Report: A Fine Balance: Contraceptive Choice in the 21st Century-An Action Agenda

In September 2012, the EngenderHealth-led RESPOND Project, funded by the U.S. Agency for International Development (USAID), convened a diverse group of multidisciplinary experts from 11 countries at the Rockefeller Foundation Bellagio Center to examine the intersection of contraceptive choice and human rights. The object of the consultation (titled "A Fine Balance: Contraceptive Choice in the 21st Century") was to bring together people who often approach the issues of choice and rights from different perspectives, to find common ground on the meaning of contraceptive choice, and develop an action agenda on informed and voluntary contraceptive choice that both the public health and the human rights communities can embrace. The question "How much choice is enough?" was posed, and the group's response was focused through the lens of a particularly sensitive method, voluntary female sterilization. This family planning method was chosen because it is the most widely used worldwide, yet its availability and use vary among and within regions and countries, and it is the method most frequently associated with reported instances of abuse.

The RESPOND Project is pleased to announce publication of a report on this landmark gathering of family planning and rights experts, donors, and national policymakers. Reaffirming that informed and voluntary contraceptive choice is a human right but is still not a reality for women and adolescents in many settings, the participants identified the following imperatives as critical to advancing an agenda of choice and rights in family planning and reproductive health:

1. Contraceptive choice is not about an ideal method mix-it is about committing to meeting all women's needs by offering a full range of voluntary family planning methods, including short- and long-acting and permanent methods.
2. It is necessary to address the entire spectrum of challenges to choice and rights, including barriers to access as well as coercion, both subtle and blatant. 
3. Investments must be made using a holistic programmatic approach to ensure that contraceptive choice and rights are protected at the policy, service delivery, and community levels.
4. Donors and family planning programs must be held accountable for ensuring choice and rights by means of indicators and methodologies for regular monitoring. 
5. Donors, governments, and program managers must shift their focus to make family planning programs client-centered, rather than method-focused.
6. We must bring the human rights and public health communities together on common ground to embrace a common agenda.

The commitment made by 150 world leaders from international agencies, donors, and civil society organizations at the London Summit on Family Planning in July 2012 to increase funding for family planning offers an extraordinary opportunity to carry out the action agenda that emerged from the consultation in Bellagio and transform family planning programs around the world. We need to seize this moment, in which evidence-based, expert guidance and pledges of more money and political will are converging, to ensure that family planning programs respect, protect, and fulfill human rights, safeguard contraceptive choice, and provide individuals with the highest possible quality of care.

To learn more, download Report: A Fine Balance: Contraceptive Choice in the 21st Century-An Action Agenda (PDF, 1.76MB).