Family Planning Investment Impact Calculator FAQ

The Family Planning Investment Impact Calculator generates impact estimates for actual, planned or hypothetical investments specifically focused on family planning services. Family planning investments are assumed to cover the full cost of contraceptive care, which includes:

• • Service delivery costs: contraceptive commodities, drugs, supplies and health worker salaries.
• • Programs and systems costs: program management, staff supervision, monitoring and evaluation, human resources development, transport, telecommunications, health education and outreach, advocacy, infrastructure, equipment, commodity supply systems and health information systems. Programs and systems costs (also called indirect costs) are estimated by applying region-specific markup rates to direct costs (see the Family Planning Investment Impact Calculator Methodology for more information).

If your total investment includes funds for health care services other than family planning, those funds should be excluded from the total entered into the calculator. If your investment is not intended to apply to the full range of costs of providing care (i.e., funds are for specific programs or are restricted to certain elements of service provision), this tool cannot provide accurate impact estimates.

The Family Planning Investment Impact Calculator estimates the following health impacts expected to result from investment in family planning:

• • The number of women and couples who would receive modern contraceptive care. Modern contraceptive methods are defined in this analysis as any of the following:
  • • Permanent methods (female and male sterilization)
  • • Long-acting reversible methods (implants and IUDs)
  • • Short-acting methods (hormonal pills, injectables, male and female condoms, emergency contraceptive pills, patches, rings, diaphragms, vaginal spermicides and other supply methods)
  • • Lactational amenorrhea method, which involves exclusive breastfeeding for up to six months postpartum
  • • Two fertility awareness–based methods (the Standard Days Method and the TwoDay Method)
• • Unintended pregnancies averted. Unintended pregnancies are pregnancies that occur sooner than desired or that are not wanted at all.
• • Unplanned births averted. An unplanned birth is a birth resulting from an unintended pregnancy.
• • Unsafe abortions averted. Unsafe abortions are those abortions that do not adhere to the World Health Organization (WHO) definition of safe abortion (i.e., carried out by someone with the necessary skills, using a method recommended by WHO as appropriate to the gestational age).
• • Lives saved. In this context, a life saved is defined as a maternal death prevented. WHO defines a maternal death as a “death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from unintentional or incidental causes.”
• • Cost savings. The calculator provides estimates of how much will be saved on pregnancy-related and newborn care for every additional US$1 invested in family planning (through the prevention of unintended pregnancies).

Investments in family planning would also have many effects not captured by the calculator, including longer-term improvements in a range of outcomes, including gender equality, the economic well-being of women and households, productivity, resources that families can spend on children, and gross domestic product.

The calculator estimates health benefits of actual, planned or hypothetical investments in family planning. The costs for estimating the number of users served are based on the current provision of care. If the calculator is used to estimate a large hypothetical investment intended to meet a large portion of family planning need, the calculator may underestimate the costs required to serve all users. This is because larger investments are needed to drastically scale up the number of users served by a family planning program. If your interest is in the investments required to meet all need and the resulting impacts this would have, please refer to the Adding It Up 2019 report, which already produces estimates of the cost and impact of meeting all need for contraceptive care. Note that 2024 Adding It Up materials will be published in early 2025. See the Family Planning Investment Impact Calculator Methodology for more information.

Impact estimates must be interpreted in the context of current funding for family planning. For instance, the estimated impact of an investment amount equal to a country’s current funding could reflect current impact, or it could be considered additive if the investment is intended to supplement the current funding level. The country-level estimates of current contraceptive use available in our country profiles provide helpful context for the impacts of funding on the number of women and couples receiving contraceptive care. Note that these country profiles are from Adding It Up 2019 and they will be updated in early 2025.

The Family Planning Investment Impact Calculator is based on the Guttmacher Institute’s Adding It Up model, which estimates the impact of investing in a broad range of sexual and reproductive health care services in low- and middle-income countries. The methodology for the calculator is explained in detail in the Family Planning Investment Impact Calculator Methodology.

Assessing the impacts of funding over a multiyear period would require accounting for multiple years of use among modern contraceptive users, which is not feasible with this tool. Thus, the model behind the Family Planning Investment Impact Calculator assumes that all investments are made for a single calendar year, in this instance, during 2024.

The calculator currently contains estimates for 2024 (published ahead of the full Adding It Up 2024 release in early 2025). The estimates will be updated with the next round of Adding It Up, which is anticipated for 2026.

Estimates can be produced for each of 128 low- and middle-income countries (LMICs), based on the World Bank gross national income classification for 2024. They can also be produced for all LMICs or for LMICs in a specific region or subregion.

All investments in family planning must include commitments to use a high-quality, rights-based approach to family planning care. Per the World Health Organization (WHO), “Elements of quality of care include: choice among a wide range of contraceptive methods; evidence-based information on the effectiveness, risks and benefits of different methods; technically competent trained health workers; provider–user relationships based on respect for informed choice, privacy and confidentiality; and the appropriate constellation of services (including follow-up) that are available in the same locality.” The Family Planning Investment Impact Calculator does not account for whether investments will address these vital components.

Please see the following additional resources for guidance on incorporating a human rights framework into contraceptive service provision:

• • Family Planning 2030: Rights and Empowerment Principles for Family Planning
• • Population Reference Bureau: Family Planning and Human Rights: What’s the Connection and Why Is It Important?
• • WHO: Information Series on Sexual and Reproductive Health and Rights: Contraception and Family Planning
• • Office of the United Nations High Commissioner for Human Rights: Technical Guidance on the Application of a Human Rights-Based Approach to the Implementation of Policies and Programmes to Reduce Preventable Maternal Morbidity and Mortality
• • United Nations Committee on Economic and Social Council: General Comment No. 22 on the Right to Sexual and Reproductive Health

In addition to the Adding It Up model (on which the Family Planning Investment Impact Calculator is based), several other tools estimate the impact of investing in contraception, including Impact 2, from MSI Reproductive Choices; ImpactNow, from the U.S. Agency for International Development; Reality Check, from EngenderHealth; FamPlan and the Lives Saved Tool (LiST), from Avenir Health; and the FP2030-Track20 Annual Indicator Calculator. Comparisons of estimates across these models, as well as additional information on the tools, can be found in this article.

The current version of the impact calculator draws on data from Adding it Up 2024 (publication forthcoming). The 2024 calculator models the same impacts as the previous 2022 iteration, with the following changes to the inputs on which the calculator relies:

• • Contraceptive commodity and service costs: In 2022, the county-specific costs per contraceptive commodity type and category were drawn from the Reproductive Health Interchange database. The current 2024 calculator now draws contraceptive commodity and service costs from the Reproductive Health Supplies Coalition Global Family Planning Visibility and Analytics Network (Global FP VAN).
• • Cost inflation: In 2022, the International Monetary Fund’s gross domestic product (GDP) deflators were utilized in cases where inflation of prices to 2022 costs was necessary and year-on-year inflation was capped at 200%. The current 2024 calculator similarly relies on the International Monetary Fund’s GDP deflators to inflate prices, but some changes were implemented to the inflation process. Rather than capping inflation at 200%, inflation caps were calculated by taking the interquartile range of inflation across all low- and middle-income countries (LMICs) included in Adding it Up 2024, multiplying the IQR by 1.5, and adding it to the median value of inflation across all included LMICs. In addition, countries experiencing hyperinflation in 2024 were identified if the change in their GDP deflator over a one-year period (2023–2024) exceeded 50%. Those countries' inflation values were imputed with subregional inflation averages.
• • Number of women and couples receiving modern contraceptive care: Previously, the costs used to determine the number of women and couples served from an investment in the 2022 calculator relied on the costs for providing care to all women and girls wanting to avoid a pregnancy. The 2024 calculator instead uses the current modern contraceptive care costs. If the investment scenario in the calculator is intended to greatly scale up contraceptive services to meet all need, the cost per user will underestimate costs and therefore impacts of that investment.

The 2024 calculator continues to not incorporate costs associated with traditional method use. However, the Adding It Up 2024 project (to be released in early 2025) will incorporate these costs in order to better capture contraceptive use preferences across both modern and traditional methods, and the role of the family planning sector in supporting the full range of method use.

Correction (Nov. 8, 2024):
The 2024 calculator (published on September 15, 2024) incorporated outdated information on the cost of drugs and supplies associated with service provision of certain contraceptive methods: implants, injectables, IUDs, and female and male sterilization. This did not impact any contraceptive commodity costs. Updating the necessary cost components to 2024 estimates resulted in changes in the average cost per contraceptive user, which decreased for some countries and increased for others.

The Family Planning Investment Impact Calculator generates graphics for only one recipient country, subregion or region at a time; if you select multiple recipients, the calculator will produce a table but no graphics. If you want to generate graphics for multiple recipients, run the calculator for each recipient individually.

If the multiple recipients are in (or align closely with) a United Nations Population Division region or subregion, you can run the calculator for all low- and middle-income countries in that region or subregion.

If the recipients do not belong to the same region or subregion, you have two options:

1. If the investment is distributed by certain percentages or amounts (or divided approximately equally) among the different recipients, you can calculate the amount each recipient receives and enter these amounts into the calculator.
2. If you do not know how the investment is divided among the different recipients, then you should select “All LMICs” from the recipient dropdown menu and enter the full amount of the investment. This option allows the calculator to use an average estimate of impact from all LMICs. This is likely the best option if the investment is coming from a multilateral agency, such as United Nations Population Fund.

The assumptions underlying the estimates provided by the Family Planning Investment Impact Calculator (i.e., method mix distributions, modern contraceptive use rates, unintended pregnancy rates and abortion rates) are fixed, using data from 2024. For more information on the assumptions in this model, see the Adding It Up 2019 Methodology Report. Note that an Adding It Up 2024 Methodology Report will be published in early 2025.

If you want to estimate the impacts of funding that is provided on a per capita basis, you will need to convert that funding to a total by multiplying it by the population of the recipient countries, subregions or regions. You can find the 2024 population for individual countries through the United Nations Department of Economic and Social Affairs, Population Division 2024 update of World Population Prospects. Be sure to multiply by the total 2024 population (male and female, all ages) if the funding is per capita. If the funding is per woman of reproductive age, multiply by only the 2024 population of women aged 15–49.

The Family Planning Investment Impact Calculator generates impacts under the assumption that the investments cover the full cost of contraceptive care—and thus go toward both service delivery and associated programs and systems. The calculator cannot estimate impacts of individual components of the full cost of care. If your investment is for a specific family planning program or for only certain elements of service provision, this calculator may not accurately reflect the impacts of the investments you input. Other tools may be more appropriate for assessing the impact of those types of investments.

The investment amount entered must not exceed the amount needed to provide modern contraceptive services to all women in the selected country, subregion or region who are estimated to be in need of modern methods. Note that although the need for modern methods (i.e., overall demand) is used as the maximum number of potential users, not all women estimated to need modern contraception will necessarily want to use it. Visit our country profiles for information on the cost of meeting all needs for family planning. Note that these country profiles are from Adding It Up 2019 and will be updated in early 2025.

The Family Planning Investment Impact Calculator Methodology gives a more complete and specific account of how the calculator works. If you do not find the answers you need there, please email us at [email protected].

We are interested in your suggestions for improving the calculator! Please email us at [email protected].