This is an average of the three domain scores below.
The U.S. Government received a 73 (C) with transparency and a 77 (C+) without transparency for the Family Planning (FP) domain across all actors in 2022. Global FP efforts were not meaningfully included in most whole-of-government actions or key agency-level actions for both the Department of State and United States Agency for International Development (USAID) in 2022. This omission reinforced the siloed nature of global health programs and did not support the implementation of integrated sexual and reproductive health (SRH) programming based in evidence and human rights. Most agency-level actions were gender accommodating as they reinforced a gender binary and did not use inclusive language such as “internal and external condoms.” An inadequate funding request from the White House, a low level of appropriated funding by the U.S. Congress for global FP programs, and the disbursement of FP funds by USAID that was not responsive to need affected the low grade in this domain. Actors received low to moderate transparency scores for actions graded in the FP domain which also impacted the overall score for 2022.
The White House received a 77 (C+) with transparency and an 81 (B-) without transparency in the Family Planning (FP) domain in 2022. This grade was positively affected by the allocated funding for UNFPA, and negatively affected by the inadequate funding amount for USAID FP programming in the President’s proposed budget. The USAID budgetary determination significantly hindered the ability of U.S. global health assistance to support comprehensive FP programs. Generally, actions graded in this domain meaningfully referenced global FP programs, which supported the ability of U.S. global health assistance to promote SRHR in the FP domain. The White House demonstrated moderate levels of transparency across actions and funding information in the FP domain in 2022.
Congress received a 77 (C+) with transparency and an 81 (B-) without transparency in the FP domain in 2022. Congress appropriated inadequate funding for the UNFPA and USAID global FP programs, which hindered the ability of U.S. global health assistance to fully support comprehensive FP programs that promoted SRHR. However, it was unclear if global FP programs were included in the additional funds appropriated by Congress through the Consolidated Appropriations Act (H.R.2617). Congress demonstrated a moderate level of transparency with regard to actions and high transparency of funding information related to FP globally in 2022.
The Department of State received a 57 (F) with transparency and a 63 (D) without transparency in the FP domain in 2022. This domain grade was raised by the PEPFAR Five Year Plan, as well as the updated PrEP Ring FAQs, which were both responsive to need, based in evidence, and aligned with human rights principles. However, subsequent edits to the Five Year Plan did not promote SRHR, and were not based in evidence or responsive to need, and thus negatively impacted the FP score. Though some actions integrated FP and HIV services, this domain grade was low overall because the actions did not adequately include data or information about activities within FP programs, which reinforced the siloed nature of global health programs, negatively affected transparency, and hindered SRHR. In the budget evaluation, the Department of State allocated FP funds somewhat in accordance with unmet contraceptive need at the country level, which moderately promoted SRHR. Transparency was relatively low across actions but moderately high with regard to budget data in the FP domain.
USAID received a 64 (C) with transparency and a 78 (C+) without transparency in the FP)domain in 2022. This domain grade was raised by actions that integrated FP with MCH and HIV efforts to holistically promote SRHR, such as the Maternal and Child Health and Nutrition Technical Roadmap 2030 and the USAID Approach to HIV and Optimized Programming Report. Overall, this domain scored low for transparency because USAID did not indicate which content was updated in 2022. USAID had a high level of transparency of funding data but did not disburse FP funding that was responsive to need, which decreased the USAID grade in this domain.