"Ethiopia: An Emerging Family Planning Success Story" by David J. Olson and Andrew Piller
NEW YORK (10 December 2013) — A family planning success story is underway in Ethiopia, marked by substantial increases in contraceptive use and declines in the total fertility rate. This study examines key elements of success—ranging from political will, generous donor support, and non-governmental and public-private partnerships, to the government's establishment of a cadre of health extension workers—and evaluates how these efforts have expanded access and willingness to use family planning methods.
With a population of 87 million in 2010, Ethiopia is the second most populous country in Africa and the fourteenth largest in the world. If current trends hold, it will become the world’s tenth most populous country by 2050, with a population reaching 167 million. The Ethiopian government is determined to change these trends, setting an ambitious contraceptive prevalence rate target of 66 percent by 2015.
Evidence was gathered from interviews with current and former leaders of NGOs working on family planning in Ethiopia; articles and surveys; websites of governmental agencies and NGOs; and the authors’ firsthand experiences in Ethiopia.
The researchers detail lessons learned in Ethiopia that are likely to be relevant to other African countries interested in emulating this success, including:
- Ensuring political commitment to family planning at every level
- Positioning population and family planning, as Ethiopia did, at the center of the development agenda in a way that promotes integrated development
- Establishing the presence of a large and active social marketing program that contributes substantially to increasing the contraceptive prevalence rate
The researchers note that Ethiopia has made progress in integrating its response to HIV and AIDS with family planning, although public-private partnerships should be strengthened to improve the delivery of these services, even if funding levels decrease. Additionally, more efforts must be made to diversify the modern contraceptive method mix to satisfy the high unmet need.
At the 2012 London Family Planning Summit, the Ethiopian government pledged to uphold the rights of all Ethiopians to access voluntary family planning through a strong network of primary health care providers, with special attention to serving religious communities and adolescent girls and to providing youth-friendly services. The Ministry of Health is targeting regions that have high unmet need. The effectiveness of these efforts in the most challenging regions, which are overwhelmingly rural, will help determine future contraceptive prevalence rates.
Civil society and the private sector will be key partners in this undertaking. The next five years will reveal the extent to which the government and its partners can maintain the impressive momentum that has been built up in Ethiopia over the past two decades.
This article is available free of charge for a limited time at http://onlinelibrary.wiley.com/doi/10.1111/j.1728-4465.2013.00369.x/abstract
"The Efficacy of Interventions to Reduce Adolescent Childbearing in Low- and Middle-income Countries: A Systematic Review," by Kate McQueston, Rachel Silverman, and Amanda Glassman
More than 85 percent of the world’s young people live in developing countries, and nearly half of the global population is younger than age 25. Adolescent girls are a major demographic group in low- and middle-income settings, and significant resources are required to meet their reproductive health needs. This article provides the first systematic review of interventions designed to reduce adolescent childbearing in low- and middle-income countries. The authors review the scope and quality of the literature, describe the results of evaluation efforts to date, highlight best practices, and offer policy recommendations.
Evidence indicates that a variety of interventions may be able to reduce fertility, including school-based programs, health counseling, and cash transfers. The researchers conclude that funding for these initiatives should be directed toward programs for which sound evidence exists, such as cash transfers and other interventions that encourage school enrollment, and that programs of unknown effectiveness should be conducted in tandem with rigorous evaluation.
The literature on interventions to reduce adolescent childbearing has several significant gaps. The authors recommend that future research should focus on:
- Continuing impact evaluations for existing programs
- Including extensive details about programmatic costs
- Evaluating the impact of policy interventions on childbearing
This article is available free of charge for a limited time at http://onlinelibrary.wiley.com/doi/10.1111/j.1728-4465.2013.00365.x/abstract
Studies in Family Planning is a quarterly, peer-reviewed journal concerned with all aspects of reproductive health, fertility regulation, and family planning programs, and their relation to health and development in both developing and developed countries. SFP is published quarterly on behalf of the Population Council by Wiley-Blackwell.
The Population Council conducts biomedical, social science, and public health research. We deliver solutions that lead to more effective policies, programs, and technologies that improve lives around the world.
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