Family Planning: the economic rationale for investment in services in the Pacific

Sumi Subramaniam, Director of  Family Planning International, recently made a presentation to staff at the Ministry of Foreign Affairs and Trade about outcomes of the first comprehensive cost-benefit analysis of meeting unmet needs for family planning in the Pacific.  

Accompanying Sumi was Sean Mackesy-Buckley, a Research and Project Analyst for FPI responsible for technical analysis of the work.

Their presentation provided the economic rationale for greater investment into family planning in the Pacific.

International research shows that access to family planning services has direct benefits for women’s and children’s health, and that this then contributes to a wide range of broader social, environmental and economic benefits. While there has been research highlighting this evidence across the world, the Pacific has hitherto been subject to very little analysis in this area.

In 2011, Family Planning International, in cooperation with the Burnet Institute, set out to fill this research gap. Using Vanuatu and the Solomon Islands as their Pacific Island case studies, they undertook the region’s first comprehensive cost benefit analysis of meeting unmet need for family planning.

Family planning is critical to human rights and reducing unmet family planning needs in the Pacific. Across the region, at least 370,000 married women and girls do not use a modern form of contraception but report either not wanting any more children or wanting to delay the birth of their next child. The implications of this are high adolescent fertility, total fertility > ‘wanted fertility', high infant mortality, high maternal mortality, and high rates of Sexually Transmitted Disease.

Political and international investment in family planning is currently disproportionate to need, with on average only 0.03% of all ODA to the Pacific in the last 10 years going toward family planning.

To build a case for the political prioritisation, there is a need for an evidence based argument that demonstrates direct health based outcomes, as well as the impacts on social and economic development.

The cost-benefit analysis used data collated from more than 40 indicators tested by a reference group of experts. Once the data was agreed upon, the figures were entered into the software programme ‘Spectrum’ and used to project three different scenarios: unmet need constant (11%), unmet need reduced by 2050, unmet need reduced by 2020.

The cost-benefit analysis in the Solomon Islands showed a number of interesting findings. In the best case scenario, the software predicted that the rate of modern contraceptive use could increase by 10% by 2025, with maternal deaths dropping by 12% (2010-2025) and the rate of infant mortality decreasing by 20% (2010-2025).
If the unmet need were to reduce by 2020, the total fertility rate would go from 4.1 to 3.5, a significant achievement given that the average ‘wanted’ number of children is 3.

Markedly, the best case scenario also predicted a notable impact on economic growth. Using IMF projections for GDP growth, a 5% increase in GDP per capita can be expected if the unmet need reduces by 2020 with predicated savings of $10 in health and education costs for every $1 invested in family planning.

The findings of the cost-benefit analysis have laid the foundation of a case for prioritisation. FPI sees the analysis results as a way to open up opportunities for dialogue with partner organisations and governments, and give greater legitimacy to the bid for deeper investment in family planning.

This project was funded by AusAID through COMPASS: Women’s and Children’s Health Knowledge. The full research report will be published later in 2012.  Keep an eye on the Family Planning International website for news of its release. 

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