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Expand availability and access to family planning choices, including through self-care interventions and new contraceptive method innovations
Expand availability and access to family planning choices, including through self-care interventions and new contraceptive method innovations
UNFPA will support countries to expand contraceptive options and choices and improve the delivery of good quality counselling and information on each option, free from discrimination, including the benefits and risks of each method for the user to freely choose according to their preference and lifestyle. Availability reflects the extent to which a provider has the facilities, staff, commodities and necessary equipment to provide a service that meets a client’s needs. Accessibility reflects whether services can be used by those who need them. Work in this area is guided in particular by the principles of equity and leaving no one behind, and endeavours to deliver services to the last mile.
PRIORITY ACTION 2.2: Expand demand-side interventions aligned to the individual’s reproductive health intentions
PRIORITY ACTION 2.2: Expand demand-side interventions aligned to the individual’s reproductive health intentions
Programmatic options
2.2.1 FP campaigns: Promote sensitization and awareness -about family planning as part of sexual and reproductive health and rights using different channels and digital solutions with information adjusted to different population groups. Channels include traditional media such as radio, television, film, posters and other print publishing as well as mobile applications, social media and events for community mobilization through civil society organizations and community leaders. Audiences include adolescents, young adults, parents, women, men, and marginalized people such as migrants, ethnic minorities, persons with disabilities and LGBTIQ+ people.
2.2.2 Dialogue: Promote alliances with different community organizations, and engage and mobilize them through group dialogue and action to promote healthy sexual relationships, raise awareness for family planning as part of sexual and reproductive health and rights, and raise awareness about the availability of high-quality family planning/contraception services and information. Focus particularly on those furthest behind.
2.2.3 Technologies: Support the development and use of digital technologies to expand access to information and virtual family planning services to the most vulnerable and marginalized populations, including adolescents.
PRIORITY ACTION 2.3: Strengthen the supply chain to ensure availability of a wide range of quality contraceptives to the last mile, including in humanitarian contexts
PRIORITY ACTION 2.3: Strengthen the supply chain to ensure availability of a wide range of quality contraceptives to the last mile, including in humanitarian contexts
Programmatic options
2.3.1 Integrate contraceptives: Engage in evidence-based advocacy to promote high-level involvement and commitment of the Ministry of Health to reproductive health commodity security (RHCS) and efficient and effective integration of quality-assured contraceptives in supply chain management systems.
2.3.2 Procurement capacity: Strengthen the capacities of governmental institutions and/or non-governmental organizations through the development or adaptation of costed supply chain management strategies, multi-year supply plans for contraceptive products, procedure manuals and training materials for supply chain management and expansion.
2.3.3 Pre-service training: Integrate concepts of reproductive health commodity security into pre-service training curricula for pharmacy, nursing schools and biomedical science schools.
2.3.4 Private sector partnership: Map, engage and strengthen platforms to engage non-public sector partners such as local transporters and third-party delivery agents to create public-private partnership to capitalize on private sector supply chain capacity, where appropriate, and delivery to the last mile.
2.3.5 Quality assurance: Strengthen quality assurance mechanisms from product selection through production, shipment, customs clearance, storage and distribution processes to ensure the integrity and safety of products up to the end user.
2.3.6 LMIS: Promote the development and implementation of a logistic management information system (LMIS, electronic or manual) that is interconnected between the different levels, from service delivery point to central warehouse.
2.3.7 Last Mile Assurance (LMA): Develop and/or apply innovative and technology-based tools to monitor, using relevant indicators, the availability, storage, distribution and rational use of quality-assured contraceptives, while minimizing expiry and wastage in the supply chain.
2.3.8 Shaping the market: Use marketing principles and techniques to shape the provision of contraceptive services and products to improve access, choice and use for target populations through key strategies such as Total Market Approaches (TMA), new product introduction to expand choices, leveraging volumes and reach to negotiate with manufacturers, elimination of commercialization barriers or improving efficiency of procurement mechanisms.
2.3.9 Global suppliers: Expand the number of suppliers at global, regional and subregional levels in each of the contraceptive categories, and establish long-term agreements with contraceptive manufacturers approved through the WHO/UNFPA Prequalification Programmes or reliance on registration in countries with Stringent Regulatory Authorities (SRA).
2.3.10 Pricing: Support pooled and or bulk procurement across the national or sub-national level and advocate for subsidized social marketing products to be targeted and priced appropriately.
2.3.11 Pooled and third party procurement: Strengthen government capacities and put the necessary processes and platforms in place for countries to access UNFPA third party procurement mechanisms, or pooled/coordinated buying across countries/regions by working with manufacturers and global stakeholders to shape markets and right-size demand and supply for contraceptives at affordable prices.
2.3.12 Mapping: Collaborate in assessing and mapping supply chain structures and processes in order to maximize the efficiency and effectiveness by identifying and removing bottlenecks at different levels and ensuring provision of data on key reproductive health commodity security indicators.
The interventions under "Expand availability and access" contribute to the UNFPA strategic plan output “quality of care and services”.
The interventions under "Expand availability and access" contribute to the UNFPA strategic plan output “quality of care and services”.
Acceleration Plan Output 2: Quality family planning information, products and services are delivered effectively
Acceleration Plan Output 2: Quality family planning information, products and services are delivered effectively
The strategic plan refers to strengthening the capacity of health systems and institutions to provide high-quality information, services and supplies. The acceleration plan adapts this to focus on family planning: “Quality family planning information, products and services are delivered effectively.”
Output 2 covers a large number of programmatic options and is addressed under two strategic priorities: “improve quality” with a focus on method mix, human resources and human rights-based approaches (priority action 2.1) and “expand availability and access” with a focus on the supply chain and demand generation (priority actions 2.2 and 2.3).
RESOURCE: Relevant text from the family planning strategy
Availability reflects the extent to which a provider has the facilities, staff, commodities and necessary equipment to provide a service that meets a client’s needs. UNFPA will work to support governments in improving the availability of quality contraceptive products, services and information. Where a wide range of methods are available, modern contraceptive method discontinuation decreases and continued use and new uptake increases. UNFPA will support countries to expand contraceptive options and choices and improve the delivery of good quality counselling and information on each option, free from discrimination, including the benefits and risks of each method for the user to freely choose according to their preference and lifestyle.
UNFPA will support countries to address legal and regulatory barriers, strengthen national procurement and supply chain systems, improve collaboration between public and private implementing partners, anchor the distribution of contraceptives in national supply chains and strengthen logistics management Information systems (LMIS). Working through partners, UNFPA will promote a wide range of efforts to expand method mix, strengthen supply chains, strengthen health workforce capacities, improve quality of services and products, expand coverage, integrate innovative modalities for service provision such as self-care and telemedicine, and make contraceptive options for men more accessible. Also, through its market shaping efforts, improvements in forecasting and planning, and working with suppliers, UNFPA aims to achieve better prices, ensure availability of quality-assured products and stimulate innovation for new technologies including multipurpose technologies that address women’s needs and add new contraceptive options for men. since its inception in 2007.
The UNFPA Supplies Partnership is one of the world’s largest providers of donated contraceptives. Its strategic priorities towards 2030 are to: (i) increase availability and choice of quality-assured reproductive health commodities, including for family planning; (ii) strengthen supply chains to ensure contraceptives and other reproductive health commodities reach the last mile, and promote harmonization and integration of supply chains; and (iii) increase government commitment through country financial contributions to quality reproductive health supplies and services.
Accessibility reflects whether services can be used by those who need them. Work in this area is guided in particular by the principles of equity and leaving no one behind, and endeavours to deliver services to the last mile. Using a mixture of different service delivery platforms beyond the public sector facilities, such as community-based distribution, mobile outreach and other private sector partners, expands access not only for the hard-to-reach but also for those most in need. Services must also meet the needs of women and young persons with disabilities (UNFPA, 2018). Women and Young Persons with Disabilities. Guidelines for Providing Rights-Based and Gender-Responsive Services to Address Gender-Based Violence and Sexual and Reproductive Health and Rights for Women and Young Persons with Disabilities.
UNFPA will work on improving access to contraceptives by supporting governments in removing geographic, legal, cultural, social and financial barriers undermining access to contraception. This includes, for example, promoting legal reforms to remove legal barriers, addressing harmful social and gender norms, building agency and women’s empowerment, demand creation and addressing discontinuation, among other measures. UNFPA will encourage partners to harness community engagement and participation as a dynamic force for demand creation, and continue working with partners to address barriers based on harmful social and gender norms and strengthen pathways to quality of care and services.
The future of family planning includes a much wider role for self-care and self-management. Aided by World Health Organization’s consolidated guidance on self-care interventions for health, UNFPA will look beyond traditional health provider-to-client systems to include a range of self-care options (WHO, 2022). Not only pills and condoms, such options will include, for examples, vaginal rings, self-administration of subcutaneous injectable contraceptives, longer supplies of over-the-counter oral contraceptives without prescription, over-the-counter access to emergency contraception and other self-care interventions. Self-care is a strategic modality for family planning and a significant contributor to women’s agency and empowerment.
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