Dear Donors: Three Recommendations to Accelerate Progress Toward the Global Family Planning Goals

There’s a mixed bag of news in the recently released Family Planning 2020 (FP2020) global progress report on efforts to expand access to high-quality, voluntary family planning services. First the good: real strides have been made in helping more women and girls make healthy and autonomous reproductive choices. Since 2012, 30.2 million additional women and girls have capitalized upon expanded access to become users of modern contraceptives—6.2 million more than would be expected based on historical trends alone. Yet this forward progress remains well below the initiative’s aspirational trajectory, suggesting its headline goal—120 million additional users by 2020—will be an uphill climb. And many countries have failed to meet their individual financial or programmatic commitments.

So what more can be done? CGD’s new report Aligning to 2020: How the FP2020 Core Partners Can Work Better, Together offers three big recommendations for donors on the path to 2020. They are laid out in greater detail later in this blog, but in brief we urge donors to be more strategic and collaborative in how resources area allocated at the national level; we would like to see stronger incentives developed and rolled out for co-financing and performance; and we encourage greater accountability and learning across the results chain.

Our report, a year in the making, is the product of a CGD working group convened to consider the key question of how donors and the FP2020 Secretariat can best align and use family planning funds to accelerate global progress. The working group focused on the three largest family planning donors—USAID, DFID, and the Bill & Melinda Gates Foundation—but included broader participation from the FP2020 Secretariat, multilateral and foundation donors, and the FP2020 accountability partners. To inform our discussions, we conducted original empirical research looking at the flow of family planning funds (Fan et al. and Mirelman, forthcoming); we also took on “deep dive” case studies in Kenya, Nigeria, and Uganda.

CGD’s main findings on FP2020

Our report makes findings in four main areas:

• First, funding has grown, but risks are on the horizon. Currency depreciations are affecting the real value of non-US donor contributions, political crises are turning donors’ attention away from family planning, and changes in leadership may lead to declines in overall financing or affect its stability in the long term. In 2015, according to a new report from the Kaiser Family Foundation, donor funding for family planning remained flat in real terms.
   
• Second, the allocation of donor resources does not closely track family planning need. Each donor takes a different approach to cross-country allocation, using different criteria and processes. Country-led costed implementation plans (CIPs) have helped set a broad direction for countries’ family planning programs, with significant buy-in from country governments and civil society, but most still exhibit important limitations that constrain their utility to optimize resource allocation decisions.
   
• Third, alignment of commodity purchasing and supply chains has improved substantially, but the sustainability of parallel supply chains may be at risk given the volatility of aid. Fourth, countries have few incentives for co-financing family planning, and some disincentives to domestic investment.
   
• Fourth, high-level accountability for progress and results is in place, but there is little to connect success or failure to particular streams of funding or service provision.

To address these gaps, our report offers three concrete recommendations for donors and the FP2020 Secretariat:

Recommendation 1: Support more strategic and collaborative resource allocation at the country level, building on successes and existing coordination platforms.

• Costed Implementation Plans (CIPs) should be improved to include realistic, model-based targets and a blueprint (not “wish-list”) of activities where current and new donors’ resources could be most impactful. CIPs should also be redesigned to reflect key changes in the political and financial operating environment, such as decentralization or the launch of the Global Financing Facility.
   
• Donors should improve their data reporting to initiatives like the International Aid Transparency Initiative (IATI) and the OECD’s Creditor Reporting System (CRS) to be more granular and timely. Donors should also be more transparent about their current and future resource allocations (over a three- to four-year time horizon) to facilitate government planning and inform other donors’ investments.
   
• Donors should be more strategic about their resource allocation by critically analyzing variation in family planning need and access across countries, subnational regions, wealth quintiles, and age groups.

Recommendation 2: Create and test stronger incentives for greater co-financing and performance.

• Donors and country governments should consider the introduction of performance-based incentives across various different relationships and levels of government (for example, between donors and grantees, or between a national government and subnational units) where appropriate. Any performance-based incentives must be designed to fully respect the principles of voluntarism and informed choice.
   
• Donors should consider the introduction of stricter co-financing policies or matching fund schemes for commodity purchases to increase domestic resource allocation by country governments.

Recommendation 3: Enhance accountability and learning across the results chain.

• Grantees’ self-reported results should be independently verified on a regular basis and at least a portion of funded programs should undergo rigorous, independent impact evaluations.
   
• Results from past and future impact evaluations of donor-funded programs should be pooled into one database and donors should require that all project evaluations be submitted there to promote evidence-based policymaking and programming.
   
• Donors should maintain and enhance their support for initiatives that track family planning expenditures.

These recommendations provide a roadmap for donors to improve their family planning programs and allocate resources more efficiently, allowing them to better support the right of women and girls to make informed and autonomous reproductive choices. We hope donors take these recommendations and this opportunity to heart – and we’ll be watching to see whether they take the necessary steps to accelerate progress toward the FP2020 and Sustainable Development Goals.

Check out the FP2020 progress report here.

Read the latest on family planning financing from the Kaiser Family Foundation here.