Increase sustainability

An investment case for family planning can be a powerful tool. It demonstrates the high returns that can be achieved by strengthening investments in the delivery of evidence-based, high-impact interventions by presenting the full range of costs involved and the full range of benefits that flow from the interventions. Typically, investment cases are developed to influence decisions and catalyse transformative change. They are primarily aimed at donors or governments, but they can also target planners, donors and other interested stakeholders. They demonstrate the value of investment in monetary terms (e.g. productivity losses averted, benefit-cost ratios, etc.) and health outcomes (e.g. lives saved, disability-adjusted life years averted, etc.). These investment cases consider the current or status quo situation and the progress that can be achieved and identify key bottlenecks and gaps that limit sustained or further progress towards the desired goals. They include estimates of the cost required to meet the desired goals, as well as analyses of the available funding and financial gaps. A well developed investment case can help to build consensus around the importance of investing in family planning among key stakeholders, including the government and donors. The investment case can also make visible the equity gaps and current barriers at both the national and subnational level and identify opportunities for partners to address these issues.

Follow the guidance here: UNFPA  Developing investment cases for transformative results toolkit. 

Increasing access to family planning methods* can raise the contraceptive prevalence rate and prevent unintended pregnancies, which not only results in fewer maternal deaths, stillbirths and neonatal deaths, but also reduces the costs associated with maternal health services.* Investment in maternal health interventions not only decreases maternal mortality but also diminishes maternal morbidity and health complications associated with childbirth, which can cut health costs and avert economic events such as loss of income.

At least double the funding currently allocated to family planning in developing countries will be needed to end the unmet need for modern contraception.** Increasing financial sustainability of family planning programmes will thus require a significant expansion in financing as well as better, more efficient use of all available resources, the engagement of new partners including the private sector, and innovative financing mechanisms. UNFPA has been increasing its focus on a multifaceted approach to promoting financial sustainability at global, regional and country levels with three main areas of engagement in the forefront of its efforts. The shift from funding to financing means gradually shifting from a donor assistance model to a more sustainable model based on domestic financing of national development needs.

First, UNFPA will invest in deeper political economy analysis in countries and across different settings in order to advocate for repositioning family planning as a core development investment, a best-buy for health and a driver of economic development. UNFPA will build expertise to develop family planning investment cases and will target advocacy efforts to ministries of health and finance, to parliaments and to a wide range of stakeholders for an increased resource allocation for family planning at the national and subnational level. This will be carried out working with key partners including International Financial Institutions, the Global Financing Facility (GFF), the World Health Organization and country governments

UNFPA will work closely with the World Health Organization and with relevant global health H6 partners to prioritize family planning as a key component of sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) in the context of primary health care and universal health coverage. Since 2015, many countries have been developing plans to advance UHC policies to expand access to a basic package of health care for all people while protecting against financial hardship. Where family planning is integrated into a basic package of care available to all individuals, investments into UHC also contribute to financing family planning.

Second, UNFPA will expand the pool of available funding sources, primarily through focusing on strengthening domestic resource mobilization, but also through encouraging and fostering innovative public–private financing mechanisms, increasing the access and use of established financing instruments, e.g. expanding the use of matching funds, exploring debt buy-down in some contexts.

Third, UNFPA will develop its role in supporting countries to maximize the efficiency in the use of existing resources and better manage family planning commodities. This includes contributing to and engaging partners on market shaping initiatives, and encouraging governments to adopt total market approaches (TMA) to maximize market efficiency, equity and sustainability through the coordination of the public, social marketing and commercial sectors. UNFPA will work through the newly established Supply Chain Management Unit (SCMU) in collaboration with the World Health Organization in order to ensure reproductive health commodity market stability and increase sustainability. This will support regional and local manufacturers to adopt international quality standards, thus enhancing their capacity to deliver quality reproductive and maternal health commodities. Coupled with strengthening governments’ procurement and domestic resource capabilities, UNFPA will improve market dynamics, rendering them resilient to global market and supply shocks and fluctuations.

*Reducing unmet need for family planning also requires additional demand-side interventions including those targeting social and gender norms.

**The cost from 2020 to 2030 of ending the unmet need of modern family  planning is estimated at US$ 68.5 billion in 120 priority countries of which an estimated US$ 8.6 billion will likely come from donors leaving US$ 59.9 billion for countries themselves to finance. See: UNFPA (2021). Costing the Three Transformative Results. www.unfpa.org/sites/default/files/pub-pdf/Transformative_results_journal_23-online.pdf