Leading with Evidence: The Case for Greater Private Sector Engagement in Family Planning

Posted February 26, 2018

By Christina Riley, Research Officer at Institute for Reproductive Health, Georgetown University

Globally, we are at a critical juncture for meeting the FP2020 goals, well past the halfway mark and edging closer to the deadline.

As we work to get contraceptives into the hands of 120 million women and girls by 2020—and meet the Sustainable Development Goal of ensuring universal access to reproductive health, including family planning (FP) by 2030—we must understand the current landscape of contraceptive access, identify and act on areas that require strengthening.

While private providers (e.g., clinics, pharmacies, drug shops) represent a preferred source of modern contraception and health services in many parts of the developing world, a lack of market data has limited understanding of the private sector’s role in increasing contraceptive coverage and choice.

PSI’s FPwatch Project aimed to address this critical evidence gap. With support from the Bill & Melinda Gates Foundation and the Three Millennium Development Goal (3MDG) Fund, the project surveyed family planning markets in five countries with high unmet need and under-served geographies and populations.

The findings, detailed in the latest issue of PLoS ONE, provide a rigorous and in-depth look into market composition, trends in product availability, and pricing across three study countries—Ethiopia, Nigeria and the Democratic Republic of Congo. Having screened more than 23,800 outlets and selected over 5,600 for audits, FPwatch data yielded evidence to inform future policies, strategies, and funding decisions.

We found:

There is a missed opportunity to provide modern contraception through the private sector.
The ubiquity of retail outlets, such as drug shops, makes them an ideal but underutilized partner in increasing women’s access to a range of non-service-dependent contraceptives.
Subsidies and interventions, like social marketing and social franchising, could leverage the private sector’s role in increasing access to a range of contraceptives.
Our ability to achieve global FP2020 commitments depends on the expansion of national contraceptive policies that promote greater partnership and cooperation with the private sector.
Increased choice and controlling price are essential for improving women’s access to and use of modern contraception

As countries move towards their FP2020 goals, it is imperative that future strategies harness the power of the private sector to align with national programs.

Only with more optimal, varied, and visible product and service delivery channels will the millions of women and girls that the market is currently failing have a better chance at accessing the sustainable, affordable, and high-quality family planning they need.

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Digitalizing contraceptive counseling to reach rural women and girls in Ethiopia

By: Fana Abay, Marketing and Communications Director, PSI Ethiopia

In rural Ethiopia, women and girls often face significant barriers in accessing healthcare facilities, which can be located hours away. Moreover, there is a prevailing stigma surrounding the use of contraception, with concerns about potential infertility or the perception of promiscuity. To address these challenges, the Smart Start initiative has emerged, linking financial well-being with family planning through clear and relatable messaging that addresses the immediate needs of young couples—planning for the lives and families they envision. Smart Start takes a community-based approach, utilizing a network of dedicated Navigators who engage with women in their localities. These Navigators provide counseling and refer interested clients to Health Extension Workers or healthcare providers within Marie Stopes International-operated clinics for comprehensive contraceptive counseling and services.

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In IM-supported areas of Mali, 36% of CHWs in the first round were competent in performing the RDT, which rose to 53% in the second. 24% of CHWs in the first round compared to 38% in the second were competent in the treatment of fever cases and pre-referral counseling. Between both rounds, availability of ACT increased from 80 percent to 90 percent.

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Leading with Evidence: The Case for Greater Private Sector Engagement in Family Planning

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Digitalizing contraceptive counseling to reach rural women and girls in Ethiopia

Building community health worker capacity to deliver malaria care

Taking a market-based approach to scale sanitation in Ethiopia

Promoting self-managed care like Self-testing and Self-Sampling

Using peer coaches to counter HIV stigma in South Africa

simplifying consumers’ journey to care in Vietnam

Engaging the private sector for disease surveillance in Myanmar

Training health workers in Angola

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