While numerous family planning policies and strategies have been implemented, some have yielded better results than others. While some countries achieved extremely high levels of coverage, even among the harder-to-reach subgroups and based on high-quality services, others are striving for the bare minimum. Although family planning is a multifaceted outcome, successful histories are observed among countries that started from different socioeconomic backgrounds, varying levels of health sector robustness, and different degrees of women's participation in the labor market and public speech.
Trying to understand how countries from different world regions dealt with the challenge of improving family planning coverage, the family planning policies and programs implemented in five exemplary countries were identified, critically appraised, and summarized. Two of the selected countries are from Latin America (Brazil and Ecuador), one from the Middle East (Egypt), and two are African countries (Ethiopia and Rwanda).

The study, led by the ICEH postdoctoral researcher Franciele Hellwig in collaboration with family planning experts from all included countries, covered over 70 years and identified almost 200 policies. Among the similarities in the study countries is the recognition of family planning as a human right. It paves the way for policies that guarantee access to family planning services in an accessible and affordable way. However, many of the implemented policies focused on specific objectives, like reducing the fertility rate or increasing the uptake of specific modern contraceptives. This narrow focus often falls short of embracing crucial elements of a rights-based approach, such as informed choice and autonomy.

Among the five selected countries, there was a multitude of actions happening at the same time, each with its own vigor and enthusiasm. "What became evident is that this multitude of actions is essential. The involvement of different institutions and leaders is particularly important within a rights-based framework. By adding the perspectives of different agents, we can better understand the needs and challenges faced by women from different contexts", Franciele concluded.

 The full research paper is available here: Frontiers