Voluntarism and Informed Choice

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USAID’s family planning programs are guided by the principles of voluntarism and informed choice. Under these principles:

  • People have the opportunity to choose voluntarily whether to use family planning or a specific family planning method.
  • Individuals have access to information on a wide variety of family planning choices, including the benefits and health risks of particular methods.
  • Clients are offered, either directly or through referral, a broad range of methods and services.
  • The voluntary and informed consent of any clients choosing sterilization is verified by a written consent document signed by the client.

The Tiahrt Amendment

In October 1998, Congress enacted an amendment initiated by Rep. Todd Tiahrt (R-KS), reaffirming and further elaborating standards for voluntary family planning service delivery projects to protect family planning "acceptors," that is, the individual clients receiving services.

Summary of Tiahrt Requirements for Voluntary Family Planning Projects

  1. Service providers or referral agents shall not implement or be subject to numerical targets or quotas of total number of births, number of family planning acceptors, or acceptors of a particular family planning method. Quantitative estimates or indicators used for budgeting or planning purposes are permissible.
  2. No incentives, bribes, gratuities, or financial reward for family planning program personnel for achieving targets or quotas, or for individuals in exchange for becoming a family planning acceptor.
  3. No denial of rights or benefits such as food or medical care to individuals who decide not to use family planning services.
  4. Clients must be provided comprehensible information on benefits and risks of the family planning method chosen.
  5. Experimental methods must be provided only within the context of a scientific study, and participants must be advised of all potential risks and benefits.

Within 60 days after the USAID Administrator determines that a single violation of requirements (1), (2), (3), or (5) has occurred, or, in the case of (4), a pattern or practice of violations has occurred, the Administrator must submit a report to Congress describing the violation and corrective actions taken to address it.

Legislation and Guidance

The first document below contains the full text of the Tiahrt Amendment. The following documents are important sources of guidance for project implementers.

  • Requirements for Voluntary Family Planning Projects, The Tiahrt Amendment 1999 Foreign Operations Appropriations Act
    Available in English [PDF, 24KB], Spanish [PDF, 34KB], French [PDF, 24KB], Arabic [PDF, 100KB].
  • Guidance for Implementing the Tiahrt Requirements for Voluntary Family Planning Projects
    Available in English [PDF, 47KB], Spanish [PDF, 53KB], French [PDF, 55KB], Arabic [PDF, 185KB].
  • Technical Guidance on the "Comprehensible Information" Paragraph of the Tiahrt Amendment
    Available in English [PDF, 139KB], Spanish [PDF, 126KB], French [PDF, 108KB], Arabic [PDF, 209KB].
  • Acquisition & Assistance Policy Directive (AAPD 08-01), dated June 12, 2008: Voluntary Population Planning Activities – Updated Requirements and Clause
    Available in English [PDF, 59KB].

USAID Policy Paper on Population Assistance & Policy Determination 3 (PD-3)

Authorized in 1982, the paper addresses family planning in general and includes an annex containing specific guidance that should be considered carefully when implementing programs with voluntary sterilization components.

  • USAID Policy Paper on Population Assistance
    Available in English [PDF, 93KB], Spanish [PDF, 240KB], French [PDF, 93KB], Arabic [PDF, 514KB].
  • Policy Determination 3 and Addendum: USAID Policy Guidelines on Voluntary Sterilization
    Available in English [PDF, 96KB], Spanish [PDF, 80KB], French [PDF, 86KB].

The Kemp-Kasten Amendment

No foreign assistance funds can be made available to any organization or program which, as determined by the President of the United States, supports or participates in the management of a program of coercive abortion or involuntary sterilization.

Source: Annual Foreign Operations Appropriations Acts.

The DeConcini Amendment

Funds shall be available only to voluntary family planning projects which offer, either directly or through referral to, or information about access to, a broad range of family planning methods and services.

Source: Annual Foreign Operations Appropriations Acts.

The Livingston Amendment

In awarding grants for natural family planning, no applicant shall be discriminated against because of such applicant’s religious or conscientious commitment to offer only natural family planning. All such applicants must comply with the requirements of the DeConcini Amendment.

Source: Annual Foreign Operations Appropriations Acts.

Principles & Policy Requirements

Restrictions on Support for Abortions

Voluntarism and Informed Choice