Ensuring universal access to reproductive health, empowering women, men and young people to exercise their right to reproductive health, and reducing related inequities are central to development and to ending poverty. This was recognised 20 years ago at the International Conference on Population and Development (ICPD) in Cairo and was reaffirmed in 2005, when universal access to sexual and reproductive health became a specific target of the Millennium Development Goals (MDGs).

Family planning, as one of the key components of reproductive health, is one of the greatest successes in development and public health of the past 50 years. It has transformed and saved the lives of millions of women and children. It has helped slowdown population growth and has enabled many families to break the cycle of poverty. The links between population dynamics and environmental and economic challenges have become more recognised over time. Universal access to family planning is a human right and is central to gender equality and women’s empowerment, with proven benefits in women’s health, child survival and HIV prevention.

Key for development

For adolescents, improved access to comprehensive sexuality education and modern contraception increases opportunities throughout their lives. This includes higher levels of education, fewer pregnancies, a healthier start to childbearing, and greater ability to engage in income-producing activities. Therefore, universal access to family planning is one of the key factors contributing to development: when women and couples have the necessary information and services and can plan the number and timing of their pregnancies this has a beneficial ripple effect on their education and productive lives. The country as a whole also benefits.

A recent Costed Implementation Plan for Family Planning clearly showed that for each rupee spent on family planning, the country can save six in primary education, immunisation, malaria prevention, maternal health, and water, sanitation and hygiene programmes by 2030. While in the past, there had been significant investments and a global progress in family planning, interest in the last decades has waned, both at the global and national levels. This trend was the result of several factors, including a false reassurance of declining fertility indicating that the ‘population problem’ had been overcome and diversion of resources to other emerging priorities, particularly HIV and AIDS. Recently a renewed interest in family planning has become visible through demonstrations of political will and funding promises, including the Family Planning 2020 movement, which committed to reach 120 million new users of family planning by 2020.

Voluntary and rights-based

Once again, support and demand for family planning are becoming a global movement and the world is witnessing an extraordinary opportunity to revitalise family planning programmes around the world. However, challenges continue to remain. One such challenge is ensuring that family planning services are rights-based and voluntary and that they reach the poorest quintile of the population where the unmet need is greatest.

The principles of voluntarism have been a long-standing cornerstone of international support for family planning, and the need to respect, protect and fulfill reproductive rights has been articulated since the 1994 International Conference on Population and Development (ICPD). The ICPD Programme of Action recognised that voluntary, good quality family planning services that include counseling and access to a wide range of contraceptives must be available, accessible and affordable as one of the core elements of a comprehensive sexual and reproductive health services package. 

The United Nations Population Fund (UNFPA), as the principal global inter-governmental organisation in the UN  system with the mandate for family planning, warmly welcomes the international and national stakeholders’ renewed interest in family planning. Family planning has been at the heart of UNFPA since the Fund began operations in 1969. In this regard, we are committed to accelerate the delivery of universal access to rights-based family planning. Our Family Planning Strategy 2012-2020, titled Choices not Chance, outlines how the Fund will engage with all programme countries to ensure that the countries receive optimum support for family planning, based on a comprehensive review of their situations and critical needs.

Micro planning

Family planning has come a long way in Nepal since it was initiated in 1959. From the time when there used to be no demographic information available, till 1960s, to innovative approaches like micro planning for family planning being adopted, a marked improvement has been observed.

Micro planning for family planning is an innovative approach that Nepal has initiated under the auspices of the Ministry of Health and Population to enable districts to analyse their local context using disaggregated data. This allows identification of strategies and interventions to reach the most marginalised and unreached segments of the population with appropriate and quality family planning services.  This is an example of an intervention that is rights-based as it aims to ensure equitable access to family planning services for the most marginalised people, often residing in remote villages in the country. The 2011 Nepal Demographic Health Survey showed that unmet needs for family planning continue to remain high. Thus, an increased level of inter-agency coordination and mobilisation of resources for the implementation of national and sub-national policies or strategies to address this unmet need would make a world of difference.

Achieving universal access to voluntary family planning services that respect and protect human rights requires concerted and coordinated efforts among diverse stakeholders in both public health and human right communities. It entails fostering innovative approaches and additional investments geared to achieve public health and human right outcomes through individual empowerment, community participation, and capacity buildings in order to allow men, women and couples to claim and practice their right to voluntary, quality and rights-based family planning. Having recently celebrated the first ever National Family Planning Day across Nepal on September 18, it is the right time for the country to strengthen its family planning programme to ensure universal access to voluntary rights-based family planning services.

Vallese is UNFPA Representative to Nepal