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Three Successful Sub-Saharan Africa Family Planning Programs: Lessons for Meeting the MDGs

2011 — An analysis of modern contraceptive prevalence rates (CPR) in recent Demographic and Health Surveys (DHS) shows that three countries have achieved a much more rapid increase in CPR than any other countries in sub-Saharan Africa: Ethiopia, Malawi and Rwanda. The annual increase in CPR of modern methods among married women of reproductive age was 2.3% in Ethiopia (2005–2011), 2.4% in Malawi (2004–2010), and a dramatic 6.9% in Rwanda (2005–2010), according to the DHS reports for the years noted.

Millennium Development Goal 5B calls for universal access to reproductive health, including family planning. These three countries are moving more rapidly toward this goal than any others in sub-Saharan Africa. Such progress is helping these countries move closer to what the development community calls “the demographic dividend,” a concept highlighted in the 2011 International Conference on Family Planning (ICFP) in Dakar that links progress in family planning with larger development goals.

How did these three countries make such great strides in recent years? What are the similarities and differences in how the countries made these strides? What do the data suggest, and perhaps more importantly, what is the story behind the data — what some refer to as the “backstory”? How important are individual leadership, financing systems and country-specific geopolitical and demographic issues? Are the systems in place to sustain that progress? And, what lessons can other countries learn from the Ethiopia, Malawi, and Rwanda experiences?