Working Paper

Expanding the Role of Research Evidence in Family Planning Policy, Program, and Practice Decision-making

Family planning’s global resurgence over the past decade has increased attention on implementing policies and programs that are based on scientific evidence. The FP2020 initiative, which challenges countries and donors to expand access to voluntary family planning to an additional 120 million contraceptive users by 2020, has been particularly instrumental in promoting evidence-based family planning programming and policymaking. A focus on evidence-based decision-making in family planning policies, programs and practices is increasingly important as global development resources shrink. Ensuring that family planning policies, programs and practices are evidence-based requires the generation of evidence about what interventions work and how they can work better, and getting the evidence to be used by decision-makers.

The international family planning field was founded on research, including through demonstration projects, national surveys, and decades of operations research (OR) and now implementation science, in addition to special studies. Furthermore, attention to getting evidence into action, or research utilization, also spans decades in family planning (Freedman and Berelson 1976; Foreit and Frejka 1998; Seidman and Horn 1991; Simmons et al. 2002; WHO 2006). Current initiatives such as Family Planning High Impact Practices (FP HIP), the Implementing Best Practices (IBP) Initiative, K4Health and FP2020 all focus on promoting evidence-based family planning programming. With this rich history, there is surprisingly scant research on whether and how evidence is used in decision-making for family planning programming, policies, and practices, despite a growing literature on research utilization, also known as knowledge translation among other names, in global health (McKibbon et al. 2010; Moat and David 2012; Damschroder et al. 2009).

This paper focuses on the emerging knowledge translation literature to provide lessons learned on ways to increase the role that evidence plays in decision-making for family planning and reproductive health policies, programs, and practices. It is part of a larger synthesis of the literature that explores what “evidence” means, what types of evidence policymakers, program managers, and implementers seek when facing implementation decisions and how evidence relates to other factors that influence decision-making (Hardee et al. forthcoming).

This paper and the larger synthesis are based on a literature search whose objective was to locate references on evidence-based policy in health or social science, knowledge transfer, translation or utilization for health or social science programs, evidence collected from “intervention studies” in family planning programs, and “implementation science” for family planning and reproductive health. The literature search included databases, individual websites, and reviews of bibliographies. The search was conducted in PubMed/MEDLINE, Web of Science and POPLINE, in addition to snowballing references from bibliographies. References were limited to 2000-2014 in the database searches; snowballing of materials goes back to the 1990s, and in some cases earlier, in order to capture earlier literature on research utilization in family planning and seminal writing on research utilization.