Sustainable Financing

Family planning is a development “best buy”

Investing in family planning pays off. When we equip women and young people with the tools they need to thrive, we unleash a powerful engine for progress that benefits families, communities, and societies.

Family planning enables women and girls to complete their education, it saves governments money, and it helps entire communities and nations thrive. Combining family planning and maternal health increases the impact.

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Every $1 invested in preventing maternal deaths and meeting the need for family planning yields $8.40 in health savings and socioeconomic gains.

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Family planning does more than save lives; it also saves money. For every $1 invested in reproductive family planning services, $2.20 is saved in pregnancy-related care costs.

Better, more efficient use of available resources

There’s a shift underway from funding to financing. The traditional model of external donor funding is not sufficient. Demand is growing and the need for additional resources is far beyond what donors can do. Additionally, countries recognize the health and socio-economic benefits of family planning and want to invest in their own populations. A mix of financing from a variety of sources is required to achieve predictable, reliable, adequate, equitable, and sustainable financing for voluntary family planning.

The mix of financing includes:

The country’s domestic funds from taxes and other sources
Prepayment schemes such as contributory insurance
Loans for health
Partnerships with the private sector and innovative financing mechanisms
Also, at the market level, countries can improve quality standards and expand social marketing for contraceptives.

The world is not keeping up with the financial commitments required to meet the growing demand for family planning. As a result, there will be an estimated $1 billion financing gap for contraceptives in low-and middle-income countries by 2030.

Domestic resource mobilization

Countries can work at national and sub-national levels to:

Allocate more of their budgets for family planning supplies and services, with dedicated budget lines and commitments
Fully spend the budget as planned
Use available resources in the most cost-effective way to maximize their impact
Leverage other sources of financing for family planning

As a result of domestic investment, financing will align with national priorities (free from donor conditions), increase the share of spending from pooled funds, and reduce out-of-pocket payments for family planning. This improves equitable access and reduces the hardship for people in poverty.

Illustrative national or sub-national budget cycle. (Source: Cashin et al., 2017)

Examples: How countries have achieved cost savings through improved efficiency

Investing in evidence-based proven practices, e.g. programs that have cost-effectiveness assessments
Implementing strategic purchasing reforms
Procuring in bulk to reduce commodity prices
Using pooled or coordinated buying across countries to negotiate reduced prices with manufacturers
Organizing service delivery to optimize the health workforce, such as through task shifting and integrated services
Adopting a total market approach to family planning with pro-poor efforts and engaging the private sector to expand access

Current initiatives include the UNFPA Supplies Partnership with its matching fund incentive and its Compact agreements where Ministries of Health and Finance sign commitments to increasing domestic resources for contraceptives over time. UNFPA is also working with the Global Financing Facility to mobilize domestic resources.

Tips for effective budget advocacy in domestic resource mobilization

Understand the political economy. Think about who the key decision-makers are. What motivates them? What are their interests? What pressures do they face? Who influences them? What is the distribution of power between different actors?
Make the case for investing in family planning. Set out the evidence of how investments in family planning will ultimately generate savings (e.g. on primary education costs and maternal health); contribute to development goals such as lives saved, poverty reduction, or educational attainment; or harness the demographic dividend to achieve economic growth.
Provide sustained pressure over time. Effective advocacy efforts often require multiple engagements so that decision-makers fully understand and support the need to invest in family planning. Engage the media and civil society and align all advocacy efforts around the same advocacy “ask”.
Link the “ask” to an established development goal. Advocates should highlight the contribution of family planning to other sectors and broader development targets, such as a country’s Sustainable Development Goals. This tactic can be part of a broader strategy to promote health as an investment.

Source: Domestic Public Financing HIP Brief

Did you know?

The Addis Ababa Action Agenda is a global framework for financing sustainable development. It was adopted in 2015 at the United Nations Third International Conference on Financing for Development in Addis Ababa, Ethiopia. Ten years later, in June 2025, the Fourth International Conference on Financing for Development, will address the growing gap in finance for the SDGs.

Module 3: At the Local Level

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Key Takeaway

The goal of the shift from funding to financing is to transition from development assistance for health to domestic resources. It is also about moving away from out-of-pocket spending towards domestic, prepaid and pooled financing for health.

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DRM Tips

Advocacy interventions are critical for domestic resource mobilization (DRM). Start by making the case to key stakeholders, ministries of health and finance, and parliamentarians to include a budget line for family planning (including commodities) and then to increase the total budget allocation and expenditure. The EPF Global Contraceptive Atlas “scores” public program performance, inspiring countries to improve their ranking in contraceptive services.

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DRM Example

In a sign of increasing government commitment, all eligible countries (44) have signed “Compacts” with the UNFPA Supplies Partnership. This marks a significant milestone as it represents the first time so many governments have formally committed to domestic financing for reproductive health commodities.