Foreword

We know a world with gender equality and universal access to reproductive health is possible. We have seen progress made, possibilities presented, and political discourses change. But we can get there only if we take decisive action now to expand on the progress of the past 10 years.

The 2012 London Summit on Family Planning was a pivotal moment for reproductive health and rights. Leaders from around the world gathered to affirm a woman’s fundamental right to shape her own life, plan her own future, and decide for herself whether and when to have children. The world once again recognized that family planning is transformational, with the power to unleash human potential, break the cycle of poverty, and promote gender equality. They resolved that every woman and girl, no matter where she lives—in a rich country or poor—should be able to enjoy the benefits of lifesaving, life-changing modern contraception. And they set out to make that vision a reality. 

Ten years later, the goal is within reach. An estimated 371 million women and girls in low- and lower-middle-income countries are now using a modern method of family planning. That is 87 million more than just a decade ago. The number of modern contraceptive users has increased by a third overall, and in 14 countries it has more than doubled. Although significant challenges remain, more women than ever are taking charge of their reproductive health and choosing to use family planning. 

If we build on this progress and redouble our efforts—focusing on country-led, sustainably financed programming that is inclusive of all people and responsive to their needs—we can finally close the gap on universal access to contraception. The data in this report can help point the way. 

I want to highlight three key messages to take from this year’s report. 

First, the demand for modern contraception is unstoppable. That’s what we see when we look back at a full decade of data, as we’re able to do this year for the first time. The past ten years have been full of obstacles for country health systems—wars, political upheavals, natural disasters, deadly disease outbreaks, and retrogressive policy environments—yet through it all, women everywhere have continued to seek out and use modern contraception in ever-growing numbers. This is important confirmation of something those of us in the field have known all along: The demand for family planning is real. It’s not an artifact of global donor priorities; it’s a natural result of women’s desire to control their own bodies and shape their own destinies. Women and girls seek out modern contraception because it is the key that unlocks their lives.

 

The demand for family planning is real. It’s not an artifact of global donor priorities; it’s a natural result of women’s desire to control their own bodies and shape their own destinies.


Think of the young adolescent girl whose whole future depends on delaying childbearing until she can finish school and start a career. Think of the young mother for whom adequate birth spacing is literally the difference between life and death—for her and her babies. Think of the hardworking farmer or business owner who relies on contraception to keep her world on track: feeding her family, sending her children to school, lifting herself and her loved ones out of poverty. Women all over the world want—and deserve—to be safe, healthy, and in control of their lives. They want family planning. 

What is Demand?

Demand is a core concept in family planning measurement. It is defined as the sum of two numbers: the number of women of reproductive age who are currently using a contraceptive method and the number of women with unmet need who report not wanting more children or wanting to delay the birth of their next child, but who are not using a modern method. 

Second, we must meet women where they are. A teenage bride in a traditional village is in a very different situation than a single adult in an urban metropolis. A married mother who is already linked into the maternal continuum of care has a very different experience than a schoolgirl buying condoms at the corner shop. Family planning programs must be tailored to reach the populations they are intended to serve. We need to think in terms of person-centered care that focuses on the lived experiences and real needs of women and girls, in all their complexity and diversity. 

Here again, data can help us do that. One of FP2020’s pioneer achievements was the global reporting of contraceptive prevalence for all women, not just married women. This community also led the charge to disaggregate data by age to ensure that adolescents and youth are truly seen. Our reporting on contraceptive method mix has been updated to show more detail and as of this year includes a new data point indicating whether the method was obtained from the public or private sector. All of that comes together in this year’s regional analysis on sub-Saharan Africa. The fine-grained data enable us to peel back the layers and look at sub-populations in detail. We can track the different patterns of contraceptive use, see what methods each group is using, assess where the unmet need is, and consider how family planning programs can improve their reach. 

Third, we must achieve sustainable financing for family planning.  If countries are to realize their development ambitions and meet the ever-growing demand for contraception, reliable and resilient financing is essential. Family planning doesn’t just unlock the future for individual women and girls; it is also the key to harnessing the demographic dividend and building prosperous societies. We must invest in our people—especially in our youth—and that means investing in their health, their futures, and their pathways to success. 

We have far more clarity on resource flows in the family planning sector than we did 10 years ago, thanks to the tireless efforts of partners who can track money and budgetary flows globally from donors and in countries. We know how much is being spent on family planning every year and who is providing the resources. And we’ve observed a modest but important shift toward greater funding by domestic governments for their own programs. In fact, we now estimate that domestic governments contribute as much as international donors to the total outlay on family planning. 

 

Women all over the world want to be safe, healthy, and in control of their lives. They want family planning.

The task now is to build on that framework and go further. To ensure that we have reliable, robust, and stable funding streams to finance our family planning programs for years to come, we must be innovative. Domestic governments will need to continue their efforts to mobilize resources, particularly with an eye toward diversification and resilience. Universal health insurance schemes, greater private sector involvement, co-financing development opportunities, and cross-sectoral partnerships are all avenues to be explored. Donors can also contribute to stability by making long-term commitments to shore up the countries and programs in the greatest need. Together we can develop a sustainable, holistic approach to financing these essential services. 

We have seen how much progress has been made from the ICFP conference in 2022. We have a great deal of work ahead, but I’m heartened by the incredible strength of this community part of which was showcased at the ICFP conference in Pattaya in Thailand. Commitments have poured in since we began the transition from FP2020 to FP2030, with dozens of countries and organizations already announcing formal pledges to the renewed partnership. Our new architecture is taking shape rapidly, with regional hubs coming online and projects to accelerate family planning progress getting underway. 

We’ll begin telling that story next year, with our first FP2030 Partnership Report, which we plan to issue annually. The Partnership Report will be the counterpart to this report, focusing on activities rather than data. The whole partnership will be represented, with updates from the regional hubs, progress notes from commitment makers, advocacy reports, and discussion of issues and challenges. The two reports will complement each other, allowing us to benefit from in-depth data analysis as well  as a robust narrative of progress, opportunities, and challenges from countries where we work. 

Join us on our journey. The promise we set out from the London Summit still beckons.  

Dr. Samukeliso Dube

Executive Director, FP2030