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As the final plenary session ended in Uganda last week, I felt a sense of excitement. Exhaustion, yes, but also this urge to stand up and shout…let’s do something, anything, to make the dream of ready access to family planning services world over a reality… What a privilege to spend a few days with the best minds and nearly 1300 like minded souls thinking and talking and learning about family planning. I and others commented on a real sense of feeling a mission, feeling what sociologist Emile Durkheim dubbed “collective effervescence,” that special, exuberant energy of a group with a strong common belief.
The International Family Planning Conference focused on sharing research and best practices in family planning, as well as highlighting how to bring research findings and those practices to action. The meeting was supported by the new Bill and Melinda Gates Institute at the Johns Hopkins’ School of Public Health, Makerere University’s School of Public Health, the Implementing Best Practices Initiative and USAID, along with other international and national partners.
The most-quoted citation of the conference must have been that of Dr. Khama Rogo, World Bank health sector specialist (and IntraHealth board member). To paraphrase Khama, “family planning is to maternal health what immunization is to child health.” Family planning seems to become even more powerful when classified as a preventive health intervention—preventing maternal deaths, unwanted pregnancy (and abortion), closely spaced births, low birth weight, and other risks to newborn and child health, transmission of disease, including HIV—and even preventing, or reducing significantly, CO2 emissions.
Another old, but somehow new, idea was the importance of strengthening health care delivery systems. Advocacy, community mobilization and demand generation for family planning are critical, but mean nothing if there is not a strong, effective system that meets unmet need and honors the promise to offer high-quality services. Unless we invest in health system strengthening, family planning services cannot be integrated at the facility or individual client level, and sustainable results are just not possible. And the basis of the health system must be the frontline health care providers. Too often, when things don’t work, the providers are deemed to be at fault, but don’t always get the credit when the results are good.
I also realized during the meeting that Rwanda, where I have been fortunate to work for nearly five years, has been remarkable, not only in terms of growth in family planning use, but also in leadership, advocacy, innovations in service delivery and partner collaboration. In Rwanda, the use of modern contraception increased from 10% to 27% in less than three years, through early 2008. Partners, including USAID, UNFPA, GTZ and others, have worked together to support the government’s a national program, through which all of the country’s districts use the same training modules, educational materials and messages. The Rwandan delegation realized that now is not the time for pats on the back. To become a real model in terms of family planning, Rwanda needs to continue to invest in a real national program at all levels.
A favorite moment for me and other participants came during the final “thank you” from a young Ugandan wife and husband selected to provide testimony to the benefits of family planning, a young (she’s 24, he’s 34) couple who started using family planning recently after having six children.
“We want to educate our children, to give them everything. We do not want them to be standing up and speaking as a ‘case study’ at some future conference,” said the husband.
The family planning world will continue to need case studies; let’s hope that they are real success stories, and that throughout the world, family planning use becomes the norm instead of the exception. And let’s hope that the collective effervescence for family planning continues to bubble over.
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