Changes in modern contraceptive prevalence rate (mCPR) are among the determinants of a country’s effort to improve the health status of its population. Ethiopia’s commitment to the global Family Planning 2020 partnership includes increasing mCPR and reducing total fertility rate. The success of this commitment involves multisectoral collaboration and partnership in implementation and measurement. This article presents empirical evidence, documentation of progress, and lessons that Pathfinder International learned from a decade of implementing and monitoring an integrated family planning program in Ethiopia.

We accessed data on 24,621 women of reproductive age from Pathfinder’s annual follow-up survey database. We used descriptive statistics to determine changes in mCPR and method mix between 2011 and 2019 in four regions of Ethiopia where the organization implemented family planning services. We assessed the statistical stability of survey estimates across the nine-year period using variance estimate and coefficient of variation. We ascertained plausible interpretation of the observed trends by referring to other national surveys and program documents of the organization.

We found an overall increase in modern contraceptive uptake. Over the past nine years alone there was a significant 17 percentage-point increase in mCPR.  Long-acting reversible contraceptives accounted for a significant share of this increase, particularly implants (mean difference =18%, 95% CI= 15-20%, p-value< 0.001). Among short-acting methods, use of injectables accounted for much of the increase (mean difference=4%, 95% CI= 2-7%, P<0.001).  The findings indicated that the observed changes were correlated with integration of family planning into primary health care services, improved service availability and access, and expanded method choice in the project’s intervention areas.

This analysis provided empirical evidence that aligning a program’s monitoring system with national priorities can provide information to foster timely subnational decision making, document contributions of organizations to national programs, and generate scalable lessons.