Paying for reproductive health care: what is needed and what is available?

The 1994 International Conference on Population and Development (ICPD) established goals to expand reproductive health services and estimated the funding which would be required from the international community and national governments to achieve those goals. This paper examines the relevant available financial data to determine the extent to which actual funding has met the ICPD estimates of resources needed. Annual global spending of family planning as of mid-1990s was less than half of the $17 billion estimated by the ICPD as needed in 2000. While the level of international lending has grown support from international donors has not increased enough to fill the gap. Indeed when adjusted for inflation domestic spending in many countries has fallen. Funding to prevent STDs also falls far short of the projected need. 4-17% of government health expenditures in developing countries are committed to maternal health. With the projected estimated resource levels already not being met the ICPD projections probably underestimate the resources needed since many women lack even the most basic reproductive health services. Consumer spending may be able to fill part of the shortfall in funding for reproductive health services but other strategies for meeting the goals will be needed which do not adversely affect demand or social justice.