The Role of Aid in the Provision of Sexual and Reproductive Health Services

Sammanfattning

Sexual and reproductive health and rights (SRHR) are integral to people’s well-being and a key part of the Sustainable Development Goals (SDGs). Although SRHR health outcomes have improved over the past decades or so, significant challenges remain, including poor access to effective SRHR services, in particular in low- and lower-middle income countries (LLMICs). Furthermore, most of these countries will continue to rely on external funding for these and other health services. However, despite the reliance on official development assistance (ODA), its effects on access to SRHR services remain unclear at the country level.

The purpose of this study is to contribute to an improved understanding of the role that ODA has played for SRHR. The main aim of the study is to estimate the extent to which ODA has had an effect on SRHR services. Specifically, we evaluate the effect of three different classifications of ODA on access to three types of sexual and reproductive health (SRH) service outcomes: access to skilled birth attendants, prevalence of modern contraceptives, and coverage of antiretroviral therapies against HIV/AIDS. As part of the study, we collected data from several sources on 119 LLMICs across 19 years, 2002–2020, (panel data) and applied statistical modelling to estimate the effect of ODA on these services. The results of the analysis provide an indication of the role that ODA has played over this period by presenting estimates of the relationship between ODA and these services.

Our analysis suggests that ODA has had a small, but positive effect on the SRH service outcomes over this period. The results also indicate that the effect of ODA has improved across the period 2002–2020 and is larger in low-income countries compared to lower middle-income countries, and that the effect of bilateral ODA is somewhat stronger than other sources of aid, such as multilateral sources. ODA also appears to be more effective if it reaches a certain share of overall health spending, which may indicate the need to reach a certain level before it becomes fully effective. The results of the study lend support to the continued allocation of ODA to low-income countries to support the provision of SRHR services. Countries that provide ODA, like Sweden, would be advised to continue enhancing the effectiveness of development assistance to ensure the achievement of the SDGs in this area.