Background : Improving access to family planning in the Pacific region has been slow, especially for those living in remote and rural areas. Pacific countries consistently report contraceptive prevalence rates well below the United Nations’ global averages for ‘less developed’ regions. The most recent data available on family planning usage in Kiribati from 2009 reported that the modern contraceptive prevalence rate was just 18.0% and total contraceptive prevalence rate just 22.3%. The aim of the study was to investigate knowledge and use of family planning and identify barriers to contraceptive uptake for men and women of reproductive age in South Tarawa, Kiribati, to inform future approaches aimed at increasing access to family planning. Methods: A mixed methods approach was used. A community survey of men and women of reproductive age (15-49 years) (n=500) was carried out to identify current levels of knowledge, contraceptive use and barriers to use. Focus groups (n=4) of target populations (men 15-24, men 25-49, women 15-24, women 25-49) were undertaken and in-depth interviews (n=14) were conducted with health professionals and government officials to interpret survey results, further investigate barriers and generate ideas for improving service delivery. Findings: Considerable barriers to family planning use were observed in the community survey and explored in the interviews and focus groups. They can be categorised into four thematic groups: disinterest in family planning; knowledge gaps; personal, family and social objections; and unsuitable service delivery. Conclusion: A broad range of solutions were identified and fourteen service delivery recommendations were made for family planning service providers in South Tarawa. The recommendations may also hold relevance to other Pacific countries, however we encourage service providers to consider their country context before initiating any recommendations provided in this study.