Explore the vast range of titles available.

Context Long‐acting reversible contraceptive (LARC) methods are recommended for young women, but access is limited by cost and lack of knowledge among providers and consumers. The Colorado Family Planning Initiative (CFPI) sought to address these barriers by training providers, financing LARC method provision at Title X–funded clinics and increasing patient caseload. Methods Beginning in 2009, 28 Title X–funded agencies in Colorado received private funding to support CFPI. Caseloads and clients’ LARC use were assessed over the following two years. Fertility rates among low‐income women aged 15–24 were compared with expected trends. Abortion rates and births among high‐risk women were tracked, and the numbers of infants receiving services through the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) were examined. Results By 2011, caseloads had increased by 23%, and LARC use among 15–24‐year‐olds had grown from 5% to 19%. Cumulatively, one in 15 young, low‐income women had received a LARC method, up from one in 170 in 2008. Compared with expected fertility rates in 2011, observed rates were 29% lower among low‐income 15–19‐year‐olds and 14% lower among similar 20–24‐year‐olds. In CFPI counties, the proportion of births that were high‐risk declined by 24% between 2009 and 2011; abortion rates fell 34% and 18%, respectively, among women aged 15–19 and 20–24. Statewide, infant enrollment in WIC declined 23% between 2010 and 2013. Conclusions Programs that increase LARC use among young, low‐income women may contribute to declines in fertility rates, abortion rates and births among high‐risk women.

Promotion of family planning in countries with high birth rates has the potential to reduce poverty and hunger and avert 32% of all maternal deaths and nearly 10% of childhood deaths. It would also contribute substantially to women's empowerment, achievement of universal primary schooling, and long-term environmental sustainability. In the past 40 years, family-planning programmes have played a major part in raising the prevalence of contraceptive practice from less than 10% to 60% and reducing fertility in developing countries from six to about three births per woman. However, in half the 75 larger low-income and lower-middle income countries (mainly in Africa), contraceptive practice remains low and fertility, population growth, and unmet need for family planning are high. The cross-cutting contribution to the achievement of the Millennium Development Goals makes greater investment in family planning in these countries compelling. Despite the size of this unfinished agenda, international funding and promotion of family planning has waned in the past decade. A revitalisation of the agenda is urgently needed. Historically, the USA has taken the lead but other governments or agencies are now needed as champions. Based on the sizeable experience of past decades, the key features of effective programmes are clearly established. Most governments of poor countries already have appropriate population and family-planning policies but are receiving too little international encouragement and funding to implement them with vigour. What is currently missing is political willingness to incorporate family planning into the development arena.

Modern family planning plays a vital role in reducing unintended pregnancies, a major reproductive health issue worldwide. Access to modern family planning services is essential for empowering women to have greater control over their reproductive health and rights. In Bangladesh, there remains an unmet need for modern family planning services among reproductive-aged women. Assessing the capacity of health facilities to address these unmet needs for modern family planning is crucial. The objective of this study was to assess the changes in the availability and readiness of health facilities to provide modern family planning services in Bangladesh between 2014 and 2017, and identify factors associated with facility readiness. We performed a secondary analysis of cross-sectional data from Bangladesh Health Facility Surveys (BHFS) conducted in 2014 and 2017. Availability was determined based on whether a facility offered at least one modern family planning method, and facility readiness was measured following the Service Availability and Readiness Assessment (SARA) manual. Descriptive statistics with 95% confidence intervals (CIs) were reported, and Poisson regression models were used to identify factors associated with health facility readiness. The percentage of facilities offering modern family planning services increased significantly from approximately 81% (95% CI: 78, 85) in 2014 to 89% (95% CI: 87, 91) in 2017. The availability of oral pills, injectables, and male condoms increased over this period, while the availability of long-acting reversible contraceptives (LARCs) slightly decreased, and permanent methods (PMs) remained nearly unchanged. The overall mean readiness score of health facilities declined slightly, from about 54 (95% CI: 52, 56) in 2014 to 51 (95% CI: 50, 53) in 2017. Upazila Health Complexes and Maternal and Child Welfare Centers had significantly higher readiness compared to District Hospitals in 2017. Facilities that performed routine quality assurance activities, ensured 24-hour staff coverage, maintained a system for reviewing clients' feedback, and provided family planning services regularly demonstrated significantly higher readiness to provide modern family planning services in both 2014 and 2017. Regional disparities were also observed; facilities in rural areas had significantly lower readiness than those in urban areas, and facilities from the Rangpur division showed significantly higher readiness compared to those in Dhaka in both survey years. The findings indicate a significant increase in the availability of health facilities offering modern family planning services in Bangladesh; however, a slight decline has been observed in their overall mean readiness score. Ensuring an adequate provision of equipment and supplies, expanding access to LARCs and PMs, and improving staff capacity through regular training are essential. Furthermore, strengthening quality assurance activities and investing in rural facilities are required for improving the facility readiness and advancing progress toward achieving SDG 3.7 targets of universal access to modern family planning services in Bangladesh.

Background Poor access and low contraceptive prevalence are common to many Low- and Middle-Income Countries (LMICs). Unmet need for family planning (FP), defined as the proportion of women wishing to limit or postpone child birth, but not using contraception, has been central to reproductive health efforts for decades and still remains relevant for most policy makers and FP programs in LMICs. There is still a lag in contraceptive uptake across regions resulting in high unmet need due to various socioeconomic and cultural factors. In this mixed method scoping review we analyzed quantitative, qualitative and mixed method studies to summarize those factors influencing unmet need among women in LMICs. Methods We conducted our scoping review by employing mixed method approach. We included studies applying quantitative and qualitative methods retrieved from online data bases (PubMed, JSTOR, and Google Scholar). We also reviewed the indexes of journals specific to the field of reproductive health by using a set of keywords related to unmet contraception need, and non-contraception use in LMICs. Results We retrieved 283 articles and retained 34 articles meeting our inclusion criteria. Of these, 26 were quantitative studies and 8 qualitative studies. We found unmet need for FP to range between 20 % and 58 % in most studies. Woman’s age was negatively associated with total unmet need for FP, meaning as women get older the unmet need for FP decreases. The number of children was found to be a positively associated determinant for a woman’s total unmet need. Also, woman’s level of education was negatively associated – as a woman’s education improves, her total unmet need decreases. Frequently reported reasons for non-contraception use were opposition from husband or husbands fear of infidelity, as well as woman’s fear of side effects or other health concerns related to contraceptive methods. Conclusion Factors associated with unmet need for FP and non-contraception use were common across different LMIC settings. This suggests that women in LMICs face similar barriers to FP and that it is still necessary for reproductive health programs to identify FP interventions that more specifically tackle unmet need.

We examined the impact of legislation in Texas that dramatically cut and restricted participation in the state’s family planning program in 2011 using surveys and interviews with leaders at organizations that received family planning funding. Overall, 25% of family planning clinics in Texas closed. In 2011, 71% of organizations widely offered long-acting reversible contraception; in 2012–2013, only 46% did so. Organizations served 54% fewer clients than they had in the previous period. Specialized family planning providers, which were the targets of the legislation, experienced the largest reductions in services, but other agencies were also adversely affected. The Texas experience provides valuable insight into the potential effects that legislation proposed in other states may have on low-income women’s access to family planning services.

Within a decade, women everywhere should have access to quality contraceptive services, argues John Bongaarts.

Evidence on the feasibility, effectiveness, and cost-effectiveness of integrating family planning (FP) and HIV services has grown significantly since the 2004 Glion Call to Action. This systematic review adds to the knowledge base by characterizing the range of models used to integrate FP into HIV care and treatment, and synthesizing the evidence on integration outcomes among women living with HIV. Fourteen studies met our inclusion criteria, eight of which were published after the last systematic review on the topic in 2013. Overall, integration was associated with higher modern method contraceptive prevalence and knowledge, although there was insufficient evidence to evaluate its effects on unintended pregnancy or achieving safe and healthy pregnancy. Evidence for change in unmet need for FP was limited, although two of the three evaluations that measured unmet need suggested possible improvements associated with integrated services. However, improving access to FP services through integration was not always sufficient to increase the use of more effective (noncondom) modern methods among women who wanted to prevent pregnancy. Integration efforts, particularly in contexts where contraceptive use is low, must address community-wide and HIV-specific barriers to using effective FP methods alongside improving access to information, commodities, and services within routine HIV care.

Background Over the past 30 years, Ethiopia has significantly invested in its primary health care (PHC) system, improving access to health services and overall health outcomes. However, gaps persist in delivering comprehensive reproductive, maternal, newborn, and child health (RMNCH) services. Although Ethiopia’s policy framework supports integrated PHC services, RMNCH programs often operate independently, resulting in fragmented care and missed opportunities, especially in rural and pastoral regions with limited access. This study examined current practices in integrated service delivery and the association between integrated service delivery and the adoption of postpartum family planning (PPFP) and immunization services. Methods From July to August 2024, we conducted formative implementation science research utilizing household surveys and facility assessments. A stratified multistage sampling technique recruited 1,922 women with infants ages 0–11 months across agrarian and pastoral regions, along with data from 67 facilities. The study assessed the association between integrated family planning, maternal and newborn health, and immunization service delivery with postpartum family planning and immunization practices in Ethiopia. Data were analyzed using Stata 15.1, employing Pearson’s chi-square test, post-stratification sampling weights, and random-intercept logistic regression models to estimate associations between individual- and community-level variables and the likelihood of adopting PPFP and child vaccination. Results Overall, the availability and integration of essential job aids and services varied considerably by setting, with pastoral areas consistently showing lower coverage across RMNCH touchpoints. Approximately 45% of mothers adopted PPFP, with significant regional variations, particularly lower rates in pastoral areas. About one-third received PPFP counseling during antenatal care contacts, and over three-fourths received immunization counseling during childbirth. Women who received counseling about PPFP during childbirth had 2.6 times higher odds of adoption (AOR: 2.60; 95% CI: 1.61–4.20), while those counseled during both antenatal care (ANC) and childbirth had four times higher odds (AOR: 4.06; 95% CI: 2.49–6.63). Counseling on immunization during or after childbirth increased child vaccination odds threefold (AOR: 3.39; 95% CI: 1.80–6.41), while women who did not receive integrated services during childbirth had 78% lower odds of vaccination (AOR: 0.22; 95% CI: 0.14–0.34). Women in agrarian communities and those receiving postpartum care within six weeks also had higher odds of adopting PPFP and vaccination services. Conclusions The study highlights observed associations between service integration and uptake of maternal and child health services, indicating variation across contexts and the importance of considering these patterns in efforts to improve service delivery.

Differences in religious faith-based viewpoints (controversies) on the sanctity of human life, acceptable behaviour, health-care technologies and health-care services contribute to the widespread variations in health care worldwide. Faith-linked controversies include family planning, child protection (especially child marriage, female genital mutilation, and immunisation), stigma and harm reduction, violence against women, sexual and reproductive health and HIV, gender, end-of-life issues, and faith activities including prayer. Buddhism, Christianity, Hinduism, Islam, Judaism, and traditional beliefs have similarities and differences in their viewpoints. Improved understanding by health-care providers of the heterogeneity of viewpoints, both within and between faiths, and their effect on health care is important for clinical medicine, public-health programmes, and health-care policy. Increased appreciation in faith leaders of the effect of their teachings on health care is also crucial. This Series paper outlines some faith-related controversies, describes how they influence health-care provision and uptake, and identifies opportunities for research and increased interaction between faith leaders and health-care providers to improve health care.