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Financing Family Planning: Honduras
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From 2006–2012, Honduras made significant progress in access to family planning (FP) for its population, increasing the modern contraceptive prevalence rate (mCPR) from 56–64 percent among married/in-union women. Female sterilization remains the predominant FP method; however, injectable and oral contraceptives account for a combined 46 percent of all modern contraceptive use. Despite this progress, the country’s graduation from donor funding in 2015 has left provision of FP services fragmented and underfunded.
Provision of FP services is split between the public and private sectors (Table 1), with half of all services obtained at facilities operated by the Ministry of Health (Secretaría de Salud or SS). The mCPR among women in the poorest quintile is lower than the national average, at 55 percent. However, 12 percent of these poor women used traditional methods, compared to 8–9 percent among the other quintiles. The mCPR varies more significantly with geography—over 70 percent in and around the capital, Tegucigalpa, and as low as 49 percent in the country’s most rural region, Gracias a Dios, on the northeast Atlantic coast (Figure 1).
Overall, Honduras’ health sector is characterized by disparities in access to health services, including family planning. In rural areas, only 73 percent of births occur in health facilities, compared to 94 percent in urban areas. Despite these challenges, Honduras has been largely successful in increasing access to family planning, and the government aims to address continued gaps in FP/reproductive health services with the recent adoption of a plan to meet unmet demand for family planning in rural areas. In 2012, Honduras began a process of fiscal decentralization, including in the financing and planning of health service delivery.