A focus on the fundamentals of care. Improving family planning and reproductive health care.

Although family planning (FP) has made stunning gains worldwide over the past 40 years the unmet need for FP services has never been greater than it is today and it continues to grow. Nearly 123 million unmarried and married women in developing countries (excluding China) have an unmet need for contraception--along with other sexual and reproductive health concerns (Ross & Winfrey 2002). Women aged 15--24 account for more than one-third of unmet need globally and their numbers are growing. This demographic challenge to sustaining gains in FP use comes at a time when global health priorities are shifting attention and resources away from reproductive health and family planning (RH/FP) weakening already fragile systems and services. As a result health care providers in developing-country clinics and hospitals are expected to provide a wider array of RH and other services to an increased number of clients in service settings that often dont provide the support and resources they need. Not only does this erode their motivation it also compromises their ability to provide high-quality care putting both themselves and their clients at risk. The impact on women is significant. In addition to experiencing compromised clinical safety many dont receive the RH/FP information or services that they want. And despite not wanting to get pregnant large numbers discontinue contraceptive use due to dissatisfaction with the quality of care they receive. This inflates the unmet need for FP services and contributes to unwanted pregnancy abortion and significant costs to the health care system. (excerpt)