This is an average of the three domain scores below.
The U.S. Government received a 61 (D-) with transparency and a 64 (D) without transparency for Family Planning across all actors in 2019. This grade reflected the continued harm to SRHR by the implementation of the PLGHA policy and the harm to SRHR caused by omitting family planning from key global health documents concerning women and girls by various actors. Similar to 2018, this grade was also harmed by insufficient family planning funding, the defunding of the United Nations Population Fund (UNFPA) due to an unsubstantiated Kemp-Kasten amendment violation in FY 2019, low transparency of policies by USAID, and family planning spending by USAID that was not responsive to need.
The White House received a 48 (F) with transparency and a 52 (F) without transparency because of the defunding of UNFPA (due to an unsubstantiated Kemp-Kasten amendment violation in FY 2019) and low funding proposed for USAID’s family planning program in the President’s proposed budget. These budgetary determinations significantly hindered the ability of U.S. global health assistance to support comprehensive family planning programs. This grade was further influenced by the lack of any acknowledgment of family planning programming needs from the United States Strategy on Women, Peace, and Security. The transparency grade was also low in this domain because the White House website no longer uses filters or criteria to navigate the policies listed online.
Congress received a 71 (C-) with transparency and a 71 (C-) without transparency due to inadequate funding appropriated for Family Planning and high levels of transparency within policy and funding. These budgetary determinations hindered the ability of U.S. global health assistance to support comprehensive family planning programs that promoted SRHR. The Global Health Innovation Act neither hindered nor raised the grade within this domain.
The Department of State received a 55 (F) with transparency and 61 (D-) without transparency for Family Planning in 2019. This grade was lowered by the implementation of the PLGHA policy through the 2019 PLGHA FAQs and the omission of family planning in the PEPFAR Annual Report to Congress. The grade was raised by the 2019 PEPFAR COP Guidance and the PEPFAR MER Indicator Reference Guide, both of which emphasized the importance of family planning and HIV integration. The transparency grade for policies was lowered by the State and USAID Annual Performance Report and FY 2020 Annual Performance Plan, as this document did not clarify the role of the Department of State in global family planning programming. In the budget evaluation, the Department of State largely disbursed family planning funds in accordance with unmet contraceptive need at the country level. However, access to family planning and contraception was severely impacted by the Department of State once again defunding the United Nations Population Fund (UNFPA) due to an unsubstantiated Kemp-Kasten amendment violation in FY 2019.
USAID received a 73 (C) with transparency and a 76 (C) without transparency for the Family Planning domain in 2019. USAID was graded based on a number of Agency-level guidance documents, Agency Priority Goals for Maternal and Child Health, Automated Directive System (ADS) Chapters, and two PLGHA FAQ documents. While these documents varied in their grades and most were responsive to need, they were not gender transformative and few were based in internationally recognized human rights norms. Many of these documents also lacked explicit mention of family planning programs, which further reinforced the siloed nature of USAID’s global health programming. This was particularly evident in the annual Acting on the Call report, which did not describe the extent to which—if at all—family planning and maternal and child health activities were integrated within USAID-funded programs.
Furthermore, USAID’s budget grade in this domain suggested that the Agency’s family planning programs were not responsive to need, as a significant portion of family planning funds disbursed in FY 2019 was not programmed in countries with the highest total fertility rate. Following a consultation with USAID in 2020, we have made minor adjustments to the methodology for the budget calculation for USAID’s Family Planning domain to most accurately reflect the appropriation of these funds. This change is reflected in the 2019 grades.
HHS does not receive a grade within the Family Planning domain because they do not work in international family planning.
The DoD does not receive a grade within the Family Planning domain because they do not work in international family planning.