Rights-based Family Planning
Rights-based family planning is an approach to developing and implementing programs that aims to fulfill the rights of all individuals to choose whether, when, and how many children to have; to act on those choices through high-quality sexual and reproductive health services, information, and education; and to access those services free from discrimination, coercion, and violence.
Over the last several years, global and country actors are increasingly interrogating programs and practices to ensure the rights of clients are considered and respected. Now, these efforts—in pursuit of the promise of rights-based family planning programming as a standard practice—are leading to the first insights on what it takes to operationalize this approach and measure its impact on programs, progress, and people.
Family Planning 2020 (FP2020) is proud to support these efforts by helping build the critical knowledge base on rights-based family planning—sharing the latest research, program efforts, and tools as well as providing a forum for the exchange of ideas, observations, and inspiration.
We are deeply grateful to the many organizations and experts working on integrating rights into their family planning efforts for their generous collaboration, expertise, and thought leadership. Learn more.
Understanding the Approach
Rights-based family planning involves the application of key human rights principles to how programs are planned, implemented, monitored, and evaluated. Policies, plans, and programs can only be considered rights-based if they are designed and implemented to respect, protect, and fulfill the following principles for all people.
These principles—which comprise the FP2020 Rights and Empowerment Principles—are informed by and build upon existing human rights frameworks that seek to integrate rights-based approaches specifically for family planning into programming. Ensuring that human rights principles are at the center of family planning policies, programs, measurement, and contraceptive markets represents some of our community’s most challenging work. However, investing in human rights is critical to growing sustainable, equitable, and effective programs with lasting impact.
Most family planning programs are already implementing essential elements of rights-based programming—including increasing access, improving quality, expanding method options, and ensuring informed choice—though these interventions may not automatically be associated with or described in terms of rights. For decades, family planning practitioners, have worked to advance high-quality and client-focused family planning.
The international community has also long agreed that that every individual has the right to health, and that reproductive health is a fundamental right of all people, such as through international conventions and conferences, including the International Conference on Population and Development (ICPD) in Cairo in 1994, the ICPD five-year review, and the Fourth World Conference on Women in Beijing in 1995.
However, more is needed for an approach to be fully considered rights-based and centered around the needs and preferences of clients.
Community participation, individual empowerment, and accountability need to be valued and supported as essential program elements. A rights-based approach is inclusive and seeks to empower individuals to meaningfully participate in the design, implementation, and evaluation of policies and programs. Therefore, rights-based service delivery must include:
- Rights literacy among different stakeholders to ensure that individuals know of and feel empowered to demand their rights, and that policymakers and healthcare staff understand their responsibility to protect and fulfill these rights and are aware of the practices that support or hinder them; and
- Mechanisms for investigating, managing, and redressing rights violations to hold staff accountable.
Additionally, although all women, men, girls, and boys have the right to make their own decisions about sex and their sexuality, marriage, and parenthood, a variety of factors, including age, socio-economic status, religion, marital status, and gender, make it difficult for some to exercise their rights.
The rights-based approach calls on providers and programs to understand and address these factors by focusing on the needs of hard-to-reach and marginalized groups and by eliminating policy or programmatic barriers, including all forms of discrimination, to accessing services and information. Examples of such interventions could include:
- Considering client access to family planning and reproductive health services, including the distance the client must travel;
- Considering cost of services, particularly for young people and other marginalized groups;
- Addressing providers’ attitudes biases towards certain clients or methods;
- Removing unnecessary eligibility requirements that exclude clients based on age, marital status, or gender; and
- Incorporating interventions that work outside clinics—at the policy, community, and individual levels—to address the full range of barriers that prevent and limit the ability of individual to make and act on reproductive decisions around family planning.
Until all levels of programming better address client’s rights—and what these rights mean in the context of service delivery—the gap between rhetoric and reality will remain.
The ambitious goal—to enable 120 million more women and girls to use contraceptives by 2020—announced at the 2012 London Summit on Family Planning proved catalytic in many ways. It ushered in renewed interest in and funding for family planning, elicited global commitments to provide more women with access to the services and programs they want and need, and emphasized a new approach that called for using human rights principles as the foundation of all family planning activities.
Today, FP2020 is committed to advancing the body of evidence around the importance and impact of a rights-based approach, as well as building the community of practice of those who are working in this area. The Secretariat continues to convene consultations and meeting to advance this discussion as well as work with technical experts to showcase progress in incorporating rights into family planning programs, national strategies, and costed implementation plans.
In June 2016, FP2020 co-convened a consultation on “Realizing Sustainable Programming for Rights-Based Family Planning,” in which representatives of donor organizations, implementing agencies, research groups, United Nations entities, and civil society focused on the practicalities of applying the rights-based approach. Participants shared current rights-based family planning programming and monitoring efforts, heard the perspectives of key donors on how rights figure into their portfolios, explored the challenges and tensions inherent in this work, and identified new approaches to incorporate rights into new and existing programs. The consultation was preceded by a consultation in May 2016 on the nexus of reproductive empowerment, gender and rights-based family planning, and followed in October 2016 with a meeting on measuring the impact of rights-based family planning programs. These smaller consultations were co-convened with USAID and the Interagency Gender Working Group (IGWG).
In addition, measuring rights continues to be a key part of the FP2020 measurement agenda and the annually released FP2020 Core Indicators. Several of the FP2020 Core Indicators provide a glimpse into issues of agency and autonomy, quality, availability, and informed choice across the 69 FP2020 focus countries. The National Composite Index for Family Planning (NCIFP), a survey developed by Track20 in 2015, attempts to capture the extent to which national family planning programs address issues of quality, equity, and accountability, among others (learn more about how counseling, informed choice, and decision making are measured in the FP2020 Core Indicators and the NCIFP).
These meetings and other recent efforts build upon the work of FP2020’s Rights and Empowerment Working Group—established from 2013 to 2015—to ensure that all of the partnership’s activities are underpinned by rights. Among the Working Group's key achievements was the development of the FP2020 Rights and Empowerment Principles, a document that outlines the common understanding of rights principles related to family planning that the FP2020 partnership believes must be respected, protected, and fulfilled in order to reach and sustain goals for meeting contraceptive needs.
Several key rights-based family planning resources and efforts—frameworks, tools, reports, and pilots—have been developed that provide principles, entry points, and solid programming advice to help countries and practitioners develop family planning programs that respect and protect human rights. These include frameworks from the World Health Organization, the Population Council's Evidence Project, and EngenderHealth, along with efforts from partners like International Planned Parenthood Federation, Marie Stopes International, and Palladium to operationalize these frameworks.
Connect and Contribute
We are deeply grateful to the many organizations and experts working on integrating rights into their family planning efforts and their generous collaboration, knowledge sharing and thought leadership. In particular, we gratefully acknowledge the work of EngenderHealth, the International Planned Parenthood Federation (IPPF), Marie Stopes International, Palladium, the Population Council, and the USAID Support for International Family Planning Organizations (SIFPO) 2 Project and its implementers for their on-going search for evidence, program improvements, and willingness to push a concept to reality.
We especially wish to thank Elizabeth Arlotti-Parish, Michal Avni, Vicky Boydell, Lynn Bakamjian, Jay Gribble, Karen Hardee, Kaja Jurczynska, Joan Kraft, Jan Kumar, and Karen Newman and countless more who have supported and contributed to these efforts.