Transformation Doesn’t Happen Over Night

How can we best help countries realize their existing commitments to rights and ensure that rights-based approaches are the standard for all countries? These are the questions at the heart of an emerging dialogue in the family planning and reproductive health community. In case you missed it, check out the excellent piece by Shannon Harris of Engender Health and the Futures Group, “Keeping Complexity in a Human Rights–Based Approach to Family Planning: Is It Worth It?

Since the London Summit in 2012, elements of reproductive rights have begun to permeate family planning commitments and implementation plans. Of the 28 developing countries that have FP2020 commitments, 15 made specific references to improving choice, expanding the range of methods, or reproductive rights. This is tremendous given that not too long ago, “reproductive rights” was still a dirty term in some circles. Such gains should not be trivialized.

Country Improving Choice Expanding Method Mix Respecting Rights to FP/RH
Bangladesh X
Cote D’Ivoire X
Ethiopia X
Ghana X
India X
Indonesia X
Kenya X
Myanmar X X
Mozambique X
Niger X
Philippines X
South Africa X X
Uganda X
Zambia X
Zimbabwe X

The eight countries who specifically mention offering the full range of contraceptive methods as part of their commitments deserve praise. Three countries—South Africa, the Philippines, Myanmar—also specifically referred to reproductive or human rights in their commitments. But a commitment is simply a promise. Monitoring and support are necessary to translate these country commitments, including the integration of rights-based approaches, into action.

One of the most important questions to ask is: Where do countries with limited experience engaging with reproductive rights dive in? Identifying a clear entry point is not inherently a simplification; it is about prioritization.

Country ownership of commitments and implementation plans are critical to their success. When discussing rights-based approaches, we often emphasize the importance of community participation. We should apply these same principles in this context—in other words, let’s pay attention to where countries themselves are starting and follow their lead.

If you look at the rights language in country commitments, the most pressing priorities are voluntarism, informed choice and diversifying the method mix. In order for women around the world to fulfill their rights, they need access to comprehensible family planning information and high-quality services, which includes the ability to freely choose among a range of methods.

Offering comprehensive information on the full range of contraceptive options and a robust method mix that meets the needs of all women at all stages—pre-conception, postpartum and post-abortion—is one tangible step countries can take to build a rights-based family planning program. Women’s reproductive rights are fulfilled when, for example:

  • A woman who wants to limit her future childbearing receive a long-acting method because her local provider has been trained to provide implants and IUDs.
  • A woman is able to choose an effective, modern method of family planning as a result of quality, family planning counseling following an abortion.
  • A young woman and her partner are able to decide on and purchase a female condom as their contraceptive method since their health facility has a full range of options in stock.

 

We are all working toward the same transformative change: the day when all family planning programs and policies are rights-based. But we must realize that countries have different starting points, and thus different needs. For now, many countries have yet to connect the pivotal role that voluntarism and informed choice play in shaping strong and successful family planning programs. We need to not only hold countries to their commitments on rights, but offer manageable tools to help them get there. This means, as a global community, we must ask the hard questions: In practical terms, how useful are the current set of frameworks and guidance documents for policymakers, program designers, program implementers and civil society organizations? How do we support countries in navigating the complex inventory of activities required to respect, protect and fulfill rights in family planning programs?

We have three critical tasks ahead. Countries with existing rights-based commitments need to be supported in fulfilling these pledges. We must prioritize certain elements of rights-based programs to help countries turn concepts into reality. Finally, work remains to be done to ensure that all countries embrace a comprehensive approach to rights-based family planning – wherever their starting point may be.

2020 Vision is a new series featuring global family planning policy insight and analysis. Stay tuned next month for a more in-depth discussion on how voluntarism, informed choice and a robust method mix can be implemented in family planning programs.