Conclusion

In the late 1990s, 10 sub-Saharan African health workforce crisis countries had similar modern method CPRs among married women. Although the 10 countries currently share comparable Health Workers Reach Index scores at the national level, five of the countries emerged as family planning success stories over the following 10–15 year time period, while five made no or only scant improvements in the CPR. Acknowledging that there are many important factors besides health worker access that determine levels of contraceptive use, this exploratory analysis nonetheless raises questions about whether government commitment and certain policy choices vis-à-vis health workforce distribution and qualifications—even when absolute levels of health worker density are low—could make a difference in the provision of family planning services in resource-constrained countries.

In July 2012, global leaders—including the UK Government, the Bill & Melinda Gates Foundation, and the United Nations Population Fund, among others—came together and committed in partnership “[…] to support the rights of an additional 120 million women and girls in the world’s poorest countries to use contraceptive information, services and supplies, without coercion or discrimination, by 2020” (Family Planning 2020 n.d.). Increased political commitment to and investment in the health workforce—numbers, types, distribution, qualifications, and support—will be needed to achieve this unassailable goal.