Principles Underpinning High Impact Practices (HIPs) for Family Planning
Family planning programs aim to support individuals and couples in exercising their rights to choose the timing and spacing of their pregnancies, to have the information and services to act on that right, and to be treated respectfully, equally, and without discrimination. To achieve this, programs must seek to incorporate the following principles in the implementation and scale-up of all High Impact Practices.
Voluntarism – Guarantee clients’ decisions are grounded in voluntary action and non-coercion.
Informed Choice – Provide accurate, complete, correct, and comprehensible information so individuals and couples can make informed reproductive health and contraception decisions.
Contraceptive Method Choice – Make the broadest feasible range of contraceptive methods available and accessible, that are appropriate to the level of service.
Client-centered – Create a safe, non-judgmental environment that respects and recognizes client reproductive intentions (delaying, spacing, or limiting pregnancy), lifestyles, and preferences throughout their lives.
High Quality – Ensure availability of safe and high quality contraceptive products and build knowledge, skills, and competencies of care providers for provision of evidence-based family planning information and voluntary services.
Continuity of Care – Build and sustain systems to support clients through an uninterrupted supply of contraceptives and related commodities, integrated services along the reproductive life course where feasible, referral systems, and follow-up care.
Equity – Strive to identify and understand social, ethnic, financial, geographic, age-related, linguistic, and other barriers that may inhibit health seeking behavior and voluntary contraceptive use, and make programmatic adjustments to overcome these disparities.
Gender Equality – Endeavor to be inclusive of women and men by removing barriers to their active engagement and decision-making, recognizing the role of family planning in supporting more equitable power dynamics and healthy relationships.
High Impact Practices (HIPs) are a set of evidence-based family planning practices vetted by experts against specific criteria and documented in an easy-to-use format.
Endorsed by more than 30 organizations, HIPs help build consensus around our current understanding of what works in family planning.
HIPs are identified based on demonstrated magnitude of impact on contraceptive use and potential application in a wide range of settings. Consideration is also given to other relevant outcome measures including unintended pregnancy, fertility, or one of the primary proximate determinants of fertility (delay of marriage, birth spacing, or breast feeding). Evidence of replicability, scalability, sustainability, and cost-effectiveness are also examined.
HIPs are categorized as:
- Enabling Environment: Systems or structural interventions which affect factors indirect to contraceptive use.
- Service Delivery: Changes in the organization of services which directly affect access, availability, and quality of family planning services.
- Social and Behavior Change: Interventions which directly affect knowledge, attitudes, behavior, and social norms that influence contraceptive use. Read the SBC Overview document.
In addition, technologies or practices that are not typically standalone interventions, but rather implemented in conjunction with HIPs to further intensify the impact of the HIPs, are referred to as HIP Enhancements.
The HIP briefs can be used for advocacy, strategic planning, program design, exploration of research gaps, to inform policies and guidelines, and to support implementation. Review Guidance for Developing an Evidence Brief.
Learn about the organizational structure.
Watch a recorded webinar that addresses the use of appropriate standards of evidence for recommending best practices in family planning and reproductive health.
Guidance on assessing the potential sustainability of Practices as part of an evidence review: Considerations for High Impact Practices in Family Planning discusses the importance of focusing on sustainability when determining a high impact practice in family planning, while ensuring that definition of “sustainable” is clear and accurate, when making the decision.
Discussion Paper on Equity for the HIP Initiative is centered around four questions: 1) how is equity defined for health and family planning, 2) what are the frameworks for conceptualizing equity, 3) what are the measures relevant for family planning programs, and 4) what evidence is needed to assess the impact of HIPs on equity. The paper also notes useful resources on equity programming and measurement, and provides references.