Investing in Family Planning for a Lifetime of Returns

By Dr. Jose G. Rimon II, Director, Bill & Melinda Gates Institute for Population and Reproductive Health, JHSPH and Director of The Challenge Initiative (TCI) Project, and Dr. J.M. Ian Salas, Assistant Scientist at the Department of Population, Family and Reproductive Health and Research Economist at the Bill & Melinda Gates Institute for Population and Reproductive Health, JHSPH

For more than two decades, the global development community has anchored support for contraception in its role of advancing the reproductive health and rights of women worldwide. Since the 1994 Cairo Conference on Population and Development, family planning has been framed as a means to enable women to freely determine whether, when and how many children they will have.

Many shied away from touting the economic benefits of family planning to avoid conflating it with the idea of population control and coercion. The health benefits of contraception—preventing unintended pregnancies, averting unsafe abortions and reducing maternal and child deaths—were strongly emphasized while economic benefits were seemingly relegated to the background.

A welcome development in recent years is the accumulation of evidence on the extensive and far-reaching dividends that investments in family planning yield beyond improving women’s health. We now know more definitively that family planning also leads to more educated communities, a healthier population and planet and wealthier nations.

Family planning is the second-best “buy” for global development after liberalizing trade, a conclusion endorsed by Nobel laureates and other leading economists after their assessment of development priorities related to the Sustainable Development Goals. This research, published by the independent Copenhagen Consensus Center, indicates that achieving universal access to contraception could result in long-term health and economic benefits worth $120 for each dollar spent on family planning.

Family planning helps nations climb the economic ladder faster. Harvard economists David Bloom and David Canning estimated that a third of East Asia’s economic boom was due to favorable changes in population size and age structure, which were brought about by smaller family sizes. This boost to economic growth is called the demographic dividend. A recent study projected that per capita income in Kenya, Nigeria and Senegal could rise by 47 to 87 percent by 2050 if their unmet need for family planning is satisfied.

Government investment in family planning more than pays for itself. Economist Scott Moreland calculated that each dollar invested in family planning allows a government to forego $2 to $6 dollars of spending on other social services like education and immunization. Those extra dollars can go toward infrastructure, health and education to help governments harness the demographic dividend.

Yale economist T. Paul Schultz found that family planning not only leads to better health and more education for both women and their children, it also results in higher income and greater household assets for their families. He reached this conclusion after analyzing data on the enduring effects of having improved access to family planning in Matlab, Bangladesh 20 years after the initial intervention.

Family planning lifts families out of poverty. University of Michigan economist Martha Bailey and others found that in the U.S., people born in counties which received funding for family planning programs in the 1960s were 2 to 4 percent less likely to live in poverty in their childhood and as adults.

Family planning improves a country’s political stability. Political demographer Richard Cincotta showed that countries with a youth bulge have a high risk of social unrest and political violence. This risk will dissipate when the youth bulge shrinks and each adult supports fewer children, which can be achieved through fertility decline.

Family planning promotes our planet’s health. Project Drawdown, led by noted environmentalist Paul Hawken, estimated that investments in family planning that slow down population growth will reduce carbon emissions by nearly 60 gigatons through 2050. Together with investments in girls’ education, these two strategies are considered the most effective existing solutions to mitigate climate change.

All this evidence points to the same conclusion: family planning is one of the smartest and most cost-effective investments a country can make. We believe this is a key reason why there is renewed interest in family planning in sub-Saharan Africa.

Because of stronger government and civil society support for family planning, the uptake of modern contraceptive methods has dramatically increased in countries like Ethiopia, Kenya, Malawi and Rwanda, paving the way for them to reap these benefits. However, many other stakeholders have yet to understand family planning’s exceptional return on investment and act on this information. Research confirms that family planning stands out as a development strategy because of the myriad of long-lasting benefits that it delivers. This message needs to be more widely and convincingly told.

Let us reposition family planning as a development solution that goes beyond improving reproductive health and protecting women’s rights. Family planning is transformational not only because it enables girls and women to chart their own destinies, but also because it grows the economy, reduces poverty, promotes well-being of families, improves national security and safeguards the future of our planet.

Banner photo credit: PSI/Manprit Shergill

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