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Total Expenditures on Family Planning
Total spending on family planning is composed of three main segments:
- Domestic government expenditures
- International donor contributions
- Out-of-pocket spending by consumers who access services in the private sector or pay fees for public sector services.
Total expenditures in 2021 are estimated at US$4.2 billion across all low-income and lower-middle-income countries (Figure 14). This is 1% lower than last year’s estimate. International donors contributed an estimated 42%, domestic governments 41%, and consumers 17%.
Figure 14
DISTRIBUTION OF FAMILY PLANNING EXPENDITURES IN LOW- AND LOWER-MIDDLE-INCOME COUNTRIES BY SOURCE OF FUNDS, 2021
Note: Figures based on analysis by Track20 and the Expert Advisory Group on International Family Planning Expenditures.
The distribution of expenditures by type varies significantly by country. Programs in some countries are very donor-dependent, while others are largely funded by national governments or consumers. Data for each segment are collected and reviewed by the Family Planning Expenditures Expert Advisory Group, which provides guidance on combining the available information into a single estimate.
Domestic Government Expenditures
As described in the previous section, these are now available for 59 low- and lower-middle-income countries. Estimates for spending
in 2021 are available for 19 countries. Estimates for other countries are from earlier years: 19 for 2020,14 for 2019, five for 2018, and two for 2016.
The total for reporting countries is US$1.57 billion. Reporting countries represent 91% of all modern contraceptive method users in low- and lower-middle-income countries. Adjusting for the missing countries raises the estimated domestic government expenditures to US$1.73 billion.
International Donor Contributions
Financial contributions from international donors are tracked by several organizations, each using different methodologies.
- The Kaiser Family Foundation tracks bilateral disbursements for family planning by interviewing each of the top 10 donor countries and using the OECD CRS database for all others (see above). For 2021 KFF reports donor funding of US$1.39 billion.
The Institute for Health Metrics and Evaluation (IHME) collects data from a number of sources, including the OECD-DAC CRS, World Bank, regional development banks, USAID-financed NGOs, and UN agencies. Key word searches of project descriptions are used to distinguish family planning funding from other types of development assistance for health (DAH). Estimates include funding from bilateral donors as well as from foundations and NGOs. For 2020, the most recent year available, IMHE estimates donor disbursements at US$1.1 billion. This is different from the KFF estimate because of different approaches to allocated expenditures in broader reproductive health categories to family planning. The IHME estimate includes US$144 million from foundations and NGOs that is not in the KFF estimate.
The Bill & Melinda Gates Foundation reports expenditures directly to FP2030; the amount reported in 2020, the most recent year available, was US$258 million. Combining that figure with the KFF estimate of US$1.39 billion in 2021 for bilateral donors and with the IHME estimates for other foundations, NGOs, and other organizations (US$144 million), total donor contributions for family planning come to US$1.79 billion in 2021.
The Reproductive Health Supplies Coalition and Avenir Health estimate out-of-pocket expenditures on family planning as part of their Landscape & Projection of Reproductive Health Supply Needs (LEAP) analysis. Estimates are produced separately for married and unmarried contraceptive users, using information on the number of modern method users (from Track20 and the UN Population Division), method mix, price points, and the percentage of users obtaining their services from the private sector (from DHS, multiple indicator cluster surveys, and other national surveys).
Total out-of-pocket expenditures in 2019, the most recent year available, are estimated at US$710 million in all low- and lower-middle-income countries and US$3.16 billion when upper-middle-income countries are included.
For more information, analysis and reports:
For more information, analysis and reports:
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