2020 family planning targets in doubt besides progress

05 January 2018

The 2020 goal of reaching 120 million additional girls and young women with modern contraceptives is likely to be missed, despite millions of new users.

Women waiting in a health clinic

As of July 2017, more than 309 million women and girls in the world’s poorest countries are using a modern form of contraception – 38.8 million more than in 2012.

This rise in contraceptive use was published in December in the annual report from Family Planning 2020 (FP2020) – a global partnership for rights-based family planning. FP2020 aims to get modern contraceptives to 120 million more women and girls in 69 focus countries by 2020.

While the increase in contraceptive use is to be applauded – it falls far short of the 120 million goal that needs to be met in two years time.

The new report, FP2020: The Way Ahead, estimates that between July 2016 and July 2017 alone, the use of modern contraception in these focus countries prevented 84 million unintended pregnancies, 26 million unsafe abortions, and 125,000 maternal deaths.

Modern contraceptives – including condoms, the pill, implants and injectable contraceptives – give women and girls the ability to decide when they want to get pregnant and start a family. This provides them with better opportunities to stay in school and pursue other economic opportunities.

Young women and girls at risk of unintended pregnancies, particularly in sub-Saharan Africa, are also at a higher-risk of HIV infection. As such there is a strong need to integrate these services, linking HIV prevention efforts with access to family planning, so as to prevent both unwanted pregnancies and mother-to-child transmission of HIV.  

Africa accounts for almost half of these new users of contraception. Since 2012, 16 million new women are using modern contraception in the FP2020’s priority African countries.  The rate of contraceptive use is still growing fast in Africa, and has risen from 19.5% in 2012 to 23.4% in 2017. The fastest rate of growth was in Eastern and Southern Africa.

Asia accounts for more than half of the additional users of contraception,  with 21.9 million new users in this region. The report estimates that 38% of all women of reproductive age in Asia are using a modern method of contraception. The rate of contraceptive use is growing slower in this region compared with Africa because modern contraceptive use rates are already higher in Asia.

Injectable contraceptives were the most common methods in use in 28 countries, followed by pills in 16 countries, condoms in nine countries and intrauterine device (IUDs), also known as the coil, in eight countries.  There is a steady increase in the prevalence of implants and injectables.

However progress is still off-track. The goal to reach an additional 120 million women and girls with modern contraceptives will not be met at the current rate of progress. In a comment by the medical journal, the Lancet: “The overall figure hides patchy progress, with east African countries such as Kenya among those with the fastest growth in use of modern contraceptives, whereas progress in west Africa and southeast Asia is much slower. In some of the most populous countries in southeast Asia, such as India, subnational inequity is an important additional factor."

In 2016, donor governments provided US$1.1 million in bilateral funding for family planning. But political shifts in the last year, most notably in the US, bring funding uncertainty for family planning programmes. Despite this, FP2020’s focus is on the issues at stake:

“The family planning community is united, resilient and ready to meet the future.” Says Dr Natalia Kanem, Executive Director of UNFPA. “There may be uncertainties on the horizon, but our community’s dedication to women and girls is stronger than ever.”

Avert CEO, Sarah Hand, commented, “To end AIDS by 2030 we need to see HIV services integrated within wider family planning and reproductive health services. Recognising that women and girls carry the heaviest burden of HIV infection globally, we need to promote choice, and sexual and reproductive health rights of young women and girls in all our collective efforts. “

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