Family Planning for a Prosperous Future

Investing in policies, partnerships, and innovations to strengthen reproductive health care, end unmet needs, and support sustainable development

A Special Report from FP Analytics, with support from Bayer

MARCH 2025

Introduction

Sexual and reproductive health and rights (SRHR) represent a critical building block in global health and sustainable development by creating the basis for healthier, longer lives, enabling educational and professional attainment, and underpinning gender equality. The manifold returns of investment in SRHR—in the areas of health, socioeconomic development, peace and security, and the environment—present a range of inter-generational benefits on the order of trillions of dollars over time. The importance of SRHR, and particularly family planning and reproductive health services, is enshrined in global commitments including the International Conference on Population and Development (ICPD) Programme of Action, the Beijing Declaration and Platform of Action, and the United Nations Sustainable Development Goals (UN SDGs). Nevertheless, in recent years, many countries and regions have experienced stalling and backsliding on progress in furthering family planning and reproductive health.

Against the backdrop of complex crises such as armed conflicts, climate-driven natural disasters, supply chain disruptions, and rapidly evolving health emergencies, family planning and reproductive health services have been de-prioritized in recent years. During the COVID-19 pandemic, many countries experienced lockdowns and health care system strain, which deterred sexual and reproductive health-seeking behaviors and redirected funding. Meanwhile, the number of women and girls living in conflict-affected countries increased by 50 percent between 2013 and 2023, disrupting primary health services and leading to an uptick in sexual and gender-based violence. In addition to the impacts of what has been described as a global polycrisis, the politicization of family planning and reproductive health services in various parts of the world is further complicating and curtailing bilateral and multilateral financing and policymaking for SRHR, and contributing to shrinking space for civil society actors.

Executive Summary
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Sexual and reproductive health and rights (SRHR) represent a critical building block in global health and sustainable development by creating the basis for healthier, longer lives, enabling educational and professional attainment, and underpinning gender equality. The manifold returns of investment in SRHR—in the areas of health, socioeconomic development, peace and security, and the environment—present a range of inter-generational benefits on the order of one trillion dollars over time. However, against the backdrop of complex crises such as armed conflicts, climate-driven natural disasters, supply chain disruptions, and rapidly evolving public health emergencies, family planning and reproductive health services have been de-prioritized in recent years, threatening global progress.

Barriers to meet family planning and reproductive health goals include decreased funding from traditional sources and a lack of transparency regarding the distribution of funds to specific aspects of care such as contraceptives. Supply chain disruptions affecting the distribution of commodities, diagnostics, and therapeutics, alongside a shortage of trained, specialized health care workers, further hamper progress. Reflecting the combined effects of these multiple challenges, recent family planning and reproductive health data indicate a slowdown in progress toward meeting global targets. As of 2024, the UN Population Division estimated that 258.5 million women around the world face unmet need for modern family planning methods, 87 percent of whom live in low- and middle-income countries (LMICs).

The year 2025 marks six years since the Guttmacher-Lancet Commission report, 30 years since the International Conference on Population and Development and the Beijing Declaration, and just five years until the UN Sustainable Development Goals deadline. As such, it provides an opportunity for key stakeholders—from multilateral institutions, to governments, to civil society organizations (CSOs) and non-governmental organizations (NGOs)—to reaffirm their commitments to eliminating unmet need for SRHR and achieving reproductive health and family planning goals.

To that end, this special report, produced by FP Analytics with support from Bayer, seeks to identify areas of unmet need and barriers to progress toward family planning and reproductive health goals, analyze the benefits of intervention, and provide insights into the state of SRHR programs and financing in the post-pandemic era. Consisting of a global landscape analysis and in-depth case studies on five LMICs with significant unmet need—Brazil, Ethiopia, India, Indonesia, and Nigeria—this report highlights scalable recommendations to close gaps in research, policy, investment, and partnership, seeking to catalyze action from key stakeholders.

Key takeaways and recommendations for action include:

Prioritize and sustain funding for family planning

Secure sustainable funding pathways for family planning and reproductive care to reduce vulnerability to exogenous shocks such as conflict, pandemics and epidemics, or shifts in political will. A locally led approach, augmented by the input and investment of private-sector and non-governmental actors, can ensure long-term strategic prioritization and financing.
Integrate family planning and reproductive health services into universal health coverage plans and financing, as a fundamental aspect of health care. Strategic prioritization of family planning and better integration into primary health care needs to be led by governments in partnership with multilateral institutions, to catalyze the financing, technical expertise, and resources that are necessary to bolster these interconnected services.
Invest in the transparency and reliability of financial flow data to ensure accountability, identify funding gaps, and strengthen resource allocation for family planning and reproductive health care. Governments can collaborate with multilateral and research institutions and philanthropies to enhance financial and budget data systems.

Expand rights-based access to a range of contraceptives

Enshrine the sexual and reproductive rights and the health of all persons in national and international laws and policies, to support a rights-based approach to family planning and enable sensitive service delivery to marginalized and criminalized groups.
Expand access to the full range of modern contraceptive methods, with the aim of ensuring freedom of choice and eliminating unmet need for family planning. Governments and multilateral institutions can collaborate with the private sector to overcome barriers such as cost and health worker training to ensure access, even in poor and remote communities.
Ensure equitable access to family planning and reproductive health services for underserved populations, including youth, unmarried persons, and communities in remote and rural areas, and break long-standing stigmas around these services. International and local non-governmental organizations can act as bridges to underserved groups and are key to local health systems strengthening, service delivery, advocacy, and information-sharing.

Mobilize cross-sectoral and complementary partnerships

Articulate the extended benefits of family planning and reproductive health outcomes within the context of global sustainable development, and identify areas for fruitful cross-sectoral collaboration. Demonstrating that these goals represent an investment in global economic development, well-being, and climate change adaptation and mitigation can catalyze action and funding from a variety of traditional and unexpected sources.
Pursue innovative collaborations, including public-private partnerships, to combine the complementary skills, expertise, and resources of different stakeholders in reproductive health and family planning, and improve service delivery at the national and local levels. The private sector can provide market-based approaches while governments create regulatory and policy environments that facilitate impactful cross-sectoral partnerships.
Invest in the collection of high-quality, comprehensive, gender- and age-disaggregated data on family planning and reproductive health, their multifaceted impacts, and the costs of inaction, around the world and in LMICs particularly.

Given the interconnected challenges and complex crises the world faces, business-as-usual efforts risk deepening inequities, undermining reproductive health, and delaying gender equality. Targeted, dedicated investment in family planning, however, can produce significant dividends, including to save women’s lives and strengthen education, economic development, peace and security, and climate and environmental outcomes. The 2030 SDG deadline provides a clear target for catalyzing action, but stakeholders need to work together to build on and sustain progress in the coming decades.

The landscape of funding for reproductive health is a complex one where a range of stakeholders, from governments to bilateral and multilateral donor agencies, philanthropic foundations, and others play an important role mobilizing resources and shaping programmatic priorities. In 2023, donor government funding for family planning was USD 1.47 billion but still fell short of the pre-pandemic level of USD 1.58 billion in 2019. Even when funding is pledged, it may not be disbursed for its intended use, or at all. At the current rate at which investments are made, and without increased and transparent financing—both domestic and international—the commodity financing gap for family planning in the world’s poorest countries could amount to USD 1.5 billion by 2030. Funding shortfalls and bottlenecks, combined with inadequate last-mile delivery of commodities and care due to ill-equipped infrastructure or governance systems, risk stagnating progress on family planning and reproductive health.

At the current rate at which investments are made, and without increased and transparent financing—both domestic and international—the commodity financing gap for family planning in the world’s poorest countries could amount to USD 1.5 billion by 2030.

Reflecting the combined effects of these compounding challenges, recent family planning and reproductive health data indicate a slowdown in momentum to meet global targets. As of 2024, the UN Population Division estimated that 258.5 million women around the world face unmet need for modern family planning methods, 87 percent of whom live in low- and middle-income countries (LMICs). The COVID-19 pandemic disrupted contraceptive use for tens of millions of women and resulted in an estimated 1.4 million unintended pregnancies in 2020 across 115 countries. Meanwhile, although maternal deaths decreased by 34 percent between 2000 and 2020—a significant public health victory—progress has stagnated in recent years, with the average rate of reduction between 2016 and 2020 falling short of targets. At 223 deaths per 100,000 live births, the current global maternal mortality ratio is three times higher than the SDG goal of reducing maternal mortality to 70 per 100,000 live births by 2030. In addition, as of 2023, 39.9 million people globally were living with HIV, with women and girls accounting for 44 percent of all new HIV cases. All of these indicators contribute to the delay in closing the gender gap—which no country is on track to achieve by 2030—and in meeting critical sexual and reproductive health goals.

FIGURE 1

Key Indicators of Family Planning and Unmet Need

Regions with high unmet need for family planning also face high maternal mortality, high adolescent birth rates, and gender inequality.

Maternal mortality dropped by 34 percent globally between 2000 and 2020, but the average of 223 deaths per 100,000 live births remains far above the SDG target of 70.

Global progress in reducing adolesecent pregnancies remains uneven, with Sub-Saharan Africa recording the highest rate at 97.9 births per 1,000 women aged 15-19 years.

Gender equality stagnated or declined in nearly 40 percent of countries from 2019 to 2022, affecting more than 1.1 billion women and girls.

Sources: UN Population Division (2024 data), Equal Measures 2030 (2022 data), WHO (2020), and WHO (data latest year available)

The year 2025 represents a critical juncture for reflection, redoubling of efforts, and reinforcement of the pathway to progress in family planning and reproductive health, marking six years since the Guttmacher-Lancet Commission report, 30 years since the ICPD and the Beijing Declaration, and just five years until the SDG deadline. As such, 2025 provides an opportunity for key stakeholders—from multilateral institutions, to governments, to non-governmental organizations (NGOs)—to reaffirm their commitments to eliminating unmet need for SRHR and achieving reproductive health and family planning goals.

To that end, this special report, produced by FP Analytics with support from Bayer, identifies areas of unmet need and barriers to progress toward family planning and reproductive health goals, analyzes the benefits of intervention, and provides insights into the state of SRHR programs and financing in the post-COVID-19 era. Consisting of a global landscape analysis and in-depth case studies on five LMICs with significant unmet need—Brazil, Ethiopia, India, Indonesia, and Nigeria—this report highlights scalable recommendations to close gaps in research, policy, investment, and partnership, seeking to catalyze concerted action.

Research Methodology
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In pursuit of actionable takeaways, the research methodology for this in-depth special report combines qualitative and quantitative approaches to provide a comprehensive analysis of family planning and reproductive health globally and in five selected countries.

Qualitative Research Interviews

FPA conducted 22 semi-structured interviews, each lasting approximately one hour, with subject-matter experts and representatives from intergovernmental organizations, civil society groups, academic institutions, and other in-country or global experts.
These interviews were conducted between October 2024 and January 2025 and were guided by a carefully designed questionnaire, adjusted depending on the expertise of the interviewees, to explore key themes and challenges in family planning and reproductive health.
Interviewees were identified by the FPA team through purposive outreach based on desk research and through a snowball sampling method based on referrals from interviewees.
Informed consent was obtained during the interview, and written consent was secured for the attribution of responses where applicable, after FPA transcribed and analyzed interviews. For a complete list of interviewees, refer to Interview Log below.

Survey of Literature

FPA conducted an open-source, desk-based comprehensive review of literature, drawing on primary and secondary sources, including publications by academic and research institutions, governments, nongovernmental and intergovernmental organizations, and media outlets.
The review focused on social, economic, health, environmental, and political dimensions relevant to family planning and reproductive health.

Statistical Analysis of Quantitative Data

FPA analyzed data from open-source and publicly accessible international databases, national health surveys, and previous cost-benefit and return on investment (ROI) studies in the family planning and reproductive health sector, and global health in general.
The statistical analysis provided insights into the trends, gaps, and funding landscape of family planning and reproductive health. Additionally, FPA developed data visualizations to highlight key statistical insights.

Selection Criteria for Five Case Studies in the Report

Guided by the availability of publicly accessible and reliable data, Brazil, Ethiopia, India, Indonesia, and Nigeria were selected for the in-depth case studies in order to:
- Maximize geographic diversity, spanning multiple regions across the world;
- Reflect significant unmet need and among the most populous countries worldwide;
- Represent major regional economies, including low- and middle-income countries; and
- Illustrate the role of international financial flows, as these countries are recipients of sizable multilateral, bilateral, and philanthropic funding.

Interview Log
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Alvaro Bermejo, Director General of the International Planned Parenthood Federation

Andrea M. Wojnar, UNFPA India Representative and Country Director Bhutan

Anne Pfitzer, Director of FP/RH for the MOMENTUM Country and Global Leadership project, led by Jhpiego

Claire Charamnac, Social Development Specialist at the Asian Development Bank

Hassan Mohtashami, UNFPA Representative in Indonesia

James Okara Wanyama, UNFPA Humanitarian Programme Coordinator in Ethiopia

Joachim Chijide, Family Planning/Reproductive Health Commodity Security Specialist for UNFPA Nigeria

Kathleen Mogelgaard, President and CEO of the Population Institute

Kayode Afolabi, Executive Director at Reproductive Health and Child Survival Ltd, and former Director of Reproductive Health in the Nigerian Ministry of Health

Koki Agrawal, Family Planning Director, Jhpiego

Jennifer Pope, Vice President for Sexual and Reproductive Health, HIV, and TB at PSI Global

Luis Bahamondes, Professor of Gynaecology at the State University of Campinas Medical School

Martyn Smith, Director at Reproductive Health Supplies Coalition

Monica Kerrigan, FP2030 Managing Director for the North America and Europe

Phil Anglewicz, Principal Investigator, Performance Monitoring Action Project at Gates Institute, Johns Hopkins University

Supriya Madhavan, RMNCAH-N and Gender Lead at the World Bank’s Global Financing Facility

Yana van der Meulen Rodgers, Professor of Labor Studies and Employment Relations (LSER) at Rutgers University

Family Planning and Reproductive Health Development Practitioner, USA

Multilateral Sector Family Planning and Reproductive Health Expert, Ethiopia

Family Planning and Reproductive Health Development Practitioner, Nigeria

Multilateral Sector Family Planning and Reproductive Health Development Practitioner, USA

Multilateral Sector Family Planning and Reproductive Health Data Scientist, USA

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