Agenda setting for contraceptive access: applying Kingdon’s framework to policy change

This commentary explores the factors affecting access to contraception through the lens of Kingdon’s Multiple Streams Framework (MSF). Despite the proven benefits of contraception in improving women’s health, reducing maternal mortality, and enhancing socioeconomic outcomes, millions of women globally face challenges in accessing contraception. This gap is attributed to barriers such as limited access, affordability issues, cultural and religious opposition, and gender-based challenges. Kingdon’s MSF, which consists of the problem, policy, and politics streams, provides a structured way to analyze these challenges in the context of contraceptive access. The problem stream focuses on unmet needs and the consequences of restricted contraceptive access, while the policy stream emphasizes developing targeted policies to address these gaps, as exemplified by Ghana’s Family Planning Costed Implementation Plan (GFPCIP) 2024–2030. The politics stream considers the influence of political factors, including public opinion and government support, on contraceptive policy. The commentary also highlights the critical role of policy entrepreneurs in facilitating the coupling of these streams to open a policy window for meaningful change, emphasizing the importance of coordinated advocacy efforts to advance contraceptive access.