A review of family planning policies and services in WHO Eastern Mediterranean Region Member States

Background: Family planning (FP) is a cost-effective public health and development intervention. Eastern Mediterranean Region (EMR), has one of the lowest contraceptive prevalence rate (CPR) and high unmet need for family planning. Aims: The aim of this review is to assist Member States in highlighting those areas that need strengthening to improve quality of FP services in information and commodity supplies. Methods: A structured questionnaire focusing on FP services was sent to 22 Member States of the WHO Eastern Mediterranean Region between August and December, 2015. Sixteen (73%) countries responded. Results: Family planning services are part of the basic health benefits package and are delivered at hospitals, primary healthcare centres and outreach clinics to all women regardless of their ability to pay in the majority of Member States. In 16 Member States the family planning/birth spacing (FP/BS) counselling and FP methods are provided by general practitioner/family doctor, nurses and midwives. In many Member States the services are integrated with child health, STI and HIV services. In 16 Member States FP/BS is part of the pre- and in-service training programmes for all cadres of healthcare providers. FP/BS is actively promoted through effective social marketing of FP/BS methods in two thirds of Member States. Conclusions: The findings of the survey indicate that national policies and programmes endorse FP to achieve national targets. Despite progress in many areas in FP services, many countries still struggle with weak implementation of FP programmes. There are also policy gaps for key vulnerable groups including the poor, the disabled and adolescents. This review highlighted policy and programmatic gaps required to strengthen those FP services that can help improve maternal and infant health outcomes. Special programmes for adolescents, refugees and persons with disabilities need to be streamlined and strengthened.