Background and Rationale for the Programme

Demographic and Economic Rationale
The Republic of Iraq is located in Western Asia, The country borders Turkey to the north, Saudi Arabia to the south and Syria to the west. The population of Iraq has grown from 8 million people in 1965 to around 40 million people in 2019 (United Nations Population Fund, 2016).
In the last twenty years are population has nearly doubled from 22 million in1999 to approximately 40 million in 2019 (United Nations Population Fund, 2016).
Factors have fuelled the growth in population include: (United Nations Population Fund, 2016).
• High fertility rate, estimated at 4.2 children per woman
• Low prevalence of the use of modern contraceptive methods, estimated at 33.6 percent nationwide
• Iraq’s high life expectancy, which is estimated at 70.9 years for women and 67.6 years for men. 

Based on the above statistics, population control through the family planning is critical to safeguarding the future of the country. While population control is essential at this juncture, it happens to coincide with national priorities. Currently, the international and national priorities with regards to the country are to establish and maintain by securing its borders, conducting credible elections and building infrastructure including health care system structures. It is noteworthy that the issue of population control via family planning is not given priority from key stakeholders. Nonetheless, the significant youth population in Iraq argues for the need to address family planning as a matter of urgency: 60 percent of Iraqi citizens are young people below 25 years, who are confronted with inadequate education and health services due to conflict and displacement. Furthermore, one in three young people in the age bracket of 15-29 years is illiterate, potentially limiting their access to family planning advice and making them especially vulnerable (United Nations Population Fund, 2016).

Another reason that necessitates the rollout of family planning services in the country arises from the massive displacement that occurred as a result of the long-running conflict in the country, of which women and children have been the primary victims. Displacement has led to population influx in certain areas, especially rural regions. In addition many health facilities have been damaged due to conflict, drastically reducing the capacity of the country to deliver high-quality and timely health services, especially family planning services.

Current Status of Family Planning Services
United Nations Population Fund data indicates that the country has a modern contraceptive prevalence rate of 28 percent, an unwanted pregnancy rate of 12 percent, and adolescents’ birth rate of 60 percent. Whereas Iraq has taken steps to improve on the above outcomes, it needs greater assistance to achieve significant improvement in a relatively short period, UNFPA (2014).  
Family planning services need especially critical attention in rural areas in Iraq, The people who are living in rural areas suffer from low socioeconomic status, low levels of education and a lack of assess to modern contraception; accordingly home abortions are prevalent (Al-Ridhwany et al. 2018)
Overall, there is a dire need to implement a comprehensive family planning programme that utilizes modern contraception methods to achieve optimal population. There are a number of barriers that may affect the implementation of such a programme, however. First, socio-cultural preferences significantly hinder the implementation of family planning programmes. In addition, the target population, particularly women, lack autonomy over decisions, even those that affect them personally (Roudi-Fahimi et al., 2012). Finally, cultural sensitivity and religious concerns about contraception are a significant hindrance to successful programme implementation.

Part Two – Programme Design

Title: Developing an Effective Family Planning Programme that Utilizes Modern Methods of Contraception to Meet the Sustainable Development Goals (SDGs) and the FP2030 Goals in rural area in Iraq.  
“The World Health Organization definition is this: “Family planning allows individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. It is achieved through use of contraceptive methods and the treatment of involuntary infertility”
Goals: To reduce the total fertility rate of Iraqi women from the current 4.2 to 2.1.

The following design for a family planning programme in rural area in Iraq will employ the landscape analysis method. The method is appropriate for the study since it enables planners to map the present stakeholders and the available range of services in the various parts of the country, especially urban and rural areas (Miller et al., 1997). The method will allow researchers to determine the challenges that confront the delivery of effective family planning services. In particular, it allows for assessment of quality of care, the provision of equipment, training, and dissemination of information, and determination of the appropriate levels of supply of contraceptives (Miller et al., 1997).

  1. Increase the percentage of women using modern contraceptives from the 2011 baseline level of 28%-33% to the target level of 55%
  2. Reduce negative perceptions towards family planning among Iraqi women from the current prevalence of 49% to 15% through two years of community awareness.
  3. Increase the proportion of primary healthcare centres offering family planning from 15% to 50%
  4. Increase the proportion of healthcare facilities receiving donor support to 40% across all six governorates of Iraq.
    Al Ameen and Al Deen (2016) and Agha and Rasheed (2007) found that the ideal age of target population for family planning services in Iraq are women from 15-40 years, mostly from low and medium socioeconomic status. University Research Co., LLC. (2011) outlines that the key stakeholders in the family planning process are health officials working at the national and district levels, health professionals who work in hospitals and clinics, organizational funders of family planning services in the country, community-based health groups, and operators of privately managed health organizations and facilities. The preferred method of stakeholder engagement is community organizing, which promises maximum benefits in spreading awareness, ensuring easy access to contraceptives, and building trust in the proposed methods.