an advocacy toolkit

80 Pages·2005·1.04 MB·English

STRENGTHENING FAMILY PLANNING
POLICIES AND PROGRAMS
IN DEVELOPING COUNTRIES:
AN ADVOCACY TOOLKIT
D
AI
US
DECEMBER 2005
This publication was produced for review by the United States Agency for International Development.
It was prepared by the POLICY Project.
The POLICY Project is funded by the U.S. Agency for International
Development (USAID) under Contract No. HRN-C-00-00-00006-00,
beginning July 7, 2000. The project is implemented by the Futures Group
in collaboration with the Centre for Development and Population
Activities (CEDPA) and Research Triangle Institute (RTI).
ISBN 1-59560-004-3
For more information, please contact:
POLICY Project
c/o Futures Group
One Thomas Circle, NW, Suite 200
Washington, DC 20005
Tel: [phone]
Fax: [phone]
Email: [email protected]
Website: www.policyproject.com
www.futuresgroup.com
STRENGTHENING FAMILY PLANNING
POLICIES AND PROGRAMS
IN DEVELOPING COUNTRIES:
AN ADVOCACY TOOLKIT
USAID
DECEMBER 2005
The author’s views expressed in this publication do not necessarily refl ect the views of the United States Agency for
International Development or the United States Government.

CONTENTS
ACKNOWLEDGMENTS iv CHAPTER 3. Family Planning and
the Prevention of Mother-to-Child
ABBREVIATIONS v Transmission 35
SECTION ONE. Expanding Access and
INTRODUCTION 1
Contraceptive Choices for HIV-Positive
Women 36
CHAPTER 1. Family Planning and
Birth-Spacing Impacts On Maternal and SECTION TWO. Costs and Benefi ts of Adding
Infant Mortality and Morbidity 3 Family Planning to Services to Prevent
Mother-to-Child Transmission of HIV 39
SECTION ONE. Unmet Need for
Family Planning 4
CHAPTER 4. Family Planning and
SECTION TWO. Contraceptive Security 8 Gender Equity 43
SECTION THREE. Optimal Birth Spacing 11 SECTION ONE. Gender Equity 44
SECTION FOUR. Maternal Mortality and
CHAPTER 5. Adolescent Reproductive
Morbidity 14
Health 49
SECTION FIVE. Child Health and Survival 18
SECTION ONE. Youth-Friendly Services 50
SECTION SIX. Postabortion Care 21
SECTION TWO. Maternal Mortality Due to
Young Age at First Birth 53
CHAPTER 2. Family Planning and
Macro-Level Impacts 25
CHAPTER 6. Country-Level Advocacy
SECTION ONE. Global Declarations—ICPD Strategy for Repositioning Family
Program of Action and Millennium Planning/Reproductive Health 57
Development Goals 26
SECTION ONE. Advocacy Strategy 58
SECTION TWO. Reproductive Health and
Human Capital 30 CHAPTER 7. Models, Frameworks,
and Tools 63
SECTION THREE. The Demographic Dividend 33
SECTION ONE. Models 64
SECTION TWO. Frameworks 67
SECTION THREE. Tools 70
iii
ACKNOWLEDGMENTS
This advocacy toolkit is a product of the combined
efforts of many dedicated reproductive health and family
planning professionals affi liated with the POLICY Project.
The following individuals and groups contributed
content to this document: Michelle Prosser, Sarah Smith,
Beverly Johnston, John Stover, Arnab Acharya, Jay Gribble,
Nancy Murray, Norine Jewell, Carol Shepherd,
Margaret Hamilton, Rachel Sanders, Emily Sonneveldt,
William Winfrey, and the Interagency Gender Working
Group.
The POLICY Project is indebted to the U.S. Agency for
International Development (USAID), which provided
funding for this toolkit. In particular, we would like to
thank Elizabeth Schoenecker, Mai Hijazi, and Diana Prieto
of GH/OPRH/PEC and Rose McCullough of GH/OHA/IS,
who provided valuable feedback and comments.
iv
ABBREVIATIONS
AED Academy for Educational Development MTCT Mother-to-child transmission of HIV/AIDS
AIDS Acquired immune defi ciency syndrome MVA Manual vacuum aspiration
AIM AIDS Impact Model NGO Nongovernmental organization
ARV Antiretroviral PAC Postabortion care
CBD Community-based distribution PLHA Person living with HIV or AIDS
CEDPA Centre for Development and Population PMTCT Prevention of mother-to-child transmission of
Activities HIV/AIDS
CPR Contraceptive prevalence rate RHAP USAID’s Regional HIV/AIDS Program
DHS Demographic and Health Survey RTI Reproductive tract infection
GBV Gender-based violence SPARHCS Strategic Pathways to Reproductive Health
Commodity Security
GDP Gross domestic product
STI Sexually transmitted infection
HIPC Highly indebted poor country
TOT Training-of-trainers
HIV Human immunodefi ciency virus
VCT Voluntary counseling and testing
ICPD International Conference on Population and
Development UN United Nations
IEC Information, education, and communication UNAIDS The Joint United Nations Programme on
HIV/AIDS
IPPF/WHR International Planned Parenthood Federation/
Western Hemisphere Region UNFPA United Nations Population Fund
IUD Intrauterine device UNGASS United Nations General Assembly Special
Session
JSI John Snow, Inc.
UNICEF United Nations Children’s Fund
LAM Lactational amenorrhea method
USAID United States Agency for International
MDG Millennium Development Goal
Development
MNPI Maternal and Neonatal Program Effort Index
WHO World Health Organization
MOH Ministry of Health
v

INTRODUCTION
Family planning remains one of the most cost-eff ective Th e toolkit is divided into seven chapters covering the
public health measures available in developing countries. following topics:
Use of family planning is associated with lower rates of
• Family planning and maternal and infant mortality and
maternal and infant mortality and can infl uence economic
morbidity
growth. It is an essential component in the prevention of
mother-to-child transmission (PMTCT) of HIV/AIDS • Family planning and macro-level socioeconomic
and in adolescent reproductive healthcare programs, and impacts
it can play a role in improving gender equity. Expanding
• Family planning and prevention of mother-to-child
access to and improving the quality of family planning
transmission of HIV
programs around the world is central to improving and
maintaining the health of individuals and societies and
• Family planning and gender equity
helping them reach their full potential.
• Adolescent reproductive health
Th e POLICY Project is committed to keeping family
planning issues at the forefront of local, national, regional, • Country-level advocacy strategies
and international health and development discussions,
• Models, frameworks, and tools
initiatives, and programs. Awareness about declining
resources for family planning initiatives, programs, Chapters are divided into theme-based sections, which
and services has increased in the last few years with provide a short background on the issue and a synopsis
new initiatives for “repositioning family planning” and of key points. Each section also includes examples of
“contraceptive security” observed in many countries and successful advocacy strategies and one or two illustrations
regions. Th is tool represents an attempt to give step-by- of country experiences that led to policy change.
step guidance to help developing country advocates at the
Th is toolkit is designed to be user-friendly. Th e user can
community and national levels to move the repositioning
refer to a single section on a particular topic or cross-
and contraceptive security agendas forward and keep
reference multiple sections, using examples from the
the focus on family planning within their broader
strategies, illustrations, tools, and frameworks provided
development goals.
to help the user develop customized advocacy messages
Th e purpose of this toolkit is to assist advocates in the and activities. For example, it may be more culturally
family planning/reproductive health fi eld in their eff orts acceptable to approach family planning in certain
to promote policy dialogue on the health, social, and countries or regions using a birth-spacing approach.
economic benefi ts of increasing access to family planning In countries where HIV is prevalent, using the family
services. By tailoring the messages included in the toolkit, planning/PMTCT approach may be more appropriate.
advocates can present culturally relevant arguments to Where poverty alleviation and the Millennium
promote family planning and birth spacing in their Development Goals (MDG) are a main focus, linking
particular settings. family planning with macro-level impacts may be most
infl uential.
1