Advocating for Family Planning Policy

Overview

Advocacy plays a crucial role in building and sustaining momentum for family planning progress. In recent years, a renewed focus on expanding access to family planning has come about in response to the fact that unmet need for family planning remains unacceptably high. In a 2014 report, UNFPA and the Guttmacher Institute estimated that 225 million women want to avoid pregnancy but lack access to family planning services. This unmet need is fueled partly by both a growing population and a shortage of family planning services.

Yet we know that family planning contributes to all 17 of the Sustainable Development Goals (SDGs) and is explicit in Target 3.7: By 2030, ensure universal access to sexual and reproductive health care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs.

The Advocacy Process

Strategic, targeted, well-designed, and evidence-based advocacy is essential to help donors and decision makers develop or revise family planning policy and budgets to support health and development for all. Advocacy is an ongoing, incremental process that demands planning, patience, and persistence. In their proven approach to gaining “quick wins” for family planning advocacy, Advance Family Planning outlines three essential phases, broken down into nine practical steps.

Continue reading to learn the three essential phases of advocacy, broken into nine practical steps.

Phase 1: Build Consensus

1. Determine which stakeholders to involve. Consider the private sector, government, health care providers, research or academic institutions, civil society, donors, and nongovernmental organizations.

2. Pinpoint a SMART objective that supports your broad goal.

3. Identify a decision maker who has the power to address your issue.

Phase 2: Focus Effects

4. Review the context: What are decision makers saying about the issue, and what challenges and opportunities exist?

5. Know your decision maker: What are the decision maker’s stance and record on the issue? What are his or her concerns, values, and interests?

6. Determine the request: What will you ask the decision maker to do? Will you use a rational, emotional, or ethical argument to make your case?

Phase 3: Achieve Change

7. Develop a work plan and budget.

8. Set benchmarks for success.

9. Implement and assess your change.

Whether the goal is increased resource allocation for family planning, supportive policies that expand access to family planning services—for example, by allowing volunteer community health workers to provide injectable contraception, or improved contraceptive security, advocacy is an essential step in the policy process.

Click through the menu below to explore messages, research, and educational resources related to this topic.

Advocacy is essential to reaching the Family Planning 2020 goal of delivering contraceptives, information, and services to an additional 120 million women of reproductive age worldwide by the year 2020. This increased access to voluntary family planning could cumulatively prevent 100 million unintended pregnancies, 3 million infant deaths, and 200,000 pregnancy- and childbirth-related deaths.

  •  Advocacy is crucial to achieving the FP2020 goal of delivering family planning to an additional 120 million women globally by 2020.
  •  Advocacy is an ongoing and cyclical process.
  •  Effective advocacy for family planning policy proposes specific, actionable solutions.
  •  Advocacy strategies must be flexible to reflect the ever-changing environment.
  • Goal: desired long-term result of an overall mission; the purpose of a project
  • Objective: specific outcome sought in support of the overall goal
  • Quick win: discrete, critical policy or funding decision that must occur in the near term to achieve a broader goal
  • SMART: a specific, measurable, attainable, relevant, time-bound objective

The Global Health eLearning Center offers several courses on cultivating a promising policy environment. 

  • Gender and Sexual and Reproductive Health 101: This course seeks to provide learners with an introduction to the links between gender and sexual and reproductive health and introduce the basics of gender integration in sexual and reproductive health programs.
  • Youth Sexual and Reproductive Health: This course has two main goals: To provide an introduction to key sexual and reproductive health issues of youth, including the relationship between gender norms and health; and to present an overview of the best programmatic approaches for improving young people’s sexual and reproductive health.
  • Promising Programmatic Approaches for Adolescent and Youth Sexual and Reproductive Health (AYSRH): This course provides an overview of promising approaches as well as case studies of effective programs that improve young people’s sexual and reproductive health. It is intended to complement the Youth Sexual and Reproductive Health course, which is a suggested prerequisite since it provides more information on the diverse needs of adolescents.

Below is a selection of peer-reviewed articles on total market approach and related topics.

Aichatou B, Seck C, Baal Anne TS, Deguenovo GC, Ntabona A, Simmons R. Strengthening Government Leadership in Family Planning Programming in Senegal: From Proof of Concept to Proof of Implementation in 2 Districts. Glob Health Sci Pract. 2016;4(4):568-581. Based on a previous pilot experience, in a next proof-of-implementation phase, district authorities enthusiastically assumed leadership and mobilized local resources to implement a simplified package of family planning interventions, with outside technical support. Comparing a 6-month baseline period with a 6-month implementation period, couple-years of protection increased from about 2,000 to about 4,000 (82% increase) in one district, and from nearly 6,000 to about 9,000 (56% increase) in the second. Longer implementation periods could further support institutionalization and sustainability.

Binanga A, Bertrand JT. Pilot Research as Advocacy: The Case of Sayana Press in Kinshasa, Democratic Republic of the Congo. Glob Health Sci Pract. 2016;4(4):542-551. The pilot study obtained Ministry of Health approval to allow medical and nursing students to provide the injectable contraceptive Sayana Press and other methods in the community, paving the way for other task-shifting pilots including self-injection of Sayana Press with supervision by the students as well as injection by community health workers.
 
Lipsky AB, Gribble JN, Cahaelen L, Sharma S. Partnerships for Policy Development: A Case Study From Uganda’s Costed Implementation Plan for Family Planning. Glob Health Sci Pract. 2016;4(2):284-299. The development and launch of the costed implementation plan (CIP) in Uganda was successful in many ways. However, it would have benefitted from more focus on long-term partnership development critical for executing the CIP and by including district health officers—key players in executing the plan—more substantially in the process. Using a partnership approach sets the stage for ensuring that the right people are contributing to both development and execution.
 
Mukaba T, Binanga A, Fohl S, Bertrand JT. Family Planning Policy Environment in the Democratic Republic of the Congo: Levers of Positive Change and Prospects for Sustainability. Glob Health Sci Pract. 2015;3(2):163-173. Building on expressed support from the Prime Minister to the Ministries of Health and Planning, the country’s new family planning commitment grew out of: (1) recognition of the impact of family planning on maternal mortality and economic development; (2) knowledge sharing of best practices from other African countries; (3) participatory development of a national strategic plan; (4) strong collaboration between stakeholders; (5) effective advocacy by champions including country and international experts; and (6) increased donor support. The question becomes: Will the favorable policy environment translate into effective local programming?
 

The High Impact Practices in Family Planning (HIPs) team has developed briefs that synthesize the evidence and provide recommendations on how to implement selected HIPs.

Demonstrable commitment to family planning strengthens the enabling environment in which programs and policies are implemented. Galvanizing Commitment: Creating a supportive environment for family planning programs (2015; PDF, 559KB) examines the process of commitment making, highlighting three forms of commitment—expressed, institutional, and financial—at the global, regional, country, and subnational levels and considers why galvanizing support for family planning is important, presents examples of different types of commitment and how they advance the enabling environment, and offers experiential learning from experts in the field.

Policy: Building the foundation for systems, services, and supplies (2013; PDF, 882KB) describes various policy levels, the importance of policies for family planning, and tips on supporting and implementing effective policy change. Policies set the tone for family planning programs. Ministries of Health play a primary role in developing health sector policy, with the aims of improving health system performance and promoting the health of the people. Policies and laws that affect health systems and health outcomes are also developed outside the health system.

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