Improve quality
Improve quality of person-centred care and services by expanding contraceptive choices, counselling, health workforce skills, competency and quality of care at the service delivery point
Quality family planning services are effective, safe, person-centred, timely, equitable, integrated and efficient. There are many determinants of availability and access to high-quality family planning services including information and awareness, method choice availability and contraceptive method mix, provider capacity and attitudes, physical/geographical access, financial access challenges and other factors. Improving the quality of family planning services requires government commitment through policy frameworks as well as investment in human resources to cultivate the provision of better care.
Addressing these often systemic challenges requires action to strengthen the capacity of delivery systems, institutions and communities to provide high-quality family planning information, products and services as part of a comprehensive approach. UNFPA will sharpen its focus on where UNFPA can offer added value in addressing systemic barriers to access and availability and will partner with others to expand the quality and reach of family planning to ensure they are accessible to all, including those furthest behind.
PRIORITY ACTION 2.1: Improve the availability, acceptability, affordability and quality of human rights-based and gender-responsive family planning information and services
Programmatic options
2.1.1 Method mix: Advocate and provide technical assistance for countries to diversify the contraceptive method mix by ensuring new and lesser-used contraceptives methods are included in the National Essential Medicines List (EML) and available at service delivery points.
2.1.2 Distribution channels: Ensure high-quality, affordable products and service modalities through multiple distribution channels via the public and private sectors and non-profits, including at community level.
2.1.3 Human rights-based: Strengthen the professionalism of health service providers (especially midwives and community health workers) by improving their knowledge, capacity and skills, and improving behaviours and attitudes related to family planning in order to ensure health services follow the human rights-based approach, are client-centred, and are based on respectful care within integrated SRHR services.
2.1.4 Standards: Advocate and provide technical support to align, regularly update and monitor the quality and adherence to service delivery standards, guidelines, protocols and competencies of service providers in accord with technical, human rights-based and gender-responsive programming principles.
2.1.5 Training: Customize and adapt family planning or contraceptive methods training using World Health Organization guidelines and tools such as Medical Eligibility Criteria for Contraceptive Use (WHO, 2015) and Family Planning: A Global Handbook for Providers (WHO and Johns Hopkins, 2022 update).
2.1.6 Integration: Build capacity of government and other stakeholders on the integration of family planning services and information within primary health care and SRH service delivery points including maternal health (antenatal, postpartum and post-abortion care), HIV and sexually transmitted infections (STI) services, infertility services and gender-based violence (GBV) prevention and response services.
2.1.7 Professional associations: Provide support to capacity building of national professional associations and facilitate South-South cooperation, collaboration and international networking.
2.1.8 Human resource planning: Support countries to adopt medium-term human resources plans and policies that reflect strategies to improve quality, deepen integration, expand access and reach to family planning for those furthest behind.
2.1.9 Training curricula: Support integration of new and lesser-used contraceptives and standards for services into the national pre-service and in-service training curricula for health care providers and strengthen existing training. This includes humanitarian health workers, post-training follow-up, on-the job-training and mentorship to sustain the knowledge and skills gained through training.
2.1.10 Engagement of providers and communities: Facilitate the engagement of health service providers and community members in efforts to identify and address community-level barriers to meeting the demand for contraceptives, and facilitate their participation in local health sector planning, monitoring and social accountability.
2.1.11 CHWs: Support the integration and expansion of community health care workers’ (CHWs) practical engagement with communities, especially those furthest behind and hardest to reach by providing contraceptive choice through a wide range of methods, safely and effectively, following WHO guidance and recommendations.
The interventions under "Improve quality" 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
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.”
Note: Output 2 covers a large number of strategic interventions and is addressed under both “improve quality” with a focus on method mix, human resources and human rights-based approaches (priority action 2.1) and “expand access and availability” with a focus on the supply chain and demand generation (priority actions 2.2 and 2.3).
RESOURCE: Related text from the family planning strategy
Improving the quality of family planning services requires government commitment through policy frameworks as well as investment in human resources to cultivate the provision of better care. Quality is about promoting sexual and reproductive health care services, including family planning, that are effective, safe, person-centred, timely, equitable, integrated and efficient (WHO). When health care is person-centred, individuals, families and communities are served by and are able to participate in trusted health systems that respond to their needs in humane and holistic ways. The drive for quality affects both delivery of and demand for family planning services. Inadequate quality of care contributes to limited knowledge about family planning and contraceptive methods, low uptake of modern contraception, discontinuation of contraceptive use and limited access to services.
Investing in the health workforce is at the centre of enhancing the quality of care and services. A skilled and competent health workforce operating in a culture of improving quality in all aspects of service delivery has to be supported with ongoing mentorship, supportive supervision, well-equipped health care facilities, functional information systems, uninterrupted supply of reproductive health commodities and strong monitoring of performance, quality of care and client satisfaction.
Working with other partners, including the World Health Organization, UNFPA will support countries to close gaps in the health workforce and shortcomings in staffing for contraceptive services addressing in particular skills and competencies, attitudes and behaviours especially those rooted in social and gender norms. UNFPA will also support countries to improve working environments and professionalization, including through promoting task sharing policies and the social, administrative and national accountability mechanisms needed to improve quality of care in family planning services.