Family Planning 2020: the meaning of progress

Monday, 3 November 2014 08:48 GMT

Women holding children wait for a medical examination at the health centre in Gbangbegouine village, western Ivory Coast, July 4, 2013. REUTERS/Luc Gnago

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FP2020 progress report shows from 2012 to 2013 the number of women and girls using modern contraception rose by 8.4 million

Imagine yourself in the following situation: you’ve just walked 12 kilometers through the dusty heat, carrying your baby on your back, to reach the nearest health clinic. You’ve walked there because you don’t have any other means of transportation. But it’s very important that you get to the clinic, because this is your only way to access contraception.  You don’t want to get pregnant again right now— you can’t afford  to physically, emotionally or financially—and your three-month dose of Depo-Provera is about to run out.

But when you get to the clinic, they tell you they’re out of stock of Depo-Provera. You ask about other methods—maybe a contraceptive implant, which you’ve heard good things about, or pills—but those are out of stock too.  In fact, the only contraceptive supplies the clinic has on hand are condoms.  But that won’t work:  your husband absolutely refuses to use a condom. Actually, he doesn’t want you to use contraception at all—and now you need to hurry home before he realizes where you’ve gone.  

This story isn’t hypothetical: its everyday reality for millions of women, including many in the world’s poorest countries. Two and half years ago, at the London Summit on Family Planning, the FP2020 movement was launched to turn that reality around. Our goal? To bring modern contraception within reach of 120 million women and girls by the year 2020 so they are empowered to make the decisions they need to about their futures, freely and for themselves.

This week FP2020 is publishing its second progress report, including the first full set of annual data indicators to measure whether our efforts are working. The news is good: from 2012 to 2013, the number of women and girls using modern contraception rose by 8.4 million. To put it in human terms, think of that dusty walk to the family planning clinic, and imagine it this time with a happy ending—contraceptives in stock, all bases covered. Now multiply that by 8.4 million. 

The report details the incredible global partnership that has led us here, and that will take us all the way to our ultimate goal in 2020. More than 70 governments, civil society organizations, and private sector entities made commitments at the London Summit in 2012, and donors pledged billions of dollars. Those commitments are rapidly translating into action.

Countries that have never before endorsed family planning—such as Myanmar and Uganda—are now holding national conferences on the subject. Ministries of health are developing costed implementation plans and adding contraceptive line items to their budgets. Innovative technology is being harnessed to build capacity, improve method mix, and promote accountability. Donors, governments, and the private sector are collaborating to solve thorny supply problems that have kept contraceptives out of the hands of those who have the least access to modern methods. 

In Senegal, for example, the problem of inventory stock-outs is being solved with a system called “Informed Push.”  Instead of clinics and pharmacies having to call in orders for contraceptives, a driver with a truckful of supplies stops by regularly to top up the stock. It’s the same kind of system used in the commercial sector for vending machines, and it works just as well for contraceptive commodities. In Kenya, they’re combating empty-shelf syndrome with another ingenious solution: inventory control via text message. The nurses at clinics simply send inventory reports via text message to a central data management center, and the commodities they need are immediately sent out. 

There are also wide-reaching projects that cross international borders, like the rollout of Sayana Press in Burkina Faso, Niger, Senegal, and Uganda.  Sayana Press is a new form of injectable contraceptive that uses technology that was developed for vaccines. It’s so simple and safe to use that even lower-level health workers can administer the injections. That’s important in countries where doctors and nurses are scarce.

An even bigger project is underway to expand access to contraceptive implants, which last for three or five years.   Price agreements with pharmaceutical manufacturers have cut the cost of supplies in half, with the result that the number of implants procured across the world's poorest countries has tripled. Training programs are being ramped up to ensure that local healthcare providers have the skills to educate women about the possible side effects of implants, and to insert them safely and correctly if this is a woman’s desired contraceptive method. 

Innovation isn’t limited to medical technology; data systems are being upgraded too. An exciting new field is mobile phone-assisted data gathering, which replaces traditional pencil-and-paper surveys with smartphone technology. The data collectors interview people at home, and then send the results via smartphone to a central server. This gives planners immediate insight into what is happening in local communities, so they can make program changes and supply chain adjustments as necessary.

Our report tells all these stories and more—with a special focus on the hardworking providers whose unflagging dedication makes all the difference. Like the retired nurse in Tanzania who still gets up at dawn every day to deliver counselling and family planning supplies via her auto-rickshaw. And the volunteers in Nigeria whose mobile clinics bring lifesaving healthcare—including contraceptive supplies—to the most remote areas of the country. 

This is what progress looks like. We still have long road to 2020, but together, we’ll get there. With so many hearts and minds turned to this cause, I know we’ll get there.