What Are High-Impact Practices in Family Planning (HIPs)? | Family Planning High-Impact Practices (HIPs)

HIPs are promising or best practices that, when scaled up and institutionalized, will maximize investments in a comprehensive family planning strategy. Identified by international experts in family planning and reproductive health, HIPs help family planning programs focus their resources and efforts to ensure they have the broadest reach and greatest impact.

HIPs are grouped into two interrelated categories: (1) creating an enabling environment and (2) high-impact practices in service delivery. Creating an enabling environment facilitates implementation of high-impact practices in service delivery. The list of HIPs is not intended to constitute or replace a strategy, which should be informed by the Elements of Success in Family Planning Programming and driven by country context.

Enabling Environment

The following enabling-environment HIPs are correlated with improved health behaviors and/or outcomes. Better outcomes include lower rates of unintended pregnancy, reduced fertility rates, or improvements in one of the primary proximate determinants of fertility (increased modern contraceptive use, delayed marriage, improved birth spacing, or increased breast feeding).

Galvanize commitment to family planning through advocacy and policy development.
Develop, implement, and monitor supportive government policies.
Support financing for family planning services and supplies at the national and local levels.
Invest in contraceptive security by developing an effective supply chain, supportive policies and regulations, financing, coordination and planning, and commitment
Ensure contraceptive choice by making a wide range of family planning methods available.
Implement a systematic, evidence-based health communication strategy that includes communication through multiple channels to enable people to make voluntary and informed health care decisions.
Develop in-country capacity to lead and manage family planning programs.
Advocate keeping girls in school.

Service Delivery

HIPs in service delivery:

improve use of family planning services, including contraceptive use and continuation
contribute to ensuring informed choice and volunteerism
have potential application in a wide range of settings

When identifying HIPs in service delivery, experts also considered whether the practices were replicable, scalable, and sustainable. Data on cost and cost-effectiveness of service delivery practices are lacking. USAID recommends this area as a high priority for future research.

HIPs in service delivery are categorized by the strength and consistency of the evidence base (Proven, Promising, or Emerging) and based on criteria used by the World Health Organization.

Promising practices in service delivery are those where good evidence exists that these interventions can lead to impact, but more information is needed to fully document implementation experience and impact.

These interventions should be promoted widely, provided that there is careful evaluation both in terms of impact and process.

Provide a wide range of family planning methods through mobile outreach services.
Train and support pharmacists and drug shop keepers to provide a wide range of family planning methods. In addition to condoms and pills, pharmacists often play a key role in providing injectables, emergency contraceptive pills, and Cyclebeads® for SDM.
Offer family planning services to postpartum women (up to 12 months after birth), such as screening women during routine child immunization contacts.

Proven practices in service delivery are those where sufficient evidence exists to recommend widespread implementation, provided that there is careful monitoring of coverage, quality, and cost, and that operations research helps understand how to improve implementation.

Train, equip, and support community health workers (CHWs) to provide a wide range of family planning methods. In addition to pills and condoms, CHWs can safely and effectively provide emergency contraceptive pills, injectables, the Standard Days Method (SDM), and the Lactational Amenorrhea Method (LAM). They also can refer clients for long-acting and permanent methods (LA/PMs).
Provide family planning counseling and services at the same time and location where women receive services related to spontaneous or induced abortion.
Support distribution of a wide range of family planning methods and promotion of healthy contraceptive behaviors through social marketing.

Emerging practices in service delivery are those in which some initial experiences with developing interventions exist, but there is a need for more intense intervention development and research.