Reaching Each Rung of the Health Care Ladder
We work to ensure access to—and use of—high-quality, safe and effective voluntary family planning. We work with individuals and communities to explain the variety of contraceptives and how they work, while addressing beliefs and behaviors around their availability and use. We support facilities and providers in efficiently delivering quality family planning services. And we work with governments and other stakeholders to shape an environment that supports consistent delivery and use of family planning methods.
Our Multipronged Approach
Recognizing the need to provide girls and women with effective and safe voluntary family planning appropriate to their situation, we work to incorporate a variety of methods into the contraception menu. These range from client-controlled methods such as lactational amenorrhea, progestin vaginal rings, and self-injectables; to long-acting and reversible contraceptives, such as IUDs and implants; to permanent methods such as male and female sterilization. We help countries expand the range of options offered after birth or miscarriage and before discharge to include IUDs, implants, and a range of short-acting methods.
By integrating voluntary family planning and reproductive health care with other services, such as infant and young child health and nutrition and immunization, we can extend our reach. For example, we support messaging on the use of family planning in the first year after delivery during antenatal care (ANC) in innovative approaches such as group ANC. We also support the development of family planning counseling messages and job aids for HIV testing service providers to help them meet the needs of their HIV-positive clients.
Since 2006, we have led global efforts to provide women with voluntary family planning information and services. We use a human-centered design approach: we identify the contraceptive needs within a community and then work with governments and other stakeholders to meet them. We promote distribution of contraceptives by community health workers and through community-based programs, and innovations such as self-injectables. We also work to ensure that women receiving post-pregnancy care have the option of spacing future pregnancies by accepting a family planning method before leaving the facility.
Effective counseling is fundamental to high-quality family planning services. Trained health care workers who respectfully and knowledgeably counsel women and families on their voluntary family planning options and provide these services increase method uptake and continued use. We develop and implement training for health care workers across the health care system. We support both pre-service and in-service education through curricula emphasizing competence and performance, on-the-job practice, mentorship and supportive supervision. We promote task-sharing, such as training nurses, midwives and other non-physician providers to administer various contraceptive methods.
We support ministries of health to institutionalize voluntary family planning provision in their countries’ health systems. We advocate for and draft policy documents (such as Afghanistan’s National Reproductive Health Policy), costed national implementation strategies and plans, and service delivery guidelines that incorporate World Health Organization recommendations, including PPFP guidance (such as the reference manual on PPFP/PPIUCD counseling in India) and measurement of PPFP uptake. With our support, contraceptive services in India have averted an estimated 16.4 million unintended pregnancies and 10 million abortions, and saved the lives of 83,000 children and almost 10,000 women in the past 4 years.
In all of our programs, we seek out innovations to increase our impact. From preparing frontline health workers to deliver voluntary family planning services, to expanding uptake of PPFP, to advocating for programs and policies to increase access to contraception for adolescents and first-time parents, Jhpiego champions innovative ideas that will ensure that individuals everywhere can choose and consistently use the voluntary family planning methods that best suits their needs.
From 2014 to 2018, 2,787,655 women initiated a modern contraceptive method following a pregnancy through Jhpiego-supported programs.
Jhpiego currently supports family planning and reproductive health care programs in 25 countries. The programs listed here give a snapshot of our work in this critical area.
The United States Agency for International Development’s flagship maternal and newborn health program, the Maternal and Child Survival Program, led by Jhpiego, supports countries to implement a range of strategies to reach women with voluntary postpartum family planning care, allowing them to space pregnancies for their health and the health of their families.
With support from the Bill & Melinda Gates Foundation and Merck for Mothers, Jhpiego is conducting operations research to advance learning around the provision, uptake and continuation of the full range of contraceptives offered in the immediate postpregnancy period in public- and private-sector facilities in Indonesia and Kenya.
Want to learn more about this effort? Read these articles by Jhpiego technical experts:
Jhpiego is addressing the family planning and reproductive health needs of women and families in Tanzania through a range of integrated programs.
- The Sauti Project, funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development (USAID), integrates reproductive health care and HIV services, bringing them closer to the people who need them.
- The USAID Boresha Afya project provides high-quality, respectful integrated services, focusing on reproductive, maternal, newborn and child health. The project, which serves women and families in select districts of Zanzibar and seven regions of the Lake and Western Zones, has been implemented in 1,823 health facilities.
- The Uzazi Salama Rukwa (Safe Motherhood in Rukwa) project is working to improve access to family planning and health outcomes of women and their newborns in Rukwa. The project, funded by Global Affairs Canada and led by Plan International, expects to reach more than 150,000 vulnerable young mothers in this remote and underserved region.
With support from the Bill & Melinda Gates Foundation, Jhpiego is promoting access to voluntary family planning methods through the introduction and scale-up of the injectable contraceptive DMPA-SC (Sayana® Press) into national family planning programs in eight West African countries.
Jhpiego technical experts regularly publish in peer-reviewed journals. You can find collection of journal articles and other resources here. Topics range from group antenatal care messaging to screening and counseling to integration of family planning services with infant and young child nutrition and HIV treatment programs.
Learning Resource Packages & Toolkits
- Skills Update for Contraceptive Implant Side Effect Management and Removal Learning Resource Package. Information and skills update for contraceptive implant providers on managing implant side effect and implant removal.
- Minilaparotomy under Local Anesthesia Learning Resource Package. Reference manual, facilitator’s guide, and learner’s guide focusing on minilaparotomy under local anesthesia, one of the most common approaches to female sterilization.
- Providing Long-Acting Reversible Contraception (LARC) Learning Resource Package (Modular/Facility-Based). Integrated learning package focused on providing high-quality long-acting reversible contraception services using a modular, facility-based approach for training, capacity-building and mentorship.
- Menstrual Hygiene Management in Emergencies Toolkit. This tookit, developed by Columbia University and the International Rescue Committee with Jhpiego as a co-publisher, provides guidance for integrating menstrual hygiene management into existing programming. A miniguide is available in English, French and Arabic.