Family planning (FP) policies play a crucial role in improving contraceptive use, especially in low- and middle-income countries. However, many policies intended to encourage the availability, uptake, and use of contraceptives by women and their partners lack clear evidence of their effectiveness. The USAID Global Health Supply Chain Program-Procurement and Supply Management (GHSC-PSM) conducted research that assessed 20 variables across 59 countries, providing the first published analysis of the complete dataset from the Contraceptive Security Indicators Survey. This list highlights essential insights from this comprehensive study.
1. Contraceptives are Essential Medicines
Including more contraceptive methods on a country’s National Essential Medicines List (NEML) positively correlates with a broader method mix strategy in the private sector. This inclusion increases choice by promoting registration, procurement, distribution, guidance, and associated education efforts. The correlation was significant in middle-income but not low-income countries, highlighting its importance in middle-income contexts.
2. Health Insurance for Family Planning Makes a Difference
Health insurance coverage for family planning is correlated with higher modern contraceptive prevalence rates (mCPR). However, it is also correlated with a reduced variety of contraceptive methods available in the private sector. This effect was observed more significantly in middle-income countries compared to low income countries. Therefore, to fully capitalize on the insurance investment, countries should address this issue by engaging with the private sector to encourage a wider range of private-sector contraceptive options.
3. Information Management is Critical
Having a logistics management information system (LMIS) that includes FP commodities is strongly correlated with higher mCPR in both low- and middle-income countries. An effective LMIS yields integrated and effective contraceptive supply processes, leading to greater access, lower discontinuation rates, and reduced unmet need.
4. Affordability is Key
Charging clients for family planning services and contraceptive commodities in the public sector is negatively correlated with mCPR. Countries should consider this when establishing policies designed to increase contraceptive use.
5. National Government Financing is Crucial
National government funding for contraceptives (in contrast to donor funding) is strongly correlated with both higher mCPR and private-sector contraceptive method mix strategy. While donor funding remains essential to cover gaps, governments should recognize that using their own money will likely lead to a greater impact.
6. Commitment and Governance Matter
Sufficient opportunity for Contraceptive Security (CS) committees to meet and play an active role positively correlates with higher mCPR. Countries with formal FP2020 (now FP2030) commitments showed significant progress in expanding access to contraceptives in low-income countries and method mix strategies in the private sector. These findings highlight the importance of effective governance in family planning.
Conclusion
Understanding how FP policies influence the desired outcome of contraceptive use is key to achieving the health goals set by countries through contraceptive access for women around the world. Health ministries and international funding agencies can successfully increase contraceptive prevalence rates by implementing policies backed by evidence. This evidence-based approach relies on insights from years of data, allowing policymakers and health organizations to drive significant improvements in family planning services.
You can explore the data yourself here and read the full article, including how effects differ by national economic status, here.
