Potential for Family Planning Program Sustainability in Sub-Saharan Africa: Evidence from 33 Countries

Karen Hardee, Hardee Associates LLC
Rebecca Rosenberg, Avenir Health
Imelda Feranil, Avenir Health

Sustainability, with countries taking ownership for funding and ensuring access to services and contraceptive commodities, has long been an aim for FP. Focusing on 33 countries across two sub-regions in sub-Saharan Africa, this paper uses a supplement to the National Composite Index of Family Planning (NCIFP) cross-national survey in 2023, designed to take the pulse of stakeholders steeped in their countries’ FP program about the state of sustainability, actions that are being taken, and the main challenges their countries face. Items related to donor dependency, coordination, FP in country plans for Universal Health Coverage (UHC), planning for future demand, and key barriers. Both regions scored highest on the extent to which FP is included in plans for UHC and lowest on the items related to donor dependency, indicating high dependency for contraceptive commodities and programmatic support. Donor dependence and lack of domestic financing were most often cited barriers, with human resources; commodities and logistics; and sociocultural, gender and religious barriers all receiving over 10% of the responses on key challenges. Understanding program experts’ perspective, and similar and unique challenges countries face will help shape support to strengthen the capacity of countries to move towards FP program sustainability.

Keywords: Family Planning and Contraception, Qualitative data/methods/approaches, Population Policies

See extended abstract.