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Pulling it all together and moving past ‘increasing access’ » Family Planning

Pulling it all together and moving past ‘increasing access’

November 21st, 2008 by maggie chen Leave a reply »

If my math is right, this is our seventh round of blog posts. In this post, I’m going to try to pull together what I’ve been writing about, and look at how to move forward from here.

My intent in this blog was to address the status of family planning on an international level by examining the different ways in which organizations are working to connect women who desire contraception with the actual methods and supplies needed to successfully contracept. I also wanted to look deeper into longer term birth control methods. After covering Implanon and IUDs, I came to a bit of a wall. To my knowledge, there aren’t any other long-acting reversible methods. I’ve heard it quoted that out of all pharmaceuticals, we spend the most money each year on reproductive research (not sure if this is actually true in the numbers). However, it appears as though further development of long-acting, reversible contraception is not a high priority right now. Some work is being done, though. A year ago, I helped out with a study of a method-in-development that will be similar to the NuvaRing, but lasts for a year. NuvaRing is one per month, but this new vaginal ring can be used for 12 months. The dosing schedule is the same, 3 weeks in and 1 week out, but the new ring is saved during the week out and re-inserted at the start of the new cycle as opposed to being thrown away. The main pros are less hormonal waste in landfills and fewer pharmacy trips.

This is all to say that I’m surprised it only took two blog entries to cover the range of long-acting, reversible methods. In terms of initiatives to connect women with contraception, I tried to provide snapshots into actual initiatives and provide a rationale for the importance of family planning.

In my earlier posts, I wrote repeatedly about “increasing access.” For awhile, I have believed that increasing access to family planning is the first step in assisting women who do not want a baby right now or at all in the future. Lately, I’ve been questioning whether access is the most appropriate way to approach the issue. Today in a meeting for my thesis, one of the researchers I’m working with threw out her opinion on increasing access. She said, “Access doesn’t seem to change the numbers of women who are actually using birth control.” This is only the opinion of one person, but perhaps access should not be viewed as the cure-all for increasing family planning use.

The question that follows is, Then what should we focus on? A guiding theme throughout this class has been the importance of involving women in interventions or movements that target them. This is important to the acceptability, initial success, and sustainability of the intervention. If ‘increased access,’ which is itself a vague term, is not the answer to enabling women to control their fertility, then we should start back at what women want. Research on contraception for women in developing countries and rural areas should focus on those women’s voices (this could be called a needs assessment). Key questions that need to be addressed are: How is family planning traditionally viewed and performed in their community? What are their opinions on different forms of birth control? If a woman does not want a baby right now, what is her preferred way of preventing pregnancy?

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2 comments

  1. lfinzer@stanford.edu says:

    Fascinating post! Did she refer to research to back up that statement? I think the key questions you raise in the last paragraph are important and good starting places for any intervention, but I’d also question whether her statement was based in data or personal opinion and whether it holds true for all communities.

  2. anonymous says:

    asdf

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