Upsurge in family planning use globally amid decline in funding Dr Samukeliso Dube

Lungelo Ndhlovu, [email protected]

THE population of women of reproductive age has increased by 20 percent globally since 2012 yet donor government financing for family planning programmes is nosediving, a new global report has revealed.

New figures released by FP2030 in its annual measurement report 2023, shows that the number of women using modern contraception has grown by 92 million since 2012 against dwindling resources to meet the growing demand.

“An estimated 377 million women were using a modern method of contraception in 2023 in 85 countries against a total number of over 1 billion women in those countries. Their use of modern contraception averted 141 million unintended pregnancies, 30 million unsafe abortions and 141 000 maternal deaths in 2023 alone,” reads the report.

The new report released recently says although there is a growing demand for family planning services across the globe, low and middle-income countries are severely impacted by a reduced amount of resources.

While there has been significant achievements in family planning across the globe since 2012, the decline in funding should be a warning sign ahead that continued progress over the next several years is far from guaranteed.

“Investing in family planning remains one of the best buys in global health. I want our world leaders to take pause and realise the potential we have in front of us if we meet this foundational human right of universal access to modern contraception. With the deadline for the Sustainable Development Goals around the corner, this is the time to be energised and to have enough optimism to meet this moment,” says Dr Samukeliso Dube, Executive Director, FP2030.

FP2030 is a global partnership dedicated to promoting and expanding access to family planning services.

Comprising governments, civil society organisations, private sector partners,and development agencies, FP2030 works collaboratively to advance family planning as a fundamental human right and an essential component of sustainable development.

Donor government funding stood at US$1,35 billion in 2022, representing a decline of US$129 million compared to 2021, again down almost 15 percent from 2019.

Geopolitical conflicts in Ukraine and the Middle East are diverting development assistance and challenging global co-operation. Also, the global movement to deny sexual and reproductive rights, particularly to adolescents and lesbian, gay, bisexual, transgender and intersex (LGBTI) people, has been bolstered by the US Supreme Court’s overturning of the right to abortion.

“The Report comes at a critical time in our movement. We’re at the intersection of several crises: Globally, 800 women are dying every day in childbirth. 218 million women in low and middle-income countries have an unmet need for modern contraception meaning they want to avoid a pregnancy but are not using a modern method,” Dr Dube says.

The stagnation in funding is especially problematic when it comes to donor-dependent methods like contraceptive implants, which have proven hugely popular in Africa. But they remain expensive for most users. They must be subsidised by the international community, if progress in family planning programmes is to be sustained.

Implants are an important addition to the method mix.

Consequences of low funding for family planning programmes can be dire. The world could experience 141 million unintended pregnancies, 30 million unsafe abortions and 141 000 maternal deaths in one year alone. 

“Fewer resources of family planning push women to unintended pregnancies, child births, or unsafe abortion, leading to health consequences and push women, families, communities and countries into ill-health and poverty,” reads the report.

FP2030 has implored donor governments, international donors and governments to put aside, as a matter of urgency, huge and increased investments on family planning at global, regional, national and sub-national levels, with a particular focus on low and middle-income countries. 

“The global community should aim at achieving a collectively higher level of expenditure than is the case now. We need to maintain implant access where it already exists and expand access to regions and demographic groups that have been left behind,” the report says.

Funding from six donor governments, namely Australia, Canada, Denmark, Germany, Sweden and the United Kingdom (UK), decreased in 2022. Some of these declines were largely due to budgetary decisions associated with the humanitarian response to the conflict in Ukraine.

Two countries, the Netherlands and Norway, increased funding while the US remained flat. However, the US continued to be the largest donor to family planning in 2022, accounting for 43 percent (US$582,9 million) of total funding from governments, followed by the Netherlands (US$217,4 million) the UK (US$174,7 million), Sweden (US$121,3 million) and Canada (US$88,3 million).

Nearly 96 percent of family planning funding is provided bilaterally. The remaining four percent is in the form of multilateral contributions from core resources of the United Nations Population Fund (UNFPA).

Domestic governments spent an estimated US$1,68 billion on family planning in 2022. Domestic expenditures are defined as all government expenditures that support family planning, including commodity purchases, demand creation campaigns, investments in training and research and service delivery.

“Our focus this year is post-partum family planning, a topic chosen specifically by the regional hubs. In 2023, there were more than 95 million births in low and lower middle-income countries, and 59 million births were unintended.”

Additionally, more than 80 percent of births to the youngest mothers, under the age of 20, occur in these countries.

Post-partum family planning is a high impact practice with demonstrated ability to improve maternal and newborn health outcomes and increase the uptake of contraception. Women in the first post-partum weeks have little risk of pregnancy, but this is a critical window for counselling on family planning.

The report is a measurement and compilation of family planning data across 85 countries and presents insights into contraceptive use, adolescent and youth sexual and reproductive health and finance trends. 

According to the UNFPA, for every dollar invested in family planning, benefits to families and societies are estimated to be at least US$8,78, altogether generating US$660 billion in economic benefits by 2050.

The Guttmacher Institute has found that every additional dollar spent investing in family planning would save US$3 in reproductive, maternal and newborn healthcare costs, thus contributing to global health, gender equality and sustainable development.


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