2023 Equality, Health and Social Protection Evaluation

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

Jesper Sundewall, Björn Ekman, Jessy Schmit

Sexual and reproductive health and rights (SRHR) has long been a priority in Swedish aid. Despite progress, many people in poorer countries lack access to SRHR, and the dependence on aid in the health sector is often considerable. What role does aid play in increasing access to sexual and reproductive health services? The EBA study The Role of Aid in the Provision of Sexual and Reproductive Health Services (EBA 2023:01) answers this question through a quantitative analysis of how international aid during the period 2002-2020 affected access to three different health services: skilled birth attendance, modern contraceptives, and antiretroviral therapy against HIV/AIDS.

Main conclusions:

  • Aid has had a small but positive effect on access to sexual and reproductive health services during these two decades.
  • The contribution of aid to increased access to sexual and reproductive health services has been greater in low-income countries than in lower middle-income countries.
  • The results suggest that aid has a greater impact when it exceeds a certain share of the recipient country’s total health expenditure, which could imply that aid needs to reach a certain level before it becomes fully effective.
  • The positive relationship between aid and access to skilled birth attendance, modern contraceptives and antiretroviral therapy against HIV/AIDS appears to have strengthened over the time period, pointing to increased effectiveness and learning on the part of donors.