Despite decades of progress, millions around the world still lack reliable access to information, services, and a range of contraceptive methods that would allow them to make free, informed choices through their reproductive lives. That gap is not closing on its own, and today it faces new threats: shrinking budgets, deprioritization by donors, increasing conflicts, climate change, and more. This risks stalling hard-won gains or even backsliding.
We sat down with Megan Christofield, Jhpiego’s Principal Technical Advisor for Family Planning and Reproductive Health, to discuss how exactly this work continues and why it cannot afford to lose momentum now.
Indrani Kashyap (IK): Why does the world still need to focus on family planning?
Megan Christofield (MC): Family planning is something people have to manage over their entire reproductive lives, 30 years, maybe longer. It’s not a single health event. People’s circumstances shift constantly—where they live, if they’re partnered, whether they have a steady job, what they want from life, whether they’re in school—and family planning needs to change with it.
Jhpiego understands this, which is why we work across 14 countries in Asia and Sub-Saharan Africa on 17 diverse family planning projects. Our portfolio spans four strategic pillars: diversifying where people access care, expanding self-determined contraceptive options, building political and social will, and, increasingly, shaping resilient futures for this field.
Read more: Family Planning Helps Jennifer and Ezekiel Stay Focused on What Matters Most in Tanzania.
IK: The World Contraceptive Day 2026 theme is “No Barriers, Just Choices.” How is Jhpiego removing barriers to care?
MC: One major way Jhpiego’s work breaks down barriers is by focusing on entry points to care, from postpartum counseling to community health workers to, increasingly, e-pharmacies.
In Kenya, for example, we’ve worked with e-pharmacies to find ways you could get a prescription contraceptive delivered to your doorstep, in the privacy and convenience of your own home. That work has required many types of expertise, especially our policy and regulatory expertise, to understand what’s allowed under national law and to shape e-pharmacy law itself. It also involved thinking about the user journey from the time they first hit that button saying, “I want an injectable delivered to my house.” What does the journey look like from there? We’ve had to look at financing issues, such as how much the service costs, who pays for it, and how we can bring insurers on board to subsidize this type of care. And then, of course, our FP clinical expertise, which really shines because we’re helping e-commerce vendors truly think about what constitutes a quality patient-client interaction, especially when it happens over the phone.
Read more: A Pop-Up Ad and a New Choice: How Digital Health Is Bringing Family Planning Within Reach
When it comes to expanding choices, we have investments that seek to expand the range of contraceptive options, particularly by integrating access to long-acting reversible contraceptives like hormonal IUDs and implants into health care. These are not always available in health systems due to the higher capital investments required, along with the need to get providers and facilities trained to offer them. And we’ve made investments to expand access to self-administered contraception, such as the self-injected DMPA SC, which is quite popular and continues to be an important part of our work.
It’s more than expanding access to singular products; it’s about how systems and providers offer a full range of methods, to offer choice, not one product being better than anything else.
Read more: Five years to Build a Future
IK: With major shifts in donor funding this year, you’ve pointed to domestic resource mobilization as urgent work. What does that look like?
MC: You can’t go two minutes these days without someone mentioning the need for greater domestic financing for family planning. They’re right, and responding is complex. It’s all relational, right? It’s about our ability to listen to what government leaders want and need, build trust, and coach and support them to connect with the right types of resources and see the results for themselves. But it is doable, and our teams are well positioned to do that kind of work.
For example, Jhpiego has led the East Africa hub for The Challenge Initiative in Kenya, Uganda, and Tanzania for a decade. Initially funded by the Gates Foundation and now by Bayer, the project has helped governments mobilize millions of US dollars in domestic resources by coaching governors and local health leaders through budget processes and strategic planning. We’ve also done a lot of coaching on data use so they can start tracking the family planning data themselves and see what’s possible when they make these types of commitments.
A newer project, SASA (SMART Advocacy for Strategic Action), builds on a decade of prior work in Kenya. It is strengthening civil society’s capacity to advocate to governments for conducive family planning policies and budgets. And we are expanding this work to Senegal and Ethiopia.
IK: You’ve also talked about shaping resilient futures for family planning. Why does that matter now?
MC: It’s the hardest one to communicate, but I think it’s the most important. Family planning always operates on shifting terrain—policy changes, disinformation, social and cultural change that reposition family building in new ways—and part of our job is reading the landscape early enough to move in ways that ensure individuals and couples can make an informed choice around family planning in any of those contexts. Right now, this means confronting misinformation about reproductive health on social media, work that Jhpiego pursues through the Action for Women’s Health Fund, and getting ahead of ethical AI in family planning—including partnerships with Viamo using their voice-AI tools—so information about contraception stays accurate.
We are focused on supporting governments and health system leaders as they navigate changing opportunities and challenges over the next decade or two. Some of that also comes down to how we equip our own teams to use cross-cutting tools like systems thinking to better understand the distal factors shaping family planning availability and desires. We’re using design thinking to co-create programs with providers and clients so that they better reflect how users want family planning services and information to be structured. We increasingly do strategic foresight work, bringing signals of the future into our strategic thinking so we shape our work around how the future might play out, rather than just responding to the present or the past.
IK: As someone who has dedicated years to strengthening contraceptive care, what do you hope for the future?
MC: It’s simple. I want to see a world where people can reliably access the care, information, and services they need to live out their reproductive intentions without having to second-guess whether the information is accurate, whether they’ll be judged, or whether the clinic will even have what they need in stock. Just reliable health care and a full range of methods, available to people regardless of where they live.
Learn more about Jhpiego’s family planning and reproductive health work here.
Indrani Kashyap is Associate Director for Regional Communications at Jhpiego.
