Invisibility problem: why current economic evaluations understate the value of sexual and reproductive health and rights, and three strategic shifts to address it

Abstract

Summary box: • Most economic evaluations of sexual and reproductive health and rights (SRHR) interventions capture only health-sector benefits, rarely accounting for cross-sectoral returns in education, labour, justice and social protection.

• A 27% reduction in global SRHR financing in 2023, compounded by donor withdrawal since 2025, driven mainly by geopolitical pressures, is undermining progress across health, education, economic development and equity goals.

• Better evidence is unlikely to reverse decisions made on economic grounds, but evaluations that make cross-sectoral returns visible give ministries beyond health a demonstrable stake in SRHR investment and standing to defend it.

• We propose three strategic shifts to make the broader returns on SRHR investments more visible: adopting multisectoral and societal rather than a uniquely health-sector perspective; embedding life-course and intergenerational analysis and applying disaggregated approaches to address equity concerns, including those enabled by emerging analytical methods.