As 2022 draws to a close, more than two dozen countries have made Family Planning 2030 (FP2030) commitments, and many others are in the process of doing so. Commitment makers have pledged to expand access to voluntary, rights-based contraception in their countries by implementing or scaling up specific policies, programs, and actions. More than a vague pledge, an FP2030 commitment adheres to accountability and measurement frameworks; involves evidence-based advocacy and collaborative partnerships; and opens access to a vast global and regional support network. Governments do not develop these commitments alone; they do so in collaboration with the networks of national stakeholders who will help them meet their commitments over the coming decade.
Over the past year, Pathfinder International teams around the world have contributed to the development of their countries’ FP2030 commitments and related costed implementation plans (CIPs) and action plans. We checked in with our colleagues in Bangladesh, Burkina Faso, Kenya, Mozambique, Niger, Nigeria, and Uganda to learn more about the role Pathfinder teams have played in the development of country commitments and action plans, the lessons learned along the way, and the challenges and opportunities the new commitments illuminate.
Pathfinder’s roles in the commitment development process
To organize the commitment development process, many countries established technical working groups or stakeholder committees—in which Pathfinder has taken part and provided technical assistance—that regularly met or held workshops to reflect on trends in health outcomes and lessons learned from the FP2020 commitments, draft or review the FP2030 commitments, incorporate rounds of reviewer feedback, develop activities and indicators for each commitment, plan for dissemination, and, finally, launch the commitments. In several countries, including Burkina Faso, Nigeria, and Uganda, Pathfinder also lent financial support to the process, helping ensure the meaningful involvement of multi-sectoral and multi-level stakeholders, including subnational health officers and partners. Pathfinder also contributed to the development of the CIP in Burkina Faso and supported the development of action plans and accountability mechanisms in Uganda and Kenya.
Applying lessons from FP2030 commitments
“As CSO focal point, we should have a plan with other CSOs to meet, coordinate, and contribute to the advancement of FP in Mozambique as one single movement.” — Katia Amado, Project Director, Pathfinder in Mozambique
In the countries where Pathfinder lent support, the FP2030 commitment development process yielded a valuable opportunity to reflect on challenges and successes related to the previous decade’s FP2020 commitments and then apply those lessons to FP2030. Key learnings included the following:
- Some FP2020 targets were so ambitious that countries struggled to meet their indicators. In addition, the FP2020 commitments lacked an accountability framework, missing an opportunity to instill a sense of responsibility for meeting the commitments. As governments embark on the FP2030 commitment process, clear guidance on what makes a strong but realistic commitment—including how to align countries’ FP2030 commitments with national policies and strategies, and grounding action plans and indicators in evidence—is helping to ensure meaningful progress. As part of this guidance, FP2030 has added an accountability framework.
- It is not enough to work only at the national level. In some countries, inadequate dissemination of FP2020 commitments and strategies to the subnational level meant that those closest to implementation were unfamiliar with the content of the FP2020 commitments. Active engagement of subnational partners in the FP2030 commitment development process has helped ensure their alignment with national stakeholders and strategies.
- For any country to meet its FP2030 commitments, an inclusive, well-coordinated, multisectoral approach is key, as family planning (FP) and related outcomes are affected by more than just the health sector. Good coordination among civil society organizations (CSOs) and other stakeholders (for example, men and boys, youth, and the media) helps ensure a unified movement toward realizing the country’s FP2030 commitments. While the commitment-development process can feel tedious, it can also yield frank conversation and knowledge-sharing among these stakeholders, providing a solid foundation upon which to build toward the realization of the FP2030 commitments.
Even having applied such valuable lessons learned to the development of countries’ FP2030 commitments, implementation challenges are inevitable. Prominent among these challenges is that of sustaining the focus of ministries of health on their FP2030 commitments in equal measure with other national commitments. This includes ensuring adequate allocation of resources to implement the work needed to reach countries’ FP2030 goals and employing creativity in working around inevitable resource gaps to make progress. Ensuring ongoing commitment, ownership, and resources for FP and related services is particularly critical, yet often lacking, at state levels. Turnover among health and development stakeholders can exacerbate these challenges, demanding time and resources to orient newcomers to the commitments and their rationale and related implementation strategies.
In some settings, policies that restrict access to sexual and reproductive health (SRH) services, including contraception, for those younger than 18 will likely hinder progress toward FP2030 goals—particularly in the sub-Saharan Africa region where youth make up a large proportion of the population in many countries. Even in contexts with supportive policies for adolescent and youth access to information and services, inadequate government funding for youth friendly services, provider bias, and social and cultural norms can limit access to quality adolescent and youth SRH services.
Other common anticipated challenges include data quality; supply-chain disruptions; shocks and stressors brought on by conflict-, climate-, and disease-related emergencies; and a continued need to improve coordination, alignment, and efficiency among implementing partners.
“In Nigeria, at least, the FP2030 commitment is centered around universal health coverage. There is an objective around allocating at least 1% of the total revenue at the national and subnational levels for family planning. That is something we keenly want, as a community, to follow up on. If we’re able to get that, it will yield great opportunities for family planning in the country at all levels.” — Amina Dorayi, Nigeria Country Director, Pathfinder International
Despite these challenges, the FP2030 commitments present an enormous opportunity to mobilize resources and unify multisectoral, multilevel efforts to improve health and development outcomes across the countries where Pathfinder works. The FP2030 commitments are grounded in lessons learned from FP2020 and tailored to the particular challenges each country faces. For example, Bangladesh’s draft commitment contains strategies to address existing barriers to postpartum FP, a key area in which improvement will significantly impact the overall national FP program. These strategies encourage government flexibility around policies that have historically hindered contraceptive access.
Pathfinders shared hopes that their countries’ FP2030 commitments will contribute to improving access to SRH and contraceptive services for adolescents and young people, thereby reducing maternal, infant, and neonatal mortality—through supportive policy, allocation of resources for youth-responsive services, and implementation of diverse, innovative, inclusive service delivery models. These may include clinic-based services with separate spaces for provision of youth-responsive services, social franchise models, faith-based facilities, digital health, telemedicine and hotlines, pharmacies, community-based services, mobile outreach, and pop-up services in non-health settings like schools, universities, workplaces, prisons, military facilities, and safe spaces.
Finally, those involved in the development of their countries’ FP 2030 commitments noted their potential to help strengthen both individual and health-system resilience. FP programs that are well-financed at national and state levels are less vulnerable to disruptions of service related to shocks and stressors, including conflict, climate-related emergencies, pandemics, and other crisis situations. And when individuals and couples have access to the full range of contraceptive methods, including long-acting reversible contraceptives, as well as postpartum and postabortion contraception, they have more agency over their own lives and families, making them more resilient to unexpected challenges.
Realization of the FP2030 commitments so many countries are making has the potential to improve gender equality and health outcomes on a massive scale, at the same time strengthening the agency and protecting the human rights of individuals so that they can choose their own paths and thrive. Pathfinder is committed to working with countries to meet their goals, because the success of even one country has ripple effects across the world. This week, our team in Kenya is thrilled to participate in the national dissemination of the FP2030 Action Plan on October 26 as key thought leaders and contributors to the youth component ahead of subnational implementation. As we look toward the future, we envision the success of all.