CREATING AN ENABLING ENVIRONMENT
CREATING AN ENABLING ENVIRONMENTCREATING AN ENABLING ENVIRONMENT | FP2020 THE WAY AHEAD 2016-2017 /en/fp2020-in-countries/creating-an-enabling-environment
Family planning programs must have political support to operate successfully. Government policies, laws, regulations, and funding priorities can either help or hinder the delivery of family planning services. Often, barriers to accessing family planning services have their roots in obsolete or conflicting policies that will need to be addressed in order to make progress on the country’s FP2020 goals. Development partners have been working with advocates, implementers, and governments on this critical area of work for decades, and these essential efforts continue.
Supportive policies ensure that family planning has a prominent place on the national agenda, that adequate financial resources are allocated, that individual reproductive rights are respected and protected, that clinical guidelines are up-to-date and appropriate. Less formal but no less important is political will: the commitment of individuals in positions of authority to enable and encourage progress on family planning.
CASE STUDY: MAURITANIA
Mauritania is a member of the Ouagadougou Partnership (OP) and, until this year, was the only OP country without a law supporting access to family planning. This made it difficult for the government to deliver on its OP and FP2020 commitments, and created a conflict with the international agreements on reproductive rights that the country has signed.
That changed with the adoption earlier this year of Mauritania’s first-ever reproductive health law, the culmination of a ten-year campaign by reproductive rights advocates. The new law recognizes reproductive health and family planning as universal rights guaranteed under the Mauritanian constitution. It also prohibits all forms of violence against women, including female genital mutilation.
Operationalization of the new law is proceeding apace. In September the Ministry of Health instructed all health facilities, public and private, to offer every woman the full range of contraceptive methods in order to ensure free and informed choice. Postpartum family planning has been added to the government’s regulatory standards, and providers are instructed to offer it beginning with the first prenatal consultation.
CASE STUDY: PAKISTAN
When Pakistan committed to FP2020 at the 2012 London Summit, it had just embarked on a massive overhaul of its federal system. The Ministry of Health had been abolished and responsibility for health policies, financing, and programming devolved to the four provinces— all part of the shift from a centralized state to a system with significant provincial autonomy.
Five years on, the devolution process has matured and stabilized, thanks in large part to positive political will and outstanding cooperation across ministries and provinces. The original FP2020 commitment has been transformed into provincial goals, and each province has taken ownership of its FP2020 strategy. The federal Ministry of Health has been reconstituted as a coordinating body, fostering alignment and synergy across the provinces.
At the 2017 Family Planning Summit, Pakistan presented its renewed FP2020 pledge as a package commitment from the federal government and the four provinces. High-level delegations from each province attended the Summit, and the provincial chief ministers pledged to personally monitor progress on their FP2020 goals.
CASE STUDY: MADAGASCAR
Madagascar inherited a pro-natalist law from the French colonial period that prohibits any promotion of contraception. The law, which dates back to 1920, is an anachronism that conflicts with Madagascar's commitment to strengthen and expand its family planning program. Last year the Malagasy government and its partners drafted replacement legislation that will make access to reproductive health services a universal right. The bill has cleared a number of legislative hurdles but is yet to be passed into law.
In the meantime, Madagascar has continued to move forward with its family planning program. In September the country celebrated National Family Planning Week, a multi-day exploration of the national family planning program and policies. The week culminated in the launch of Madagascar's first-ever costed implementation plan for family planning. The Plan d’action national budgétisé en planification familiale à Madagascar 2016-2020 is a five-year roadmap designed to improve voluntary access to and use of modern contraception by women and girls who wish to control if, when, and how often they become pregnant. The launch represents a victory for Madagascar’s Ministry of Health and a commitment to action on behalf of the Malagasy government.