This summer, 26 countries and private donors met at the London Summit on Family Planning to pledge $2.6 billion to expand family planning services to 120 million more women in the poorest countries around the world. But while the summit renewed focus on reproductive health with its ambitious target, “we’re now at that point where we have to really sit down and work through” how to achieve that goal, said Julia Bunting of the UK’s Department for International Development at the Wilson Center on September 17.

Bunting was joined by Scott Radloff, director of USAID’s Office of Population and Reproductive Health; Win Brown of the Bill and Melinda Gates Foundation; Jill Sheffield of Women Deliver; and Karen Hardee, moderator and Futures Group Senior Fellow, to discuss what comes next.

Retaking the World Stage

The summit, organized jointly by the UK Government, the Bill and Melinda Gates Foundation, and the United Nations Population Fund, is emblematic of the latest era in family planning, said Radloff – “a period of growing attention and partnerships.”

“For too long, [family planning] had been an issue that many people were not prepared to talk about, it was caught up in all sorts of politics,” Bunting said.

Compounding the lack of political will, beginning in the mid-1990s, “donor attention shifted to other health priorities,” said Radloff, marking an era of “growing neglect” lasting through 2008.

When family planning first appeared as a major development priority, in the 1960s and ’70s, the focus was largely on addressing demographic and health issues in Latin America, Asia, and North Africa, he said. Now, both the rationale and geographic focus have shifted.

“High-need, low-income countries of Africa and South Asia” are priorities for action, Radloff said, and human rights, public health, demography, and economics drive interest in expanding access to services. That broad focus, backed by the momentum coming out of the summit, has created “an unprecedented opportunity for progress” in those priority areas, “particularly for countries that didn’t benefit from the first revolution around family planning,” he said.

From Commitment to Implementation

With a goal set and money pledged, “there’s a lot of implementation to be done,” said Brown. “What does the governance structure look like? Who do we reach out to? How do we turn this into…a global family planning movement?”

The first implementation task is for participants to agree on how to monitor – and therefore how to measure – progress on expanding family planning access (a meeting in New York City later in the week was set to do just that).

Improving access to data will be important, said Brown. Much of the data that informs family planning policy and programming comes from Demographic and Health Surveys (DHSs), and while they contain a wealth of information, the surveys tend to stay focused at the national level, with little data on subnational or local levels, he said. They’re also only completed every few years. To effectively monitor and evaluate the summit’s eight-year goal, more localized and more frequent data will be needed.

That data will have to reflect a range of qualitative indicators beyond just sheer numbers. “The measurement and the indicators that we come up with have to reflect core values: rights, choice, voluntaryfamily planning, quality of care, transparency of data,” said Brown.  The question facing summit participants now, he said, is how to ensure not just that 120 million more women gain access to family planning services, but that they do so in a way that respects the core values underpinning that quantitative goal.

Integration: The Key to Success

How best to reach an additional 120 million women in diverse environments is another question facing summit participants. While discussions are ongoing, one thing appears clear so far: integration will be key.

“We don’t want this to be a vertical program,” said Bunting. “It needs to be integrated across everything…How that happens on that ground is what we will have to work out.”

Some of the strongest family planning successes, Radloff said, have come in countries that have taken an integrated, community-based approach to providing a range of health services to girls and women.

For example, a wealth of opportunity lies in integrating family planning with postpartum services, he added, noting that “it’s when we know women have the highest need for spacing and limiting, and to the extent that we can better reach women at that point in their reproductive lives, we’ll have even greater success in meeting needs.”

A Big Tent Issue

With so many interests converging under its banner, family planning is fast becoming a “big tent” issue for development. But even with that diversity, Bunting said, the audience needs to be expanded. “The people that …we are speaking to are tending to be the usual suspects,” she said. Making the case to others beyond the standard bearers of family planning – to economists and finance ministers andenvironmentalists and sustainable development advocates, for example – will be a necessity as participants work to maintain the summit’s momentum, she continued.

“We’ve got to widen the tent. If we want to succeed, we have to make sure that everybody is a part of it,” Bunting said; that everybody “can see how family planning can contribute to the goals that they’re trying to achieve.”

The summit was the first step in the right direction, bringing together local, national, and international representatives from governments, civil society, and the private sector to create “a melting pot of perspectives,” said Sheffield. As work begins to achieve the summit’s goals, she said, “not one of those sectors, individuals, or agencies can do this alone. We’re only going to achieve progress by doing this together.”

Photo Credit: USAID Administration Dr. Rajiv Shah chairs the donor commitments panel at the London Summit on Family Planning, courtesy of the UK Department for International Development.

Drafted by Kate Diamond, edited by Schuyler Null