The Power of Options — and the Options of Power

Jay Gribble
4 min readSep 25, 2023
Girls attending school in Pakistan. Photo: Khaula Jamil/Health Policy Plus

by Jay Gribble

When I think about the theme of this year’s World Contraception Day — the Power of Options — I am initially filled with a spirit of optimism. The notion that women have options when it comes to meeting their family planning needs is powerful. Having the capacity to choose an appropriate method from a convenient source that aligns with where people are in their life course is a dream that we all hold on to. In fact, the language that different people use to refer to contraception — such as birth control, family planning, birth spacing — reflects those different options.

Yet for many women around the world, having options is far from a reality.

For these women, perhaps the theme should be the ‘Options of Power’ — considering the few options they have and the lack of power they experience in so many aspects of their lives. This year’s World Contraception Day theme comes as a reminder that each of us, individually and collectively, need to continue to work to ensure that all women are empowered and have options in life, whether it’s to use the contraceptive they want or any other decision they want to make.

“This year’s World Contraception Day theme comes as a reminder that each of us, individually and collectively, need to continue to work to ensure that all women are empowered and have options in life…”

Finding Power

To help women, especially young women, empower themselves to decide, governments, the private sector, schools, and other institutions and individuals with the ability to change women’s lives should foster environments that allow women to be active agents of their own lives. This requires changing social norms so that gender equality is a reality; guaranteeing educational and employment opportunities that help level the playing ground for women and girls, and providing access to capital for women’s small businesses, agriculture, and other opportunities.

Girls need to be encouraged to dream big and empower themselves to decide what they want to do with their lives. No more leaving school to fetch firewood or water, no more predatory teachers that take advantage of girl students who want to stay in school, no more “good old boy” networks that promote based on connections, gender, and wealth. These are all tall orders, but for women and girls to begin to experience the power of options, we all need to step up and support the changes needed to overcome gender-based biases, financial and economic barriers, and social customs and traditions that dictate norms and behaviors that perpetuate inequities in society.

Options in Contraceptive Use and Beyond

If we want to create an environment in which all people have options in life, then we need to rethink how governments and the private sector function, especially for those at the bottom of the pyramid.

If avoiding an unintended pregnancy is to be a woman’s option, then she must be able to act on her decision to use contraception, which means that her method of choice needs to be accessible within a reasonable distance and at a reasonable price.

Through Health Policy Plus, we supported countries to introduce Sayana Press — a new injectable contraceptive method and worked to make it available through drug shops and pharmacies to ensure its accessibility and affordability. Our efforts to strengthen women’s leadership skills in several countries contributed to improved implementation of youth policies, better access to contraception for young women, and improved access to data to monitor policy implementation.

Investment in community health workers, social and behavior change, and removing medical barriers to family planning are necessary if the burden and responsibility is to be on women. Now, our work through PROPEL Health is supporting the Liberian Ministry of Health to develop a self-care policy that removes medical barriers and increases women’s autonomy in contraceptive use.

Respectful care from providers and self-care for commodities should be the norm rather than the exception. If women are to have options in life, for contraceptive use and beyond, then we must have a policy environment that reflects their needs and input, sufficient funds to translate policies into implemented programs, and mechanisms to follow through on policy commitments to ensure the goals are achieved.

Living with Power and Options

The aspiration of this year’s theme is that all women will be able to take charge of their own lives and have the agency and autonomy to make that happen. Many of us dream of a day when all people, regardless of gender, can take responsibility for their actions because they have access to the information and services they need.

World Contraception Day 2023 reminds me that we are a long way from achieving this year’s theme, but by staying focused on it as a goal, and by being willing to work for women’s and girls’ empowerment and gender equality, we move closer to a world where all people can claim their own lives and have options — and the needed information — to make choices and decisions about contraception and all aspects of life.



Jay Gribble

Jay Gribble, Senior Fellow at Palladium & Deputy Director of USAID’s PROPEL Health project, has expertise in policy, research, communication & family planning.