This is an ad for Pathfinder, a charitable organization that works to improve women’s access to birth control around the world.
What I find particularly interesting about this ad is the two ways that the image can be read. Obviously, it is a woman’s hand with fingers crossed. The obvious meaning is that she’s hoping for something (in this case, presumably that she won’t get pregnant). The second way it could be seen however is that she’s evoking crossed legs – the way young girls are often taught to stay virginal, regardless of how practical the advice actually is.
Truthfully, the crossed-legs method is probably a more reliable method of birth control than the crossed fingers, but for many women it’s not as achievable. Pathfinder is suggesting that those women need better options.
I actually think that this image works really well for the message they are trying to convey. This is one of those issues where a print ad isn’t going to convince the people who aren’t already convinced, so you really just need an evocative ad to catch the attention of the people who are and encourage them to take action. This is an evocative ad and has a good chance of doing that, so I think it works.