Family Planning: Women’s Needs Must Be Visible

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This image shows a woman standing in a doorway, with her back to the camera. She is holding a child on her hip and they are both looking out to the garden. This image illustrates a blog about Family Planning ahead of Women Deliver.
At Women Deliver 2019, family planning will be a key area of discussion. Photo: Alice Floyd/IWDA

When we talk about ‘reproductive rights’… It’s the difference between people as objects, and people as agents: between regarding people as pawns on the policy chessboard and recognising them as the players, the decision-makers, the drivers of policy; autonomous individuals intimately concerned with the direction of their own lives. Under these conditions women, especially, enjoy better health and live fuller lives. – Nafis Sadik, Special Adviser to the UN Secretary General

Women’s ability to control the number of children they have, the time between births and access to contraception is of monumental importance to their lifelong health, opportunities for education and work, and safety.

The 1994 Program of Action arising from the International Conference on Population and Development, affirmed sexual and reproductive health as a universal human right and it will be a key area of focus at the 2019 Women Deliver conference in Vancouver.

While access to family planning for all genders has improved significantly over the last 50 years, millions of people today still lack the education, facilities and security they need to exercise their bodily autonomy.

Women’s access to sexual and reproductive knowledge, contraception and maternal health facilities has played a key role in improving gender equality around the world. The connection between family planning and women’s health, economic empowerment, and safety and security is now better understood than ever before.

But, we still lack the data we need to comprehensively understand women’s access to family planning services, and ability to realise their reproductive rights against the 2030 Agenda.

Organisations like Marie Stopes and the Guttmacher Institute have undertaken significant work to understand women’s sexual and reproductive health and rights (SRHR) around the world, including access to family planning.

The Guttmacher Institute has played an important role in generating data specific to the Sustainable Development Goals (SDGs) through its Family Planning 2020 initiative, but despite their efforts, significant data gaps persist.

Charting family planning against the SDGs

Sustainable Development Goal 5 – Gender Equality – includes target 5.6: Universal access to reproductive rights and health – an area of unfinished business from the Millenium Development Goals (MDGs).

To measure SDG target 5.6 are two indicators:

  • 5.6.1: The proportion of women aged 15-49 who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care.
  • 5.6.2: Number of countries with laws and regulations that guarantee full and equal access to women and men aged 15 years and older to sexual and reproductive health care, information and education.

However, while the intention is good, right now, just 51 countries have the data required to report on indicator 5.6.1, and there is no agreed methodology for indicator 5.6.2 –that means we are not on track to even understand the full scope of the issues let alone address them through the SDGs.

This is a significant problem, because it means we cannot see where the need is greatest. The efforts of policy makers and leaders to target programs and policies where they’re most needed is hamstrung, and women suffer as a result.

Efficient and effective, gender-sensitive policy relies on the use of accurate data that can be disaggregated at least by sex to inform policy and program work.

This is where the Individual Deprivation Measure (IDM) can help.

The IDM and family planning

The IDM is a new, gender-sensitive measure of multidimensional poverty that collects data at the individual level about 15 key dimensions of life – including family planning and other areas relevant to sexual and reproductive health and rights.

The IDM was informed by over 3,000 people with lived experience of poverty. Their input contributed to the understanding that reproductive health can impact the economic circumstances of women through their education and employment opportunities.

Aspects of hardship associated with reproductive health raised during participatory research included menstruation and access to family planning and prenatal services.

Of 15 key dimensions of life studied by the IDM, three in particular can inform targeted understanding of family planning:

Health

  • Accessibility of health care – including maternal health
  • Quality of available health care
  • Self-reported health status

Family Planning

  • Access to affordable family planning and prenatal services
  • Contraception use
  • Women: past and current pregnancy
  • Women: menstrual hygiene and menstruation

Voice

  • Voice within the household
  • Control over personal decisions
  • Control over resources and work

The data for these dimensions is collected from each adult inside the household, building an understanding not just of inequality or needs at the local, country, or regional levels, but of inequality inside the same household. This knowledge is vital to responding effectively to the  family planning and sexual and reproductive health and rights needs of women and men.

We can’t meet the SDGs without improving women’s access to universal reproductive  rights and health and we can’t improve that access without improving the data. Women Deliver 2019 is a key opportunity for policy makers, activists and researchers to commit to closing this data gap.

The granular data generated by the IDM can assist policy makers and global leaders to build a detailed picture of the family planning needs of people around the world, and to ensure their policies are targeted and efficient, but most importantly, that they are effective.

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