Keeping Complexity in a Human Rights–Based Approach to Family Planning: Is It Worth It?

Submitted by Shannon Harris, on behalf of the team led by Futures Group and EngenderHealth that developed the Voluntary, Rights-Based Family Planning Framework

Human rights–based family planning (FP) programming—what does it mean? Where do you start to translate it into practice? How comprehensive do you need to be? It is easy to become daunted by a long list of inputs and activities, such as those listed in the voluntary, rights-based family planning framework developed by a team led by Futures Group and EngenderHealth. The recent 2020 Vision newsletter refers to the overwhelming nature of existing guidance documents for ensuring that FP programs are rights-based and offers a simplified starting point. But will simplification of a complex set of challenges lead to the transformation in FP programming that our field needs?

We welcome the dialogue started by Population Action International (PAI) about how to move forward to protect and fulfill human rights within FP programs. This conversation is needed; multiple voices and views add richness to the discussion. PAI suggests starting with three priorities: voluntarism, informed choice, and achieving a diverse method mix. Certainly, we have to start somewhere, and these three elements are essential to rights-based FP— programs must be vigilant in preventing instances of coercion and in ensuring full, free, and informed contraceptive choice.

However, these program elements are not sufficient to ensure equitable access to services for all nor to ensure that the services are of high quality. They also do not address community factors that impede access to and use of FP. And they do not address the issue of accountability. These are critical considerations for reaching and fulfilling the human rights of the 220 million women with an unmet need for FP.

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Reviews of Evidence and Tools Support Rights-Based Family Planning Framework

In 2013, EngenderHealth and Futures Group published a new framework, Voluntary Family Planning Programs that Respect, Protect, and Fulfill Human Rights: A Conceptual Framework, that offers a holistic approach to realizing human rights as a part of voluntary, high-quality family planning (FP) services. The framework’s linkage of FP and human rights was informed and supported by systematic reviews of supporting evidence and available tools. The results of these reviews are now available in two companion papers:

Evidence paper CoverVoluntary Family Planning Programs that Respect, Protect, and Fulfill Human Rights: A Systematic Review of Evidence synthesizes the findings from a literature review of more than 290 relevant interventions, evaluations, and case studies, to engender a better understanding of the elements of a successful rights-based FP program. The report reviews the current evidence for rights-based FP and identifies practices that protect and fulfill the rights of clients and prospective FP users to achieve desired reproductive intentions.

Tools Paper CoverVoluntary Family Planning Programs that Respect, Protect, and Fulfill Human Rights: A Systematic Review of Tools presents an extensive review of 150 training and assessment tools, frameworks, methodologies, implementation guides, and job aids that support and promote the fulfillment of rights at the policy, service, community, and individual levels. Links to tools reviewed are provided to allow policymakers, program planners, and managers to access resources that will enable them to assess, design, implement, monitor, and evaluate rights-based FP programs.

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