Photo credit: Elwa Designs for FHI 360
In 2021, FHI 360 committed an estimated US$85 million over five years to support the goals of Family Planning 2030 (FP2030), a global movement dedicated to advancing the rights of people everywhere to access reproductive health services safely and on their own terms. As this effort advances, together we must reflect on the question: What is the future of family planning?
In recent years, an increasing emphasis has been placed on self-care as a strategy to promote the sexual and reproductive health of women, men and young people. In the health sector, self-care is defined as, “The ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a healthcare provider” (World Health Organization, 2019). Self-care approaches may improve individual agency, reduce stigma, increase equity and ensure that underserved populations receive essential services, including family planning.
However, we have found that the term “self-care” in the context of family planning can be somewhat confusing. While WHO’s definition recognizes that self-care may involve support from a health care provider, the rationale for investments in this area often emphasizes the need to address shortages in skilled medical providers. Yet the reality is that many family planning methods are provider-dependent, including long-acting reversible contraceptives, which are among the most effective options available. Given this, we believe “blended care” may be a more appropriate and balanced term moving forward.
What does blended care mean for family planning? In our experience, it can take different forms. For example, blended care can occur when an individual:
- Receives a provider-dependent method, such as the hormonal IUD, but then uses self-care strategies to manage contraceptive-induced menstrual changes, such as irregular bleeding.
- Chooses to self-administer an injectable contraception and then seeks support from a provider or community health care worker to initiate use or when questions or concerns arise.
- Takes their child for immunization services and then receives counseling that leads to adoption of a contraceptive involving self-care, such as a fertility awareness-based method.
- Seeks information about family planning on a digital health platform, including identifying a location to obtain services from a trained provider.
Given that individual- and provider-based services are often utilized concurrently (or sequentially) by the same person, it is essential that governments, donors and service delivery groups in the public and private sectors invest in both areas. We must support individuals to take charge of their own health and wellness — and we cannot abdicate our responsibility to strengthen health systems and ensure there are adequately trained providers who have the skills, supplies and motivation required to provide high-quality services.
Indeed, recent evidence from Kenya and Nigeria collected through the Performance Monitoring for Action surveys revealed that while the majority of respondents expressed interest in receiving information related to family planning via mobile phones and social media, they also overwhelmingly felt that it is important to engage with a provider when starting or using potential self-care methods, including oral contraceptive pills, emergency contraception and injectables.
Both individual- and provider-based care are critical to the future of family planning. As such, an explicit commitment to blended care can help ensure that all individuals have reliable access to high-quality products and services that will meet their changing needs and desires throughout their lives.
Check out our booth and events during the International Conference on Family Planning to learn more about FHI 360’s work to advance the future of family planning, and share your thoughts on social media using #FPForward.