The Global Family Planning Movement: At a Crossroads Lori Ashford Population Reference Bureau May 17, 2005

A Half Century of History Longstanding links to concerns about population growth Health of mothers and children also a rationale but doesn’t galvanize equal political support 1994 Cairo conference viewed as a “turning point”

Perceptions of Family Planning Have Shifted “Since [the Cairo conference] family planning is only a component of reproductive health and not necessarily the most important one…” “As a funding priority, AIDS stands out in a class on its own. What is left for all the other programs?” “If America doesn’t want it, why should you introduce it?” Source: A. Tsui and A. Blanc, “The Dilemma of Past Success: Insiders Views on the Family Planning Movement”

Perceptions, cont. “Remember the population bomb? The new threat to the planet is not too many people but too few.” Newsweek International, Sept “Family planning programs, like the fertility transition they helped to drive, will be a transient phenomenon.” John Caldwell et al, 2002

Still, the Need for Family Planning Remains Fertility decline – not straight and orderly Unmet need for contraception and unintended pregnancies are common Needs are highest among the poorest women Women in low-fertility countries also have needs

Women Who “Need” Family Planning Source: ORC Macro, Demographic and Health Surveys Percent of married women ages who prefer to avoid a pregnancy

Modern Contraceptive Use Among Poor and Rich Women Percent of married women Source: World Bank, 2004, Round II Country Reports on Health, Nutrition, and Population Conditions Among the Poor and the Better-Off in 56 Countries

Use of Contraception (% of married women) Planning Status of Recent Pregnancies Women’s Need for Family Planning in Romania Source: Reproductive Health Survey Romania, 1999

Family Planning is Still a Good Investment Reducing numbers of abortions Prevention of maternal deaths Improvements in child health Promotion of gender equality HIV/AIDS – prevention of mother-to-child transmission Cost-effective

Ways to Regain Focus on Family Planning Finding synergies with other programs and issues Repositioning Family Planning in Africa – USAID’s efforts Including family planning and reproductive health in the Millennium Development Goals

Challenges Competition for policymakers’ attention and limited resources Complex data and messages don’t make for an easy “sell”