When a young woman walks into a clinic seeking family planning, she deserves more than a promise, she deserves readiness.
Recently published research from urban east-central Uganda reveals a concerning gap between access and actual readiness of health facilities to deliver voluntary, rights-based family planning. While nearly all facilities claim to offer family planning services, many lack the basic infrastructure, supplies, and trained personnel to fully meet clients’ needs especially for long-acting and permanent methods.
Published in Reproductive Health by Jacquellyn Nambi Ssanyu, Rornald Muhumuza Kananura, Leif Eriksson, Peter Waiswa, Mats Målqvist, Joan Nakayaga Kalyango , the study unpacked the readiness realities in Jinja City and Iganga Municipality, two rapidly urbanizing regions under demographic pressure. Drawing on data from 152 health facilities and 261 health workers, the researchers used WHO’s Service Availability and Readiness Assessment (SARA) and Situation Analysis methodology to paint a detailed picture of readiness, biases, and service equity.
Key Findings
- 94% of facilities offered family planning but the average readiness score was just 46.7%, signaling critical gaps in quality and preparedness.
- While short-acting methods were widely available (99%), access to long-acting reversible contraceptives (34%) and permanent methods (9%) remained limited due to stockouts, low staff confidence, and training gaps especially in private-for-profit facilities.
- Alarmingly, 98% of providers imposed at least one access restriction often based on age, marital status, parity, or spousal consent with private-not-for-profit (PNFP) facilities showing the highest levels of bias.
- Readiness improved with external supervision, administrative meetings, and reduced provider-imposed barriers highlighting clear levers for policy and program change.
To realize the promise of universal access to family planning under SDG 3.7, the researchers recommend the need to strengthen governance of services across both public and private sectors, implement comprehensive training for health workers in both sectors, and align policies to ensure equitable access to a full range of services for all clients.
To read more about the study: https://bit.ly/4l5EnLb