Meeting demand for family planning within a generation: the post-2015 agenda.

Expanding access to family planning has been a key aim of health and development programming for almost 50 years. During that time, important gains have been made in addressing unmet need for family planning, increasing contraceptive prevalence, and preventing unintended pregnancies. Over the past two decades, however, the pace of these gains has slowed, especially in several countries in sub-Saharan Africa and south Asia. Meanwhile, an ever growing body of research shows the wider benefi cial eff ect of family planning on improving maternal and child health and survival, increasing economic wellbeing of individuals, families, communities, and nations, fostering environmental sustainability, and empowering women. The international community and many low-income countries are aiming to accelerate progress in family planning, as made evident by support for FP2020. Simultaneously, the world is refl ecting on achievements and on gaps remaining in the years since the United Nations Conference on Environment and Development of 1992, the International Conference on Population and Development (ICPD) of 1994, and the Millennium Summit of 2000, which established the Millennium Development Goals (MDGs). A post-2015 agenda is emerging that aims to join the streams of Rio+20 sustainable development goals, ICPD Beyond 2014, and the post-MDG development agenda. Consensus is mounting on the vision and benchmarks needed to end preventable child deaths, eliminate preventable maternal deaths, and create an AIDS-free generation. Now is the time to advance a post-2015 agenda that refl ects the importance of family planning as part of what UN Secretary-General Ban Ki-moon describes as the “fundamental sexual and reproductive rights [component of the post-2015 conversation]” already embraced by these three streams. USAID, together with UNFPA, has been working with many other organisations and individuals to defi ne a measure and benchmark for the family planning component of the post-2015 sexual and reproductive health and rights agenda. Measurement of progress in family planning is imperative to drive improvements in policy and programming. It is important to select a measure that refl ects the aim of family planning— to support the rights of individuals and couples to choose whether and when to have a child by providing them the means to implement their decisions—and promotes voluntarism, informed choice, rights, and equity. Endorsed by technical discussions and analyses, our process has led us to this measure, already widely used and accepted by UNPD, FP2020, and the Commission for Information and Accountability for Women’s and Children’s Health, among others: percent demand for family planning met with modern contraceptive methods. Total demand for family planning is currently defi ned as the percent of married or in union women aged 15–49 years who want to delay or limit childbearing, although we intend to revise the defi nition to incorporate all sexually active women of reproductive age as data and projections become available. It is measured by adding the proportion of this population currently using any contraception to those with unmet need, which is defi ned as seeking to stop or delay childbearing but not using contraception. Demand for family planning met with modern contraceptive methods is then defi ned as the proportion who use modern contraception divided by total demand