The Pace of Progress
As of July 2016, at the midpoint of FP2020, the world’s 69 poorest countries had reached a new milestone: for the first time in history, the number of women and girls using a modern method of contraception topped 300 million.
That 300 million is more than just a statistic: it represents an unprecedented number of women and girls who are now able to take charge of their own health and shape their own lives and families.
The health infrastructure and expertise required to provide family planning services to 300 million individuals is immense, and in itself represents a tremendous accomplishment. It is particularly impressive in light of the fact that it was just 13 years ago, in 2003, that the number of contraceptive users in these countries reached 200 million.
The data in this year’s report highlight the progress the family planning community has made since the 2012 London Summit on Family Planning, as measured by FP2020’s 17 Core Indicators. The data also indicate some of the challenges remaining at global, regional, national, and subnational levels.
Another example is India, the largest FP2020 country, with more than 130 million contraceptive users. India is currently completing analysis of its National Family Health Survey (NFHS-4), and once available, the full set of national and state-level data will provide an important opportunity to assess progress. But the government is already looking closely at its existing program data and aiming to provide a wider range of short-term and long-acting methods, including injectables, through the public sector. India is also expanding its investment in postpartum family planning and taking action to improve the quality of family planning services. In the coming year, the new NFHS-4 data will enable family planning partners in India to gain a better understanding of the progress to date and shape their programs and investments accordingly.
These are just two examples of how a deeper examination of each country’s data can illuminate the existing situation and point to opportunities for action.
We can also accelerate progress by addressing the persistent challenges that span numerous countries. The analysis of Core Indicators in Chapter 03 highlights a number of key issues:
- Despite gains, there is still great unmet need for contraception. Many countries need to expand and improve the quality of services to satisfy current demand while also working to generate greater demand. The Sustainable Development Goals use demand satisfied with modern methods as a key indicator for family planning, and countries that don’t meet their FP2020 goals will face a steep path to achieve the 75% demand satisfied called for by 2030.
- A diverse mix of contraceptive methods makes it more likely that women will be able to find a method that suits their needs and preferences. FP2020 data on method mix and contraceptive availability suggest that women in many countries do not have access to a full range of short-term, long-acting, and permanent methods.
- Stock-outs remain a pervasive problem with a profound impact on women’s ability to use contraception. Too often the contraceptives that are supposed to be available simply aren’t on the shelves. Particularly worrisome are countries that report a high percentage of facilities with stock-outs of the most commonly used methods.
- Counseling is an important aspect of rightsbased family planning, and women need to be informed of the various contraceptive methods available and the potential for side effects. The data suggest that many countries need to improve counseling to enable more women and girls to exercise informed choice.
- Many women begin using contraceptives and then discontinue, putting themselves at risk of an unintended pregnancy. Contraceptive discontinuation rates are particularly high for short-term methods, including pills and injectables. Across countries with available data, almost 1 in 5 women using pills or injectables will discontinue use for method-related reasons.
Halfway through the FP2020 initiative, we have an opportunity to accelerate progress by focusing on the challenges and opportunities that have already emerged. The evidence base is growing for a wide range of issues and interventions, and the Core Indicators provide important data on the family planning landscape in each country. The resulting insights can help us shape more effective programs, investments, and policies to reach women and girls with the services they need.
3. Kenya Demographic Health Survey 2014. Available from: http://dhsprogram.com/publications/publication-FR3...
- When mCPR is very low, countries tend to see slow annual growth in mCPR. The length of this period varies by country, but to position themselves to enter a period of rapid growth, countries should make sure that barriers to family planning services are not preventing growth.
- Countries will enter into a period of more rapid mCPR growth. The rate of growth and length of this period varies and depends on countries monitoring progress and investing wisely in the appropriate interventions that will maintain progress. Countries that are able to grow at very high rates will transition through this period quickly, increasing the potential benefits of a demographic dividend.
- Finally, when contraceptive prevalence reaches higher levels, growth begins to slow down and eventually plateaus. Programs at this stage need to focus on long-term sustainability, continued improvements in service quality, expanding the range of methods available, and striving to reach underserved groups.