By Marie Ba, Director of the Ouagadougou Partnership Coordination Unit (OPCU).
Photos: Wikimedia Commons
NEW YORK, United States of America, September 25, 2026: Family planning in Francophone West Africa stands at a crossroads. Fifteen years ago, in many communities across the region, too many women still had limited ability to decide when to become pregnant and how to space their pregnancies, at the expense of their health and aspirations. Today, millions more women are able to shape their own futures, but these gains remain fragile. As the conditions that made this progress possible change rapidly, the needs of women and families remain urgent. The Ouagadougou Partnership (OP), bringing together Benin, Burkina Faso, Côte d’Ivoire, Guinea, Mali, Mauritania, Niger, Senegal and Togo, has demonstrated what political will and collective action can achieve. Since 2011, the countries have kept family planning on the agenda, set shared goals and built a regional platform for accountability, cooperation and shared learning. Between 2011 and 2025, the Ouagadougou Partnership is estimated to have helped avert 30.3 million unintended pregnancies, nearly 8.9 million unsafe abortions and approximately 1.8 million maternal deaths. More than four million women became users of modern contraception, many of them for the first time.
But while we were making progress, the world around us was changing. At the same time, Africa’s health financing landscape is shifting rapidly and external resources are becoming more uncertain, with reproductive health particularly exposed. This evolution requires us to look beyond the question of funding volumes alone and ask how we protect essential priorities. For our countries, this is much more than a financing challenge. It is also a test of leadership and of our ability to govern essential services with limited resources. Across our region, the needs are real. One in four married women is still unable to meet her need to space or limit births with a modern contraceptive method. Every day, women continue to lose their lives in childbirth. Behind these figures are women, girls and families whose life trajectories depend directly on access to quality services. Family planning is both a health priority and an investment in human capital. When women can decide whether and when to have children, the effects are felt in family health, children’s education, women’s participation in the economy and productivity. But the political issue goes far beyond the amount of funding available. It is a question of political responsibility, choices and accountability.
The Ouagadougou Partnership ministerial roundtable, held in New York on 24 September 2026 on the margins of the 81st session of the United Nations General Assembly, brought this into sharp focus: governing means making choices. In a context of financing transition and reform of the global health architecture, the question is not only how much we pledge or budget, but what we choose to protect, what we actually disburse and the results those resources produce for women and young people. For a woman, the impact is immediate and personal. She may walk for hours to reach a clinic, only to find that the contraceptive method she needs is out of stock. She may meet a health worker doing their best but overwhelmed by demand. Or she may find that family planning is treated separately from the care she receives for herself and her children. These barriers are frustrating and difficult to overcome. Yet at the level of our societies, their consequences are significant: unintended pregnancies, interrupted schooling, health risks and lost economic opportunities.
This is why we have rethought the next phase of the Ouagadougou Partnership. Financing, supply chains, health workers and service delivery are often treated as separate technical issues. Yet they are links in the same political chain. The question, therefore, is this: how does a government turn a national priority into a service that reaches a woman when she needs it? A budget allocation is only the beginning. A commitment without predictable financing and execution remains a promise. If commodities are purchased but do not reach health facilities, the investment is wasted. If health workers are too few or unevenly distributed, access remains limited. If family planning operates separately from the services through which women already enter the health system, we must ask whether we are organizing care around institutions rather than around people’s lives. This is also why dialogue between Ministries of Health and Finance is essential: resource mobilization must go hand in hand with securing resources, disbursing them and using them effectively.
On these issues, countries can also learn from one another. The New York discussions highlighted several approaches already being explored in the region: integrating family planning into primary health care, using programme-based budgeting to better secure resources, strengthening community health, and pursuing more innovative financing approaches. These experiences represent valuable learning capital for the entire Ouagadougou Partnership. We are not seeking to replicate a single model, but to collaborate more closely and examine what has worked, why it worked, what it required from governments, what it cost, and what another country can learn from it.
This is one of the political strengths of the Ouagadougou Partnership.
Its success lies in the fact that countries agreed on a common objective, strengthened national planning, measured progress and kept family planning at the centre of political attention. The Ouagadougou Partnership also created a space for peer learning, mutual challenge and accountability. In the current period, this function is even more important: it must enable countries to better connect health priorities, budget decisions and results. We need this political cooperation more than ever. The 2030 target is 13 million users of modern contraception, but projections point to a gap of nearly three million. We must close it now. We need to examine where women are still being left behind and why. Are services reaching the communities where unmet need is greatest? Are supply and distribution systems reliable? Are health workers deployed where they can have the greatest impact? Are family planning services sufficiently connected to maternal care and primary health care? Are approved budgets actually being disbursed? Are we using data quickly enough to change course when an approach is not delivering results? Because the answers will vary from one country to another, regional cooperation is essential. It must also be supported by broader dialogue involving Ministries of Finance and other sectors, as well as the private sector, African philanthropy, civil society and development partners.
National ownership must also mean much more than taking on a larger share of expenditure as external resources decline. It means each country having the capacity to set its priorities according to its needs, direct resources where they will have the greatest impact, strengthen systems and take responsibility for results. Domestic resource mobilization is indispensable, but it cannot be the only answer. Development partners remain essential. In a context of transition, their support must be more closely aligned with national priorities and help strengthen sustainable systems rather than prolong dependency. This is the next task of the Ouagadougou Partnership: to support the shift away from excessive dependence on external financing toward stronger ownership, without losing sight of the primary goal of accessible, high-quality services for women and young people.
When Guinea hosts the Ouagadougou Partnership Annual Meeting in December 2026, we will have an opportunity to take this reflection forward: to examine what countries have learned, assess where systems need to evolve, identify solutions that can be adapted to different contexts, and define the direction of the Ouagadougou Partnership as we approach 2030 and beyond. I invite all our partners to join us in Guinea. Fifteen years after the creation of the Ouagadougou Partnership, this meeting will be an opportunity to celebrate our achievements, but above all to turn the lessons of these fifteen years into concrete choices for the future. The next chapter must be one of stronger national leadership, more sustainable financing and regional cooperation capable of ensuring that the progress achieved truly benefits women, young people and families across West Africa.
