Technical Focus in Family Planning

By integrating voluntary family planning and reproductive health care with other services, such as antenatal and intrapartum, maternal, infant and young child health nutrition and immunization, we can extend our reach and address women’s unique needs at different life stages. For example, we support messaging on the use of family planning in the first year after giving birth, during antenatal care (ANC), through innovative approaches such as group ANC. We also support the development of family planning counseling messages and service integration job aids for HIV service providers to help them meet the needs of their clients at risk of acquiring, or living with, HIV.

Our approaches are informed by user insights, drawing on the contraceptive preferences and needs within a community and the ways in which clients and health care providers could be organized to deliver on those needs, and then working with governments and other stakeholders to meet them. We promote distribution of contraceptives by community health workers and through community-based programs, as well as through pharmacies and accredited drug dispensaries and outlets, and encourage integration of innovations such as self-injectables within those channels. We also work to ensure that women receiving post-pregnancy care have the option of spacing future pregnancies by accepting a family planning method before leaving the facility.

Effective counseling is fundamental to high-quality family planning services. Trained health care workers who respectfully and knowledgeably counsel women and families on their voluntary family planning options, respecting a woman’s right to determine whether to use family planning and what method suits her at the time that they provide these services, increase method uptake and continued use. We develop and implement onsite training, mentorship and supportive supervision for health care workers across the health care system. We support both pre-service and in-service education through curricula, lesson plans and clinical practice emphasizing competence and performance, behavioral drivers of quality care provision, on-the-job practice, mentorship and supportive supervision. We promote task-sharing, such as educating lay health workers, nurses, midwives, pharmacist and pharmacy assistants and other nonphysician providers to administer various contraceptive methods.

We support ministries of health to institutionalize voluntary family planning provision in their countries’ health systems. We advocate for and draft policy documents, national and subnational costed implementation plans for family planning, and service delivery guidelines that incorporate World Health Organization medical eligibility criteria and practice recommendations, including postpartum family planning (PPFP) guidance and measurement of family planning quality indicators and PPFP uptake. For example, with our support, improved contraceptive services in India have saved the lives of an estimated 86,000 children and 10,000 women in the past six years.

In all of our programs, we seek out innovations to increase our impact. From preparing frontline health workers to deliver voluntary family planning services, including new contraceptive methods in their markets, to expanding uptake of postpartum and postabortion family planning, to advocating for programs and policies to increase access to contraception for adolescents and first-time parents and new indicators in health management information systems to track family planning program performance, Jhpiego champions innovative ideas that will ensure that individuals everywhere can choose and consistently use the voluntary family planning methods that best suits their needs.

Jhpiego hosts one of four TCI regional hubs, which is funded by the Bill & Melinda Gates Foundation and Bayer, Inc, through the Bill & Melinda Gates Institute for Population and Reproductive Health. Through the East Africa regional hub, Jhpiego is assisting Tanzania, Kenya and Uganda to scale up family planning services to reach additional women and girls. TCI’s technical assistance model incentivizes local governments, private sector entities and donors to buy into the most successful and high-impact family planning interventions, rapidly adapt them to the local context, efficiently scale them up and mobilize local resources to sustain these programs, systems and services beyond a local challenge grant’s graduation.

Since 2013, the introduction and scale-up of contraceptive implants have unequivocally increased access to family planning method choice worldwide. As the uptake of contraceptive implants continues on a remarkable trajectory, and the product is fully mainstreamed into family planning programs, a concerted effort to ease implants off dedicated product support is needed, and attention toward remaining market and access challenges (e.g., product and service availability in the private sector) is crucial. With funding from the Bill & Melinda Gates Foundation, Jhpiego expands method choice through updated models of product stewardship and market development for post-introduction contraceptive technologies (such as implants). To do this, Jhpiego collaborates with stakeholders to evolve product coordination bodies, uses service delivery insights to improve implant market health, and expands access to implants in the private sector.

With funding from Margaret A. Cargill Philanthropies, Jhpiego is implementing a project to improve maternal, newborn and child health by increasing coverage of high-quality PPFP services in 12 districts in Indonesia and leveraging the country’s existing PPFP gains and momentum. Applying the World Health Organization’s Health Systems Building Blocks framework, the project addresses gaps related to health workforce, information, contraceptives, financing, leadership/governance and community barriers, as well as gaps associated with introducing PPFP services. The project will also generate practical recommendations for wider PPFP scale-up as part of the Government of Indonesia’s initiatives. It will take special considerations to ensure continuity of PPFP service delivery  during and after the pandemic.

This five-year project seeks to increase access to, and equitable use of, high-quality, gender-sensitive and integrated nutrition and reproductive, maternal, newborn, child and adolescent health services (including family planning and water, sanitation and hygiene) in the Western Highlands of Guatemala. The project aims to reach more than 400 communities, with a 5% reduction in stunting, 35% reduction in newborn mortality, 22% reduction in child mortality and 34% reduction in maternal mortality in selected regions. Jhpiego is implementing this work, funded by the U.S. Agency for International Development, in partnership with Instituto de Nutrición de Centroamérica y Panamá (INCAP), Asociación de Servicios Comunitarios de Salud (ASECSA) and Project ECHO.

The Jhpiego-led, five-year Integrated Family Health Services Project (IFHS) supports the Government of Burkina Faso to increase access, equity and uptake of quality, gender-sensitive, integrated services for malaria and reproductive, maternal, newborn, child and adolescent health and nutrition in 19 districts in the Centre-Est, Centre-Ouest and Sud-Ouest regions. Using a client-centered approach, with a focus on marginalized and vulnerable populations, the project is minimizing missed opportunities and providing timely, targeted care. IFHS is expanding use of a digital health platform at all levels of the health system in the targeted regions to promote quality integrated service delivery and improve data quality and use of data for clinical decision-making and management. Other consortium members of the U.S. Agency for International Development-funded project are Terre des Hommes, Viamo and local organizations Conseil Burkinabe des Organisations de Développement Communautaire and Association Songui Manegré/Aide au Développement Endogène.