Expanding family planning services in Sierra Leone: A transformative, smart investment

Sierra Leone continues to face significant constraints in financing family planning, marked by limited fiscal space, declining government allocations, and high dependence on external partners. This study models the financial needs, expected health outcomes, and economic returns under alternative coverage scenarios. Achieving a modern contraceptive prevalence rate of 50% by 2030 would require an additional USD 65 million and is projected to avert more than 3.1 million unintended pregnancies and 10,000 maternal deaths. These improvements would generate approximately USD 640 million in socioeconomic benefits, representing nearly a ten-fold return on investment. In contrast, failure to scale up family planning services could result in economic losses exceeding 0.8% of gross domestic product (GDP). Closing the financing gap will require strengthened domestic revenue mobilisation, greater efficiency in public spending, and fulfilment of national health financing commitments. Overall, the evidence shows that family planning is a highly cost-effective investment that improves health outcomes, promotes gender equality, and accelerates economic growth, making it one of Sierra Leone's most powerful strategies for achieving sustainable development.