Family Planning in the Sustainable Development Goals

A Critical Link for Post-2015 Success

Ellen H. Starbird

Director, Office of Population/Reproductive Health

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Advancing RH/FP can positively influence and advance the

sustainable development goals

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Includes Reproductive Rights, including Universal Access to family planning

• 222 million women in developing countries have an unmet need for

contraception.

• Women want to control their fertility, but too often lack the means, access

and agency to do so.

• Empowering women to choose the number, timing and spacing of their

pregnancies is not only a matter of human rights, but touches on many

issues vital to sustainable development including health, education, and

women’s status in society.

• .Universal access to family planning and reproductive isn’t the only path to

sustainable development, but without addressing these issues, the impact

and effectiveness of other interventions will be less.

Voluntary Family Planning is a Key Intervention for Health and Development*

Social & economic

benefits

Improves women’s opportunities

Improves family well-being

Mitigates adverse effects of population dynamics on

o Natural resources, including food & water

o Economic growth

o State stability

Reduces maternal

mortality/morbidity

Reduces infant

and child mortality

Reduces abortion

Key intervention in

HIV settings e.g.

PMTCT

Health

benefits

Enable women and

couples to decide

number, timing and

spacing of births

*In addition to family planning activities, we also engage in a number of reproductive health-related activities,

including breastfeeding, post-abortion care, female genital cutting, fistula prevention, child marriage, and gender

and youth RH programming.

Principles of voluntarism

and informed choice are

fundamental

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Proposed Sustainable Development Goals

Goal 1 End Poverty in All its Forms Everywhere Goal 2 End Hunger, Achieve Food Security and Improved Nutrition and Promote Sustainable Architecture Goal 3 Ensure Healthy Lives and Promote Well-Being for All At All Ages Goal 4 Ensure Inclusive and Equitable Quality Education and Promote Lifelong Learning Opportunities for All Goal 5 Achieve Gender Equality and Empower All Women and Girls Goal 6 Ensure Availability and Sustainable Management of Water and Sanitation for All Goal 7 Ensure Access to Affordable, Reliable, Sustainable and Modern Energy for All Goal 8 Promote Sustained, Inclusive and Sustainable Economic Growth, Full and Productive Employment and Decent Work for All Goal 9 Build resilient infrastructure, Promote Inclusive and Resilient Infrastructure, Promote Inclusive and Sustainable Industrialization and Foster Innovation Goal 10 Reduce Inequality Within and Among Countries Goal 11 Make Cities and Human Settlements Inclusive, Safe, Resilient and Sustainable Goal 12 Ensure Sustainable Consumption and Production Patterns Goal 13 Take Urgent Action to Combat Climate Change and Its Impacts Goal 14 Conserve and Sustainably Use the Oceans, Seas and Marine Resources for Sustainable Development Goal 15 Protect, Restore and Promote Sustainable Use of Terrestrial Ecosystems, Sustainably Manage Forests, Combat Desertification, and Halt and Reverse Land Degradation and Halt Biodiversity Loss Goal 16 Promote Peaceful and Inclusive Societies for Sustainable Development, Provide Access to Justice for All and Build Effective, Accountable and Inclusive Institutions at all Levels Goal 17 Strengthen the Means of Implementation and Revitalize the Global Partnership for Sustainable Development

Goal 3 Ensure

Healthy Lives and

Promote Well-

Being for All At All

Ages

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Where specifically is family planning?

Goal 5 Achieve

Gender Equality

and Empower

All Women and

Girls

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Where specifically is family planning?

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SDGs if Family Planning/Reproductive Health is NOT Included

MDG 5B Goal: Achieve universal access to RH

5.3 Contraceptive prevalence rate

5.4 Adolescent birth rate

5.5 Antenatal care coverage

5.6 Unmet need for family planning

Post-2015 Target: Achieve universal access to SRHR (SDGs,

ICPD Beyond 2014, post-MDG high level panel)

a. FP measure (described in the coming slides)

b. TBD– non-FP measure

c. TBD– non-FP measure

d. TBD– non-FP measure

From the MDGs to the SDGs

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FP Metric for SRHR SDG

MEASURE: Percent demand for FP satisfied with modern

contraceptives

In English: Of sexually active women of reproductive age who do not want to become

pregnant, the percent who are using modern contraceptives.

In Demography: MCPR / [CPR + Unmet Need]

Underlying principles:

Voluntarism, informed choice, equity, rights

This is a key, necessary measure, but certainly not the only measure of SRHR.

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Proposed FP Benchmark for SDGs

BENCHMARK: At least 75 percent demand for FP is satisfied with

modern contraceptives in all countries

Arrived at the benchmark based on these parameters:

• What would be ambitious and achievable

• What would align OECD and high performing low income countries

• What would capture equity, and incentivize countries to address equity in

demand satisfied across wealth, age, residence, and other factors.

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2030 Goal: Distribution of Countries by FP Demand Satisfied and MCPR

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2030 Goal: Distribution of USAID-supported Countries by FP Demand Satisfied and MCPR

FP2020 Goal: Progress is Slower Than Needed

67.0

M

59.0

M 51.0

M

42.0

M

34.0

M

25.0

M

16.9

M

FP2020 GOAL CURRENT

TREND HISTORIC TREND

Source: FP2020 : PARTNERSHIP IN PROGRESS

Annual Percentage Point Change in Modern Contraceptive Use Between Last 2 Surveys

Rapid Progress

(≥ 1.0)

Encouraging

Progress

(0.5–< 1.0)

Slow

Progress

(> 0–< 0.5)

Getting worse

Rwanda Liberia Haiti Mauritania* Mozambique✗✗

Kenya Togo* Burkina Faso* Ghana Guinea*✗✗✗

Malawi Tanzania India Benin* Nepal✗✗

Madagascar Niger* Pakistan DR Congo

Ethiopia✓✓✓ Bangladesh Philippines Afghanistan

Zambia Cote d’Ivoire* Nigeria

Senegal*✓✓✓✓ Yemen

Uganda Mali*

South Sudan does not have sufficient data for trends analysis.

Sources: Rates of change are calculated from the last two survey data points from DHS, MICS, RHS and PMA

2020 surveys. This analysis is based on the 24 PRH priority countries and the Ouagadougou Partnership countries.

*Indicates Ouagadougou Partnership Countries

Annual Percentage Point Change in Met Demand for Family Planning Between Last 2 Surveys

Rapid Progress

(≥ 2)

Encouraging

Progress

(≥ 1 to < 2)

Slow

Progress

(> 0 to < 1)

Getting worse

Rwanda Togo* Ghana Mauritania*

Niger Mali* Benin* Yemen

Senegal*✓✓✓✓ Haiti Nigeria Guinea ✗✗✗

Kenya Zambia DR Congo Nepal✗✗

Madagascar Pakistan India Mozambique✗✗

Ethiopia✓✓✓ Cote d’Ivoire*

Liberia Bangladesh

Burkina Faso* Tanzania

Malawi Philippines

Uganda

Trend data are not available for Afghanistan and South Sudan.

Sources: Rates of change are calculated from the last two survey data points from DHS, MICS and RHS. This

analysis is based on the 24 PRH priority countries and the Ouagadougou Partnership countries. *Indicates

Ouagadougou Partnership Countries

Annual Percentage Point Change in % of Births Spaced < 36 Months Apart Between Last 2 Surveys

Rapid Progress

(≥ 1.0 decrease)

Some Progress

(< 1.0 decrease)

Getting worse

Senegal*✓✓✓✓ Philippines Tanzania Nigeria✗✗

Nepal Uganda Mozambique DR Congo✗✗

Bangladesh Ghana India Pakistan

Haiti Zambia Madagascar Guinea*✗✗✗

Mali* Kenya Rwanda Niger*

Benin* Malawi

Liberia Burkina Faso*

Cote d’Ivoire* Ethiopia

Afghanistan, Mauritania, South Sudan, Togo and Yemen do not have sufficient data for trend analyses.

Sources: Rates of change are calculated from the last two survey data points from DHS and RHS. This analysis is based

on the 24 PRH priority countries and the Ouagadougou Partnership countries.

*Indicates Ouagadougou Partnership Countries

Annual Percentage Point Change in 1st Births to Women Under Age 18 Between Last 2 Surveys

Rapid Progress

(≥ 0.5 decrease)

Slow Progress

(< 0 to < 0.5 decrease)

Getting worse

Senegal*✓✓✓✓ Bangladesh Tanzania Malawi

Nepal Niger* Benin* Nigeria✗✗

India Mozambique Mali* Ghana

Pakistan Zambia DR Congo✗✗

Ethiopia✓✓✓ Guinea* Kenya

Rwanda Philippines

Uganda Burkina Faso*

Haiti Madagascar

Cote d’Ivoire* Liberia

Afghanistan, Mauritania, South Sudan, Togo and Yemen do not have sufficient data for trend analyses between 2000

and 2014. Sources: Rates of change are calculated from the last two survey data points from DHS datasets. The

denominator for this indicator is women aged 18 to 24. This analysis is based on the 24 PRH priority countries and the

Ouagadougou Partnership countries. *Indicates Ouagadougou Partnership Countries

GH/PRH View on Global Goals for FP/RH

• Enable 120 million more women and girls to use contraception

• Measured by mCPR

• Underlying rights and empowerment framework

2020: Achieve FP2020 goals

• Help countries get onto mCPR trajectory needed to reach FP2020 goals

• FP metric accepted as one of the SDG indicators for universal access to

reproductive health

2015: Accelerate progress towards FP2020 and 2030 goals

• In every country, at least 75% of demand for family planning is met by

modern contraception

• FP/RH routinely included in universal health coverage

2030: Achieve health-related SDGs

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USAID-specific Goals for FP/RH

• Double rate of mCPR increase in USAID priority countries

• Assist EPCMD countries in meeting FP2020 commitments

• Expand method mix to better align with reproductive intentions and improve

birth spacing

2020: Achieve EPCMD, AFG, and FP2020 goals

• Maintain progress in high performing countries; improve progress in low

performers

• Continue building evidence for FP-EPCMD relationships

• Strengthen USAID/UNFPA relationship at country level

2015: Accelerate progress towards 2020 and 2030 goals

• In USAID EPCMD countries, at least 75% of demand for family planning is

met by modern contraception

• FP/RH routinely included in universal health coverage

2030: Achieve health-related SDGs

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• Secure SRHR in the SDGs

• Gain agreement on metrics

• Accelerate progress in satisfying demand for family

planning

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The Job Still To Do

22a

-Advancing Social and Economic Development by

Investing in Women's and Children's Health: A New Global

Investment Framework

Family Planning Is a Best Buy