Finding the Bottlenecks in Family Planning Access
When GiveWell investigates a new cause area, we’re often focused on two priorities: directing funding where we think it can help people most and generating evidence to inform larger investments later. Family planning is a clear example. Recent foreign aid cuts—including reductions from the US, UK, and Dutch governments—deepened an already substantial need and opened up new cost-effective funding opportunities.
When we published our last podcast episode on family planning, GiveWell had made only a couple of small grants. Since then, we’ve made a number of additional grants totaling around $20 million, exemplifying how our growing research capacity and expertise enable us to expand into new areas. By doing so, we aim to move more donor funding faster to global health programs where it can do extraordinary good.
In this episode, GiveWell co-founder and CEO Elie Hassenfeld speaks with Senior Program Officer Dilhan Perera about the family planning programming we’ve funded over the past year, how we’ve structured our grant portfolio, and what we’re hoping to learn.
Elie and Dilhan discuss:
- Funding across the family planning system: Providing people with family planning resources requires a three-tiered system: (1) purchasing contraceptives, (2) moving them through the supply chain to health facilities, and (3) delivering services to clients. We have made grants at all three levels. For example, we recommended a grant for contraceptive procurement through UNFPA Supplies, which works in dozens of countries, addressing a chronic shortfall that deepened after US government cuts. We also approved a one-year grant to MSI Reproductive Choices to help move supplies from national warehouses to local health facilities in the Democratic Republic of the Congo, Malawi, and Zambia. By funding across all three levels rather than at a single point, GiveWell aims to identify the areas of greatest need where additional funding could do the most good.
- Reaching people with limited access: Many people in low- and middle-income countries have limited access to modern contraception. GiveWell has made two grants aiming to increase access at the local level, each taking a different approach. The first supports MSI Reproductive Choices’ mobile outreach program, which we are funding in Nigeria and Sierra Leone. Small teams, typically two nurses and a driver, travel to communities identified as having limited access to services. The nurses offer a group information session and individual counseling, after which people who are interested can obtain a range of contraceptive methods, including long-acting options like implants and IUDs that health workers at nearby facilities often aren’t trained to administer. The second supports Lafiya, which operates in northern Nigeria, where modern contraceptive use is among the lowest in the world. Lafiya trains nurses, midwives, and community health workers who already live in these communities to provide family planning counselling, short-term contraceptives, and referrals for other methods. By funding both approaches, we hope to learn more about differing strategies for delivering family planning and the programs’ cost-effectiveness, potentially leading to opportunities to help people in need even more.
- Building evidence alongside the grants: There are relatively few randomized trials of family planning programs and limited rigorous evidence on the specific programs we’re funding. As a result, we have a number of uncertainties. We’re particularly interested in getting better answers to the following questions: Does providing family planning commodities actually increase use, or does it substitute for what people would’ve gotten another way? Do the commodities we help procure actually reach facilities? And to what extent are people making informed choices about whether or not they want to take up contraception? We’ve built learning opportunities into all of our family planning grants, including, for example, separately funding Innovations for Poverty Action to conduct independent surveys of clients and households in the areas where MSI’s mobile outreach program works.
GiveWell’s research and grantmaking for family planning programs is still in its early stages, but it reflects a strategy across many of our newer grantmaking areas: directing donations to help people now, while generating the evidence needed to direct more funding to highly cost-effective programs in the future.
Read more about how we're thinking about family planning mobile outreach, visit our All Grants Fund page to learn how you can support this work, and listen or subscribe to our podcast for our latest updates.
This episode was recorded on July 22, 2026, and represents our best understanding at that time.
