Fragile, Threatened, and Still Urgently Needed: Family Planning Programs in Sub‐Saharan Africa

Many family planning (FP) programs in sub-Saharan Africa are fragile; recent performance has fallen off and future performance is challenged. Yet robust and wellfunctioning FP programs are still urgently needed if countries are to meet their health, equity, poverty-alleviation, and economic development goals. In support of these observations, we present data on FP parameters in subSaharan Africa overall and in eight of its countries, including Nigeria, the most populous African country; Kenya, a long-time leader in FP in the region; and Uganda, with fertility among the highest in Africa and a population projected to more than triple in the next 40 years to become sub-Saharan Africa’s fourth-most-populous country. We also draw upon findings of individual case studies of the contraceptive programs of Ghana (Solo et al. 2005c), Malawi (Solo et al. 2005a), Senegal (Wickstrom et al. 2006), Tanzania (Pile and Simbakalia 2006), and Zambia (Solo et al. 2005b), as well as a synthesis of some of these case studies (ACQUIRE Project 2005). 1 All eight of these countries, which together comprise 40 percent of the population of sub-Saharan Africa, are facing the same difficult dynamics in terms of threat and need.