Over the last decade, many developing countries have experienced social, economic, and political changes that continue to affect the delivery of healthcare services, including family planning.
For example, in several countries, health sector reform brought decision-making power to subnational levels; private sector opportunities relieved the public sector burden to provide for all; and some donor assistance has shifted from vertical programming to more integrated and sector-wide approaches.
Whether such changes have positively contributed to service delivery largely depends on the context, given that countries are at different stages of the reform process.
The emergence of new financing mechanisms and a changing funding environment for foreign assistance affects how policy-makers make decisions and allocate resources.
