Conclusion

Box 6.3

Evidence from Egypt on successful FP programming

Family planning (FP) was introduced as part of the national Population Policy for Egypt in 1973 and was later integrated with reproductive and maternal health care to align with the International Conference on Population and Development of 1994, held in Cairo. between 1980 and 2008, the total fertility rate in Egypt declined from 5.6 to 3.0 births per woman, which coincided with an expansion of contraceptive choices and an increase in the contraceptive prevalence rate (CPR) from 23 percent to 60 percent (uSAID 2011). • The national “Gold Star” program, implemented from 1995 to 2000, was successful in improving the quality and usage of family planning services. • In addition to the direct effect on fertility, family planning is credited with contributing to 3.8 million fewer infant deaths and over 7 million fewer child deaths, and for saving 18,000 maternal lives, between 1980 and 2008. • According to a World Health Organization policy brief (WHO 2009), the incentive payment program, implemented under the 1997 health sector reform program, had a positive effect on the performance of FP providers, including the provision of more information about contraceptive methods available. moreover, women who visited

FP clinics and who received incentive payments were more likely to report having participated in the choice of the contraceptive method than those in nonintervention sites. The authors of the policy brief concluded that “providers respond to payment incentives, and, on the whole, they respond in the way policy makers would like.” • Exposure to the mass media campaign “your

Health, your Wealth,” disseminated via television and radio, increased the likelihood of spousal discussions about contraception by 14.4 percentage points and had a large, statistically significant effect on modern contraceptive use of 27.4 percentage points (Hutchinson and meekers 2012). • mass media also played a key part in creating support for the FP program, in which the religious leadership issued specific edicts on the role and limits of family planning, thus creating space for use of family planning by couples interested in managing the timing and number of births (Cortez et al. 2014).

Some successful initiatives, however, have combined individual- and community-based programs. For example, an assessment of the “Safe Age of marriage” program in yemen that focused on delaying marriage among children and adolescents through community engagement concluded that the program successfully decreased young marriage in the targeted community (Freij 2010). In addition, Egypt was once one of the best performers in increasing contraceptive use and reducing fertility (box 6.3).

CONCLUSION

Showcasing global—and domestic—experiences on best practices in family planning programming, this chapter suggests lessons that may be applicable to Egypt. While no “one size” works to reduce fertility rates—over time, by geography, countries differ in their needs and responses—there are clearly different pathways to achieving population goals. This review has outlined some of the main policy areas documented as effective within their individual time and place, that may provide some useful insights for refocusing the Egypt national Population