ABSTRACT
Objectives
The objective of the paper is to identify levels of and gaps in family planning financing
in Pakistan and to assess whether current funding is sufficient to meet national and
FP2030 goals to increase contraceptive use to 60% by 2030.
Study Design
We estimate the cost of family planning services nationally and by province based
on the Essential Services Package and WHO/UNFPA cost by applying the existing Guttmacher
global Adding-It-Up methodology. Additional data are also analyzed to assess trends
in expenditures on family planning between 2017 and 2021.
Results
The estimated cost of family planning services provided in Pakistan in 2017 was US$81
million, equivalent to US$0.38 per capita. The estimated gap in costs to provide contraceptive
services to the additional 8.6 million women with unmet need for modern contraception
was US$93 million. While we found evidence of an upward trend in overall government
expenditure on family planning services over the period 2017–21, the pace of increase
was slow and uneven across regions.
Conclusions
The evidence highlights the persistent inadequacy of financing for contraceptive services
especially if Pakistan intends to achieve its ambitious national and FP2030 goal of
increasing contraceptive prevalence to 60% by 2030.
Implications
A doubling of current funding for contraceptive services is required in Pakistan.
Additional financing needs to be directed towards the poorest women with unmet need
to avoid unintended pregnancies and to improve equity in reproductive health outcomes.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ContraceptionAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Provincial Targets for the CCI recommendations.Govt. of Pakistan & UNFPA, Islamabad, Pakistan2020 (Available at:)
- FP: An Imperative for Pakistan's Development. Background paper for London Summit on FP 2012.Population Council, Islamabad, Pakistan. 2012;
- Pakistan 2017: Progress and Commitments in Family Planning. Satellite Event to the Family Planning Summit.Population Council, London. Islamabad2017
Family Planning (FP) 2020. “Family Planning 2020 Commitment: Government of Pakistan”. Familyplanning2020.org; 2017. Available at: https://www.familyplanning2020.org/sites/default/files/Govt_Pakistan_FP2020_Commitment_2017_0.pdf.
- Adding It Up: Costs and Benefits of Meeting the Contraceptive and Maternal and Newborn Health Needs of Women in Nepal, New York Guttmacher Institute, 2019 (a)
- The cost of post-abortion care in developing countries: a comparative analysis of four studies.Health Policy Planning. 2016; 31: 1020-1030
- National Health Accounts Pakistan 2015–16.Islamabad: Government of Pakistan, Statistics Division, Pakistan Bureau of Statistics, 2018 (a)
- Expenditures on family planning in FP2020 focus countries in 2015.Track20 Project for the International Family Planning Expenditure Tracking Advisory Group, 2017
- Adding it up: The benefits of investing in sexual and reproductive health care.The Guttmacher Institute and United Nations Population Fund, New York2004
- Adding it up: the costs and benefits of investing in family planning and maternal and newborn health.Guttmacher Institute, New York2009
- Adding It Up: Investing in Contraception and Maternal and Newborn Health, 2017 Estimation Methodology.Guttmacher Institute, New York2018
- Adding It Up: Investing in Sexual and Reproductive Health, 2019.Guttmacher Institute, New York, NY2020
- Adding It Up: Investing in Sexual and Reproductive Health 2019—Methodology Report.Guttmacher Institute, New York2020
- Guttmacher Institute Releases Sexual and Reproductive Health Profiles for More Than 130 Countries.Guttmacher Institute, 2021 (. Available at:)
- A Report on Costing Essential Package of Health Services Primary Health Care Facilities in Sindh.Technical Resource Facility, Pakistan2012 (a)
- A Report on Costing Essential Package of Health Services Primary Health Care Facilities in.Technical Resource Facility, Punjab, Pakistan2012 (b)
- A Report on Costing Essential Package of Health Services Primary Health Care Facilities in Khyber Pakhtunkhwa.Technical Resource Facility, Pakistan2012 (c)
UNFPA Procurement Services, Reproductive Health Interchange. Available at: https://www.unfpaprocurement.org/home.
- Pakistan Demographic and Health Survey 2017–18.NIPS and ICF, Islamabad, Pakistan and Rockville, Maryland, USA2019
- 6th Population and Housing Census, 2017.Statistics Division, Pakistan Bureau of Statistics, Government of Pakistan, Islamabad2018 (b)
- Trends in contraceptive need and use in developing countries in 2003, 2008, and 2012: an analysis of national surveys.Lancet. 2013; 381: 1756-1762https://doi.org/10.1016/S0140-6736(13)60597-8
- Adding It Up: Costs and Benefits of Meeting the Contraceptive and Maternal and Newborn Health Needs of Women in Pakistan: Methodology Appendix, New York Guttmacher Institute, 2019 (b)
- Technical Brief: Family Planning Spending Assessment Approach.FPSA Approach Technical Brief, 2020 (. Available at:) ([28])
FP2030. (2021). THE TRANSITION TO FP2030: Measurement Report 2021. FP2030 report/Available at: https://fp2030.org/sites/default/files/Data-Hub/FP2030_DataReport_v5.pdf.
- Pakistan Maternal Mortality Survey 2019: Key Indicators Report.NIPS and ICF, Islamabad, Pakistan, and Rockville, Maryland, USA2020
United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects 2019, Online Edition. Rev. 1; 2019.
World bank. World Bank Indicators. Available at: https://data.worldbank.org/indicator.
Government of Pakistan. Benazir Income Support Program (BISP). https://www.bisp.gov.pk/index.
Article info
Publication history
Published online: November 26, 2022
Accepted:
November 10,
2022
Received in revised form:
November 10,
2022
Received:
February 21,
2022
Footnotes
☆Funding: No funding to report for this submission.
☆☆Declaration of Competing Interests: My co-authors and I declare that we do not have any conflict of interest
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
