October 14, 2015

Let’s Not Lose the Trees for the Forest: A Conversation about the SDGs and Family Planning

Written by Amanda Puckett BenDor and Roy Jacobstein, IntraHealth International

Last month, the United Nations launched the 15-year Sustainable Development Goals (SDGs). Building off of the Millennium Development Goals (MDGs), the SDGs aim to make the planet a better place by outlining an agenda of 17 wide-ranging, aspirational goals. Health, climate change, and peace are bedfellows among these global goals.

We think it is important to step back to look at the whole picture of the SDGs, but to not lose sight of the trees for the forest.

Family planning contributes to the advancement of all the SDGs.

For instance, the most important health interventions—the trees, so to speak, of infectious diseases, reproductive health and family planning, HIV, child survival, noncommunicable diseases, and aging—are crowded into the forest of one health-related goal: Ensure healthy lives and promote well-being for all at all ages. (Not to mention the even larger forest of the SDGs writ large).  

Family planning is one “tree” that contributes to the advancement of all the SDGs—just as it did to all eight of the MDGs.

Greater access to voluntary family planning is leading to greater modern contraceptive use in low-income countries, even approaching levels enjoyed by higher-income countries. We are seeing this in East African countries such as Kenya, Ethiopia, Rwanda, and Malawi, and in the countries of Southern Africa. Even some West African countries are beginning to take off: in Senegal, use of modern methods increased 4% each of the past two years—one of the sharpest increases achieved anywhere.

With a lot of commitment and hard work by governments, donors, and civil society, these increases will continue to reap not only health benefits, but demographic dividends to the benefit of education, housing, poverty reduction, and less pressure on the environment, to name some wider benefits from reducing unwanted fertility.

Now that the SDGs have been launched, it is time to focus our collective attention on the specific indicators that will allow us to track our progress toward the respective goals.

For us, the indicators are the concrete pathways to progress as we make our way through the forest. If they’re not clear, we’ll lose our way. And we need the accountability they instill, because we know that what gets measured gets done.

Or perhaps even more accurate: What doesn’t get measured doesn’t get done.

The Missing Family Planning Indicator

The two MDG indicators for family planning—modern contraceptive prevalence rate (MCPR) and unmet need—were, and remain, excellent. Measuring them enabled countries to mark their progress in meeting the family planning needs of the women and men they served.

The concept of unmet need has also been particularly useful in galvanizing support from donors and program leaders, as was reflected in the notable achievements of the 2012 London Summit and FP2020.

Shouldn’t we consider including a third indicator to track progress in family planning under the SDGs?

However, those two indicators don’t tell the whole story. A third indicator—the percent of family planning demand satisfied by modern contraception—enables countries to get a fuller sense of their very real achievements. Shouldn’t we consider, as Ellen Starbird of USAID and her colleagues have proposed, including this indicator to track program progress in family planning under the SDGs?

To take a country example, let’s look at Tanzania. From 1996 to 2010, Tanzania achieved an increase in MCPR of 14 percentage points (from 13% to 27%), yet unmet need only fell from 29% to 25%. So it seemed to program leaders that progress was pretty slow, despite increased prioritization and resource allocation for family planning.

When they considered the added indicator of percent of demand satisfied, however, they were reassured: In 1996 only a third of the populace’s demand for family planning was satisfied, and by 2010, over half of family planning demand (from a larger populace) was being satisfied.   

Looking Back to Look Ahead

We’re optimists at IntraHealth. Many of our colleagues agree that family planning will remain a priority for the SDGs—and will be a major factor in achieving more than goal 3, just as the global community made great inroads in prioritizing—and  providing—family planning during the MDG reign and moved the needle toward greater MCPR in almost all countries.

At the International Conference on Family Planning in Indonesia in November, we will continue this discussion. Along with colleagues from the US Agency for International Development, Johns Hopkins University, and the U.S. Census Bureau, we will be presenting a panel, “There’s More to Success than Meeting Unmet Need,” to highlight the thinking, evidence, and trends related to this call for an additional family planning indicator for the SDGs.

IntraHealth will also be presenting on innovative mHealth activities in Kenya and contraceptive security work in Senegal, and leading discussions at the K4Health Knowledge Exchange Event ahead of the conference on November 8.

We invite you to join us!

This post originally appeared on the Knowledge for Health Blog.