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Refocusing on the Essentials

By Christine Grillo

In the 1960s, only 10 percent of couples around the world used contraception; today, the rate is 63 percent. In the last 50 years, most regions of the world have embraced family planning, with measurable benefits: Birth rates have declined, rates of adolescent childbearing have dropped, and every year 188 million unwanted pregnancies are prevented through contraception.

In countries such as China, South Korea and Thailand, where family planning was widely adopted—up to 80 percent of couples there now use contraceptives—the positive effect is clear. As fertility and family size decreased, education (especially for girls) improved, per capita income rose, life expectancy increased, and the nations prospered. Latin America has moved quickly in the same direction.

Despite its many successes, though, interest in and support of family planning has flagged in recent years. “Generally, the U.S. has been the leading voice on family planning,” says Amy Tsui, director of the Bill and Melinda Gates Institute for Population and Reproductive Health. But conservatism about family planning during the Reagan administration “put a pall on the movement in the 1980s,” says Tsui, PhD. As family planning became politically linked with abortion in the 1990s, it lost more momentum and retreated further during the George W. Bush era.

But now it looks as if family planning is back. The Obama administration has begun to re-invest in not only contraception, but also “safe motherhood,” which covers maternal and newborn health. In January, Secretary of State Hillary Clinton announced the U.S.’s re-dedication to international family planning, while President Barack Obama requested $716 million for family planning and reproductive health programs for fiscal year 2011.

Further signaling a return to this development topic was the International Conference on Family Planning (ICFP) held in Kampala, Uganda, in November 2009 (2009fpconference.wordpress.com). Organized by the Gates Institute, Makerere University and other partners, the conference was the first of its kind in 15 years. With more than 1,300 participants from 61 countries, it focused on research and best practices. At the conference, School researchers announced the launch of a three-year collaborative effort—Advance Family Planning—to revitalize the family planning global agenda, empower developing countries, and ensure universal access to reproductive health.

The ICFP seems to have accelerated interest in family planning, especially in sub-Saharan Africa, where families still face many challenges: a dearth of clinics that offer family planning services; a short supply of contraceptives; and knowledge gaps, myths and taboos that thwart progress. But, says Tsui, African policymakers have become very committed to family planning: “We’re seeing a lot of movement after Kampala.”