Health in hand: New contraceptive option expands access to family planning

Guest post by Sara Tifft, Project Director, PATH Sayana® Press Pilot Introduction project

Worldwide, women choose injectable contraceptives because they are safe, reliable, and discreet. In many rural or remote areas, however, travelling to a clinic to receive an injection is costly and burdensome. PATH, an international nonprofit health organization, is collaborating with global partners to address this challenge. We began with a basic question: What would it take to deliver more injectable options to women, particularly outside the clinic setting?

One answer is Sayana® Press: a small, easy-to-use injectable contraceptive that has the potential to increase access and choice for millions of women worldwide.

PATH is training community health workers in the Mubende district of Uganda to expand access to family planning, including the Sayana Press injectable contraceptive shown here. Photo credit: PATH/Will Boase

PATH is training community health workers in the Mubende district of Uganda to expand access to family planning, including the Sayana Press injectable contraceptive shown here. Photo credit: PATH/Will Boase

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The Road to Implementation: A User’s Guide for Applying a Rights-Based Approach to Family Planning Programs

Guest post by Mariela Rodriguez, Research Associate, Futures Group

Human rights. Contraceptive choice. Access. Information. Empowerment. What do all of these things mean? How do they relate to family planning (FP)? Since the 2012 London Summit on Family Planning and the movement it initiated, FP2020, the topic of human rights and empowerment in FP has risen on the international development agenda. We know that the Summit “underscored the importance of access to contraceptives as both a right and a transformational health and development priority.”[i] But what does this mean in practice? How can FP programs turn rhetoric about rights into a reality?

The recently published Voluntary Family Planning Programs that Respect, Protect and Fulfill Human Rights: a Conceptual Framework Users’ Guide is intended for use in conjunction with the Voluntary Family Planning Programs that Respect, Protect, and Fulfill Human Rights: A Conceptual Framework, published in 2013 by Futures Group and EngenderHealth with funding from the Bill and Melinda Gates Foundation.[ii] The User’s Guide is intended for use by a wide audience spanning policymakers, program managers, health providers, rights advocates, civil society organizations, donors, technical assistance agencies, implementing organizations, and researchers. The document contains three modules to orient stakeholders to the framework and to guide the processes for using it to assess, plan or strengthen, monitor, and evaluate FP programs through a human rights lens.

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Family Planning for All: The Importance of Contraceptive Access and Choice following Fistula Repair

Guest Post by Carrie Ngongo (Project Manager, Fistula Care Plus)

People often assume that women who’ve undergone an obstetric fistula repair are not interested in using family planning (FP). After all, most lost a baby during the obstructed labor that led to their injury. However, recent studies (see here and here) indicate that fistula clients are often interested in using FP if they learn about available methods and services during their post-repair recovery period. When fistula surgeons and counselors make assumptions about women’s desires, they miss the opportunity to provide needed services and to offer reproductive choices to women who may have been disadvantaged and marginalized as a result of their injury.

Photo by R. Raj Kumar/EngenderHealth

Photo by R. Raj Kumar/EngenderHealth

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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.

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World Contraception Day and the UN General Assembly Millennium Development Goal Review

Celebrating World Contraception Day

Today, the international community celebrates World Contraception Day. This global campaign strives to increase awareness of contraception and encourage its use to enable people to make informed decisions about their sexual and reproductive health and to prevent unplanned pregnancy and sexually transmitted infection. This year’s motto, “Your Future, Your Choice, Your Contraception,” targets young people.

Bwaila Hospital, Lilongwe, Malawi (Photo by Holly Connor/EngenderHealth

A woman enjoys her new granddaughter at Bwaila Hospital in Lilongwe, Malawi. She is there in support of her daughter, who has requested counseling from a family planning nurse on obtaining a female sterilization. (Photo by Holly Connor/EngenderHealth)

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Respect, Protect, and Fulfill Human Rights: A New Conceptual Framework for Voluntary Family Planning Programs

How can public health programs oriented toward increasing family planning access and use ensure they reach as many people as possible with lifesaving contraception in a way that respects, protects, and fulfills human rights?

Today, the Futures Group and EngenderHealth launched a joint publication, Voluntary Family Planning Programs that Respect, Protect, and Fulfill Human Rights: A Conceptual Framework that presents a new framework for holistic, quality family planning (FP) programs with clients and their rights at the core. This practical framework integrates human rights law and principles with FP program and quality of care frameworks, and depicts how key concepts translate into concrete interventions, outputs, and outcomes into programming. It offers a pathway for governments and other implementing partners to fulfill their commitments to the provision of voluntary FP services that respect, protect, and fulfill individuals’ human rights as programs pursue health and development goals.

A mother and child in Mwea Village, Kenya. Photo credit: The Bill & Melinda Gates Foundation

“In the wake of the London Summit on Family Planning, we have seen a reenergized commitment among governments and donors to expand access to FP, especially under the FP2020 initiative,” said Jan Kumar, Senior Technical Advisor at EngenderHealth and one of the framework’s authors. “As this framework highlights, however, it is critical that any efforts to scale up family planning over the next decade must be met by equal attention to ensuring that programs respect, protect, and fulfill human rights and put clients’ needs and preferences at their core.”

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Contraceptive Choice and Human Rights in Malawi: Q&A with UNFPA’s Dorothy Nyasulu

Over the past decade, Malawi’s family planning (FP) program has made remarkable strides in expanding access to FP to help women and couples better meet their desired family size. As a direct result of advocacy efforts and renewed government commitment to FP, a broader mix of contraceptive options are becoming more widely and equitably available, including long-acting and permanent methods (LA/PMs) such as implants and female sterilization. However, despite impressive gains [1], high unmet need and barriers to FP information and services persist. To learn more, EngenderHealth’s Holly Connor sat down with Dorothy Nyasulu, Assistant Representative for UNFPA/Malawi and a leading champion on human rights and gender equality for over 20 years, to discuss the intersection of FP, contraceptive choice, and human rights in her home country.

[1] The modern contraceptive prevalence rate (CPR) increased from 22.4 in 2004 to 32.6 by 2010 (Malawi Demographic and Health Surveys)

Dorothy Nyasulu and Holly Connor of EngenderHealth/The RESPOND Project at a regional family planning stakeholders meeting in Malawi in February 2013.

Dorothy Nyasulu, Assistant Representative of UNFPA/Malawi and Holly Connor, Senior Program Associate, EngenderHealth/The RESPOND Project at a regional family planning stakeholders meeting in Mzuzu, Malawi in February 2013.

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Championing Contraceptive Choice: Promoting and Protecting Rights beyond FP2020

Artwork by Sita Magnuson, The Value Web ®

Artwork by Sita Magnuson, The Value Web ®

The London Summit on Family Planning, which took place a year ago this month, kicked off a potentially new era for international family planning (FP). By focusing renewed attention, rallying political commitment, and garnering a substantial increase in pledged funding to support services, it raised FP on the global health and development agenda. The London Summit also reinvigorated the focus on human rights in FP programs, which coalesced in part around the concern that human rights could be sacrificed in the pursuit of the numerical goal of reaching 120 million new women and girls in the world’s poorest countries with FP information, services, and supplies by 2020 (known as FP2020). Attention to these issues has also been fueled by preparations to formulate the post-2015 development agenda that will follow the expiration of the Millennium Development Goals (MDGs). Continue reading