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Donor Government Assistance for Family Planning in 2015

Introduction

At the London Summit on Family Planning (FP2020), the global community made commitments totaling US$2.6 billion in additional funding for family planning by 2020 (see Box 1). With the commitment period of several donors coming to an end in 2015 and with 2016 marking the halfway point towards fulfillment of the FP2020 goals, it is important to assess the progress made as well as plans moving forward. The status of global funding for family planning takes on added relevance as donors navigate additional budgetary and other pressures, including the ongoing refugee crisis and other competing demands, as well as the effects of Brexit.

Box 1: London Summit on Family Planning
 In July 2012, the U.K. Government and the Bill & Melinda Gates Foundation, in partnership with UNFPA, civil society organizations, developing countries, donor governments, the private sector, and multilateral organizations met at the London Summit on Family Planning (FP2020) and made commitments aimed at improving access to voluntary family planning services.

London Summit on Family Planning Goals & Outcomes: “By 2020, the goal is to deliver contraceptives, information, and services to a total of 380 million women and girls in developing countries so they can plan their families.”

  • Sustain coverage for the estimated 260 million women in the world’s poorest countries who are currently using contraceptives (as of June 2012); and
  • Provide family planning for an additional 120 million women in these countries.
  • The Summit resulted in stated commitments totaling US$2.6 billion in additional funding for family planning activities from all sources (donor governments, non-governmental organizations, philanthropies, multilateral organizations, and domestic resources).

While funding from all sources – domestic public and private spending, donor government bilateral assistance, multilateral organizations, and private philanthropy (see Box 2) – is needed to help fulfill international family planning goals and commitments, donor governments provide a significant share of the total.1 Following the London Summit, the Kaiser Family Foundation conducted an analysis of donor government funding for family planning activities in 2012 to establish a FP funding baseline that could be used to track funding levels over time as well as specific donor government progress in meeting the Summit’s commitments.

Box 2: Other Sources of Funding for FP in Low- & Middle-Income Countries
In addition to donor governments, there are three other major funding sources for family planning assistance: multilateral organizations, the private sector, and domestic resources.

Multilateral Organizations: Multilateral organizations are international organizations made up of member governments (and in some cases private sector and civil society representatives), who provide both core contribution support and donor-directed funding for specific projects.  Core support from donors is pooled by the multilateral organization which in turn directs its use, such as for family planning.  Donor-directed or earmarked funding, even when provided through a multilateral organization, is considered part of a donor’s bilateral assistance.

The primary multilateral organization focused on family planning is the United Nations Population Fund (UNFPA), which estimates that it spent US$341 million (US$92 million from core resources and US$249 million from non-core resources), or 42.7% of its total resources, on family planning activities in 2015.2 Another important source of multilateral assistance for family planning is the World Bank which provides such funding under broader population and reproductive health activities. In 2014, the World Bank estimates that it spent US$251 million on population and reproductive health, an increase of US$30 million above the 2013 level (US$221 million).3 With the creation of the Global Financing Facility (GFF), the World Bank is expected to play an increasingly important role in supporting family planning activities.

Private Sector: Foundations (charitable and corporate philanthropic organizations), corporations, faith-based organizations, and international non-governmental organizations (NGOs) provide support for FP activities in low- and middle-income countries not only in terms of funding, but through in-kind support; commodity donations; and co-investment strategies with government and other sectors. For instance, the Bill & Melinda Gates Foundation has become a major funder of global health efforts, including family planning activities, and is a core partner of FP2020. In 2015, the Gates Foundation provided US$148 million for family planning.4

Domestic Resources: Domestic resources include spending by country governments that also receive international assistance for FP and spending by households/individuals within these countries for FP services.  Such resources represent a significant and critical part of the response.  Since the London Summit, a total of 36 low- and middle-income countries have made specific commitments to increase their family planning spending.

This report provides an analysis of donor government bilateral funding for family planning activities in 2015 compared to prior year levels. It includes data from the 29 governments who were members of the Organisation for Economic Co-operation and Development (OECD), Development Assistance Committee (DAC) in 2015.5 Data were collected directly from ten donors, who represent approximately 99% of bilateral family planning funding, and are profiled in this report: Australia, Canada, Denmark, France, Germany, the Netherlands, Norway, Sweden, the U.K., and the U.S. Data for the remaining DAC members was obtained from the OECD Credit Reporting System (CRS). For purposes of this analysis, family planning services were defined to include the following activities as specified in the CRS: “counseling; information, education and communication (IEC) activities; delivery of contraceptives; capacity building and training.”6 Bilateral totals include actual funding amounts provided (e.g., cash transfers) as well as other types of transactions and activities (e.g., technical assistance), products (e.g., commodities), and donor government earmarked contributions to multilateral organizations (e.g. contributions to the Global Programme to Enhance Reproductive Health Commodity Security at UNFPA).

Where bilateral family planning funding was included as part of broader reproductive and maternal health activities or other non-health-sector activities, we worked directly with donor governments to identify family planning specific amounts to the extent possible (see Methodology for more information). Where it was not possible to disaggregate FP funding from broader reproductive and maternal health activities, the estimated level of family planning funding may be an overestimate. At the same time, some family planning funding provided under non-health-sectors remains largely unidentified, likely resulting in an underestimate of total family planning funding.

Findings

Bilateral Assistance

In 2015, donor governments disbursed7 US$1,344.0 million in bilateral funding for family planning activities (see Table 1, Figure 1 & Appendix 1), essentially flat compared to 2014 when measured in real terms (adjusting for the effects of exchange rate fluctuations and inflation). However, when measured in current U.S. dollars, 2015 was a decrease of US$88.6 million (-6%) below 2014 levels (US$1,432.7 million) and essentially a return to 2013 levels (US$1,325.0 million). The decline, when measured in current U.S. dollars, is due to a complex set of factors, primarily the significant appreciation of the U.S. dollar in 2015, which resulted in the depreciation of most other donor currencies, but also to real declines (in currency of origin) by several donors. Among the donors profiled, five (Denmark, France, Germany, the Netherlands, and Sweden) actually increased FP funding in 2015 – when measured in their currencies of origin, while funding from three donors (Australia, Norway, and the U.K.) declined. Funding from two donors (Canada and the U.S.) remained flat. Despite the decline in 2015 compared to 2014, donor government bilateral assistance for family planning is still approximately US$250 million above the 2012 baseline (US$1,093.6 million).

Figure 1: Donor Government Bilateral Assistance for Family Planning, 2012-2015

Figure 1: Donor Government Bilateral Assistance for Family Planning, 2012-2015

The United States (US$638.0 million) was the largest bilateral donor in 2015 accounting for almost half (47%) of total bilateral assistance (see Figure 2). The U.K. (US$269.9 million, 20%) was the second largest bilateral donor, followed by the Netherlands (US$165.8 million, 12%), France (US$68.6 million, 5%), and Sweden (US$66.0 million, 5%).

Figure 2: Donor Governments as a Share of Total Bilateral Disbursements for Family Planning, 2015

Figure 2: Donor Governments as a Share of Total Bilateral Disbursements for Family Planning, 2015

While the majority of donor governments increased family planning funding between 2012 and 2015, recent trends have been largely driven by the two largest donors, the U.S. and U.K., which have accounted for approximately two-thirds of total funding over the period.

Progress Towards FP2020 Commitments

Eight of the donor governments profiled in this analysis made multi-year commitments at the FP2020 Summit in 2012: Australia, Denmark, France, Germany, the Netherlands, Norway, Sweden, and the U.K. (see Appendix 2). Data collected for 2012-2015 indicate that seven of the eight donors have either fulfilled or are on track to fulfill their FP2020 commitment including: Denmark, France, Germany, the Netherlands, Norway, Sweden, and the U.K. Australia, whose commitment period ends in 2016, had made progress, but due to recent declines, would need to significantly increase family planning funding in 2016 in order to fulfill its commitment.

Donor Contributions to UNFPA

While the majority of donor government assistance for family planning is provided bilaterally, donors also provide support for family planning activities through contributions to the United Nations Population Fund (UNFPA) (see Box 3).8 Most of UNFPA’s funding is from donor governments, which provide funding in two ways: 1) donor directed or earmarked contributions for specific activities (e.g. donor contributions to the Global Programme to Enhance Reproductive Health Commodity Security at UNFPA), which are included as part of bilateral funding; and 2) general contributions to “core” activities that are untied and meant to be used for both programmatic activities (family planning, population and development, HIV-AIDS, gender, and sexual and reproductive health and rights) and operational support as determined by UNFPA.

Box 3: United Nations Population Fund (UNFPA) Mission, Goals, & London Summit on Family Planning Commitment
Created in 1969, UNFPA supports sexual and reproductive health activities in many low- and middle-income countries and was a key partner in the London Summit on Family Planning. 

UNFPA Goal: “The goal of UNFPA is to deliver a world a world where every pregnancy is wanted, every childbirth is safe and every young person’s potential is fulfilled. To accomplish this, UNFPA works to ensure that all people, especially women and young people, are able to access high quality sexual and reproductive health services, including family planning, so that they can make informed and voluntary choices about their sexual and reproductive lives.”9 

UNFPA Mandate:

  • “Build the knowledge and the capacity to respond to needs in population and family planning;
  • Promote awareness in both developed and developing countries of population problems and possible strategies to deal with these problems;
  • Assist their population problems in the forms and means best suited to the individual countries’ needs; and
  • Assume a leading role in the United Nations system in promoting population programmes, and to coordinate projects supported by the Fund.”9

UNFPA London Summit on Family Planning Commitment: “UNFPA will double the proportion of its resources focused on family planning from 25% to 40 % based on current funding levels, bringing new funding of at least US$174 million per year from core and noncore funds. This will include a minimum of US $54 million per year, from 2013-2019, in increased funding for family planning from UNFPA’s core resources.”

In 2015, donor governments provided US$392.6 million in core contributions to UNFPA, a decrease of US$78.9 million (-17%) below 2014 levels (US$471.5 million). Similar to bilateral funding, much of this decline can be attributed to the appreciation of the U.S. dollar. In fact, when measured in the currency of origin, all of the donors profiled essentially maintained their contribution to UNFPA’s core resources at the prior year level, with the exception of Denmark, which increased funding. Sweden provided the largest core contribution to UNFPA in 2015 (US$57.4 million), followed by Norway (US$55.6 million), the Netherlands (US$39.7 million), and Denmark (US$35.7) (see Figure 3 and Table 2).10 Among the ten donors profiled, two provided a larger contribution to UNFPA’s core resources than their total bilateral disbursement for family planning: Denmark and Norway.

Figure 3: Donor Governments as a Share of UNFPA Core Contributions, 2015

Figure 3: Donor Governments as a Share of UNFPA Core Contributions, 2015

Table 2: Donor Government Contributions to UNFPA (Core Resources), 2012-2015 (in current US$, millions)
Country 2012 2013 2014 2015 Difference
2014 – 2015 2012 – 2015
Australia $14.9 $15.6 $13.9 $11.7 $-2.2
(-15.8%)
$-3.2
(-21.5%)
Canada $17.4 $16.0 $14.0 $12.4 $-1.6
(-11.5%)
$-5
(-28.7%)
Denmark $44.0 $40.4 $41.9 $35.7 $-6.2
(-14.8%)
$-8.3
(-18.9%)
France $0.5 $0.0 $0.0 $0.6 $0.1
(20%)
Germany $20.7 $24.0 $24.7 $21.3 $-3.4
(-13.8%)
$0.6
(2.9%)
Netherlands $49.0 $52.4 $48.4 $39.7 $-8.7
(-18%)
$-9.3
(-19%)
Norway $59.4 $70.6 $69.1 $55.6 $-13.5
(-19.5%)
$-3.8
(-6.4%)
Sweden $66.3 $65.8 $70.3 $57.4 $-12.9
(-18.3%)
$-8.9
(-13.4%)
U.K. $31.8 $31.5 $33.1 $30.8 $-2.3
(-6.8%)
$-1
(-3.1%)
U.S. $30.2 $28.9 $31.1 $30.8 $-0.3
(-1%)
$0.6
(2%)
Other Donors $98.0 $108.8 $125.0 $96.6 $-28.4
(-22.7%)
$-1.4
(-1.4%)
Total $432.2 $454.0 $471.5 $392.6 $-78.9
 (-16.7%)
$-39.6
 (-9.2%)

Conclusion

After several years of funding increases since the 2012 London Summit on Family Planning, donor government funding for family planning was essentially flat in 2015 in real terms, and fell when measured in current U.S. dollars.  While the decline was primarily driven by the appreciation of the U.S. dollar, some donors did reduce funding, as measured in their currencies of origin.  At the same time, seven of the eight profiled who made commitments at the London Summit, have either fulfilled or are on track towards fulfilling their commitments. Still, as donor commitment periods come to an end and given the uncertainty associated with the value of the U.S. dollar, it is unclear what the scope of support for family planning will be going forward.

Executive Summary Methodology

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.