitutes comprehensive, rights-based sexual and reproductive health (SRH) care?” We found some useful literature and human rights documents to point us in the right direction, but most importantly, we wanted to make sure our answer was grounded in the lived experiences of women and girls.

Field research in Bahir Dar, Ethiopia. Photo by M.B. Hastings/CHANGE

Community-based health workers in Bahir Dar, Ethiopia met with CHANGE to share their comprehensive approach to sexual and reproductive health and rights. Photo by S. Sippel/CHANGE

Continue reading

Walking Together: Strengthening Health Facility and Community Links to Improve Access and Choice

Guest post by Molly Tumusiime, Program Associate (Community Engagement), EngenderHealth/Uganda

The Right to Health asserts that people are entitled to access reproductive health services, including family planning (FP), that are acceptable to them and of the highest possible quality. However, there are many barriers to individuals’ realizing this right at many levels. While policy change and provider training can support increased FP access and use and better ensure contraceptive choice, interventions at the policy and service delivery levels alone are insufficient. Community-level barriers also impede service utilization and should be addressed in participatory and cooperative ways.

In 2010, EngenderHealth began piloting site walk-throughs (SWTs) in Bangladesh, Ethiopia, Ghana, Tanzania, and Uganda. This promising approach—rooted in the core human rights principles of participation, empowerment, and accountability—catalyzes community participation in health and strengthens the accountability of service providers to communities. In addition, SWTs foster linkages and collaborative partnerships between health providers and community members in addressing barriers to informed choice and service access and in improving the quality and acceptability of services.

Photos by E. Brazier/EngenderHealth

Photos by E. Brazier/EngenderHealth

Continue reading

Hot Topic: Rights and Choice at the International Conference on Family Planning

From November 12–15, an estimated 4,000 government officials, policymakers, program managers, researchers, academics, and youth advocates will gather in Addis Ababa, Ethiopia for the 3rd Annual International Conference on Family Planning (ICFP).

The theme of this year’s conference—cohosted by The Bill and Melinda Gates Institute for Population and Reproductive Health and Ethiopia’s Ministry of Health—is “Full Access, Full Choice,” echoing the Family Planning 2020 (FP2020) initiative’s call to ensure that rights and contraceptive choice are central to meeting the commitment made at the London Summit on Family Planning to reach an additional 120 million women with access to contraception by 2020.

Continue reading