Family Planning Strategies across selected Muslim countries: A review to inform Malaysia’s next steps Prepared by UNU-IIGH for the LPPKN Technical Working Committee October 2020 1 | P a g e Contents Acronyms ....................................................................................................................................................... 4 Acknowledgements ....................................................................................................................................... 6 EXECUTIVE SUMMARY ................................................................................................................................... 7 i) Summary of results across selected countries ....................................................................................... 7 ii) Specific lessons for Malaysia ................................................................................................................. 9 1. BACKGROUND .......................................................................................................................................... 13 1.1 Malaysia’s Family Planning context ................................................................................................... 13 1.2 The need to develop a Family Planning Policy for Malaysia ............................................................. 14 2. CONCEPTUALISING FAMILY PLANNING ................................................................................................... 15 2.1 International Family Planning commitments .................................................................................... 15 3. METHODOLOGY ....................................................................................................................................... 19 3.1 Objectives of review .......................................................................................................................... 19 3.2 Selection of comparative Muslim countries ...................................................................................... 19 3.3 Data collection ................................................................................................................................... 19 3.4 Guiding frameworks for developing a Family Planning Policy .......................................................... 21 3.4.1 Socio-ecological framework........................................................................................................ 21 3.4.2 UNFPA Framework...................................................................................................................... 22 3.4.3 The Family Planning policy development process...................................................................... 26 4. FINDINGS.................................................................................................................................................. 37 4.1 The Islamic perspective of Family Planning ....................................................................................... 37 4.1.1 Religious context across selected countries and their impact on Family Planning.................... 38 4.1.2 Women’s need for Family Planning ............................................................................................ 39 4.2 Family Planning policies and services across the Islamic world ........................................................ 40 4.2.1 Integrating sexual and reproductive health services into primary health care ......................... 40 4.3 Contextual situation across selected countries ................................................................................. 42 4.3.1 Demographic trends and human development indicators ........................................................ 42 4.3.2 Sexual and reproductive health indicators ................................................................................. 46 4.4 Family Planning Policy environment across selected countries ........................................................ 51 4.4.1 Malaysia ...................................................................................................................................... 51 4.4.2 Turkey ......................................................................................................................................... 57 4.4.3 Egypt ........................................................................................................................................... 59 2 | P a g e 4.4.4 Morocco ...................................................................................................................................... 63 4.4.5 Bangladesh .................................................................................................................................. 65 4.5 Country comparison of FP policies, programme and indicators ....................................................... 70 4.5.1 Findings from the 2014 National Family Planning Effort Index comparison .............................. 71 4.5.2 Findings from the 2017 National Composite Index on Family Planning comparison ................ 72 5. DISCUSSION.............................................................................................................................................. 74 5.1 Family Planning best practices .......................................................................................................... 75 5.2 Family Planning policies and programme across selected countries ................................................ 75 5.3 Family Planning service delivery across selected countries .............................................................. 77 5.4 Monitoring and Evaluation ................................................................................................................ 78 5.5 Priorities for Family Planning in Malaysia ........................................................................................... 79 5.6 Limitations of the review.................................................................................................................... 81 6. CONCLUSIONS .......................................................................................................................................... 82 7. RECOMMENDATIONS .............................................................................................................................. 83 8. ROAD MAP FOR FORMULATING AND IMPLEMENTING A FAMILY PLANNING POLICY ............................ 86 Appendix 1 Technical Working Committee Membership ........................................................................... 92 Appendix 2 Contextual information across selected Muslim countries...................................................... 93 FP2020’s Core Indicators comparison across selected countries ........................................................... 98 Appendix 3 Family Planning environments across selected countries ......................................................... 99 Appendix 4 Recommendations from Malaysia’s 2010 Population Strategic Plan Study .......................... 112 Appendix 5 Country comparison using Family Planning Effort and National Composite Index on Family Planning ..................................................................................................................................................... 114 Appendix 6 Resources for Family Planning policy and programmes ........................................................ 118 3 | P a g e Acronyms Acronym Expanded name ACCRH Advisory and Coordinating Committee for Reproductive Health AFR Adolescent Fertility Rate AFHCs Adolescent-friendly Health Centers ARROW Asian-Pacific Resource and Research Centre for Women ASRO Arab States Regional Office CEDAW Convention on the Elimination of All Forms of Discrimination Against Women CIP Costed Implementation Plan CPR Contraceptive Prevalence Rate CRC Convention on the Rights of the Child CSE Comprehensive sexuality education CSO Civil Society Organisation DHS Demographic Health Survey EU European Union FRHAM Federation of Reproductive Health Associations, Malaysia FGM Female Genital Mutilation FP Family Planning GBV Gender-Based Violence GDI Gender Development Index GII Gender Inequality Index GNI Gross National Income HIV/AIDS Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome HPV Human Papilloma Virus HPF East and North Africa Health Policy Forum HPNSP Health, Population and Nutrition Sector Programme Plan ICPD International Conference on Population and Development ICT Information and Communication Technology IEC Information, Education and Communication IPPF International Planned Parenthood Federation ITGSE International Technical Guidance on Sexuality Education IVF In Vitro fertilization LAPM Long acting and permanent methods LGBTQI+ Lesbian, gay, bisexual, transgender, queer and intersex LMICs low-and middle-income countries LPPKN Lembaga Penduduk & Pembangunan Keluarga Negara NCWO National Council of Women's Organisations Malaysia MDG Millennium Development Goal MENA Middle East and North Africa MHAS Maylasian Healthy Ageing Society MMR Maternal Mortality Ratio MWFCD Ministry of Women, Family and Community Development MoE Ministry of Education MoH Ministry of Health MOHFW Ministry of Health and Family Welfare NAHP National Adolescent Health Policy NCIFP National Composite Index on Family Planning NFPE National Family Planning Effort Index NGO Nongovernment Organisation PEKERTI National