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Finding the nexus between Family Planning and Universal Health Coverage

A version of this blog post originally appeared on FP2030’s website. Knowledge SUCCESS partnered with FP2030, Management Sciences for Health, and PAI on a related policy paper outlining the intersectionality between family planning (FP) and universal health coverage (UHC). The policy paper reflects learnings from a 3-part dialogue series on FP and UHC, hosted by Knowledge SUCCESS, FP2030, MSH and PAI.

The International Conference on Family Planning – the premiere venue for family planning advocates, researchers, and policy makers to come together – just concluded, and experts discussed the latest trends in rights-based family planning, new research and data, and particularly the nexus between family planning and universal health coverage (UHC). Now, it has never been more urgent to take action to achieve UHC – especially as the target date for the Sustainable Development Goals is only seven years away.

UHC is a measure of the world’s commitment to ensuring good health and well-being for all (SDG 3). It characterizes an ideal where all people have access to the health services they need, when and where they need them, without financial hardship or other barriers. This includes — but is not limited to — access to sexual and reproductive health and rights (SRHR) and family planning, which are not only human rights but catalysts for economic development. Specifically, access to family planning provides individuals with the choice and agency to freely decide if or when to become parents, as well as the number and timing of their children. This right is enshrined in various global, regional and national laws, policies, and instruments, which obligate governments to respect, protect, and fulfill this right.

According to the World Health Organization (WHO), prior to the COVID-19 pandemic, at least half of the world’s population could not access essential health services, including family planning. Meanwhile, 800 million people spent at least 10 percent of their household budget on health care expenses, and half a billion people were pushed further into extreme poverty by out-of-pocket health spending. These gaps are especially pronounced in low- and middle-income countries, where an estimated 23 million adolescent girls and young women were not able to meet their needs for contraception before the pandemic due to structural barriers such as negative service provider attitudes, lack of access to health information, and discriminatory laws rooted in gender inequality. Despite the resilience of health systems and people in general, pandemic conditions exacerbated pre-existing social inequities in access to and use of family planning services. The pandemic exposed serious inequities and gaps in emergency preparedness: women and girls suffered more disproportionately from the economic blowback and serious health consequences of the pandemic. Notably, the long-term impacts of the pandemic on the global and national economies may have future impacts on family planning financing.

Family planning plays a critical role in achieving UHC globally and ensuring everyone worldwide can access lifesaving healthcare. Healthcare will not be universal without access to family planning. As countries develop various policies and design programs to ensure all citizens have access to health as a human right, the history and lessons from family planning are invaluable. The family planning community has recognized, and in some cases successfully addressed, the structural barriers that continue to plague health systems. Achieving UHC presupposes the inclusion of family planning with effective financial protection from hardship, ensuring family planning services are available, accessible and affordable for everyone.

The inclusion of family planning services in a country’s UHC policy also presents one of the biggest returns on investment in attaining sustainable UHC. According to UNFPA, every dollar invested in family planning generates $8.40 in economic gains However, we have not yet cracked the formula that ensures we ‘leave no one behind’. We will not do so by mere slogans but ensuring our limited and finite health resources at national level and as a global health community reach the last mile.

We are at a turning point. Given the quickly-closing timeline for achieving the Sustainable Development Goals, and the impact that the COVID-19 pandemic has had on gender equality and family planning supply chains, now is the time for us — as individuals, movements, advocates and nations — to recommit to our collective goals to achieve good health and well-being and gender equality for all.

Adebiyi Adesina

Director of Health Financing and Systems Strengthening, PAI

Adebiyi Adesina leads PAI’s UHC Engage, Primary Health Care Initiative and Government Accountability for Family Planning Budgets projects as well as the organization’s technical focus on health financing and health system strengthening efforts to improve and expand sexual and reproductive health and rights policies, programs and services. Adebiyi has over 20 years of experience in an array of technical areas, including strategic planning, civil society engagement and translation of data, evidence and insights for policy and donor decision-making. Before joining PAI, he worked as a consultant on health financing and health systems resource planning as part of the World Bank Group’s Health, Nutrition and Population Global Practice. He also spent 11 years at Avenir Heath (previously Futures Institute) working on health economics and financing modeling to make the investment case for family planning and HIV/AIDS across Asia, Latin America and sub-Saharan Africa. Adebiyi has a doctor of public health degree in global health policy and economics, a master’s degree in public health policy and management and a bachelor’s degree in peace and conflict studies from the University of California, Berkeley. He speaks English and Spanish and is conversational in French and Yoruba.

Cate Nyambura

Global Partnerships Consultant, FP2030

Cate Nyambura is an international development expert and consultant specializing in program management, advocacy, research, and strategic partnerships. Her academic background is in biomedical research and public policy. Cate has worked on topics such as sexual and reproductive health and rights, family planning, women’s rights, young women’s leadership, adolescent health, HIV/AIDS prevention, care, treatment, and research for over a decade. Her work, borne out of student activism, transitioned into community organizing and currently involves working across the intricate linkages between grassroots organizing; national, regional, and global advocacy; programming; strategic partnerships management; and research as a consultant. Cate is the global partnerships consultant at FP2030. She is part of the program advisory board for the Strategic Initiative for the Horn of Africa, served as the chair for the regional activities working group for COFEM, and Board of Directors at the Ipas Africa Alliance. Cate is a 2019 Goalkeeper, a 2016 Mandela Fellow, Royal Commonwealth associate fellow, 120 Under 40 winner, and was named one of the five young African women changemakers to know in 2015 by This is Africa. She has been published in the Agenda Feminist Journal (2018 Edition), the Gender and Development Journal (2018 edition), and other global platforms.