Family Planning

our goal
We are working to empower women and girls to take charge of their own health, enabling them to make informed decisions about family planning and have access to contraceptive options that meet their needs.
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An Accredited Social Health Activist (ASHA) worker counsels a couple during a home visit in Uttar Pradesh, India. ©Bill & Melinda Gates Foundation/Prashant Panjiar

At a glance

  • Thanks to the dedication and ingenuity of the global family planning community, 60 million more women are using modern contraceptives to plan their families today than a decade ago. However, more than 200 million women and girls in low- and middle-income countries who want to avoid pregnancy aren’t using a modern method of contraception.
  • While a range of factors prevent these women from using contraception, many are choosing not to use family planning because current methods don’t meet their needs. In fact, nearly 40 percent of women who begin using contraception stop within the first year because they’re dissatisfied with their method. At the same time, development of new contraceptive technologies is chronically underfunded and investments have remained stagnant for years.
  • Enabling girls and women to avoid unwanted pregnancy can unlock progress on a wide range of issues, from gender equality and maternal health to girls’ education. It’s also a smart investment: Fully meeting the need for contraception and maternal and newborn health care would cost US$600 million less than only meeting the need for maternal and newborn health care.
  • We’re committing US$280 million per year from 2021 to 2030 to develop new and improved contraceptive technologies, support family planning programs that reflect the preferences of local communities, and enable women and girls to be in control of their own contraceptive care—where, when, and how they want it.

Our strategy

The foundation’s family planning strategy centers on ensuring that women and girls can access the contraception and family planning services they desire, so they can decide whether to have children, when, and how many.

Today’s contraceptive methods don’t meet the needs of all women and girls. We’re ramping up our investments in research and development to create new and better options that are informed by a deep understanding of women’s and girls’ preferences—and what prevents them from using contraception. We’re also investing in new and innovative approaches to bring women and girls the information, services, and contraceptive products that enable them to manage their own health.

We work closely with local partners in our priority countries to ensure that efforts to increase access to family planning services are informed by better data, tailored to communities, and integrated into the primary health care system.

Finally, we are committed to expanding the pool of donors to generate more sustainable family planning funding.

"Contraceptives are one of the most powerful tools we have. It puts the power in the hands of young girls and women to plan their families, and quite honestly to plan their futures."
Melinda French Gates
Graduates of a midwifery school attend a contraception seminar in Makassar, Indonesia.
Graduates of a midwifery school attend a contraception seminar in Makassar, Indonesia.

Areas of focus

Among women who want to delay or avoid pregnancy, concerns about side effects are the most common reason they give for not using modern contraception. By reimagining existing products and developing new technologies, we aim to expand the range of contraceptive options available to women and girls, at a price they can afford. We also work with countries and partners to ensure that these products are manufactured, procured, and distributed in sufficient quantities, preventing stockouts at clinics and drug shops.

We’re exploring and testing innovative ways to improve the quality and impact of family planning services, including through local drug shops and direct-to-consumer channels, so more women and girls can access methods that work for them, closer to home. But we know that improving the supply of family planning services and products isn’t the only need; myths and misinformation about family planning, as well as social norms and regulations that limit the ability of women and girls to act on their choices, also need to be addressed, and we are exploring new and innovative ways to reduce these barriers as well. With all of these “test and learn” interventions, we generate data and evidence to guide better policies and programs.

We work directly with countries—including India, Nigeria, and Ethiopia—where our resources can have the greatest impact and where our foundation has a local presence. We also engage on a more limited scale in Kenya, Pakistan, and Francophone West Africa. Everywhere we work, we advocate for high-impact practices to be included in national plans and to address data gaps by improving the evidence base on priority interventions. To advance global impact, we support partners that include FP2030, the United Nations Population Fund, SEMA Reproductive Health, and the Global Financing Facility to bring these innovations to a wide range of countries so more women and girls can benefit.

We work to build local capacity to collect, analyze, and use family planning data efficiently. We also support the development and testing of new indicators to help decision-makers prioritize, fund, and improve family planning services. We work to advance global monitoring of family planning progress to create a clearer picture of the field and improve accountability at the country, regional, and global levels.

Our family planning advocacy work focuses on generating sustainable financing to support country ownership of family planning programs, build political leadership, and position family planning firmly within broader health and development agendas. We also aim to overcome regulatory and policy barriers that slow the uptake and introduction of high-impact family planning interventions. To hold decision-makers to account and expand the conversation on family planning, we work to elevate the voices of new and existing family planning champions in the spaces where they can have the most impact.


Why focus on family planning?

The case for closing the gap in modern contraception use is clear: When women and girls have access to contraceptives and care that enable them to make informed decisions, they are more empowered to live their lives as they—and not others—choose. More girls can go to school, more women can work outside the home, and more newborns can thrive and have a chance at a productive future.

Enabling women and girls to be agents of their own health is crucial to overcoming harmful gender norms. To do this, we need to trust women and girls to make the decisions that are right for them and offer them services and products that meet their preferences—through affordable, convenient, and respectful care. This also requires reimagining contraceptive options, improving how family planning services are delivered, and improving outdated health systems.

Achieving a more prosperous and equal world starts with ensuring that women and girls are empowered to lead the lives they aspire to and can plan for the families they want. We must see women’s sexual and reproductive health not just as a personal issue, but also as a political one that is central to women’s empowerment, gender equality, and achieving development goals.

A nurse speaks with Ann Starrs, the foundation's director of Family Planning and foundation staff at a primary health center in Lagos, Nigeria.
A nurse speaks with foundation staff at a primary health center in Lagos, Nigeria.


The COVID-19 pandemic has strained health systems around the world and disrupted access to essential services, including family planning. An estimated 12 million women in low- and middle-income countries lost access to family planning services during the first year of the COVID-19 pandemic, resulting in nearly 1.4 million unintended pregnancies. While this number is significant, it is much lower than the figure projected at the beginning of the pandemic, when it was estimated that 47 million women could lose access to family planning services.

The impact of COVID-19 on funding, however, has been clearly negative. A portion of much-needed family planning resources and attention has been shifted to emergency COVID-19 response measures, and the economic impact of the pandemic is likely to linger for years to come.

These shifts demonstrate the need for an expanded pool of donors and more sustainable funding for family planning. They also highlight the need for family planning to be considered a vital component of strong primary health care systems—essential to improving maternal and child health and critical to achieving the goal of health care for all.

We’re heartened to see that many places have adapted to these challenging times by expanding telemedicine and updating guidelines so contraceptives are readily available and women can continue to safely access family planning care. It’s because of these swift decisions that the pandemic hasn’t had a more devastating effect.

In response, we’re drawing on these lessons to inform innovative ways to make family planning products and information available to women and girls everywhere. But to do this, we must preserve family planning funding to protect decades of progress and build back in a more equitable and sustainable way.


Strategy leadership

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A mother and newborn at a health center in the Patna district of Bihar, India.
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