Family Planning in the Sustainable Development Goals A Critical Link for Post-2015 Success Ellen H. Starbird Director, Office of Population/Reproductive Health
Advancing RH/FP can positively influence and advance the sustainable development goals 2
Includes Reproductive Rights, including Universal Access to family planning 222 million women in developing countries have an unmet need for contraception. Women want to control their fertility, but too often lack the means, access and agency to do so. Empowering women to choose the number, timing and spacing of their pregnancies is not only a matter of human rights, but touches on many issues vital to sustainable development including health, education, and women s status in society..universal access to family planning and reproductive isn t the only path to sustainable development, but without addressing these issues, the impact and effectiveness of other interventions will be less. 3
Voluntary Family Planning is a Key Intervention for Health and Development* Health benefits Reduces maternal mortality/morbidity Reduces infant and child mortality Reduces abortion Key intervention in HIV settings e.g. PMTCT Enable women and couples to decide number, timing and spacing of births Principles of voluntarism and informed choice are fundamental Social & economic benefits Improves women s opportunities Improves family wellbeing Mitigates adverse effects of population dynamics on o Natural resources, including food & water o Economic growth o State stability *In addition to family planning activities, we also engage in a number of reproductive health-related activities, including breastfeeding, post-abortion care, female genital cutting, fistula prevention, child marriage, and gender and youth RH programming. 4
Proposed Sustainable Development Goals Goal 1 Goal 2 Goal 3 Goal 4 Goal 5 Goal 6 Goal 7 Goal 8 Goal 9 Goal 10 Goal 11 Goal 12 Goal 13 Goal 14 Goal 15 Goal 16 Goal 17 End Poverty in All its Forms Everywhere End Hunger, Achieve Food Security and Improved Nutrition and Promote Sustainable Architecture Ensure Healthy Lives and Promote Well-Being for All At All Ages Ensure Inclusive and Equitable Quality Education and Promote Lifelong Learning Opportunities for All Achieve Gender Equality and Empower All Women and Girls Ensure Availability and Sustainable Management of Water and Sanitation for All Ensure Access to Affordable, Reliable, Sustainable and Modern Energy for All Promote Sustained, Inclusive and Sustainable Economic Growth, Full and Productive Employment and Decent Work for All Build resilient infrastructure, Promote Inclusive and Resilient Infrastructure, Promote Inclusive and Sustainable Industrialization and Foster Innovation Reduce Inequality Within and Among Countries Make Cities and Human Settlements Inclusive, Safe, Resilient and Sustainable Ensure Sustainable Consumption and Production Patterns Take Urgent Action to Combat Climate Change and Its Impacts Conserve and Sustainably Use the Oceans, Seas and Marine Resources for Sustainable Development Protect, Restore and Promote Sustainable Use of Terrestrial Ecosystems, Sustainably Manage Forests, Combat Desertification, and Halt and Reverse Land Degradation and Halt Biodiversity Loss Promote Peaceful and Inclusive Societies for Sustainable Development, Provide Access to Justice for All and Build Effective, Accountable and Inclusive Institutions at all Levels Strengthen the Means of Implementation and Revitalize the Global Partnership for Sustainable Development 5
Where specifically is family planning? Goal 3 Ensure Healthy Lives and Promote Well- Being for All At All Ages 6
Where specifically is family planning? Goal 5 Achieve Gender Equality and Empower All Women and Girls 7
SDGs if Family Planning/Reproductive Health is NOT Included 8
From the MDGs to the SDGs MDG 5B Goal: Achieve universal access to RH 5.3 Contraceptive prevalence rate 5.4 Adolescent birth rate 5.5 Antenatal care coverage 5.6 Unmet need for family planning Post-2015 Target: Achieve universal access to SRHR (SDGs, ICPD Beyond 2014, post-mdg high level panel) a. FP measure (described in the coming slides) b. TBD non-fp measure c. TBD non-fp measure d. TBD non-fp measure 9
FP Metric for SRHR SDG MEASURE: Percent demand for FP satisfied with modern contraceptives In English: Of sexually active women of reproductive age who do not want to become pregnant, the percent who are using modern contraceptives. In Demography: MCPR / [CPR + Unmet Need] Underlying principles: Voluntarism, informed choice, equity, rights This is a key, necessary measure, but certainly not the only measure of SRHR. 10
Proposed FP Benchmark for SDGs BENCHMARK: At least 75 percent demand for FP is satisfied with modern contraceptives in all countries Arrived at the benchmark based on these parameters: What would be ambitious and achievable What would align OECD and high performing low income countries What would capture equity, and incentivize countries to address equity in demand satisfied across wealth, age, residence, and other factors. 11
2030 Goal: Distribution of Countries by FP Demand Satisfied and MCPR 12
2030 Goal: Distribution of USAID-supported Countries by FP Demand Satisfied and MCPR 13
FP2020 Goal: Progress is Slower Than Needed 16.9 M 25.0 M 34.0 M 42.0 M 51.0 M 59.0 M 67.0 M FP2020 GOAL CURRENT TREND HISTORIC TREND Source: FP2020 : PARTNERSHIP IN PROGRESS
Annual Percentage Point Change in Modern Contraceptive Use Between Last 2 Surveys Rapid Progress ( 1.0) Encouraging Progress (0.5 < 1.0) Slow Progress (> 0 < 0.5) Getting worse Rwanda Liberia Haiti Mauritania* Mozambique Kenya Togo* Burkina Faso* Ghana Guinea* Malawi Tanzania India Benin* Nepal Madagascar Niger* Pakistan DR Congo Ethiopia Bangladesh Philippines Afghanistan Zambia Cote d Ivoire* Nigeria Senegal* Uganda Yemen Mali* South Sudan does not have sufficient data for trends analysis. Sources: Rates of change are calculated from the last two survey data points from DHS, MICS, RHS and PMA 2020 surveys. This analysis is based on the 24 PRH priority countries and the Ouagadougou Partnership countries. *Indicates Ouagadougou Partnership Countries
Annual Percentage Point Change in Met Demand for Family Planning Between Last 2 Surveys Rapid Progress ( 2) Encouraging Progress ( 1 to < 2) Slow Progress (> 0 to < 1) Getting worse Rwanda Togo* Ghana Mauritania* Niger Mali* Benin* Yemen Senegal* Haiti Nigeria Guinea Kenya Zambia DR Congo Nepal Madagascar Pakistan India Mozambique Ethiopia Liberia Burkina Faso* Malawi Cote d Ivoire* Bangladesh Tanzania Philippines Uganda Trend data are not available for Afghanistan and South Sudan. Sources: Rates of change are calculated from the last two survey data points from DHS, MICS and RHS. This analysis is based on the 24 PRH priority countries and the Ouagadougou Partnership countries. *Indicates Ouagadougou Partnership Countries
Annual Percentage Point Change in % of Births Spaced < 36 Months Apart Between Last 2 Surveys Rapid Progress ( 1.0 decrease) Some Progress (< 1.0 decrease) Getting worse Senegal* Philippines Tanzania Nigeria Nepal Uganda Mozambique DR Congo Bangladesh Ghana India Pakistan Haiti Zambia Madagascar Guinea* Mali* Kenya Rwanda Niger* Benin* Liberia Cote d Ivoire* Malawi Burkina Faso* Ethiopia Afghanistan, Mauritania, South Sudan, Togo and Yemen do not have sufficient data for trend analyses. Sources: Rates of change are calculated from the last two survey data points from DHS and RHS. This analysis is based on the 24 PRH priority countries and the Ouagadougou Partnership countries. *Indicates Ouagadougou Partnership Countries
Annual Percentage Point Change in 1 st Births to Women Under Age 18 Between Last 2 Surveys Rapid Progress ( 0.5 decrease) Slow Progress (< 0 to < 0.5 decrease) Getting worse Senegal* Bangladesh Tanzania Malawi Nepal Niger* Benin* Nigeria India Mozambique Mali* Ghana Pakistan Zambia DR Congo Ethiopia Guinea* Kenya Rwanda Uganda Haiti Cote d Ivoire* Philippines Burkina Faso* Madagascar Liberia Afghanistan, Mauritania, South Sudan, Togo and Yemen do not have sufficient data for trend analyses between 2000 and 2014. Sources: Rates of change are calculated from the last two survey data points from DHS datasets. The denominator for this indicator is women aged 18 to 24. This analysis is based on the 24 PRH priority countries and the Ouagadougou Partnership countries. *Indicates Ouagadougou Partnership Countries
GH/PRH View on Global Goals for FP/RH 2030: Achieve health-related SDGs In every country, at least 75% of demand for family planning is met by modern contraception FP/RH routinely included in universal health coverage 2020: Achieve FP2020 goals Enable 120 million more women and girls to use contraception Measured by mcpr Underlying rights and empowerment framework 2015: Accelerate progress towards FP2020 and 2030 goals Help countries get onto mcpr trajectory needed to reach FP2020 goals FP metric accepted as one of the SDG indicators for universal access to reproductive health 19
USAID-specific Goals for FP/RH 2030: Achieve health-related SDGs In USAID EPCMD countries, at least 75% of demand for family planning is met by modern contraception FP/RH routinely included in universal health coverage 2020: Achieve EPCMD, AFG, and FP2020 goals Double rate of mcpr increase in USAID priority countries Assist EPCMD countries in meeting FP2020 commitments Expand method mix to better align with reproductive intentions and improve birth spacing 2015: Accelerate progress towards 2020 and 2030 goals Maintain progress in high performing countries; improve progress in low performers Continue building evidence for FP-EPCMD relationships Strengthen USAID/UNFPA relationship at country level 20
The Job Still To Do Secure SRHR in the SDGs Gain agreement on metrics Accelerate progress in satisfying demand for family planning 21
Family Planning Is a Best Buy -Advancing Social and Economic Development by Investing in Women's and Children's Health: A New Global Investment Framework 22a