Of all the services affected by the aid cuts of 2025, sexual and reproductive health was among the first and the hardest hit. RFLD’s 2026 data report, Funding Feminist Movements in Francophone West Africa, documents the scale of the loss. For women in a region where maternal mortality remains high, the closures mean fewer places to obtain contraception, antenatal care and post-abortion care.
A 94% fall in US funding
The United States was the largest funder of family planning and reproductive health worldwide. In 2025, its funding for these services fell by an estimated 94% (Focus 2030, 2026b). The freeze ordered in January 2025, followed by the cancellation of most USAID programmes, cut supply chains for contraceptives and stopped the salaries of health workers in many countries at short notice.
What IPPF members lost
The International Planned Parenthood Federation (IPPF) surveyed 86 of its member associations to measure the impact. They expected a loss of US$87.2 million over 2025 to 2029, of which US$26.0 million in Africa (IPPF, 2025).
The effects on services were concentrated in Africa. Of the 1,394 service points closed by IPPF members after the 2025 US cuts, 1,175 were in Africa. Of the 969 jobs lost, 396 were in Africa. Member associations on the continent expected to serve 5.9 million fewer clients.
Crisis settings and violence services
Sexual and reproductive health services are closely linked to services for survivors of violence. UN Women’s survey of October 2025 found that 34% of 428 women’s rights organisations had suspended or shut down programmes on violence against women, and that 40% had scaled back or closed shelters, legal aid or psychosocial services (UN Women, 2025b). When a clinic closes, women also lose a safe place to report violence and be referred for help.
The July 2026 survey by UN Women, covering 855 organisations in 52 crisis and conflict countries, found that at least one million women and girls had lost access to support since January 2025, while 84% of organisations reported higher demand (UN Women, 2026).
The situation in francophone West Africa
Francophone West Africa combines high maternal mortality with weak public health budgets and a strong dependence on external funding for family planning. Many community organisations in RFLD’s network distribute information, accompany women to clinics and run awareness sessions on sexual and reproductive health and rights. When the clinics they work with close, their own work loses its purpose, and they rarely have reserves to adapt.
Political changes add to the difficulty. Several countries in the region have adopted restrictive laws since 2024, and groups working with lesbian, bisexual and queer women face growing legal uncertainty. In such a context, international funders are sometimes reluctant to finance any work labelled as sexual rights, which further reduces the space for health organisations.
Governments must step in
The Maputo Protocol, ratified by most states of the region, guarantees women’s right to health, including sexual and reproductive health. Its Article 26(2) requires states to allocate budgetary resources for the implementation of women’s rights. RFLD’s report asks governments of the region to allocate and publish these resources and to create national funding windows for women’s organisations, with transparent criteria and annual reports.
RFLD tracks how states implement the Protocol through its Maputo Barometer. The barometer shows that ratification is not enough: without a budget, rights on paper do not reach the clinics where women seek care.
What donors can still do
The scale of the US withdrawal cannot be replaced quickly. Donors who remain committed can, however, protect the organisations that keep services and information flowing at community level. RFLD asks them to give flexible, multi-year funding that lets these organisations keep their staff and reserves, and to fund through regional intermediaries that know which groups are still active and safe to support.
Health budgets under scrutiny
Women’s organisations in the region are also working to make public health spending more accountable. One of the nine institutional strengthening grants awarded by RFLD in 2026 supports a consortium of Voix EssentiELLES and OSIDEA in Senegal. With US$28,062.50 under the SEA-T programme, the consortium carries out a gender-responsive review of health budgets in five francophone West African countries.
Budget analysis of this kind helps women’s organisations ask precise questions of their governments. How much is allocated to maternal health? How much is actually spent? Who benefits? As external funding for reproductive health falls, the share of national budgets devoted to women’s health becomes even more important, and civil society needs the skills to follow it.
RFLD’s report links this work to Article 26(2) of the Maputo Protocol, which requires states to allocate budgetary resources for women’s rights. Publishing these allocations would allow women’s organisations to track whether governments are filling the gap left by donors.
Key figures
- 94%: estimated fall in US funding for family planning and reproductive health in 2025.
- 1,175: IPPF service points closed in Africa, out of 1,394 worldwide.
- US$26.0 million: expected loss for IPPF members in Africa over 2025 to 2029.
- 5.9 million: fewer clients expected to be served by IPPF members in Africa.
About the report
This article draws on RFLD’s data report Funding Feminist Movements in Francophone West Africa: 2026 Data (RFLD/DR/2026/03), published on 4 October 2026. Read the summary of the report, download the English edition or the French edition. Sources cited in this article are listed in full in the report.
