Pressing global health concerns, such as population growth and reproductive health issues, including family planning and safe abortion, demand thorough, rapid assessment and timely, affordable interventions to respond to urgent needs. In developing countries, particularly in sub-Saharan Africa, access to quality reproductive health and family planning services, is limited, especially among the poor and hard-to-reach populations. Proper provider training, patient education and counseling, and reliable service or method provision at the facility and community level are integral to increasing access and contraceptive prevalence.

This study will provide, for the first time in a post war country, the necessary empirical evidence to support investment in family planning and safe abortion as part of a larger strategy to reduce maternal mortality and decrease unwanted fertility. The evidence from the findings will be used for fundraising, empowering communities and supporting the current decentralization process by giving districts evidence-driven recommendations for determining level of spending to achieve reductions in maternal and child mortality, fertility and ultimately slow population growth. Our specific aims in this arena are: (1) to increase awareness and use of modern contraceptive methods; (2) to reduce the number of unwanted pregnancies and abortion-related morbidity and mortality, and; (3) to assess the cost effectiveness. Our intervention will accomplish these aims through three main components: improving distribution of contraceptives in private pharmacies, strengthening facility-based family planning and PAC resources, and extending key facility-based services and education into the least accessible communities using a network of health outreach workers.

To address the low knowledge and use of family planning methods, and to reduce unwanted pregnancy and unmet need for family planning, this project will focus on 3 major domains:(1) Science and technology: we will make the best use of available evidence-based results and technologies to create availability of services and appropriate use of FP and safe abortion technologies for both community and facility levels; (2) Service delivery: we will train, motivate and equip, adequate numbers of providers, health care staff, and community health workers in both public and private sectors; and (3) Demand generation: We will create awareness, motivate, empower and expand the ability to make informed decisions on reproductive health issues, and help participants to adopt healthy behaviors.