Cost savings of task-sharing in family planning: estimates across 128 low- and middle-income countries

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BACKGROUND: Task-sharing, the expansion of health service provision to a broader range of health workers, where the number of providers is expanded through training and support of additional cadres, offers a strategy to alleviate some of the human resource and financial challenges that limit low- and middle-income countries' (LMICs) ability to deliver essential health services, including family planning (FP). In this study, we apply the World Health Organization's (WHO) recommendations to estimate the potential cost-savings from task-sharing FP services. METHODS: We use the Adding It Up (AIU) 2024 model estimates on contraceptive services for 128 LMICs to estimate the direct costs of providing contraceptive care for six methods - condoms (male and female), oral contraceptive pills, emergency contraceptive pills (ECP), injectables, implants and intrauterine devices. We compare the costs of two scenarios - a status quo (under current provider guidelines for FP service delivery) and a task-sharing scenario (implementing WHO task-sharing guidelines for FP service delivery). RESULTS: Implementing WHO task-sharing recommendations within the next year would save an estimated $1.6 billion USD across all LMICs. Task-sharing reduces the direct cost of service delivery for all six methods, saving 34% for male condoms, 31% for injectables, 30% for pills and IUDs, 22% for ECPs, 12% for implants and 9% for female condoms. These cost savings were largely consistent at the global, regional, and sub-regional levels. CONCLUSIONS: WHO recommendations for task-sharing service delivery offer a critical cost-saving policy mechanism that leverages limited human and financial resources to better meet contraceptive needs while at the same time reducing health system costs. Cost estimates generated from the AIU model show that implementing WHO recommendations for task-sharing family planning services is a promising strategy for expanding access to contraceptive care across LMICs. Amidst increasing cuts to family planning financing, strategies for delivering quality services at lower costs are critical to ensuring continued access to care. TRIAL REGISTRATION: Not applicable.

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