The Role of the Private Sector in Family Planning

Originally posted at shopsproject.org

This week, world attention will be drawn to the International Conference on Family Planning in Addis Ababa. To set the stage, I’d like to share some thoughts on one area that deserves more attention in family planning: the role of the private sector. Both the public and private sectors have critical roles to play, but the private sector, and in particular the for-profit private sector, is often forgotten when family planning programs are discussed. For us to improve family planning outcomes, it is critical to bring them into the fold.

When we talk about the private sector, I’m referring to a wide range of providers who are at the front lines of providing health care to millions in the developing world. They range from traditional practitioners to nurses, midwives and doctors in solo or group practices to chemists and pharmacists. Recent data show that in sub-Saharan Africa and Asia, close to 40 percent of women rely on the private sector as their source for family planning. We need to make sure that when those women go to private providers, they are able to access correct information that helps them to select the best method for them, a wide range of methods to choose from, and the best quality of care possible.

One way to ensure this is by making sure that private providers have training opportunities similar to those that their public sector colleagues receive. In Nigeria, where about 60 percent of women obtain their family planning in the private sector, we focus on training nurses, midwives, and doctors. They are trained in family planning counseling skills, clinical skills in long-acting reversible contraceptives, and infection prevention and control to ensure client and provider safety. This is critical, especially in a country where a woman on average would have between five and six children over her lifetime and unmet need is a significant problem. There is a particular need for spacing of children, for which long-acting reversible contraceptives can be a good option. 

In Bangladesh, the number of women seeking deliveries from private facilities has increased four-fold between 2001 and 2010, yet when a woman comes into a hospital for a prenatal visit, to deliver her baby, or for an immunization for her child, doctors and nurses were not taking advantage of the opportunity to counsel and provide family planning. We are working with these facilities to integrate family planning into the other services they provide. We’ve trained doctors and nurses at 35 private hospitals in long-acting and permanent method clinical skills, counseling, and infection prevention. We developed materials for private health care facilities to promote and market long-acting and permanent methods as a new service integrated into existing offerings. In short, we worked to ensure that when a woman visits a facility for a prenatal visit or to get her child immunized, her doctor talks to her about family planning before and after delivery.

I look forward to sharing our work at the conference, and seeing friends and colleagues. More importantly, I’m looking forward to learning new techniques and tools that can make our programs even more effective. This is a wonderful opportunity for the international community to learn from one another and advance the field to ensure that all women have increased access and choice.

See what the SHOPS project will present at the International Conference on Family Planning.

Pictured above: A contraceptive technology update training session in Nigeria, in which private providers observe the insertion of an IUD on an anatomical model.