UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT
Since 1965, USAID has pioneered the US government’s work in international family planning and reproductive health and has supported sexual and reproductive health and reproductive rights across the globe. Through global advocacy, technical and programmatic innovations, strong field presence, sustained commitment and a wide range of specialized technical assistance, the agency is the preeminent donor in family planning (FP), accounting for some 40% of all donor assistance. This has been done in a highly cost-effective manner: for every dollar spent in family planning, up to US$6 million can be saved in interventions aimed at achieving other development goals.
USAID’s family planning program is based on principles of voluntarism, informed choice, rights, and equity. Since the agency began working in the family planning arena, modern contraceptive use in the developing world has more than quadrupled—from less than 10% to more than 40%. In the 28 countries with the largest USAID-sponsored programs, the average number of children per family has declined by one-third, from more than six to less than four. This past year, USAID reached more than 84 million women, preventing 15,000 maternal deaths and saving the lives of more than 230,000 infants.
USAID’s evidence-based programs reach women and men with clinic and community-based programs that enhance reach and accessibility, enabling more women and couples to choose the number, timing, and spacing of their children through access to a mix of high-quality contraceptive options that are safe, acceptable, and affordable. USAID has introduced innovations that have increased the accessibility of FP. These program components include:
• Social and behavior change communication
• Promoting positive gender norms and male involvement
• Contraceptive research and development for birth control and for dual-purpose use in preventing pregnancy and HIV transmission
• Contraceptive procurement and supply chain management
• Maximizing quality in service delivery and program improvement through implementation science
• Policy dialogue at the national and district levels to create a supportive environment for FP services, delivery and methods
• Health systems strengthening for sustainability of all health programs
• Contraceptive social marketing programs
• Private-sector engagement to give consumers more health care choices, better-quality services, and to help governments concentrate dwindling resources on poor and hard-to-reach communities
• Strong data collection, monitoring and evaluation
Enabling couples to determine whether, when, and how often to have children is vital to safe motherhood and healthy families. As such, family planning is crucial to the agency’s mission of ending extreme poverty and health goals of Ending Preventable Child and Maternal Deaths and creating an AIDS Free Generation. By enabling women and couples to practice healthy timing and spacing of pregnancies, family planning could reduce maternal deaths by 30% and child deaths by 25% globally.
LOOKING TO THE YEAR 2020
As a founding partner of FP2020, USAID continues to envision stronger programs that will allow the family planning community to meet the FP2020 goal of reaching an additional 120 million women and girls with FP programs, services and supplies. USAID’s future directions affirm its continued commitment to voluntarism, informed choice, rights, and equity; acknowledge the importance of youth as a key population; and identify five areas where additional work for the next five to seven years can accelerate progress: method choice, social and behavior change communication, product availability, family planning workforce, and total market approach. This work is undertaken with attention to the policy, research, health systems strengthening, and monitoring and evaluation (M&E) dimensions of these focus areas in 24 priority countries plus West Africa, and with an increased emphasis on partnerships.
The five- to seven-year time frame for these focus areas aligns with the FP2020 goal of enabling 120 million additional women and girls to access contraception by 2020. One more lens on these future directions is the post-2015 agenda and the opportunity that exists for a grand convergence by 2030 between the developing and developed world in terms of health statistics and economic well-being. In policy dialogue, USAID will continue to link FP progress to the opportunity for a demographic dividend, and encourage increased domestic resource allocation for family planning and reproductive health in countries that are experiencing rapid economic growth.