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ReviewBMJ global health2026

Assessing family planning progress in exemplar countries: development of a conceptual framework and case study methodology.

Zahid Ali Memon, Hina Najmi, Abeer Mian, Sacha St-Onge Ahmad, Muhammad Islam, Kevin Samuel, Marleen Temmerman, Ali Mohammad Mir, Zeba Sathar, Zulfiqar A Bhutta

Abstract readReview
In one paragraph

Review in BMJ global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Zahid Ali MemonDepartment of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan zahid.memon@aku.edu.ORCID 0000-0002-5321-8885
Hina NajmiInstitute of Global Health and Development, The Aga Khan University, Karachi, Sindh, Pakistan.ORCID 0000-0001-9287-2380
Abeer MianDepartment of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan.ORCID 0000-0002-1650-5754
Sacha St-Onge AhmadCentre for Global Health and Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada.ORCID 0000-0003-2635-5988
Muhammad IslamCentre for Global Health and Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada.ORCID 0009-0003-7570-9946
Kevin SamuelCentre for Global Health and Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada.ORCID 0009-0006-7671-8053
Marleen TemmermanCentre of Excellence in Women and Child Health, The Aga Khan University Hospital Nairobi, Nairobi, Kenya.ORCID 0000-0003-2069-8752
Ali Mohammad MirPopulation Council Pakistan Office, Islamabad, Pakistan.ORCID 0000-0001-8613-1228
Zeba SatharPopulation Council Pakistan Office, Islamabad, Pakistan.ORCID 0000-0002-0068-9923
Zulfiqar A BhuttaCentre for Global Health and Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada.ORCID 0000-0003-0637-599X

Funding

the Bill and Melinda Gates Foundation INV-024094
6 · The paper itself

Abstract

Family planning (FP) is a critical component of reproductive health, enabling individuals to plan the number and timing of children through various contraceptive methods.We outline the conceptual framework and country case study methodology used by the Exemplars in Family Planning (EFP) project. This was based on the wider Exemplars in Global Health programme, which uses mixed-methods to examine determinants of FP progress in countries that exceed expectations for health outcomes. The EFP project integrates findings from case studies on six such countries, including quantitative analyses of trends and drivers of modern contraceptive prevalence, systematic reviews, policy, programme and financing assessments, and qualitative data collection with policymakers, providers and community actors. Data triangulation across these methods, complemented by consortium input and country workshops, enabled robust validation of findings and identification of cross-cutting themes. This approach produced a nuanced understanding of FP progress by capturing interactions between government programmes (demand and supply), service delivery mechanisms, subnational contexts and individual determinants. Quantitative decomposition and trend analyses quantified the contributions of population characteristics, behavioural factors and interventions, while qualitative and stakeholder data contextualised these findings within local sociocultural, health system and policy environments.This multicountry, mixed-methods analysis led by local researchers and supported by a global consortium enhanced methodological rigour, contextualised findings and enabled cross-country learning on FP progress. It identified key cross-cutting drivers and offers evidence-informed guidance to improve contraceptive uptake and demand satisified, while highlighting the need for context-specific interventions and further longitudinal, multicountry research.

Indexed as

Family Planning ServicesContraceptionDeveloping CountriesGlobal HealthHumansProgram EvaluationGlobal HealthHealth services researchStudy design

Identifiers

PMID42264505
PMCPMC13250193

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.