Global Trends in Family Planning Programs, 1999-2014

By Kuang, Bernice; Brodsky, Isabel | International Perspectives on Sexual and Reproductive Health, March 2016 | Go to article overview

Global Trends in Family Planning Programs, 1999-2014


Kuang, Bernice, Brodsky, Isabel, International Perspectives on Sexual and Reproductive Health


CONTEXT: Since 1972, the Family Planning Effort Index has measured national family planning program activities in developing countries and provided a longitudinal perspective on a standardized set of program characteristics.

METHODS: In 2014, experts in 90 developing countries assessed national family planning program effort in four main component areas--policies, services, monitoring and evaluation mechanisms, and access to methods--using a standardized questionnaire. Results were compared with previous years' data.

RESULTS: Globally, family planning program effort has progressed in all four main component areas. The service component, historically the weakest, was rated lowest of all components in 2014, at 47% of the maximum effort, despite a marked improvement of 7.6 percentage points since 1999. Policies, generally the strongest component, remained the strongest in 2014, with 55% of the maximum score and a 6.7 percentage-point improvement since 1999. Monitoring and evaluation improved the most, by 7.8 percentage points, from 45% to 53%, while access improved more modestly, by 2.7 points, from 49% to 52%. Family planning efforts were generally strongest in Asia and Oceania and generally weakest in Central Asia and Eastern Europe.

CONCLUSIONS: Global family planning programs have improved consistently over the last few decades, although there is room for further development in all regions.

International Perspectives on Sexual and Reproductive Health, 2016, 42(1):33-44, doi: 10.1363/42e0316

National family planning programs emerged in the 1960s and are now active in many developing countries throughout the world. These programs vary greatly in effectiveness and coverage. Strong national family planning programs have certain key features, such as provision of a variety of high-quality family planning, counseling and contraceptive options, as well as broad multisectoral governmental and private sector support. Clear national policies help provide structure to family planning programs, which should be sustained by regular monitoring and evaluation, training, supervision, and logistic support. Because services and methods should be accessible to the entire population, effective programs have extensive outreach strategies to serve the general population and targeted approaches to reach underserved populations through mass media programs, social marketing or community-based distribution. Also, successful programs have rights-based quality assurance measures in place to ensure voluntary and well-informed uptake of family planning. (1)

National family planning programs benefit from regular monitoring to identify both successes and areas in need of development. Since 1972, the Family Planning Effort Index has provided standardized periodic measurements of the strength of national-level family planning programs worldwide. Its measures, categorized into four main component areas--policy context, service provision, monitoring and evaluation, and access to methods--are based on important features of successful programs. (2,3) This longitudinal data set spans five decades and serves as the only publicly available international source for analyzing changes in national family planning programs over time. Because the Family Planning Effort Index measures inputs, rather than outcomes, programs are able to use it to determine where greater effort should be expended; also, Family Planning Effort Index scores have often been used by major donors and development partners both to identify program weaknesses and to measure progress over time. Family Planning Effort Index scores have also figured in numerous analyses over the years to investigate program impact separately from socioeconomic changes on contraceptive use and fertility levels and changes. (4-6)

While the prominence of family planning on the development agenda has risen and fallen over the years, the Family Planning Effort Index has historically been used as a reliable and consistent data source for countries and development agencies. …

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