IPPF Official Update
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.
At global, regional and national levels, IPPF persuades governments and decision makers to promote sexual and reproductive health and rights, to change policy and to fund programs and service delivery. In 2014, IPPF made significant progress to improve an enabling environment towards strengthening the recognition of SRHR at the regional level:
- Working in partnership with the African Union (AU) on the Maputo Plan of Action. IPPF’s Liaison Office in the African Union headquarters in Addis Ababa plays a critical role in influencing policy processes at the African Union and the United Nations Economic Commission for Africa. The African Union has requested that the IPPF Africa Regional Office works with civil society organizations across Africa to conduct a review of the Maputo Plan of Action. The plan is Africa’s policy framework for universal access to comprehensive sexual and reproductive health services, including family planning. The review will assess progress and make recommendations for the next phase. IPPF convened the General Assembly of the African Parliamentary Forum on Population and Development in the Ivory Coast. The assembly produced a positive statement on Africa’s position on sexual and reproductive health and rights for the new Sustainable Development Goals. This was taken forward to the 6th International Parliamentarians’ Conference on the Implementation of the ICPD Programme of Action in Sweden where African parliamentarians reaffirmed their commitment to gender equality, women’s empowerment, elimination of violence against women, and universal access to sexual and reproductive health services.
Engaging BRICS: More than 42 per cent of the world’s population live in the five BRICS countries of Brazil, Russia, India, China and South Africa, which means that the policies and views of governments in these countries are critical for the health and well-being of billions of people. IPPF works in BRICS countries in partnership with civil society organizations, including Member Associations, to raise awareness among the leaders and policy makers of the importance of sexual and reproductive health and rights.
- In March 2014, South Africa hosted the BRICS Inaugural Seminar of Officials and Experts on Population Matters. IPPF’s Director-General and the Western Hemisphere Regional Director participated, alongside Member Associations and representatives from other civil society organizations mobilized by IPPF. A milestone agreement was reached with the BRICS countries adopting a framework for ongoing cooperation and learning on contraception, sexual and reproductive health and reproductive rights, gender equality and women’s rights.
- In February 2015, IPPF convened a civil society forum in Brasilia, ahead of the First BRICS Meeting of Ministers Responsible for Population Matters. IPPF worked with civil society organizations, including the Member Associations of China and India, to review the zero draft of the Agenda for BRICS Cooperation on Population Matters 2015–2020. Country official delegates were encouraged to support sexual and reproductive health and rights, and gender equality in negotiations on the content of the final document. Following this work, the agenda agreed by ministers at the First BRICS Meeting of Ministers Responsible for Population Matters reflects many of IPPF’s key concerns such as sexual and reproductive health rights, and empowerment of women and girls.
IPPF continues to advocate for affordable pricing for contraceptives and raise awareness and change the attitudes of community, political and public opinion leaders to support SRHR for all. We introduce new contraceptive methodologies to meet the needs of under-served communities and address the known barriers to voluntary family planning service uptake of vulnerable populations. In 2014, IPPF successfully called for the expansion of high-quality and affordable contraceptives through:
- Collaboration with the Reproductive Health Supplies Coalition (RHSC): IPPF continued to play an integral role in the membership-based RHSC. Through its role as co-chair of the RHSC Advocacy and Accountability working group, IPPF has mobilized global, regional and national civil society to call on governments for increased political and financial support to family planning and reproductive health supplies. IPPF contributed to the RHSC Take Stock initiative by pledging to develop and roll out a Federation wide RH Commodity Security Strategy to help IPPF identify potential stockouts and mitigate against them, by building capacity in supplies management and strengthening supply chains across the Federation.
- Partnership for price reductions: IPPF continues to work with other international partners to ensure that the price reductions for implants achieved through the minimum volume guarantees actually reach women needing these products. IPPF is also advocating for UNFPA to list products by formulation, rather than brand name—this is likely to increase take-up of more affordable generics and create a more sustainable market. Partnership with UNFPA to boost family planning services in 13 countries through ensuring affordable family planning supplies.
- IPPF participates in technical groups such as the High Impact Practices in Family Planning (HIPPs) Group and the UN Commission on Life-Saving Commodities, particularly the Implant Technical Reference Team.
- Piloting Sayana Press: Reproductive Health Uganda is working in partnership with PATH to pilot Sayana Press—a self-injection method—with clients receiving services at two urban family planning clinics in Gulu District, with a focus on provision to young people. The research will be instrumental in understanding the appeal of the concept of home and self-injection among younger women, and determine whether women can self-inject Sayana Press competently in an unsupervised setting.
- IPPF is also a member of the International Contraceptive Access (ICA) Foundation—a partnership that has enabled several Member Associations to obtain access to LNG-IUS (levonorgestrel releasing intrauterine system) a hormonal intra-uterine contraceptive device. In 2014, LNG-IUS were shipped to the following IPPF Member Associations: Curacao, Dominican Republic, Paraguay, Mongolia, St. Lucia and Sri Lanka.
- IPPF also actively participates in the UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), and regularly attends HRP policy committee meetings.
IPPF is the global and regional convener and mobilizer of civil society organizations that advocate for public, political and financial commitments to voluntary family planning. Through our advocacy, we influence and support enabling environments to increase high quality, affordable sexual and reproductive health services and for governments to be accountable for the pledges that they made at the 2012 London Summit on Family Planning. IPPF Member Associations regularly hold their governments to account by ensuring that citizens know their rights, by monitoring and tracking that people’s rights are being delivered, and by supporting constructive engagement among citizens, services and government officials to address barriers and challenges. In 2014:
- IPPF worked in partnership with Advance Family Planning to mobilize action at district, national and international levels with a focus on the implementation of commitments made by governments in 2012 at the London Summit on Family Planning. In 2014, IPPF’s Director-General spoke on a high-level panel about the importance of maintaining momentum on contraception and maternal and newborn health, alongside the United Kingdom’s International Development Secretary, Justine Greening, and Melinda Gates of the Bill & Melinda Gates Foundation. As a partner in the USAID-funded Evidence Project, IPPF began research into how social accountability mechanisms can increase access to contraceptive services.
- Through successful advocacy, the Family Planning Association of Nepal celebrated the first-ever Family Planning Day on 18 September 2014. Nepal’s Health and Population Secretary, the Minister of Health and Population, and the National Planning Commission inaugurated the Day which has helped put family planning back on the priority list.
- Association de Bien-Etre Familial–Naissances Désirables of the Democratic Republic of Congo collaborated with local networks to convince the government to allocate its first-ever funding for purchase of contraceptives in 2013. Previously, contraceptive procurement depended solely on donor support.
- Tonga Family Health Association delivered technical input to revise the national youth strategy. Through extensive advocacy, the Member Association secured a specific objective on sexual and reproductive health for young people.
In 2014, the government of Uganda launched its US$200 million official Family Planning Costed Implementation Plan, 2015–2020 (FP-CIP) to reduce unmet need for contraception from 40 to 10 per cent, and increase the modern contraceptive prevalence rate to 50 per cent by 2020. RHU convened and led a youth group and an expert group to provide feedback during the FP-CIP’s development process. Of the 18 countries preparing FP-CIPs, this is the only example of these plans being developed following this approach. RHU’s activities were instrumental in ensuring that young people’s needs and a rights-based approach to family planning programmes were included in the plan. The Association also worked with the government to ensure that the FP-CIP is fully costed, and to raise resources with bilateral donors to fund its various components.
IPPF is a global leader in family planning service delivery and advocacy, and has been at the vanguard of delivering comprehensive voluntary family planning services for over 60 years. IPPF is the global and regional convener and mobilizer of civil society organizations that advocate for public, political and financial commitments to voluntary family planning. In 2014, IPPF continued to unite a global movement to improve the health status of poor and young people, in particular women and girls, through an enabling family planning policy environment and access to a range of cost-effective, high-impact health services. Particularly, the Federation succeeded in securing:
- National legislative change for access to contraception: 81 successful policy initiatives and or positive legislative changes in support or defense of sexual and reproductive health and rights (SRHR) to which Member Associations’ advocacy contributed. This included 27 increased national budget allocations for contraception, access to contraception and SRHR of vulnerable people;
- Global and regional norm setting for rights-based family planning: 18 successful regional and global policy initiatives and/or positive legislative changes in support or defense of SRHR to which IPPF’s advocacy contribute. IPPF implemented its largest-ever international advocacy program to prioritize sexual and reproductive health and rights—including rights-based family planning--within the new Sustainable Development Goals;
- Reproductive rights are human rights: 54% of Member Associations monitor obligations made by government in the international human rights treaties that they have ratified. IPPF Member Associations continue to use the United Nations Periodic Review process to raise concerns and make recommendations about sexual rights in their countries – including access to contraception.
The IPPF Member Association, Rahnuma-Family Planning Association of Pakistan (Rahnuma-FPAP) stands as an example of country impact. Rahnuma-FPAP is part of Pakistan’s national FP2020 Champions Group. Rahnuma-FPAP has agreements with national and provincial ministries, including the Ministry of National Health Services, the Population Welfare Department in Punjab, and the National Institute of Population Studies, and implements maternal and newborn child health programs in the provinces of Balochistan, Punjab and Sindh. These programs support service delivery and family planning in line with the national government’s commitment to FP2020. Rahnuma-FPAP, working with other civil society organizations, advocated for more family planning services with the provincial governments of Khyber Pakhtunkhwa, Punjab and Sindh. Together, these three provinces account for more than 85 per cent of the total population of Pakistan. As a result, the provincial governments have incorporated commitments on family planning into their draft population policies and other influential policy documents; increased budgetary lines for contraception in both 2013–14 and 2014–15; allocated resources to procure contraceptives; established and reconfigured health delivery points to strengthen service reach; and increased their targets for contraceptive prevalence rates.