Zimbabwe’s relatively high use of modern contraception in the region is putting the spotlight on whether continued investment, access and informed choice can keep pace with the sexual and reproductive health needs of women and girls.

The issue was raised at the 50th SHE & Rights session held ahead of World Contraception Day, where experts called for sexual and reproductive health and rights to be treated not only as a health issue, but also as an investment in women, families and economies.

Guttmacher Institute research has previously identified Zimbabwe as having one of the highest levels of modern contraceptive use in sub-Saharan Africa. Its Zimbabwe-specific data showed that in 2015, 66 percent of married women and sexually active unmarried women were using a modern contraceptive method.

However, the same Guttmacher analysis found that one in 10 married women and two in 10 sexually active unmarried women who wanted to avoid pregnancy were not using a contraceptive method.

The figures show that high contraceptive use does not necessarily mean that every woman who wants contraception can access a method that suits her needs.

Dr Elizabeth A Sully, Director of International Research at Guttmacher Institute, said investment must focus on whether services actually reach women.

“Funding must be invested in commodities and in supply chains and ensuring that methods are reaching women who need them,” she said.

Sully was speaking about Guttmacher’s Adding It Up 2024 research, which examines the costs, needs and benefits of investing in SRHR across 128 low- and middle-income countries.

The research argues for a more person-centred approach to measuring contraceptive need, taking individual preferences and choices into account rather than assuming that every woman who wants to avoid pregnancy wants the same contraceptive method.

In Asia, the research estimates that 129 million women of reproductive age have an unmet need for modern contraception. When the measure is narrowed to women who want to avoid pregnancy, are not using a contraceptive method and indicate a desire to use one in the future, the figure is 36 million.

For Zimbabwe, the figures provide a useful reminder that measuring access should go beyond simply counting contraceptive users.

Sully said the investment case also goes beyond health outcomes.

“It will result in a 65% decline in maternal deaths and 62% decline in newborn deaths. We would also see a 26% decline in unintended pregnancies,” she said.

“For every additional dollar that is invested into family planning and contraceptive care, there is a savings of US$1.97 on pregnancy-related and newborn care.”

The session also raised concerns about the sustainability of financing for SRHR, particularly as international development assistance declines.

Riju Dhakal, Programme Officer at the Asian-Pacific Resource and Research Centre for Women, said SRHR cannot be separated from wider economic and social challenges.

“We cannot let sexual and reproductive health and rights be exclusive of the different developmental priorities. We also need to look at the intersections of sexual and reproductive health and rights with poverty, economic justice, climate destabilization and other development bottlenecks,” Dhakal said.

According to the SHE & Rights briefing, official development assistance for SRHR fell by 46 percent between 2024 and 2026.

Dhakal said countries therefore need to examine whether commitments made at international and regional meetings are reflected in actual national budgets.

“Two things are clear. First, the donor aid for sexual and reproductive health is falling. Second, at the same time, the rhetoric around domestic financing is rising fast,” she said.

She urged governments and advocates to use Guttmacher’s Family Planning Investment Impact Calculator to examine what full contraceptive coverage could cost in individual countries and compare that with what governments have actually budgeted.

“We have four concrete asks: localize the numbers with the help of the two calculators; track the pledge for investment; look through if it’s actually in the approved budget when we talk about domestic financing; and use the human rights lens,” Dhakal said.

For Zimbabwe, this approach could help shift the conversation from broad commitments to questions about what is actually available at health facilities, particularly for adolescents, young women and people in underserved communities.

Jane Nyanjom, Associate Director of Advocacy and Partnerships at Reproductive Health Network Kenya, said access also depends on whether policies, resources and services work together.

“We also have to look at choices and informed decision making when we look at the issues of unmet needs and also of demand as well as of commodities,” Nyanjom said.

“The gap in the African region is majorly on access, affordability and awareness.”

She also pointed to the importance of accurate information and addressing myths and misinformation surrounding sexual and reproductive health.

Dr Imran Pambudi, Director of Vulnerable Groups Health Services at Indonesia’s Ministry of Health, said health systems should be judged by how effectively they serve people who are most likely to be left behind.

“The true strength of a health system is revealed not in how it serves the majority but in how it protects the most vulnerable,” Pambudi said.

He said SRHR services should be integrated into wider healthcare systems, with attention to financing, trained health workers, medicines, referrals and follow-up care.

“Progress cannot be measured only by the number of facilities or trained staff. It must be measured by whether people can truly access services, receive care with dignity and have their rights protected,” he said.

The SHE & Rights session therefore placed Zimbabwe’s family planning experience within a wider African and global financing debate: high contraceptive use is important, but sustained investment, reliable commodities, accurate information, affordability and meaningful choice remain central to ensuring women and girls can access the services they need.