New podcast episode: Advancing GiveWell’s work on family planning

By GiveWell @ 2025-08-07T19:52 (+26)

As GiveWell’s research team grows, that increased capacity and expertise allows us to evaluate a wider range of programs to find the most cost-effective opportunities to help people. Over the past year and a half, we’ve been investigating a new research area—family planning services that help people decide whether and when to have children.

Family planning programs have particularly complex challenges around targeting, logistics, and ensuring informed and voluntary choice. However, GiveWell's increasing research capacity now positions us to take on new and complex investigations like this. We’ve been reviewing evidence, consulting with experts, modeling the benefits of contraception, and conducting initial grant investigations, focusing on programs that aim to increase access to and use of modern contraception. This work is especially timely as anticipated cuts to foreign assistance could significantly reduce existing family planning support, creating substantial new funding gaps.

In this episode, GiveWell CEO and co-founder Elie Hassenfeld speaks with Senior Research Associate Dilhan Perera about the complexity of evaluating family planning programs. They explore the types of programs GiveWell is considering, the unique challenges this area presents, and key questions we’re working to answer.

Listen to Episode 9: Advancing GiveWell's Work on Family Planning

This episode was recorded on June 24, 2025 and represents our best understanding at that time.

Elie and Dilhan discuss:

Types of family planning programs: GiveWell is investigating several approaches, including direct service delivery to underserved communities, programs that provide counseling, and supply chain interventions that work with health facilities to prevent stockouts of contraceptives.
The complexity of evaluation: Unlike programs such as malaria prevention that target a well-defined population and try to maximize coverage, family planning programs must account for individual preferences and avoid coercing people into using contraception they don’t want. This requires more sophisticated monitoring systems to prevent coercion, which raises the overall cost and complexity of effective program delivery.
Operational challenges and trade-offs: Programs must often choose between reaching the most underserved communities (which are often remote and expensive to reach) and working within existing health facilities. The challenges in either approach include making sure people are accurately informed about their family planning options and navigating supply chain issues like stockouts.

We’re actively considering a handful of funding opportunities in family planning. Our goal is to make initial grants that will not only have a direct impact but also help us learn more about this type of intervention, helping us better compare these programs against other funding opportunities.

Visit our All Grants Fund webpage to learn more about how you can support this work, and listen or subscribe to our podcast for our latest updates.

Rasool @ 2025-08-08T09:57 (+7)

A large recent RCT found that free contraception had no impact on birth rates in Burkina Faso - I wonder if/how this affects this cause area

Ian Turner @ 2025-08-09T00:21 (+2)

Note that reduction in births is not an important KPI from GiveWell's perspective. Read their page about what they see as the benefits of contraception.

Jason @ 2025-08-09T13:35 (+3)

It seems likely that some of the proposed benefit mechanisms would be associated with a decline in birth rates:

reducing "unwanted pregnancies (i.e., pregnancies that the mother did not desire to have at any time)" thus "lowering the number of births per woman"
"[w]ith fewer children in the household, each child may see higher consumption, more educational investments, and/or more parental attention"

Another mechanism -- reducing "mistimed pregnancies (i.e., pregnancies that occur sooner than the mother desired)" -- would not change birth rates over the long term. But an access-improving program presumably would have caused some pregnancies to be counterfactually delayed to a future year. So one might expect it to have reduced birthrates in at least the earlier part of the program.