The FP2020 commitments were bold and ambitious. This checklist can help us all achieve them. In summer 2012, donors, policy makers and implementing partners gathered at the London Summit on Family Planning. The outcome was FP2020 - a political and financial commitment to provide 120 million underserved girls and women with the opportunity to freely, reliably and safely use modern contraception by 2020. It was an ambitious goal. This checklist can help us all achieve it.

1. FAMILY PLANNING
FOR GIRLS
THE GET-IT-RIGHT
CHECKLIST

2. CONTENTS
3. INTRODUCTION
4. OUR AIM
5. WHY GIRLS?
10. THE CHECKLIST
22. YOUR FEEDBACK
23. SOURCES
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3. 3
INTRODUCTION
In summer 2012, donors, policy makers and implementing partners gathered
at the London Summit on Family Planning.
The outcome was FP2020 – a political and financial commitment to provide
120 million underserved girls and women with the opportunity to freely,
reliably and safely use modern contraception by 2020.
It was an ambitious goal. This checklist can help us all achieve it.
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4. 4
OUR AIM
Of the 120 million people that FP2020 is aiming to reach, 26 million are
adolescent girls. We need to make sure their voices, needs and rights are not
forgotten.
This checklist outlines steps that enable you to make strategic investments
that expand family planning to adolescent girls, especially the most vulnerable.
It’s a resource that can transform the way we think about and deliver family
planning services to girls.
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5. 5
WHY GIRLS?
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6. GIRLS ARE CURRENTLY
BEING IGNORED
‘Business as usual’ in family planning has marginalised girls’ needs and sidelined
their voices.
Cultural beliefs that girls should not be sexually active or in charge of their
reproductive choices are used to justify denying them access to information about
puberty, reproductive health and contraception. Social stigma, limited decisionmaking power and cost are common barriers to adolescents’ access to services.1
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7. GIRLS ARE HAVING SEX AND
HAVING CHILDREN
Research shows that unmet need for family planning is highest among the 300
million adolescent girls (15-19) around the world.2
Globally, about 16 million adolescent girls (15-19) give birth every year; 95%
of them in developing countries where half of all first births are to adolescent
girls.3,4
Among girls younger than 18 years, 90% of first births occur within marriage.5
Studies in four Sub-Saharan African countries have found that at least one
in four adolescents (24-44%) are not aware of any source for obtaining
contraceptives.6
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8. DOING NOTHING PUTS GIRLS’
LIVES AT RISK
Medical complications from pregnancy and childbirth are the leading cause of
death among girls aged 15-19 – more than 70,000 adolescent girls die each year in
pregnancy or childbirth.7,8
Adolescent girls who give birth before their bodies are physically ready for
childbirth are twice as likely to die during pregnancy and childbirth compared with
women over 20.9
Girls aged younger than 15 are five times more likely to die during pregnancy or
childbirth.
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9. INVESTING IN FAMILY PLANNING
FOR GIRLS IS SMART ECONOMICS
AND SAVES LIVES
Targeted family planning for adolescent girls is a strategic, cost-effective
investment that empowers girls: preventing a pregnancy in adolescence costs
$17 per year, saves $234 per year and contributes to growing economies by
hundreds of millions.10,11,12
Girls who have access to family planning information and contraception are
older when they first have sex, are less likely to experience coerced sex if they
have a supportive social network of adults and peers and are more likely to use
contraception when they do have sex.13
Reliable access to adolescent-friendly family planning changes girls’ individual
life trajectories, breaks cycles of poverty across generations and accelerates
economic growth in developing and developed countries alike.
This transformative process is the girl effect.
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10. 10
THE CHECKLIST
The checklist contains six key goals that we should all aim to
achieve in order to deliver better family planning for girls. For
each goal we have highlighted key questions that need to be
asked and how you’ll know if you’ve got it right.
GOAL 1: MAKE IT WORK FOR EVERY GIRL
GOAL 2: INVOLVE GIRLS
GOAL 3: COLLECT, ANALYSE AND REPORT ON SEX
AND AGE-DISAGGREGATED DATA
GOAL 4: RESPECT GIRLS’ RIGHTS
GOAL 5: TRANSFORM HER WORLD
GOAL 6: MEASURE IMPACT AND
SHARE LEARNING
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11. GOAL 1:
MAKE IT WORK FOR EVERY GIRL
Why
Girls as a group are vulnerable, especially when they are sexually active and/or married.14 And the most vulnerable among
them have the greatest needs and must be actively targeted and recruited.15
It’s the most vulnerable girls whose needs are greatest, whose lives will improve the most and who will yield the greatest
return to their families and communities.
Key Questions
Do your investment strategies, plans and programmes articulate which girls are the most vulnerable to early pregnancy
and the circumstances under which they become pregnant?
Does your organisation have knowledge, human capacity or investments in locations where the most vulnerable
adolescent girls with high unmet need for FP are living in poverty?
You’ll know you’ve got
it right if…
Plans differentiate between, and invest in, separate interventions for married girls and unmarried girls.
Family planning information and contraceptive services explicitly aim to reach vulnerable, hard-to-reach girls across the
following categories:
Domestic workers
Child brides and married adolescents
Child mothers
Out-of-school girls
Orphans
Girls with disabilities
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12. GOAL 1 (CONTINUED):
MAKE IT WORK FOR EVERY GIRL
You’ll know you’ve got
it right if…
(Continued)
Survivors of violence
Very young adolescent girls (10-14)
Girls living with HIV
Funds invested in programming for specific vulnerable populations of adolescent girls are tracked.
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13. GOAL 2:
INVOLVE GIRLS
Why
Girls have clear ideas of the obstacles they face and ideas about what needs to change for them to have their needs met.16
Girls’ isolation and vulnerability can make them hard to find. There are different ways to both look for them and invest in
them, for example linking a family planning programme to a different profile of a girl who has need for information and
services.
Key Questions
Have you meaningfully involved girls in all aspects of policy, programme investment, design, implementation and
evaluation?
Does your organisation earmark funds to support targeted recruitment of adolescent girls?
You’ll know you’ve got
it right if…
Adolescent girls are involved in a way that cultivates and strengthens their voice, including the girls who are most
vulnerable to early pregnancy.
Quality of participation is assessed and monitored according to Hart’s Ladder – an internationally recognised measure
of youth participation.17
At a minimum: adolescent girls share in adult-initiated decision-making on how to meet their needs (level 6)
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14. GOAL 2 (CONTINUED):
INVOLVE GIRLS
You’ll know you’ve got
it right if…
(Continued)
Funds are earmarked for different recruitment strategies that target every girl, from the most to least vulnerable.
Girl-to-girl: relying on girls to spread the word among peers who have similar social circumstances, especially
beneficiaries of targeted family planning programmes, can reach all profiles of girls
House-to-house: engaging women leaders in a community to visit households and request girls’ participation can
reach the most vulnerable
Community structures: using public activities such as civil society or religious groups may not reach the most
vulnerable
Existing programmes/schools: focusing here has limited reach
Following up with girls who access family planning information and services through supported programmes is
integrated into the evaluation framework.
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15. GOAL 3:
COLLECT, ANALYSE AND REPORT ON
SEX- AND AGE-DISAGGREGATED DATA
Why
Girls’ family planning needs to vary by age, sexual activity and marital status.
You can’t reach them if you can’t count them or see the ‘big picture’ relationships between girls’ family planning use and
their social circumstances. For example, data maps illustrate where unmet need intersects with high prevalence rates of
child marriage and girls’ education levels.
Key Questions
Do your plans articulate which segments of adolescent girls are at risk of early pregnancy, and rank risk level by segment?
Do you report on the girls you serve by tracking sex, age and marital status?
You’ll know you’ve got
it right if…
You collect, analyse and report on sex- and age-disaggregated data on for all girls, including 10-14 year olds.
You use national and sub-national data for girls 10-14 years and 15-19 years to structure interventions:
Age at marriage
Age at first birth
HIV status
Unmet need
Knowledge, attitudes and use on contraception, HIV and violence.
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16. GOAL 3 (CONTINUED):
COLLECT, ANALYSE AND REPORT ON
SEX- AND AGE-DISAGGREGATED DATA
You’ll know you’ve got
it right if…
(Continued)
School grade for age
Legal age of marriage, employment and consent to sexual relations
You rely on data correlations between adolescent girls’ family planning knowledge, use and unmet needs, and their
social circumstance to structure interventions:
Marital status
Place of residence, eg urban vs rural disparities
Educational achievement and/or school enrolment status
Attitudes on violence
Your results, impact and lessons learned are data-disaggregated by sex and age where applicable.
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17. GOAL 4:
RESPECT GIRLS’ RIGHTS
Why
Adolescent girls, like all women, have the right to choose when, how often and with whom to have sex; to access and use
sexual and reproductive health services, information and education; to live in equality and free of discrimination.
Girls face a double vulnerability stemming from their youth and their sex. International human rights and national laws and
policies can help girls access family planning information and services only if they are in place, if they are enforced and if
girls are aware of them.18
Key Questions
Are girls’ rights to available, accessible, acceptable, high-quality care respected and are their family planning needs met?19
Are girls aware of their internationally recognised right to access and use high-quality contraception when they need it –
and do they know the benefits associated with exercising that right?
You’ll know you’ve got
it right if…
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Girls who participate in FP programming know their rights to, and the benefits of: 20
Information, informed consent and refusal
Health services
Contraception
Freedom from harm and ill-treatment
Dignity and respect
A satisfying and safe sex life
Liberty, autonomy, self-determination and freedom from coercion
Marriage of their own choice

18. GOAL 4 (CONTINUED):
RESPECT GIRLS’ RIGHTS
You’ll know you’ve got
it right if…
(Continued)
Non violence
Refusal of unwanted sexual touching and sexual activity
A national plan for providing family planning with a full range of contraceptive options that includes provision of family
planning for girls is in place, along with necessary oversight and accountability mechanisms.
National plans, strategies and programmes to prevent violence against girls as well as services to meet the needs of
survivors are in place.21
Girls’ access to family planning information and services is not hindered by:
Cost
Distance to services
Transport difficulties
Laws prohibiting access to information and services by age
Health service norms, protocols and guidelines support girls’ informed choices, girls’ decision-making and their right to
confidential, affordable contraception of the highest quality.
Interventions and services are adolescent-friendly – meeting the World Health Organisation standards:
Girls have access to information about contraceptive options
Girls have access to contraceptives
Girls feel comfortable going to services
Providers foster decision-making by girls
Community-based contraceptives distribution includes girls as both distributors and beneficiaries
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19. GOAL 5:
TRANSFORM HER WORLD
Why
Child marriage, sexual coercion, gender inequality and access to education are all factors that can impede girls’ access to
information and services.
Placing contraception within walking distance of girls is insufficient. Family planning for girls has to complement nonhealth interventions that give girls the social and economic assets to demand and use family planning.
Key Questions
How does the environment where girls live affect their access to information and services?
How does your programme reflect knowledge of the conditions of girls’ lives?
How do social and cultural factors, as well as the daily routines that influence where and how girls spend their time restrict
agency, mobility and access to resources?
You’ll know you’ve got
it right if…
Your programme builds on knowledge of the following dimensions of girls’ social connectedness/isolation:
Girls’ living arrangements (with parents, husbands, in-laws, as domestic servants etc)
Nature of gender norms and community support (among parents, teachers, traditional leaders and others) for girls
and their equality and rights
Policy, regional and school-level support for girls’ education
Family planning programming for girls is linked to creative, girl-led community campaigns that target the people girls
live with – parents, brothers, sisters, husband, in-laws, among others.
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20. GOAL 5 (CONTINUED):
TRANSFORM HER WORLD
You’ll know you’ve got
it right if…
(Continued)
Campaigns aim to transform gender and cultural norms, redefining a new way forward for girls (and boys) – how and
where girls spend their time, the value of education and delayed marriage, and the roles that men and women play in
creating opportunities for girls to thrive.
FP programming for girls is linked to mass media campaigns that challenge gender stereotypes and promote
comprehensive sex education (in schools and other settings).22
Mass media campaigns recruit influential figures – community and religious leaders, athletes and female leaders
Family planning programming for girls increases and tracks girls’ social networks among adult mentors and peers.
Family planning programming for girls increases and tracks girls’ savings, safe (non-exploitative) income and her
decision-making control over daily purchases.
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21. GOAL 6:
MEASURE IMPACT AND SHARE LEARNING
Why
Shared learning is critical to reaching family planning goals.
Driving forward progress to achieve FP2020 goals cannot occur without reporting what does and does not work for girls.
Key Questions
How can the global community design better interventions and share information to increase access to family planning
information and services for girls?
Are girls’ opinions, suggestions, achievements and apprehensions reflected in impact evaluations and summary reports?
You’ll know you’ve got
it right if…
The intervention includes baseline and end-line data collection, allowing for post-intervention evaluations and sharing of
evidence-based knowledge.
The intervention builds upon evidence and recently published literature.
The programme is designed and funded with scale-up in mind from the onset.23
Investments and programmes include public dissemination plans eg publish or otherwise share the process and the results
(success or failure).
The programme increases access to information and services for girls. For example:
What percentage of adolescent girls have accurate knowledge of menstruation, and the privacy and means to handle it?
What percentage of voluntarily sexually active adolescent girls seek to avoid pregnancy? What percentage use
contraception? What percentage use condoms during high-risk sex?
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22. YOUR FEEDBACK
We want to know how you’ve used this checklist, what you’ve learned and
how you think it could be improved.
Email us at info@girleffect.org
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23. SOURCES
1
Biddlecom AE et al., Protecting the Next Generation in Sub-Saharan Africa: Learning from Adolescents to Prevent HIV and Unintended Pregnancy, New York: Guttmacher
Institute, 2007.
2 Greene, ME, S Joshi and OJ Robles. (2012a). By Choice, Not by Chance: Family Planning, Human Rights and Development (State of World Population). New York: UNFPA.
3 Melvin, A. and U. Uzoma. (2012). Adolescent mothers’ subjective well-being and mothering challenges in a Yoruba community, Southwest Nigeria. Social Work in Health
Care. 51 (6): 552-567.
4 Bruce, J. Reaching The Girls Left Behind: Targeting Adolescent Programming for Equity, Social Inclusion, Health, and Poverty Alleviation. Prepared for: ‘Financing
Gender Equality; a Commonwealth Perspective, Commonwealth Women’s Affairs Ministers’ Meeting, Uganda, June 2007, http://www.popcouncil.org/pdfs/Bruce2007_
Commonwealth_FullText.pdf
5 Bruce, Judith and John Bongaarts (2009). The new population challenge. New York: Population Council. Calculations by Bongaarts.
6 Biddlecom AE et al., Protecting the Next Generation in Sub-Saharan Africa: Learning from Adolescents to Prevent HIV and Unintended Pregnancy, New York: Guttmacher
Institute, 2007.
7 Patton, G.C., et al. “Global Patterns of Mortality in Young People.” The Lancet 374.9693 (2009): 881-892.
Retrieved from http://download.thelancet.com/pdfs/ journals/lancet/PIIS0140673609607418.pdf?id=e16241398b8eb460:61453979:12f087a24d6:-14711301520582196
8 Brown, G. (2012). Out of wedlock, into school: Combating child marriage through education. London, UK: The Office of Gordon and Sarah Brown. www.
gordonandsarahbrown.com
9 WHO. (2011). WHO Guidelines on Preventing Early Pregnancy and Poor Reproductive Outcomes among Adolescents in Developing Countries. Geneva, Switzerland: WHO.
10 Sewall-Menon, Jesssica, Judith Bruce, Karen Austrian, Raven Brown, Jennifer Catino, Alejandra Colom, Angel Del Valle, Habtamu Demele, Annabel Erulkar, Kelly Hallman,
Eva Roca, and Nadia Zibani (2012). The cost of reaching the most disadvantaged girls: Programmatic evidence from Egypt, Ethiopia, Guatemala, Kenya, South Africa, and
Uganda. New York: Population Council.
11 World Bank (2011). World Development Report 2012: Gender Equality and Development. International Bank for Reconstruction and Development. Washington DC: The
World Bank.
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24. SOURCES
12 Chaaban, J. and W. Cunningham (2011). Measuring the Economic Gain of Investing in Girls: The Girl Effect Dividend. Policy Research Working Paper, No. 5753. Human
Development Network, Children and Youth Unit, and Poverty Reduction and Economic Management Network, Gender Unit. Washington DC: The World Bank.
13 Temin M and Levine R (2009). Start with a Girl: A New Agenda for Global Health. Washington DC: Center for Global Development.
14 New Population Challenge; Bruce and Bongaarts
15 Girl-Centered Program Design: http://www.popcouncil.org/pdfs/2010PGY_AdolGirlToolkitComplete.pdf
16 Greene, M., L. Cardinal, E. Goldstein-Siegel, Girls Speak: A New Voice in Global Development. International Center for Research on Women; Girls Count Series. www.
coalitionforadolescentgirls.org.
17 Hart’s Ladder: http://www.myd.govt.nz/documents/engagement/harts-ladder.pdf
18 Ibid.
19 Adapted from Hardee, K., J. Kumar, L. Bakamijian, K. Newman, M. Rodriguez, K.Wilson. (2013). Framework for Voluntary, Human Rights-based Family Planning Programs:
Ensuring that They Respect, Protect and Fulfill Rights: A Conceptual Framework.
20 Drawn and adapted from Respectful Maternity Care Advisory Council, White Ribbon Alliance. 2011. “Respectful Maternity Care: The Universal Rights of Childbearing Women.”
Retrieved Jan. 20, 2013.
21 For best practices and evidence, see: www.endvawnow.org.
22 Kirby, D., B. Laris and L. Rolleri. (2007a). “Sex and HIV Education Programs: Their Impact on Sexual Behaviors of Young People throughout the World.” Journal of Adolescent
Health 40 (3): 206-217; UNESCO (United Nations Educational, Scientific and Cultural Organization). 2009a. UNESCO’s Short Guide to Essential Characteristics of Effective
HIV Prevention. Paris, France: UNESCO. www.unesco.org/aids; UNESCO (United Nations Educational, Scientific and Cultural Organization). 2009b. International Technical
Guidance on Sexuality Education: An Evidence-informed Approach for Schools, Teachers and Health Educators. Volume 1: The Rationale for Sexuality Education. Paris,
France: UNESCO. www.unesco.org/aids.
23 ExpandNet: Scaling Up Health Innovations: http://www.expandnet.net/tools.htm; Cooley, L., R. Ved, K. Fehlenberg (2012). Scaling Up – From Vision to Large-Scale Change:
Tools and Techniques for Practitioners (http://www.msiworldwide.com/wp-content/uploads/Scaling-Up-Toolkit.pdf) & A Management Framework for Practitioners (http://
www.msiworldwide.com/wp-content/uploads/Scaling-Up-Framework.pdf).
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25. GIRLS ARE THE MOST POWERFUL
FORCE FOR CHANGE ON THE PLANET.
GET INSPIRATION AND TOOLS
TO UNLEASH THE GIRL EFFECT AT
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