USAID Strategies for Repositioning Family Planning in Sub-Saharan Africa: their Results and Remaining Challenges

Although the international family planning program at USAID had enjoyed priority attention and funding from its inception in the 1960s until the time of the Cairo Conference in 1994, by 2001, its funding had stagnated at low levels for five years; the Mexico City Policy had been imposed; HIV/AIDS was gaining ascendancy in funding within the Agency; and both fertility levels and modern contraceptive prevalence rates (MCPR) in several sub-Saharan African (SSA) countries were stagnating. Some scholars even suggested that the international family planning movement was at the stage of fragmentation and decline. Consequently, USAID in collaboration with the World Health Organization and other partners began an initiative to reposition family planning in SSA. Within ten years, the initiative had achieved numerous impressive results: the annual funding for family planning at USAID increased by over 50%; MCPR saw unprecedented increases in several SSA countries; increased funding commitments were coming in from host country governments and international donors; and family planning now enjoys greater visibility and is recognized as a key variable for economic development. This paper’s goal is to explain the strategies adopted by USAID to reposition family planning, discuss the key achievements, and highlight the challenges that remain