Family planning investment in Africa

An estimated 218 million women in low- and middle-income countries still have an unmet need for modern contraception, and the United Nations estimates that 19% of women in sub-Saharan Africa have an unmet contraceptive need.

When women and girls have access to contraceptives and health services they want and need, they’re able to make informed reproductive decisions and are more empowered to live their lives as they choose. Women and girls who have agency over their health can reach their full potential—more girls can go to school, and more women can work outside the home. Those choices also contribute to healthier pregnancies and safer births, meaning more newborns can thrive and have a chance at a productive future.

We focus on helping women and girls access the health services and products, including family planning, that align with their preferences—ones that are affordable, convenient, and culturally appropriate. We also support efforts that improve how family planning services are delivered and improving health systems to meet the needs of women and girls.

Our commitment will support the advancement of more than 40 innovations in five critical and chronically underfunded areas, particularly those affecting women in low- and middle-income countries. This investment includes:

• Obstetric care and maternal immunization: Making pregnancy and delivery safer
• Maternal health and nutrition: Supporting healthier pregnancies and newborns
• Gynaecological and menstrual health: Advancing tools and research to better diagnose, treat, and improve gynaecological health and reduce infection risk
• Contraceptive innovation: Offering more accessible, acceptable, and effective options
• Sexually transmitted infections (STIs): Improving diagnosis and treatment to reduce disproportionate burdens on women

The Gates Foundation does not manufacture or distribute hormonal IUDs (H-IUDs). Nor does the foundation manufacture or distribute contraceptives of any other kind. We fund partners that are helping expand access to trusted, voluntary contraceptive options, reflecting our longstanding commitment to ensuring women everywhere can obtain effective and affordable healthcare.

Governments ultimately decide which health products make the most sense for their people based on local needs, safety standards, and public health priorities.

The Gates Foundation does not sponsor or conduct clinical trials for family planning products. Our role is to provide funds to our partners that are facilitating research into innovative contraceptive technologies that women want and need, including requiring they meet high ethical standards and gathering evidence that can inform development. We partner with organizations to help governments understand the potential of new methods in existing health systems. We also fund partners to work with Ministries of Health and community health programs to understand what support they need to offer the products they choose to introduce and make available as part of routine primary care and family planning services.

To bridge gaps in weaker health systems, we fund partners in country to support clinical and community health worker training, enable access to approved products, and supply chain support. This includes funding manufacturers and distributors to maintain affordability and reliable delivery across diverse settings. We support voluntary, rights-based family planning programs that empower women to make informed choices about their reproductive health.

We are deeply committed to the principle that all women have the right to make informed, voluntary choices about their reproductive health. Safeguarding against coercive use or provider-driven uptake of any family planning products starts with strong provider training that emphasizes rights-based counselling and informed consent. We fund organizations with expertise in provider training and counselling to work in partnership with governments, health systems, and other stakeholders. Through this support, providers are better equipped with the information they need to present the full range of approved contraceptive options to their patients, enabling women to choose what works best for them.

We also support monitoring and accountability mechanisms, such as feedback systems and independent oversight by community organizations, to identify and address concerns quickly. Our goal is that every woman receives accurate, unbiased information in a respectful setting, and that her choice is driven solely by her own needs and preferences.

The Gates Foundation’s commitment to women’s health in low- and middle-income countries is comprehensive. Our work in family planning – including expanding contraceptive options, access, and knowledge – is one piece of our broader women’s health portfolio. That portfolio also includes strategic, integrated investments in women’s health research and development and maternal, newborn, and child health. We see family planning as critical to reducing maternal mortality by enabling women to choose if and when to start a family, space their pregnancies, and avoid high-risk births. We are equally focused on ensuring women have access to quality care throughout their life, including pregnancy and childbirth.

Beyond this, we are investing in strengthening the broader health systems so that they can provide a seamless continuum of care. By supporting countries to strengthen their health systems, we help to ensure that women have access to quality care, whether it's for nutrition counselling, prevention of sexually transmitted infections, or skilled birth attendance. Contraception is a valuable tool to improve women’s health and reduce maternal mortality, but its success is ultimately dependent on a strong, integrated health system that can deliver a full range of services.

African governments and regional bodies are leading the way in shaping the policies and strategies for introducing new contraceptive options. They ultimately decide which health products make the most sense for their people based on local needs, safety standards, and public health priorities.

Our work and the work of our grantees is implemented in alignment and partnership with national health priorities and planning strategies, with ministries of health, professional associations, and regional partners and institutions in the driving seat.

The Gates Foundation's approach to women's health research in Africa focuses on fostering local leadership and expertise. A core part of this is partnering with African organizations and innovators to ensure that women’s health treatments and products are developed with local expertise, insights, and priorities at the center. This includes partnering with African scientists, universities, and innovation hubs to advance and scale up access to solutions that meet the circumstances, needs and preferences of the African women who will use them.

We recognize that low trust in health authorities can be a major obstacle.

Our work and the work of our grantees is implemented in alignment and in partnership with national health priorities and planning strategies, with ministries of health, professional associations, and regional partners and institutions in the driving seat.

By working with local and national governments, reputable institutions and partners that have decades of trust and experience on the ground, we can help ensure that the public receive accurate information and guidance from people they know and respect.