Join FP2020 by Making a Commitment

IPPF shared the following update on progress in achieving its FP2020 commitments:

IPPF has committed to significantly increasing the number of family planning services—a trebling of services from 2012 to 2020. IPPF is on track to reach the FP2020 targets to enable 120 million more women and girls to use contraception by 2010. By 2020, IPPF will increase family planning services to save the lives of 54,000 women, averting 46.4 million unintended pregnancies and preventing unsafe abortion. Results from 2014 show significant progress towards achieving this ambitious target:

• Delivery of 60.2 million contraceptive services through 54,000 service delivery points. The number of contraceptive services provided in 2014 includes 8.9 million new users. Over 5.7 million contraceptive services were deliver to young people under 25 years of age.
• Averted 5.9 million unintended pregnancies and 677,000 unsafe abortions through a CYP of 14.6 million. The number of couple years of protection (CYP) provided in 2014 increased by 21 percent to 14.6 million, which averted an estimated 5.9 million unintended pregnancies and 677,000 unsafe abortions. In the Africa and Arab World regions, the percentage increases from 2013 were 83 and 37 percent, respectively. In Africa, the growth was predominantly due to injectables, intrauterine devices, and oral contraceptive pills. In the Arab World, it was due mainly to intrauterine devices and implants.
• Delivering an Integrated Package of Essential Services. IPPF remains committed to providing a range of contraceptive choices to service users. The services in the package are proven by WHO to deliver high impact in resource-poor settings and when combined these services have the ability to transform the lives of women, girls and other poor and vulnerable populations. Our Integrated Package of Essential Services requires IPPF Member Associations to provide short- and long-acting reversible methods, as well as emergency contraception. Within IPPF’s CYP for 2014 of 14.6 million, 44 percent was provided by short-acting methods; 42 percent by reversible long‑acting methods; 14 per cent by permanent methods.

By 2015, we expect to double the number of comprehensive and integrated SRH services annually by:

• Investing in countries with the greatest need. The majority of IPPF’s unrestricted investments are made in countries with the greatest need for SRH information, education and services. These countries, identified by the Human Development Index as having low or medium levels of human development, have disproportionately high levels of maternal and child mortality, unmet need for contraception, HIV prevalence, and early marriage and childbearing. In the 73 countries identified as having low or medium levels of human development3 and where there is an IPPF Member Association or collaborating partner, the total number of sexual and reproductive health services provided in 2014 reached 122.4 million, an increase of 13 per cent from 2013. The most common categories of services provided were contraception, maternal and child health, and HIV-related services;
• Reaching poor and vulnerable groups. In 2014, IPPF reached 52.6 million poor and vulnerable service users with sexual and reproductive health services, 3.7 million more than in 2013. The estimated proportion of all service users who are poor and vulnerable is 85 percent, the highest ever achieved by IPPF. These results illustrate IPPF’s commitment to serving those most in need of sexual and reproductive health services. IPPF has more than 54,000 service delivery points, and 59 per cent of them are located in peri-urban or rural areas. This enables Member Associations to provide information, education and services to people living in hard-to-reach areas where there are few, if any, other service providers. Member Associations provide services to under-served groups who are not reached by other public or private providers, due to a reluctance to work with such marginalized populations, the additional costs involved or an absence of the specialized skills needed. Such groups are often those with greatest need, and include young people, sex workers, men who have sex with men, people who inject drugs, sexually diverse populations and prisoners.
• Adolescents and young people. In 2014, IPPF provided 66.6 million sexual and reproductive health services to young people. This represents 45 percent of all services provided, and illustrates our commitment to the largest generation of young people ever. Over the last five years, IPPF has focused on the needs of young people, with the proportion of sexual and reproductive health services provided to youth rising from 35 per cent in 2010 to 45 per cent in 2014. The most common services accessed by young people in 2014 were contraception (37 percent), HIV-related services (22 percent) and gynecology (10 percent).

Throughout 2014, IPPF continued to invest in and strengthen organizational systems and business processes to support a strong culture of performance, effectiveness, learning and accountability. Being part of a large Federation means that many Member Associations have the opportunity to learn from and share their expertise with others. While IPPF Regional Offices provide technical support to Member Associations in their regions, there is a growing trend to promote capacity building directly between Associations. In addition, as experts in the field of implementing sexual and reproductive health and rights programmes, Member Associations are also asked by external private and public health organizations to share their knowledge and experience.

• Learning Centers in the Africa Region. The Africa Regional Office has supported nine Member Associations to become designated Learning Centers. These Centers offer training and other forms of technical assistance to organizations, both within and outside the Federation. Based at the Member Associations of Cameroon, Côte d’Ivoire, Ethiopia, Ghana, Kenya, Mozambique, Swaziland, Togo and Uganda, the Learning Centers promote peer-to-peer learning by transferring expertise in how to design innovative programmes. These Member Associations consistently demonstrate their capacity to provide quality SRH information and services, and have the expertise, skills and systems to provide technical support to other Member Associations. Each Centre reflects the acknowledged strengths of that particular Member Association.
• Engaging volunteers and staff. In 2014, volunteers and staff of the Member Associations with Learning Centers took part in refresher training in their core areas of expertise to strengthen their ability to provide support on topics in demand. These included family planning, with a focus on long-acting and permanent methods; public–private partnerships; and how to deliver integrated SRH including contraception. Member Associations were supported to convert areas within their facilities into meeting spaces, and to develop or adapt training modules based on national sexual and reproductive health policies and curricula. Exchange visits involving the Member Associations in Cameroon, Ghana and Uganda offered valuable opportunities to share experiences in the day-to-day management of running a Learning Centre.
• Member Association exchange. Reproductive Health Uganda (RHU) demonstrates one example of a Learning Centre building the capacity of multiple Member Associations across the region. RHU provided training to Member Associations from Ethiopia, Kenya, Malawi and Mozambique on how to design and manage surgical camps, as well as training for Member Associations in Ethiopia, Kenya, Malawi, Namibia, Swaziland and Tanzania on a parent-focused intervention exploring the sexual and reproductive health and rights of young people. In 2014, three Member Associations with Learning Centers were successful in generating income from training public or private health providers. The Family Guidance Association of Ethiopia trained 2,628 health professionals from public and private clinics, generating 16.7 million Birr (US$816,000); Family Health Options Kenya trained 300 service providers, generating 3 million Ksh (US$32,000); while Côte d’Ivoire’s Association Ivoirienne pour le Bien‑Être Familial trained nearly 200 service providers and generated 62.6 million FCFA (US$100,000).

IPPF is currently building on the work previously undertaken across the Federation to support client-centered, integrated, rights based quality family planning services within a comprehensive approach to SRH. IPPF is building a strong civil society response to strengthen national health systems. Member Associations are part of the grassroots movement in their respective countries. They play a critical role not only as service providers within the health system, but also as a significant contributor to strengthening the health system by disseminating new guidelines and technologies, building the capacity of other peers working within the health system, and advocating for supportive policies. Below are highlights from our work in 2014:

• IPPF is reinvigorating our International Medical Advisory Panel to respond with best practice and clinic based guidelines and to share our experience amongst communities of best practice, and provides timely guidance to IPPF on critical issues related to SRH and family planning. IPPF Medical Bulletins are produced to address gaps in bio-medical evidence or critical issues relating SRHR programming.

IPPF’s commitment to quality of care is demonstrated through our Quality Assurance Package which also guides Member Associations on establishing the Integrated Package of Essential Services (IPES). In 2014, quality of care was included as a key principle for Member Associations accreditation, underpinning our continual quest for quality. Evidence from our safe abortion and family planning programmes shows that satisfied clients are one of the top three sources of referral for new clients. IPPF’s Quality of Care Technical Working Group provides global technical leadership in quality of care, along with information and policy updates, sharing guidelines and best practice, training and resources.

IPPF remains committed to building the advocacy capacity of Member Associations in 40 countries to advance rights-based family planning, within a comprehensive approach to SRH. IPPF defines capacity building as development of IPPF’s core skills in order to enable the organization and individuals to address weaknesses, to bring about change and increase effectiveness. IPPF Regional Offices are the hub of capacity building activity in the Federation and provide technical assistance to Member Associations in every aspect of organizational life, depending on their needs–including advocacy capacity building.  Our Regional Offices provide on the spot assistance, regional training workshops, publishing toolkits and arranging south to south technical assistance. Specific examples in 2014 include:  

• IPPF worked to increase Member Association capacity to advocate on sexual rights—including access to contraception—through the Universal Periodic Review Mechanism. IPPF supported Member Associations to press their governments for change, including training for Member Associations from Austria, Albania, Bosnia-Herzegovina, Bulgaria, Estonia, Kazakhstan, Spain and Tajikistan to use the UPR process. Most recently, two Member Associations who participated in the workshop have submitted shadow reports that will be reviewed by the Human Rights Council over the next year. The Macedonian and Bulgarian Member Associations also attended the adoption of their respective country UPR reports in Geneva and made oral statements on the recommendations that were adopted or rejected.
• Advocacy with the UN. Every year, IPPF successfully advocates for progressive language to be included in UN documents, including the conclusions of the Commission on the Status of Women (CSW) and the outcome document for the Commission on Population and Development (CPD). IPPF supports Member Associations to participate in these UN processes, and hold their governments in capital to account on key issues related to SRH and rights-based family planning.
• Joining Voices. IPPF’s Joining Voices project plays an important role in supporting civil society advocacy on family planning to make sure commitments are delivered. As part of Joining Voices, Countdown 2015 Europe is a consortium of 15 leading European non-governmental organizations, of which over half are IPPF Member Associations, working to ensure funding for sexual and reproductive health and rights in developing countries. Coordinated by IPPF’s European Network and working with European Union institutions, Countdown 2015 Europe holds donors to account for their policy and funding commitments to achieve universal access to reproductive health and to address the unmet need for family planning.
• Tracking advocacy progress. In 2012, new questions on advocacy were included in the Global Indicators Survey to provide additional information on advocacy progress made by Member Associations. However, certain Member Associations suggested a new approach to gathering information on advocacy progress. Currently, we are providing support for Member Associations to assess their advocacy capacity better, through a tool based on a self-assessment checklist to identify strengths and areas that need improvement.

In August 2015, the Government of Cameroon shared an update on progress in achieving its policy, financial and program and service delivery commitments to FP2020. 

• Family planning services are not systematically offered in universities, and the [Family Health Directorate] is working with the Minister of Higher Education to establish family planning in medico-social centers (MSCs) and to ensure family planning is integrated in universities. The first step was to review and validate the white paper that indicates which services the MSCs can offer. We are also currently working with partners to ensure the MSCs have a free supply of contraceptives. The launch is scheduled for the start of the next academic year, during medical visits, and will be accompanied by awareness activities with the health club.
• Family planning mobilization week: This mobilization week for repositioning family planning, which was held during the week of February 23, 2015, affected 800 women and young people and saw commitments from the Minister for Women’s Empowerment and the Family, Territorial Planning and Development, and political leaders from the Government of Cameroon. During this week, the Family Health Directorate disseminated the 2015-2020 Family Planning Operational Plan to policy makers, NGOs and partners as well as appointed singer Mani Bella as a family planning champion within the country.
• A subcommittee of the Family Planning Sub-Group was formed to develop the family planning norms and standards, and to work toward a system for the certification of providers and the accreditation of health training. In addition, the Family Planning Sub-Group established a contraceptive safety subcommittee.
• The United Nations system, as well as the partners, are committed to supporting Cameroon in meeting its commitments.

In September 2016, the Government of Uganda shared an update on progress in achieving its policy, financial and program and service delivery commitments to FP2020.

• The government of Uganda has undertaken the following to improve midwifery profession:
  • Skills training: In 2015, Uganda finalized the review of the midwifery curriculum to make it competency based. The curriculum emphasizes more practical time than theory and includes a module on family planning. 160 midwifery tutors and clinical Instructors were given skills in mentoring and coaching of students to improve the quality of training for midwives. The aim is to produce competent midwives to offer quality maternal and child health services including family planning. Four clinical instructors in charge of midwifery skills labs were trained on how to use the equipment that had been supplied by UNFPA. Forty newly recruited midwives have been oriented on maternal health and family planning services. Ninety midwives have been recruited to serve in the hard-to-reach areas.
  • Involvement in Policy Dialogue: More than 200 midwives met the First Lady of Uganda and discussed the challenges they face in delivering midwifery services. More advocacy meetings for improving the midwifery program to be spearheaded by the First Lady have been planned for 2016.Through national and regional symposia, midwives have been supported to establish a Midwives Association that will spearhead the policy dialogues. A constitution for the association is being drafted and will be disseminated to stakeholders in September 2016. Forty Young Midwives Leaders have been equipped with skills in leadership and advocacy for improved maternal health and family planning services. A scheme of services for midwives and nurses, and nursing and midwifery policy were developed and presented to the senior management of the Ministry of Health for approval.
  • Midwifery career promotion: Midwifery career promotions in secondary schools in four hard-to-reach districts were conducted. Midwifery career promotional materials have been developed to be used across the country.
• Uganda is implementing a self-injection pilot using Sayana Press in some communities with good result. Now with support from UNFPA, the government is scaling up the distribution of Sayana Press through community health workers in selected districts. Ninety midwives have been recruited to support the service delivery.
• UNFPA through the RMNCH Trust Fund has supported the government to renovate some health facilities and to purchase hospital equipment; the Association of Obstetricians and Gynecologists of Uganda (AOGU) is now helping to build capacity for use.
• With support from UNFPA, the Ministry of Health, through JHPIEGO, has helped build the capacity of 941 service providers in the provision of family planning, especially postpartum family planning and long acting reversible contraception. In addition, equipment (PPIUDs kits, Mama Natalie, and Mama U models) were given to 160 health facilities and 18 midwifery schools so that health workers have the required tools and skills for service provision and continuous practice following the training.
• Medical Eligibility Criteria Wheel: Trainer-of-trainers training was carried out with selected participants from districts, referral hospitals, and partners supporting family planning to input the development of a localized Medical Eligibility Criteria (MEC) wheel for Uganda, based on the 5th edition of World Health Organization MEC wheel. A final draft was developed and its undergoing validation from various stakeholders. A cascade training of the wheel has also been done in selected districts, and we hope to scale up the training to the rest of the country.
• Uganda has also embarked on improving the quality of services provided by community health workers (CHEWs) by developing a CHEW strategy to be able to increase family planning services at community level. The strategy has been endorsed by the top management of Ministry of Health and is now due for presentation to the cabinet.
• In 2015, UNFPA supported 7 (out of 112) core districts to provide youth-friendly (YFS) services according to national standards in 100 percent and 86 percent of the hospitals and Health Centre IVs, respectively. Furthermore, 15 health centres were supported to establish YFS in targeted districts through faith-based organizations. UNFPA supported the government of Uganda to increase YFS in humanitarian setting with 90 percent of the Health Centres in four refugee settlements by establishing 20 youth spaces reaching out to 59,100 young people with SRH information and services.
• The Ministry of Health, with support from UNFPA, conducted a national assessment on the knowledge, briefs, practices, needs of young people (10-24 years), and on access, appropriateness, and effectiveness of sexual and reproductive services.
• A scorecard has been developed to link results with resources at different levels of service delivery and aligned in the district league table. It is currently being piloted in some districts with capacity building of service providers. This will be disseminated and rolled out in 2016-2017.
• The Uganda RMNCAH assembly was held in December 2015 and stakeholders made commitments in various areas. Most importantly they committed to strengthen accountability and coordination for RMNCAH at the national, district, and community levels in order to streamline RMNCAH implementation. The government plans to hold annual RMNCAH assemblies.
• Uganda has conducted the Annual Household Panel Survey and has completed wave four (series 4) and now is in the process of data collection for wave 5. Through the Joint Assessment Framework (JAF)— a local DP platform—Uganda is able to track the annual CPR using information from panel survey and assess household behavior on family planning uptake.

RHU also helped achieve a task shifting policy that enables clinical staff to undertake sterilization (previously not allowed) and the establishment of the national Population Council, through the passing of the Population Council Bill in 2013 and its signing by the President in 2014.

• Le gouvernement du Togo s’est engagé à accroître la couverture des services en tenant compte des structures privées et associatives dans la fourniture de services de planification familiale:
  • Continuité de la franchise sociale et de la participation des structures privées à la formation pour l’offre de service de PF, aux journées portes ouvertes
• Le gouvernement du Togo s’est engagé à organiser des services de planification familiale au bénéfice de groupes isolés et marginalisés et à améliorer l’accès des populations locales aux méthodes de planification familiale au moyen de stratégies innovantes:
  • Continuité des stratégies innovantes : Stratégie mobile, stratégie avancée, Distribution à base communautaire, Journée Portes Ouvertes
• Le gouvernement du Togo s’est engagé à intégrer les services de santé sexuelle et reproductive des adolescents et des jeunes au PMA (ensemble minimal de services) des structures de santé et à recruter et former du personnel qualifié afin de proposer des services de qualité:
  • Renforcement des infirmeries scolaires pour l’offre de service de PF (formation, équipement, dotation de produits contraceptifs),
  • Formation des prestataires des formations sanitaires sur la santé sexuelle et de reproduction des jeunes et adolescents pour une intégration de la prise en charge dans le PMA.
• Le gouvernement du Togo s’est engagé à promouvoir la planification familiale avec des outils de plaidoyer (RAPID, RAPID religieux) et à institutionnaliser la campagne nationale sur la planification familiale:
  • Continuité du plaidoyer avec le modèle RAPID (RAPID, RAPID religieux)
  • Institutionnalisation de la semaine nationale pour la promotion de la santé maternelle et infantile
• Le gouvernement du Togo s’est engagé à renforcer les prévisions et la gestion des données afin d’optimiser la chaîne d’approvisionnement et de promouvoir l’excellence de la chaîne d’approvisionnement des produits contraceptifs:
  • Continuation des ateliers pour élaborer le Tableau d’Acquisition des Contraceptifs (TAC)
  • Continuité de remplissage annuel du formulaire du Système d’Alerte Précoce (SAP)

In August 2015, the Government of Togo shared an update on progress in achieving its policy, financial and program and service delivery commitments to FP2020.

• The Government of Togo held regional meetings in the country’s six health regions from July 3 to 10, 2015, to disseminate the 2013-2017 Family Planning Repositioning Plan.
• The preparations for implementing regulations for the reproductive health act is not yet effective. Negotiations with partners to finance this activity are ongoing. The Government of Togo hopes the workshop to develop this legislation will be organized before the end of August 2015 as it is scheduled from August 25 to 28.
• The Reproductive Health Act has not yet been disseminated since the implementing regulations have not been developed. Once they become effective, the government will schedule the dissemination workshop that will also be regional.
• The Government of Togo partnering with the private sector through social franchising to provide FP services.

• Les textes d’application de la loi de la santé de la reproduction en ce qui concerne la session « Planification familiale » sont élaborés en novembre 2015.

The Population Council provided the following updates on progress in achieving its FP2020 commitments:

 The  Council is examining how service delivery options outside of the formal health systems, such as pharmacies and drug shops, and workplace settings, can play an increased role in the provision of an expanded range of contraceptive methods. Expanding the range of contraceptive products available in markets not only increases uptake but simultaneously influences the supply side of service delivery as additional methods offered by providers serves to  strengthen the supply chain and health system.

• To assist the many countries that are working to diversity their method mix, the Evidence Project is drafting a working paper that explores the history of how the methods came into a better balance over time. The project analyzed existing demographic data across 123 low- and middle-income countries to provide insights into the dynamics of method-mix transitions. Drawing on this data, a set of 15 countries has been identified where notable positive changes in the composition of the method mix have occurred over time. Results suggest certain patterns in the path to an improved method mix. This analysis provides a useful perspective for better understanding the dynamics of past method-mix transitions, which can ultimately offer insights for future efforts to expand contraceptive method access and choice.

Developing and testing the effectiveness, safety and acceptability of new reproductive health technologies designed to benefit women and men in developing countries: The Population Council, with support from the USAID Office of Population and Reproductive Health, has developed two innovative contraceptive vaginal rings: a one-year contraceptive vaginal ring that can be used by women to plan their pregnancies and a three-month vaginal ring that can be used by breastfeeding women. Long-acting vaginal rings represent an important advance in contraceptive development. These methods are especially beneficial for women in low-resource settings since they are designed to be under the woman’s control and do not require insertion by a healthcare provider or regular visits to a pharmacy. Both of these factors stand to dramatically expand access to family planning options.

• The one-year contraceptive vaginal ring contains ethinyl estradiol, an approved, marketed hormonal product, and Nestorone®, an investigational progestin that has been shown to be highly effective in preventing ovulation. Because it is intended to be effective for 13 cycles and does not require refrigeration, it may be an attractive option for women in developing countries who lack access to a healthcare facility or pharmacy, and where access to reliable electricity is lacking. The Council will submit a New Drug Application to the US Food and Drug Administration and seek to introduce the vaginal ring in USAID priority countries.
• The progesterone CVR is an intravaginal ring that provides women who breastfeed at least four times a day with a contraceptive option as early as four weeks after giving birth. Each ring can be used continuously for three months, and rings can be used successively for up to one year. The progesterone CVR is an effective, user-controlled method that can aid in spacing pregnancies as it does not affect a woman’s ability to produce breast milk and does not require insertion by a healthcare provider. Fertility returns shortly after discontinuing use. The WHO and UNICEF recommend that women breastfeed exclusively for the first six months after birth and continue breastfeeding up to two years of age. However, the proportion of women who breastfeed exclusively varies greatly by culture, economic context, and time since giving birth. And once a woman stops breastfeeding exclusively or resumes regular menstruation, she is at risk of pregnancy before she may be ready to have another child. Short intervals between births can put a mother, her baby, and its siblings at risk of health complications and death.
• The progesterone CVR works by releasing a continuous low dose of the natural hormone progesterone, which reinforces the contraceptive effect of breastfeeding. Clinical trials have demonstrated that the ring is 98.5% effective in preventing pregnancy when used correctly, is safe for mother and baby, and does not affect a woman’s ability to produce breast milk, unlike estrogen-containing oral contraceptives. Once a woman receives an initial examination and orientation to the method by a healthcare provider, she can insert and remove the ring by herself, reducing the need for frequent visits to her provider. The ring does not require refrigeration or special storage conditions, an advantage in countries that do not have a strong health system infrastructure.
• The three-month progesterone CVR is approved for use in eight Latin American countries: Bolivia, Chile, Dominican Republic, Ecuador, El Salvador, Guatemala, Panama, and Peru. Although not yet approved for use in other countries, efforts are underway to determine the feasibility and likely impact of introducing the ring in Kenya, Nigeria, and Senegal, and results are expected soon from a clinical study of the ring required for registration of the progesterone CVR in India.
• In addition to developing CVRs, the Council is also investigating multipurpose prevention technologies to protect against HIV and other sexually transmitted infections, and in some cases also provide contraception, with a single product. Beyond multi-purpose technologies, our Center for Biomedical Research has begun developing male contraceptive methods including a one-year implant that is placed under the skin of the upper arm. This work relies on MENT® acetate (7α-methyl-19-nortestosterone) which is created from a synthetic steroid that resembles testosterone. If approved by regulatory authorities, MENT would be the first long-acting reversible male contraceptive. Through the development of MENT, the Council has pioneered an approach to suppress or inhibit sperm cell development without impairing a man’s sexual drive (libido). This approach reduces sperm count by administering an androgen (a male sex hormone) alone or in combination with synthetic progestins.

Engaging pharmaceutical companies to license, register and/or manufacture technologies developed by the Population Council to expand choice in developing country markets: In 2014, Population Council researchers completed studies required for the registration and introduction of the progesterone CVR in counties in Kenya, Nigeria, and Senegal. In India, the Council and the Indian Council of Medical Research evaluated the safety and efficacy of the progesterone CVR compared to the Copper T IUD in breastfeeding women who wish to space their pregnancies.

• The Council is also working with a Chilean manufacturer to expand the potential markets for the progesterone CVR, by increasing its license territory and encouraging the partner to invest more in marketing and distribution for the ring in its existing territory.
• Recently, the Council provided evidence on the safety and efficacy of the progesterone CVR to the World Health Organization, which has added the ring to its 2015 updated Essential Medicines List. The WHO established the Essential Medicines List to satisfy priority health care needs. Medicines are selected for their public health relevance, efficacy, safety, and comparative cost-effectiveness. They are intended to be available within health systems at all times in adequate amounts, appropriate doses, with assured quality and adequate information on their use, and at a price that individuals and communities can afford. The WHO’s Essential Medicines List is considered a model to help guide the development of national and institutional essential medicine lists. To complement the Essential Medicines List, WHO has also added guidance to its Medical Eligibility Criteria to ensure that providers understand the method and how to counsel women about it as a contraceptive option. This is important, because when providers are familiar with a method, they are more likely to provide it as an option to their patients.
• The Council is planning to file a New Drug Application in the United States for a one-year contraceptive ring in 2016. Once the one year ring is approved by the US FDA, the Council will work through partners to register the ring in the developing world, and will seek additional partnerships to facilitate the introduction of the product.

Additionally, the International Contraceptive Access (ICA) Foundation is a priority initiative for the Council. The ICA Foundation, a public–private partnership between the Council and Bayer OY, is helping expand access to long-acting reversible contraception in low-resource settings. The objective of the Foundation is to provide local service-delivery organizations with the levonorgestrel releasing intrauterine system (LNG IUS) contraceptive devices on a not-for-profit basis and ultimately serve the reproductive needs of women in resource-poor settings, primarily in developing countries. To date, the Foundation has provided over 67,000 LNG IUS and training materials to projects in 28 low- and middle-income countries. Since 2012 alone, the foundation has donated more than 19,000 units of LNG IUS and related education materials. Country projects include collaborations with local not-for-profit organizations, hospitals, and global partners with a network of service delivery facilities in developing countries.