A range of interlinked sociocultural, economic, and policy factors influence both the functioning and sustainability of health services, as well as social norms and practices related to health, including FP. An enabling environment for FP requires equitable policies; adequate resources; good governance, management, and accountability; and supportive social norms, including the transformation of inequitable gender norms. If these needs are not addressed during program design and implementation, investments in supply and demand interventions may be neither effective in the short term nor sustainable over time.
Strong and effective leadership is crucial for creating an enabling environment at all levels of the health system and within the community to support and advance FP/SRH. This leadership is needed to promote evidence-based policies, guidelines, and approaches; support the allocation of human and financial resources for FP/SRH; ensure that the health system has the capacity to provide quality services; and challenge social and gender norms that may adversely affect an individual’s SRH.
Pivotal to fostering an enabling environment is the need to engage governments, communities, and other members of civil society to move discourse about FP/SRH from the private to the public realm. This encourages discussion and recognition of FP/SRH as both a public health and a rights issue, wherein everyone has a stake in ensuring sexual and reproductive well-being.