Scaling up family planning approaches

Family planning allows people to have control over their own lives and future. But what happens when services are too far away, too expensive, or too confusing to navigate?

Often, people who want to prevent or space out pregnancies face serious hurdles; whether it is a clinic that is too far, a lack of trained providers or misinformation surrounding certain interventions or contraceptive methods. This is why public health experts, governments and communities have been working together on innovative approaches for how family planning is delivered.

Through the WHO Family Planning Accelerator Plus initiative, a number of groundbreaking, evidence-based solutions are being scaled up to make family planning more accessible and equitable. These include:

• Task-sharing: This work expands the frontline of contraceptive provision by empowering a wider range of health workers beyond specialist doctors. This decentralized team, which includes community health workers, auxiliary nurses, midwives, and non-specialist doctors, can now provide information and counselling, as well as administer a wide range of contraceptive methods, using streamlined guidelines.
• Post-pregnancy family planning: This work relies on providing family planning counselling and services to women immediately or in the first year after giving birth or after a miscarriage or abortion. This is a crucial moment: some women may want to delay or avoid another pregnancy, but they may not have a chance to return to the clinic for another consultation.
• Social and behaviour change interventions: Developed to support policy-makers and programme managers improve contraceptive and family planning outcomes using interventions that address individual, interpersonal, social and environmental factors influencing health behaviours. These efforts include media campaigns, community events, and the involvement of peer educators and local leaders to address fears about side effects, challenge myths and misinformation and shift harmful gender norms.

Here's how each approach is making a difference and why each matters.

Task-sharing: Expanding the frontline of care

In the past, only specialist doctors could offer certain types of contraceptive care. But in many rural or remote communities, these health professionals are few and are often located far away. This created significant barriers - long wait times, difficult travel, or a complete lack of access for services that other trained health workers could safely provide.

The task-sharing approach delegates specific, evidence-based clinical tasks to a wider range of health workers, including non specialist doctors, midwives, auxiliary nurses and community health workers.

A 2021 assessment across four countries showed clear progress following the introduction of task sharing for family planning. In Burkina Faso, the use of injectable contraception more than tripled within six months of a nationwide rollout. In Ethiopia, contraceptive use doubled while unmet need declined. Meanwhile, in Ghana and Nigeria, women increasingly chose long-acting reversible contraception methods. Together, these results demonstrate that task-sharing is a powerful strategy for transforming access to care.

Post-pregnancy family planning: Seizing a critical window of care

The period right after childbirth or miscarriage is an important, yet often missed, opportunity to talk about family planning. It can be that some women want to wait before having another child, but if they leave the hospital without support, evidence shows they may not return until they are pregnant again.

Post-pregnancy family planning solves this problem by integrating contraceptive counselling and services directly into antenatal, delivery and postnatal care. In Kenya, for example, new mothers now receive family planning information during checkups and have the option to choose a method of contraception before leaving the maternity ward.

The guide shows that integrating post-pregnancy family planning into maternal and newborn health services leads to clear improvements in contraceptive use and access.

In Ethiopia, the integration of post-abortion family planning expanded access to long-acting reversible contraception. This highlights the effectiveness of integrated service delivery in improving access to and uptake of contraception after pregnancy.

This not only helps individuals and families make healthier decisions; it also eases pressure on health systems and supports long-term economic development.

Social and behaviour change: Addressing myths and misconceptions

Access to services is only part of the equation. In many places, family planning is still surrounded by fear, misunderstanding and stigma. Some people worry about side effects, others believe myths, and sometimes women share that they cannot make decisions without their partner's approval.

Social and behaviour change (SBC) interventions are designed to address these issues. Through radio spots, local theatre, mobile messaging, community meetings and training of trusted influencers, from faith leaders to youth champions, these efforts aim to start conversations, build trust and provide accurate information.

In both Uganda and Kenya, SBC approaches have supported efforts to increase access to and use of family planning services. In Uganda, community-based initiatives such as social accountability dialogues and family planning voucher programmes improved service quality and uptake among women, including those living with HIV. In Kenya, interventions such as the Tupange Project and community dialogue initiatives under the Family Planning Results Initiative contributed to greater community engagement and the integration of family planning into health systems, helping to shift social norms and encourage open discussion about contraception.

A smarter way to scale up

These three approaches cannot happen in isolation. They are part of a larger effort to identify what works, spot bottlenecks and replicate success.

Through a method called "bottleneck analysis", countries are taking a systematic approach: reviewing national data, conducting interviews with frontline workers and communities and facilitating workshops to identify the root causes holding progress back. Then, they work together to find practical solutions - whether it is revising outdated policies, training more staff, improving supply chains or coordinating better across sectors.

The results speak for themselves: a measurable expansion of services in hard-to-reach places, more women and men accessing the care they need and more people equipped with the knowledge to make informed choices.

When people are empowered to choose if and when to have children, families thrive, children are healthier, communities are stronger and countries grow more resilient. This is the basis of a healthier, more prosperous future.