Family planning since ICPD--how far have we progressed?

The 1994 International Conference on Population and Development (ICPD) was a pivotal global event. It established voluntary family planning as a fundamental human right. We describe the progress made and challenges faced by the family planning field in the 20 years since ICPD. We present case studies from three African countries to highlight factors affecting the evolution of family planning during the past 2 decades. Measurable progress has been made in the key family planning indicators over this interval. However, improvement has slowed in recent years, and demographic forecasts predict a greater unmet need for effective contraception in the future. With a rights-based lens, we need to better understand the nuances of fertility intentions as we offer women and couples contraceptive choices pertinent to their stage of life. With a public-health lens, we need better metrics to reflect the realities of contraceptive effectiveness. Now is the time to build on two decades of family planning progress after ICPD.