Aligning Funding and Need for Family Planning: A Diagnostic Methodology

Abstract

With limited international resources for family planning, donors must decide how to allocate their funds to different countries. How can a donor for family planning decide whether countries are adequately prioritized for funding? This article proposes an ordinal ranking framework to identify under‐prioritized countries by rank‐ordering countries by their need for family planning and separately rank‐ordering them by their development assistance for family planning. Countries for which the rank of the need for family planning is lower than the rank of its funding are deemed under‐prioritized. We implement this diagnostic methodology to identify under‐prioritized countries that have a higher need but lower development assistance for family planning. This approach indicates whether a country is receiving less compared to other countries with similar levels of need.

Donor funding for family planning: levels and trends between 2003 and 2013

“…This would be consistent with the emphasis on unmet need found in documents from the USA, UK and Dutch governments ( UK DFiD 2011 ; USAID 2012 ; Kingdom of the Netherlands 2014 ). It is also consistent with Fan et al (2017 ) finding (presented in their supporting information) that disbursements for family planning in 2012–14 were moderately correlated with number of women with unmet need. Health service programme strength often affects unmet need ( Wulifan et al 2016 ), and low national levels of unmet need may indicate relatively strong national family planning programmes, meaning that targeting donor funding to countries with higher levels of unmet need may be appropriate.…”

“…Our estimates of overall funding and largest donors and recipients is also very similar to the estimates recently published by Fan and colleagues for 2004–14 ( Fan et al 2017 ), although Fan and colleagues focussed on the relationship between funding and need and did not give a full breakdown of annual funding by donor and recipient country.…”

“…In recent years a number of initiatives have sought to track global funding flows to support progress towards reproductive, maternal, newborn and child health, including family planning ( Hsu et al 2013 ; UNFPA and NIDI 2014 ; Fan et al 2017 ; Institute for Health Metrics and Evaluation 2017 ). Hsu et al (2013 ) estimated disbursements for family planning at $289 m in 2009 and $299 m as part of the Countdown 2015 initiative in 2010 (2010 USD).…”

“…UNFPA and NIDI estimates suggest that <$1 b was disbursed for family planning from bilateral donors and through the UN system in each year up to 2010 (2013 USD, our conversion) ( UNFPA and NIDI 2014 ). A recent study by Fan and colleagues using Organisation of Economic Co-operation and Development’s (OECD) CRS records reported under the family planning purpose code found that over the period 2004–14, donors disbursed $5.9 b for family planning (2013 USD) ( Fan et al 2017 ). The estimates from UNFPA/NIDI, Fan and colleagues and IHME do not provide a detailed breakdown of family planning funding by donor, recipient country and year.…”

“… Fan et al (2017 ) also investigated whether in 2012–14, donors prioritized family planning disbursements to recipient countries according to several indicators of national-level need (contraceptive use, population growth, maternal mortality, gender inequality, unmet need and demand satisfied). They found that recipient countries with greater need, across all indicators, were often under-prioritised.…”