All family planning programs must be grounded in human rights, with an emphasis on voluntarism, informed choice, quality of care, and respect for women’s dignity and privacy.
The International Center for Research on Women (ICRW) carried out a landmark study on the quality of family planning in the state of Bihar, India, in 2014-15.The results demonstrated several gaps in the delivery of sterilization and IUD services in the public health system as well as the private sector. Together with the tragic deaths of 16 women at a sterilization camp in Chhattisgarh state in November 2014, the findings are a critical reminder of the need to situate family planning programs squarely within a women’s rights and empowerment perspective.
One avenue of improvement is through CARE’s Integrated Family Health Initiative (IFHI), a five-year project to transform reproductive, maternal, and infant health outcomes in Bihar. A key focus is on raising the quality of family planning services. With funding from the Bill & Melinda Gates Foundation, CARE and its partners are implementing a comprehensive program in training, quality assurance (QA), and clinical monitoring and coaching. The intervention includes clinical skills training in female sterilization and no-scalpel vasectomies; training in integrated family planning counseling for short- and long-acting contraceptive methods; and whole-site training on infection prevention. This is complemented with follow-up visits and clinical coaching to ensure that providers and facilities are equipped to deliver high-quality service.