David and Lucile Packard Foundation

Sub-Saharan Africa (SSA) has the highest proportion of women who lack access to FPRH services and, as a result, they suffer tremendously from high-risk, unwanted pregnancies, and unsafe abortion. Making advances in this very sensitive area of social and ideational change in SSA will require not only more resources, but a much more effective use of existing resources. However, significant structural problems prevent donor funds, especially those from the European bilateral agencies which are the strongest supporters of FPRH, from being accessed and used effectively. Evidence for this is in some cases hard and in others anecdotal and impressionistic. Sometimes aid is diverted to health expenditures that do not best meet the needs of SSA women and do not represent the priorities of these European funders; sometimes inefficiency is the culprit. This grant to the Packard Foundation will support a policy research and dialogue project that will validate and document the situation in a structured and cohesive way, involving key stakeholders—European donor agencies and NGOs that advocate for FPRH, the UN Population Fund (UNFPA), African governments and civil society and researchers—to identify specific issues and their root causes, to develop consensus around practical steps for improvement and to communicate the results in compelling ways that drive change.