In health service planning, most attention usually goes to planning on the supply side of services. The question as to whether the services will be used is often neglected, even when it is clear there are factors that could limit demand and uptake of health services like denial, fear, stigma, discrimination, socio-cultural issues and high costs. Undoubtedly quality health services are needed to achieve universal access to reproductive health, but we have also learned from extensive program experience that simply providing or strengthening health services may not necessarily lead to their use, particularly by poor women and the ones most at risk. Given the scope and complexities of social, cultural, economic, and geographic factors that infringe upon ones health-seeking behavior, it is evident that not all these factors can be addressed through health system strengthening initiatives and therefore require a more expansive set of strategies and leadership at the community level to influence social norms and catalyze action.
