A family planning investment case for Chad: Evidence, costs, and pathways to sustainable financing

Roger Laly, Lucia Corball, Atieno Odenyo, Ren Maina, Matthew Cummins

Abstract

Chad faces some of the world’s highest fertility and maternal mortality rates, alongside persistently low contraceptive use, especially among adolescents. To address these challenges, the Government of Chad and the UNFPA developed a family planning investment case to assess financing gaps and model the health and economic impacts of scaling up services. Using demographic projections, costing tools, and cost-benefit analyses across multiple contraceptive uptake scenarios, the study finds that expanded family planning could avert approximately 186,000 maternal deaths, prevent 23 million cases of stunting, and generate up to CFA 100 trillion (USD 180 billion) in health savings and productivity gains by 2050. Each dollar invested is projected to return more than 300 dollars, reflecting exceptional economic value. In contrast, inaction would lead to massive health losses and long-term economic costs amounting to as much as 25% of GDP. Family planning therefore emerges as both a public health imperative and a strategic investment for sustainable development in Chad.

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References

Cleland J, Conde-Agudelo A, Peterson H, Ross J, Tsui A. Contraception and health. Lancet 2012;380(9837):149-56.

Ahmed S, Li Q, Liu L, Tsui AO. Maternal deaths averted by contraceptive use: an analysis of 172 countries. Lancet 2012;380(9837):111-25.

Starbird E, Norton M, Marcus R. Investing in family planning: key to achieving the Sustainable Development Goals. Glob Health Sci Pract 2016;4(2):191-210.

World Health Organization. Family planning/Contraception fact sheet. Geneva: WHO; 2020.

United Nations. World Population Prospects 2022: Summary of Results. New York: UN DESA; 2022.

United Nations Population Fund. The State of World Population 2022: Seeing the Unseen. New York: UNFPA; 2022.

Institut National de la Statistique, des Études Économiques et Démographiques; Ministry of Health (Chad). Enquête Démographique et de Santé 2019. N’Djamena: INSEED; 2020.

FP2030. Chad FP2030 Commitments. Washington (DC): FP2030 Partnership; 2021.

Canning D, Schultz TP. The economic consequences of reproductive health and family planning. Lancet 2012;380(9837):165-71.

Bloom DE, Canning D, Fink G, Finlay JE. Fertility, female labor force participation, and the demographic dividend. J Econ Growth 2009;14(2):79-101.

Singh S, Darroch JE, Ashford LS. Adding It Up: The Costs and Benefits of Investing in Sexual and Reproductive Health 2014. New York: Guttmacher Institute; 2014.

United Nations Population Fund. The Demographic Dividend in Africa: Policy Implications for Investments in Youth. Addis Ababa: UNFPA; 2017.

United Nations Population Fund. Developing Investment Cases for Transformative Results Toolkit. New York: UNFPA; 2021.

Institut National de la Statistique, des Études Économiques et Démographiques; Ministry of Health (Chad); ICF International. Chad Demographic and Health Survey 2014–2015. Rockville (MD): ICF; 2016.

United Nations Population Fund. West and Central Africa’s regional trend analysis in the supply and availability of reproductive health products at service-delivery point. Dakar: UNFPA WCARO; 2024.

Global Financing Facility. Chad country investment case for reproductive, maternal, newborn, child and adolescent health. Washington (DC): World Bank/GFF; 2019.

World Bank. World Development Indicators Database. Washington (DC): World Bank; 2022.

Stover J, McKinnon R, Winfrey B. Spectrum: a model platform for linking maternal and child survival interventions with AIDS, family planning and demographic projections. Int J Epidemiol 2010;39(Suppl 1):i7-10.

Datta S, Winfrey B. OneHealth Technical Manual: A tool to support the costing, budgeting, financing, and national strategies development of the health sector in developing countries. Draft version 4/25/2012. Futures Institute/Avenir Health/WHO-CHOICE; 2012. Available from: https://avenirhealth.org

Ahmed S. Effect of maternity care improvement, fertility decline, and contraceptive use on global maternal mortality reduction between 2000 and 2023: results from a decomposition analysis. Lancet Glob Health 2025. Available from: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(25)00409-7/fulltext

Kantorová V, Wheldon MC, Ueffing P, Dasgupta ANZ. Estimating progress towards meeting women’s contraceptive needs in 185 countries: a Bayesian hierarchical modeling study. PLoS Med 2020;17(2):e1003026.

Blanc AK, Tsui AO, Croft TN, Trevitt JL. Patterns and trends in adolescents’ contraceptive use and discontinuation in developing countries and comparisons with adult women. Int Perspect Sex Reprod Health 2009;35(2):63-71.

High-Impact Practices in Family Planning. Adolescent-Responsive Contraceptive Services (ARCS): Institutionalizing adolescent-responsive elements to expand access and choice. Washington (DC): USAID; 2022.

African Institute for Development Policy. Reflections on Malawi's progress in family planning and adolescent sexual and reproductive health. Exemplars in Global Health; 2020.

United Nations Population Fund. Investing in three transformative results: Realizing powerful returns. New York: UNFPA; 2022.

Krugman A. The state of global health funding: August 2025. Think Global Health; 2025. Available from: https://www.thinkglobalhealth.org/article/state-global-health-funding-august-2025

Organisation for Economic Co-operation and Development. Cuts in official development assistance: OECD projections for 2025 and the near term. Policy Brief No. 26. Paris: OECD Publishing; 2025. https://doi.org/10.1787/8c530629-en

Cummins M. The power of SMART advocacy: Driving increased family planning financing in West and Central Africa. Dakar: UNFPA WCARO; 2025. Available from: https://wcaro.unfpa.org/sites/default/files/pub-pdf/2025-07/SMART%20Advocacy%20in%20WCA%20(1).pdf

Guttmacher Institute. Investing in adolescents' sexual and reproductive health in low- and middle-income countries. New York: Guttmacher Institute; 2020. Available from: https://www.guttmacher.org/fact-sheet/adding-it-up-investing-in-sexual-reproductive-health-adolescents

Oruko S, Muga R, Kwayu F, K’Oyugi B, Ngugi P. Youth-friendly family planning services for young people: a systematic review update. Reprod Health 2019;16(1):108. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6707512/

FP2030; PAI; Women’s Refugee Commission. Recommendations for governments to maintain continuous family planning services during shocks and stressors. Washington (DC): FP2030/PAI/WRC; 2022. Available from: https://www.womensrefugeecommission.org/wp-content/uploads/2022/10/Government-brief-FP-in-crises.pdf.

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