The London Summit on Family Planning is fast-approaching on 11 July, and enormous efforts have already gone into mobilizing global support and commitments to increased access to voluntary family planning and creating frameworks for ensuring the highest-quality family planning programs, and monitoring these programs in new ways. We are all responsible - governments, donors, the private sector, academics, and civil society - for the commitments made on that day to increase the use of voluntary family planning among women in developing countries. And we all must be held accountable to ensure that this happens.
First, there are key questions we need to ask - and answer - in order to make sure women are provided the best care possible. How do we ensure that the decision to use family planning is voluntary? How do we ensure the highest quality of information, services, and contraceptives are provided?
The answers to these questions are critically important but are not found in the usual sources of data. These questions are about the quality of programs and care, and require that we build systemic monitoring into what actually happens when a woman seeking contraception gains access to a program providing contraception.
Quality of care is a core guiding principle of the London Summit on Family Planning. This means not only providing counseling on safe, effective methods of contraception but also providing access to a range of contraceptive methods from which clients can choose.
We all must be held accountable for fulfilling the promise to the poorest women and girls in the world of ensuring access to high-quality, voluntary family planning programs.
We need to know that health care providers are presenting all of the information needed for a woman to make the best decision for herself, and her family, and that the decision rests with her. This is the essence of the Quality of Care Framework that was introduced to the global family planning literature by Judith Bruce in 1990, and remains vital today. High quality care is also about ensuring that there is continuity of care with follow-up; and a connection to other types of health care services as well.
How do we make sure this is the kind of care that women and girls in the developing world have access to? Through a massive change in the way we're implementing and monitoring family planning programs. Monitoring contraceptive use in the world's poor countries is more than simply counting the increasing numbers of women who adopt injectables, IUDs, implants, or the pill from one month to the next. Doing that is hard enough, but the real challenge lies in putting in place and monitoring quality of care: holding ourselves accountable to the principle that clients remain the center of family planning services and decision-making.
The field of global family planning has a rich history of methodological advances. Measurement has been a strong point. The problem, however, is that the measurements and the data are unevenly distributed across countries and are not easily harnessed to present a holistic picture of what's happening.
Worse, when there is a picture presented, it's once every five years. We need to monitor progress, which means that we need to see results every 12 months. We need to produce valid estimates of contraceptive use much more often than we ever have in the past, and we need to do so while holding all stakeholders accountable to ensuring high-quality family planning care.
We can't do the same thing over and over and expect different results.
What will it look like on the ground if we achieve our collective goal?
Public health leaders and local leaders will be engaged in actively scrutinizing family planning services. Health centres in small villages, large cities, and everywhere in between, in the developing countries on which we're focused will never be out of stock of contraceptives. New technologies will be developed enabling each woman access to a modern contraceptive method that naturally fits her needs. Communities will take on a watchdog role to hold their government responsible for promises made. And, most importantly, women and girls will be empowered to have all of the information and options available in order to make informed and voluntary decisions on how to plan their families.
That would not be business as usual; that would be using different strategies in order to get different results. In order to get there, we all must be held accountable for fulfilling the promise to the poorest women and girls in the world of ensuring access to high-quality, voluntary family planning programs.
Do you believe every girl and woman should have the opportunity to determine her own future? Spread the word that contraception is not controversial. Take the pledge, share your own story, and ask your online communities to do the same!
This post was originally published on Impatient Optimists, the blog of the Bill & Melinda Gates Foundation.
Follow Dr. Gary L. Darmstadt on Twitter: www.twitter.com/gdarmsta