Unmet Family Planning Need Globally: A Clarion Call for Sharpening Current Research Frame Works.

Introduction Contraceptive use was a contentious issue during the course of the 19th century with it being illegal to provide contraception information in the US well into the 20th century. In a rapid about-face, the period that followed was marked by the introduction of several birth control methods as well as a feverish stage of contraceptive research and development. The impetus for the innovations in birth control technology was provided by Margaret Sanger, whose activism paved the way for the landmark 1965 Supreme Court case Griswold v. Connecticut which overturned the ban on contraceptives for married couples. In the 1900s, the family planning movement took hold in the US, during a period of intense concern over the socio-economic consequences of overpopulation, poverty, and insecurity, as foretold by Malthus more than two centuries ago. As early as the second decade of the twentieth century, organizations, such as the International Labor Organizations had declared “Poverty anywhere is poverty everywhere”. Partly as a measured defense against security concerns, Dr Reimert Ravenholt, the first director of the Office of Population at the US Agency for International Development (USAID), and Global family planning assistance program spearheaded a massive international family planning program primarily to contain poverty. He oversaw the disbursement of nearly 1.4 billion dollars for family planning programs worldwide during his 14 years at the office, 1965–1979. According to the United Nations Population Fund (UNFPA), the largest bilateral donor of family planning assistance in 2018 was the United States, followed by the United Kingdom and Sweden. Nearly six decades since the entry of the family planning program on the world stage, the original mission of provision of suitable contraception for all women of reproductive age has not yet been realized. Furthermore, the family planning program vision as stated in SDG 3.7.1 was to guarantee all women currently aged 15 to 45 universal access to family planning information and education and sexual and reproductive health-care services under the national development strategies and programs. These targets are far from being met resulting in high levels of unmet need among women in reproductive age groups in developing countries. According to new estimates for the year 2019, sexual and reproductive health services in lowand middle-income countries (LMICs) are inadequate to meet the needs of their populations. The estimates for lowand middle-income countries indicate that approximately 218 million women of reproductive age (between 15 and 49 years old) have an unmet need for modern contraception. Furthermore, about 49% of pregnancies in LMICs, which amounts to 111 million annually, are unintended. In West & Central Africa, low coverage coexists alongside high unmet family planning. Family planning programs in LMICs, such as India, have responded to high levels of unmet need through an array of measures, such as improving the variety and mix of contraceptive methods; enhancing the availability, accessibility, and