Financing gaps for Pakistan's contraceptive prevalence goals: Analyses using the Guttmacher adding-it-up methodology.

Objectives: The objective of the paper is to identify levels of and gaps in family planning financing in Pakistan and to assess whether current funding is sufficient to meet national and FP2030 goals to increase contraceptive use to 60% by 2030.

Study Design: We estimate the cost of family planning services nationally and by province based on the Essential Services Package and WHO/UNFPA cost by applying the existing Guttmacher global Adding-It-Up methodology. Additional data are also analyzed to assess trends in expenditures on family planning between 2017 and 2021.

Results: The estimated cost of family planning services provided in Pakistan in 2017 was US$81 million, equivalent to US$0.38 per capita. The estimated gap in costs to provide contraceptive services to the additional 8.6 million women with unmet need for modern contraception was US$93 million. While we found evidence of an upward trend in overall government expenditure on family planning services over the period 2017-21, the pace of increase was slow and uneven across regions.

Conclusions: The evidence highlights the persistent inadequacy of financing for contraceptive services especially if Pakistan intends to achieve its ambitious national and FP2030 goal of increasing contraceptive prevalence to 60% by 2030.

Implications: A doubling of current funding for contraceptive services is required in Pakistan. Additional financing needs to be directed towards the poorest women with unmet need to avoid unintended pregnancies and to improve equity in reproductive health outcomes.