Review of policies for free family planning services for clients in West Africa.

This report contains six chapters. Chapter 1 introduces the study and Chapter 2 outlines the study methodology. We follow with Chapter 3 which presents in-depth profiles of three West African countries that have implemented national "free FP" and illustrate the various considerations policy vehicles and experiences: Ghana Mauritania and Niger henceforth referred to as "Core countries." Chapter 4 provides a cross-country comparison of these Core countries including relevant common themes and divergences. This comparison may illuminate considerations for countries in the region that are contemplating providing FP services free of charge to clients. Accordingly Chapter 4 then broadens the regional perspective on free FP by presenting information from three additional West African countries that are on the threshold of providing free FP services: Burkina Faso Cote d’Ivoire and Mali. With these three additional countries HFG presents comparative data for six study countries in Chapter 6. We conclude with Chapter 7 a discussion of study findings and key takeaways for policymakers in West Africa. The main takeaways of the report are: 1. How countries implement free family planning services can differ widely; a more precise definition would allow the global community to better understand countries’ experiences. 2. Free FP efforts require patience and sustainable financing. 3. Socio-cultural factors and geography may inhibit family planning access more than out-of-pocket costs. 4. Stakeholders including policymakers and researchers need better data and more robust study to determine whether and how free family planning can be an effective and cost-efficient strategy to accomplish goals for family planning and other development goals. The study suggests: 1.Proceed cautiously with free family planning until further data and research are available 2. Employ realistic cost estimates of free FP and the funding streams to pay for it 3. Consider free FP as part of a suite of interventions addressing multiple barriers to FP access.