Since the 1994 International Conference on Population and Development’s Programme of Action, there has been a global consensus that human rights and reproductive rights are core principles of family planning programs. Many donors, developing countries, and implementing partners are guided by these principles and have policies designed to ensure family planning programs are rights-based, but what does it really mean in practice?
Challenges to Implementing Rights-Based Family Planning Programs
Admittedly, the lack of global consensus on the key elements necessary for any program to be considered rights-based represents a major challenge. However, substance should not be sacrificed for the sake of consensus.
Despite intensified discussion around rights-based approaches, from an implementation standpoint the existing guidance documents are overwhelming. Futures Group and EngenderHealth, for instance, have released a conceptual framework on how we can ensure human rights are respected, protected, and fulfilled during the design, implementation and evaluation of family planning programs. The World Health Organization is also developing a guidance document identifying priority actions to ensure human rights are integrated in the provision of contraceptive information and services.
These are just two examples among many attempts to document how programs should operate to respect, protect and fulfill human rights. Available frameworks and guidance documents are often characterized by an extensive list of recommendations. Can 24 recommendations spread over 10 categories realistically be tackled at once? This is not to say that all these recommendations are not important. But without some attempt at prioritization, countries may simply decide never to begin addressing rights. Striving to comprehensively document every rights-based input, activity and approach may not only be counter-productive but also overwhelm countries with competing priorities and no clear starting point for implementation.
The Way Forward
Instead, there needs to be a global consensus on a starting point to ensure rights are an integral component of family planning programs. This starting point should be based on the following:
- Voluntarism: Individuals have the ability to choose voluntarily whether to use family planning or a specific family planning method
- Informed Choice: Individuals have access to information on a wide variety of family planning choices, including the benefits and health risks of particular methods
- Achieving a Diverse Method Mix: Clients are offered, directly or through referral, a broad range (encompassing 4 categories of contraceptive methods: short term, long-acting reversible, permanent and emergency contraception) of methods and services.
It’s easy to focus on fulfilling quantifiable commitments, but commitments to improving voluntarism, informed choice, and method mix must not be overlooked. Tremendous work remains to be done to support countries in putting these principles into practice. Guidance that clearly elucidates fundamental components or steps critical to respecting, protecting and fulfilling reproductive rights is especially needed. This includes taking a hard look at what already exists and discussing how we can do better. It’s too early for the rubber stamp.
2020 Vision is a new series featuring global family planning policy insight and analysis. Stay tuned next month for a more in-depth discussion on how voluntarism, informed choice and a robust method mix can be implemented in family planning programs.
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