Hi Ula,thank you for your post and I am very happy to see this being worked on!
Family planning services and providing unmet contraception needs are, in my opinion, great interventions to pursue. Not only for the immediate effects on the women affected, but also on poverty outcomes (at the individual level, family level, and country level), for enabling countries to profit from the Demographic Dividend, and for reducing total human activity footprint and resource needs locally and globally. As you stated, it also has positive effects on farmed and wild animal suffering. All in all, every dollar spent on preventing unintended pregnancies has several positive downstream effects on cause areas like climate change, poverty and animal suffering.
What I found very interesting to read was the focus on the post-partum period. Given your explanation that seems like a good time to approach the issue. Do you know of other organizations that follow this approach, given your point that this is one of the few times a woman will come in contact with the health system?
Also, your estimate for the cost of one tonne of CO2 averted (3 tonnes per USD spent or 0.33 USD per tonne of CO2 averted) would place your intervention among some of the most cost-effective for climate change. Is this generalizable to family planning in general and, if so, how? The Coalition for Rainforest Nations places their estimates between 0.12 and 0.72 USD per tonne, and Founder’s Pledge assume somewhere in the range of 0.24 to 2.60 USD per tonne for CfRN’s past work; Clean Air Task Force’s range is between 0.10 to 1.00 USD per tonne of CO2 according to the same Founder’s Pledge report. In general, though, there are many interventions targeting climate change that are much less cost-effective. That means that, just if targeting climate change alone, your proposed intervention would already be very effective, but it additionally also has positive effects on other targets like poverty and animal suffering. In countries with even higher resource use (animal products, land, CO2 emissions) this should lead to even bigger effects.That leads me to think that family planning and fulfilling unmet contraceptive needs would generally be a very effective intervention to support for multiple outcomes. What is your view on that? Is this generalizable to other countries or not?
Thanks for your thoughtful response – it’s great to hear your impressions on our research!
“Do you know of other organizations that follow this approach, given your point that this is one of the few times a woman will come in contact with the health system?”
The expert view section of our report (p. 16) has the most information about other actors in the space. Key points:
Several groups (e.g. FP2020, FHI360, USAID, IntraHealth) are working on PPFP due to the strong evidence of its effectiveness, but only a few specialize in it – most work on PPFP alongside other family planning interventions.
Jhpiego came up in conversation with experts as a key actor working on PPFP.
Overall it seems that, while some work is taking place to promote PPFP, there’s still a lot that remains to be done – particularly in neglected geographies.
“Your estimate for the cost of one tonne of CO2 averted (3 tonnes per USD spent or 0.33 USD per tonne of CO2 averted) would place your intervention among some of the most cost-effective for climate change. Is this generalizable to family planning in general and, if so, how?… That leads me to think that family planning and fulfilling unmet contraceptive needs would generally be a very effective intervention to support for multiple outcomes. What is your view on that? Is this generalizable to other countries or not?”
In the specific case of family planning, CE is uncertain but optimistic that family planning and fulfilling unmet contraceptive needs can be impactful on a range of outcomes. However, we don’t think that CEAs should be taken at face value and are very uncertain of the true effect on climate change. More in-depth work is needed to estimate the effect. You can read more about our thoughts in our blog post on why we chose to research family planning. Project Drawdown also has a nice summary. The organization Having Kids is also doing some work that might interest you.
Founders Pledge has previously analyzed the effect of lifestyle changes that could affect the climate and looked into “having one fewer child”. The results change dramatically depending on whether or not you account for policy changes leading to reductions in future generations’ emissions.
All that to say, we would be cautious about generalizing more broadly, and would not expect the same numbers to apply. This is also why for example we discount studies that take place in different contexts when examining the evidence for a particular intervention: generalizations get messy.
As a quick example for how generalizations about family planning and climate change can get tricky: per capita emissions are much higher in first world countries than in developing contexts, but fertility rates (i.e. the average number of children born to each woman) are much lower. If we want to compare the two, we need to account for these and many other such differences. CE hasn’t looked into this question in depth, although our implementation report (which we share with co-founders) lists a couple more countries in addition to Ghana and Nigeria as potentially promising.
We hope that helps answer your questions! Thanks again for engaging with our research. :)