Existence of national laws, regulations, or policies that limit access to effective family planning services for unmarried and/or young people

 

The existence of national laws, regulations, or policies that limit access to effective family planning (FP) services for specific populations (e.g. single women, women without children, youth, etc.) as a result of gender inequitable stereotypes and/or cultural norms. The existence of the national laws, regulations, or policies must be verified.  Effective FP services refers to distribution of modern FP methods (e.g., condoms, pills, implants, etc.), accurate and informative counseling, and referrals.  Young people, as defined by the WHO, comprises those age 10-24 years.


Text of formal law or policy; evidence of official acceptance of law, regulation, or policy; reports of dissemination and implementation of law, regulation or policy


Public laws and official government documents; newspaper articles, government communiques or other public expressions; interviews with government officials; interviews with FP program managers and/or providers; health institutions' policies and regulations


This output indicator is an assessment of the legal/regulatory environment that restricts users, and as such, is a measure of the degree to which national policy supports or hinders universal access to FP, fertility decline, and the rights of unmarried and/or young people to reproductive choice and information.  It serves as a valuable baseline for the evaluation of national FP policy development and support.  A more restrictive policy environment is correlated with decreased service utilization and contraceptive use.  It influences service delivery with respect to access, quality, and FP image, and may have indirect effects on overall FP demand.


This is a qualitative (yes/no) indicator. It does not describe the law/regulation/policy that exists, nor does it indicate the extent to which effective provision of FP services is limited, how it is limited, or whether providers/pharmacies follow the regulation. Because this indicator only verifies legal statutes and not actual provider practices and biases, it alone cannot determine the full extent to access barriers for unmarried and/or young people. Furthermore, it does not indicate the number of national regulations that exist, nor if they exist solely in the private versus public sector. Finally, without knowing about the dissemination or implementation of the regulations that may exist, it is difficult to appreciate their impact on the population and on the use of contraception.


commodity, family planning, access, adolescent, policy

 

In many cultures, traditional gender roles hold double standards for males and females, dictating that sex is seen as a place for men – and is often accepted as a way for young men to prove their masculinity – but is considered immoral or shameful for young women, particularly outside of marriage (Marin, 2003).  When this moral judgment becomes institutionalized into law, restrictive access to effective FP services further stigmatizes unmarried, sexually active women and can have serious negative health consequences with regard to early pregnancy, unwanted pregnancy, and sexually transmitted infections.


 

Bertrand JT, Magnani RJ, Rutenberg. Handbook of indicators for family planning program evaluation 1994. The Evaluation Project. USAID Contract Number: DPE-3060-C-00-1054-00. Accessed at: https://www.measureevaluation.org/resources/publications/ms-94-01

Marin, B. 2003.  “HIV Prevention in the Hispanic Community: Sex, Culture, and Empowerment.” Journal of Transcultural Nursing 14:3, 186-192.

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